Healthcare

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides medical assistance coverage for sickle cell disease (rather than sickle cell anemia).

Creates the Protective Medical Equipment Freedom Act. Provides that all individual in the State have the right to wear protective medical equipment in any place of public accommodation where they have a lawful right to be without obligation to disclose health status or any other protected information, and no person, entity, or authority shall deny, restrict, or infringe upon this right. Provides that operators and public officials shall not discriminate against or penalize medical device wearers for exercising their right to wear protective medical equipment. Provides that discrimination under the Act includes, but is not limited to: denial of service; eviction from premises; any form of harassment to remove or refrain from wearing such equipment for any amount of time; specified actions taken by employers; and provision of unequal goods, services, facilities, advantages, or accommodations. Sets forth provisions concerning the protection against retaliation, the exceptions for security requirements, operational safety, age and identity restricted products, and financial institution customer identification, and an undue hardship exemption. Effective immediately.

Amends the Emergency Medical Services (EMS) Systems Act. Makes changes to defined terms. Replaces references to Primary Stroke Centers with Stroke Centers. Provides that a hospital that no longer meets nationally recognized, evidence-based standards for Stroke Centers, loses its Stroke Center certification, or has any change to its designation level shall notify the Department of Public Health and the Regional EMS Advisory Committee within 5 business days. Requires the Department to consult with the State Stroke Advisory Subcommittee for the adoption or deletion of approved stroke designation levels. Provides that the approved stroke designation levels shall coincide with the stroke designation levels recognized by Department-approved certifying bodies. Requires the Department to establish reporting requirements for designated Stroke Centers to capture information using new or existing electronic reporting tools for statewide data collection and certification purposes. Removes provisions concerning previous Stroke Center designations. Makes other changes.

Amends the Illinois Insurance Code. Establishes reimbursement rates for mental health and substance use disorder treatment services for all group or individual policies of accident and health insurance or managed care plans that are amended, delivered, issued, or renewed on or after January 1, 2027 or for any contracted third party administering the behavioral health benefits for the insurer. Requires a group or individual policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2026 or any contracted third party administering the behavioral health benefits for the insurer to cover certain medically necessary mental health and substance use disorder treatment services. Provides that, if the Department of Insurance determines that an insurer or a contracted third party administering the behavioral health benefits for the insurer has violated a provision concerning mental health and substance use parity, the Department shall by order assess a civil penalty of $1,000 for each violation. Excludes certain health care plans serving Medicaid populations who are enrolled under the Illinois Public Aid Code or under the Children's Health Insurance Program Act from provisions concerning mental health and substance use parity. Requires the Department to review the impact of the proposed mental health and substance abuse mandate on network adequacy for mental health and substance use disorder treatment and access to affordable mental health and substance use care. Permits the Department to examine out-of-network utilization and out-of-pocket costs for insureds for mental health and substance use treatment and services for all plans to compare with in-network utilization. Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, and the School Code to require coverage under those provisions. Effective immediately.

This bill nominates Anusha Thotakura to serve as a member of the Illinois Health Benefits Exchange Advisory Committee. If approved, Ms. Thotakura would join the committee responsible for advising on health benefits exchange matters in Illinois.

Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2027 that provides coverage for: habilitative services shall provide coverage for habilitative speech therapy as a treatment for stuttering, regardless of whether the stuttering is classified as developmental; rehabilitative services shall provide coverage for rehabilitative speech therapy as a treatment for stuttering; or habilitative services and rehabilitative services shall provide coverage for habilitative speech therapy as a treatment for stuttering, regardless of whether the stuttering is classified as developmental, and shall provide coverage for rehabilitative speech therapy as a treatment for stuttering. Sets forth requirements and limitations for the coverage. Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code to require coverage under those provisions. Amends the State Mandates Act to require implementation without reimbursement. Effective January 1, 2027.

Amends the Public Higher Education Act. Provides that, beginning with the 2025-2026 school year, each public institution of higher education with student health services shall provide enrolled students with access to health care professionals authorized under State law to prescribe contraception. Provides that, beginning with the 2025-2026 school year, if the public institution of higher education's student health services includes a pharmacy, the pharmacy on campus shall dispense contraception to enrolled students who wish to fill their prescriptions at the university pharmacy. Provides that, beginning with the 2025-2026 school year, each public institution of higher education with student health services shall provide enrolled students with access to health care professionals authorized under State law to prescribe medication abortion. Provides that a public institution of higher education that dispenses medication abortion from the university pharmacy shall enter into a referral agreement with a tertiary care facility with obstetrics and gynecological services in the event of complication from medication abortion or suspected complicated pregnancy prior to dispensing medication abortion. Requires each public institution of higher education to report annually to the Board of Higher Education that policies under the provisions have been adopted. Requires the Board to post to its website annually each public institution of higher education's compliance with the policies under the provisions. Effective immediately.

Amends the Mental Health Early Action on Campus Act. Provides that the expert panel designated by the board of trustees to develop and implement policies and procedures shall be comprised of at least 2 administrators, 2 members of faculty, and one mental health professional. Requires each public college or university to provide at least 3 on-site licensed clinical professional counselors or licensed clinical social workers.

Amends the Managed Care Reform and Patient Rights Act. Provides that a health care plan shall provide annually to enrollees and prospective enrollees, upon request, a statement of all basic health care services and all specific benefits and services mandated to be provided to enrollees by State law or administrative rule, highlighting any newly enacted State law or administrative rule. Provides that this requirement can be fulfilled by providing enrollees the most up-to-date accident and health checklist submitted to the Department of Insurance, reflecting statutory health care coverage compliance by the health care plan. Requires the Office of Consumer Health Insurance to post in a prominent location on the Department's publicly accessible website an annual report on the development and implementation of federal, State, and local laws, regulations, and other governmental policies and actions that pertain to the adequacy of health care plans, facilities, and services in the State and summary of all State health insurance benefit related legislation enacted in the prior calendar year that includes, at minimum, a link to the Public Act, the statutory citation, the subject, a brief summary, and the effective date. Amends the Uniform Health Care Services Benefit Information Card Act. Adds a health benefit plan offering dental coverage to the list of plans required to issue a health care benefit information card. Specifies health care benefit information cards may be electronic or physical. Requires uniform health care benefit information to display on the back of the card a statement indicating whether the plan is self-insured or fully funded and if the plan is subject to regulation by the Department of Insurance. Makes other changes.

Amends the Illinois Physical Therapy Act. Provides that initial physical therapy evaluations without a referral or an established diagnosis may be performed by a licensed physical therapist via telehealth when the physical therapist determines that an in-person examination is not required based on the physical therapist's clinical judgment and the applicable standard of care (rather than cannot be performed via telehealth unless necessary to address a documented hardship). Provides that a physical therapist or a licensed physical therapy assistant may require the patient to undergo an in-person visit instead of providing telehealth services (rather than the use of telehealth as a primary means of delivering physical therapy must be an exception and documentation must support the clinical justification). Provides that a physical therapist providing telehealth must have the capacity to provide or be able to facilitate a referral to in-person care within the State (rather than must only have the capacity to provide in-person care). Provides that the standard of care for a patient receiving physical therapy through telehealth is equal to the standard of care for in-person care.