Healthcare (Insurance)

Amends the Illinois Insurance Code. Sets forth provisions concerning minimum reimbursement rates that a health insurance company must provide for a physician providing health care services in the specified counties. Prohibits a physician from waiving minimum reimbursement protections as a condition of participation in a health benefit plan or for any other reason. Grants the Department of Insurance rulemaking authority and establishes penalty provisions for violations of the minimum reimbursement provisions.

Amends the Illinois Insurance Code. Provides that the reimbursement rate a health insurance issuer must pay to nonparticipating ground ambulance service providers subject to a unit of local government is equal to the rate established or approved by the governing body of the local government providing ground ambulance service (instead of the local government having jurisdiction for that area or subarea).

Amends the End-of-Life Options for Terminally Ill Patients Act. Expands and clarifies definitions. Requires a mandatory mental health evaluation for all patients requesting medical aid in dying. Strengthens informed consent standards and adds a referral to an Ombudsman when financial concerns influence patient choice. Revises attending and consulting physician duties to include enhanced counseling, documentation, and disclosure requirements. Adds explicit safeguards against coercion or undue influence. Requires detailed recordkeeping and safe disposal of unused medication with reporting to the Department of Public Health. Broadens immunity provisions for good-faith compliance and clarifies protections for physicians present at self-administration. Establishes a Medical Aid-in-Dying Ombudsman Program within the Department of Public Health with authority to review compliance, investigate complaints, and operate a secure reporting portal and hotline. Imposes comprehensive reporting requirements on physicians and directs the Department to publish annual statistical reports with de-identified demographic and clinical data. Prohibits solicitation of medical aid-in-dying services. Mandates training for participating health care professionals on abuse prevention, bias recognition, and disability-competent care. Revises insurance provisions to ensure coverage parity for hospice and palliative care, restricts insurer communications, and clarifies that self-administration does not affect life or health insurance benefits. Provides that a qualified patient's act of self-administering medication shall be indicated on the death certificate (rather than shall not be indicated on the death certificate).

Amends the Counties Code and the Illinois Municipal Code. Provides that coroners are first-responders for the purposes of provisions requiring a county that is a self-insurer for purposes of providing health insurance coverage for its employees to include mental health counseling for any county employee who is a first responder without imposing a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage provided.

Amends the Illinois Administrative Procedure Act. Provides that, for any law implementing the federal Patient Protection and Affordable Care Act, the Department of Insurance may adopt rules that include incorporations by reference of federal rules and regulations without identifying the incorporated matter by date and without including a statement that the incorporation does not include later amendments. Amends the Illinois Insurance Code. Makes changes concerning the assignment or transfer of property and casualty policies; formatting requirements for the insurance company supplier diversity report; and insurance coverage for dependent parents. Provides that the Director of Insurance shall maintain as confidential any records or information received from the National Association of Insurance Commissioners or other state, federal, and international regulatory agencies (instead of insurance regulatory officials of other states) that are confidential in that other jurisdiction. Provides that the Department may waive registration and course certification fees if the pre-licensing or continuing education course is provided by a government entity free of charge. Amends the Network Adequacy and Transparency Act. In applicability provisions, removes language concerning exemptions for short-term, limited-duration health insurance coverage with a network plan. Repeals the Health Care Purchasing Group Act. Effective immediately.

Amends the Illinois Health Insurance Portability and Accountability Act. Defines "grandfathered health plan". Provides that, except for grandfathered health plans, a health insurance issuer in the individual, small group, or large group market shall not deny coverage to an individual or employer due to the individual's or employer's failure to pay premiums owed under a prior policy, certificate, or contract of insurance. Specifies that nothing in the provisions concerning past-due premiums prohibits a health insurance issuer from pursuing the collection of past-due premiums from an individual or employer by any other means permitted by law. Effective immediately.

Amends the Illinois Administrative Procedure Act. Provides that, for any law implementing the federal Patient Protection and Affordable Care Act, the Department of Insurance may adopt rules that include incorporations by reference of federal rules and regulations without identifying the incorporated matter by date and without including a statement that the incorporation does not include later amendments. Amends the Illinois Insurance Code. Makes changes concerning the assignment or transfer of property and casualty policies; formatting requirements for the insurance company supplier diversity report; and insurance coverage for dependent parents. Provides that the Director of Insurance shall maintain as confidential any records or information received from the National Association of Insurance Commissioners or other state, federal, and international regulatory agencies (instead of insurance regulatory officials of other states) that are confidential in that other jurisdiction. Provides that the Department may waive registration and course certification fees if the pre-licensing or continuing education course is provided by a government entity free of charge. Amends the Network Adequacy and Transparency Act. In applicability provisions, removes language concerning exemptions for short-term, limited-duration health insurance coverage with a network plan. Repeals the Health Care Purchasing Group Act. Effective immediately.

Amends the Illinois Insurance Code. Provides that no policy of accident and health insurance shall be issued, amended, delivered, or renewed in this State on or after January 1, 2027 unless the policy provides coverage for annual lung cancer screenings for any beneficiary currently employed as an active firefighter or any person eligible for or currently receiving a retirement annuity, retirement pension, disability pension, or disability benefit pursuant to the Downstate Firefighter or Chicago Firefighter Article of the Illinois Pension Code. Requires the coverage to be provided without cost sharing. Amends the Counties Code, the Township Code, the Illinois Municipal Code, and the Illinois Public Aid Code to require coverage under the provisions of those Acts.

Amends the Limited Health Service Organization Act. Makes changes to defined terms. In provisions concerning the offering of a point-of-sale contract by a limited health service organization (LHSO), removes a provision requiring the LHSO to include an annual maximum benefit allowance not to exceed $2,500 per year that is separate from any limits or allowances applied to in-plan services. Provides that, if an LHSO expends in any calendar quarter more than 20% of its total limited health services expenditures for all its members for out-of-plan covered services, then specified limitations shall not apply subject to the LHSO minimum capital and surplus requirements applicable to a life, accident, and health insurance company. Makes other changes.

Amends the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Requires the Department of Public Health to establish the Abortion Access Fund Grant Program to award grants from the Abortion Access Fund to support access to abortion care services throughout the State. Provides that grants awarded under the Program shall only be used to fund abortion services for which the use of federal funds is prohibited for patients who are uninsured or underinsured with respect to those services. Allows the Department to establish rules necessary to implement the Abortion Access Fund Grant Program, including eligibility criteria, grant limits, application standards, requirements for the distribution and obligation of grant funds, accounting for the use of the funds, and standards for monitoring compliance with the requirements of the Program. Amends the State Finance Act to create the Abortion Access Fund as a special fund in the State treasury. Amends the Illinois Health Benefits Exchange Law. Requires specified health insurance issuers that have offered one or more qualified health plans through the Illinois Health Benefits Exchange to report to the Department of Insurance an accounting of receipts, disbursements, transfers of funds between accounts, total dollar claims paid, accrued interest, and the year-end balance for each reporting year for the separate allocation accounts that the issuer has established under specified provisions of federal law for abortion services for which federal funding is prohibited. Establishes further reporting requirements for health insurance issuers. Provides that, if the amount of premiums collected during the plan year for abortion services for which federal funding is prohibited exceeds total claims paid for such services rendered during the plan year, the Director of Insurance shall order the health insurance issuer to transfer funds, and the issuer shall complete the transfer, to the Abortion Access Fund. Makes other changes. Effective immediately.