Healthcare (Hospitals)

Amends the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. In provisions regarding a Safety-Net Hospital Health Equity and Access Leadership (HEAL) Grant Program, changes references to safety-net hospitals to references to community safety-net hospitals. Updates references to dates in those provisions. Defines "community safety-net hospital", "health system", and "medically underserved area". Makes changes to required provisions in the report to the General Assembly regarding criteria for a community safety-net hospital to be eligible for the program, deletes required provisions in the report to the General Assembly regarding potential projects eligible for grant funds, and adds required provisions in the report to the General Assembly regarding an application process and criteria, as well as policies, standards, and procedures to administer the program and ensure accountability.

Amends the Hospital Licensing Act. Provides that a hospital licensed under the Act shall not charge a covered hospital employee more than 10% of the total health insurance premium cost. Provides that any agreement permitting a charge to a covered hospital employee in excess of 10% of the total health insurance premium cost shall be deemed invalid, void, and unenforceable. Provides that a hospital in violation of those provisions shall pay a civil penalty of $500 to the Department of Public Health for each impacted covered hospital employee.

Creates the Illinois All-Payer Health Care Payment and Global Budget Act. Creates the Illinois Health Care Cost and Payment Board as an independent body within the Department of Healthcare and Family Services and sets forth its membership and powers. Defines "commercial payer" as any health insurance issuer, health maintenance organization, or third-party administrator subject to regulation by the Illinois Department of Insurance, excluding self-funded plans governed solely by ERISA. Provides that all commercial payers shall reimburse hospitals for covered services at standardized rates established by the Board. Defines "global hospital budget" as a prospective, fixed annual operating revenue amount established for a hospital to cover all inpatient and outpatient hospital services. Provides that the Board shall establish prospective annual global hospital budgets for Illinois hospitals. Provides that the Board shall establish a unified health care data system in coordination with State agencies. Creates the Health Care Payment Reform Advisory Council to advise the Board. Provides that the Governor, in consultation with the Board, shall seek all necessary federal approvals, including Medicare demonstrations and Medicaid waivers, to implement the Act. Amends the Illinois Administrative Procedure Act, Hospital Licensing Act, Illinois Insurance Code, Health Maintenance Organization Act, and Illinois Public Aid Code with regard to the new Act. Contains a severability clause. Effective immediately.

Provides that the Act may be referred to as the Illinois Newborn Equity Support Transfer (NEST) Program Act. Amends the Department of Human Services Act. Requires the Department of Human Services to establish and administer, subject to appropriations, the Illinois Newborn Equity Support Transfer (NEST) Program to provide direct cash assistance to eligible participants by July 1, 2026. Defines "participant" to mean any individual who gives birth in Illinois while enrolled in or eligible for Medicaid through Moms and Babies. Permits the Department to adopt any rules necessary to implement the NEST Program. Provides that program participants shall receive a $1,500 lump sum payment in or around the third trimester of pregnancy, prior to delivery; and a $500 monthly cash payment for the first 6 months following delivery. Requires the Department to submit reports to the General Assembly on a biennial basis that summarizes (1) the number of program participants and distribution across the State, (2) outcomes related to maternal and child health, housing stability, and economic security, or other outcomes identified by the Department in collaboration with stakeholders, and (3) recommendations for program improvements or additional populations beyond Medicaid enrollment to include as participants. Provides that cash disbursements made to participants under the NEST Program shall be considered "guaranteed income" as described in the Hospital Uninsured Patient Discount Act for purposes of determining eligibility for assistance under the Illinois Public Aid Code. Effective immediately.

Amends Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. In provisions regarding a Safety-Net Hospital Health Equity and Access Leadership (HEAL) Grant Program, changes references to safety-net hospitals to references to community safety-net hospitals. Updates references to dates in those provisions. Defines "community safety-net hospital", "health system", and "medically underserved area". Makes changes to required provisions in the report to the General Assembly regarding criteria for a community safety-net hospital to be eligible for the program, deletes required provisions in the report to the General Assembly regarding potential projects eligible for grant funds, and adds required provisions in the report to the General Assembly regarding an application process and criteria, as well as policies, standards, and procedures to administer the program and ensure accountability.

Amends the Fair Patient Billing Act. Makes changes to findings and defined terms provisions. Provides that a hospital shall not deny any protection or benefit of the Act on the basis of a patient's citizenship or immigration status or assets or prospective assets. Provides that a patient who inquires about a denial of financial assistance in whole or in part must be permitted to appeal the decision within at least 90 days. Requires a hospital to use only a uniform financial assistance form developed and provided by the Attorney General no later than December 31, 2026. Provides that every hospital bill and every collection notice must notify the patient, in the patient's preferred language, of the availability of hospital financial assistance and charity care. Establishes further provisions concerning hospitals pursuing collection actions; outsourced health care services; patient responsibilities; and applicability of the Act. Amends the Hospital Uninsured Patient Discount Act. Sets forth provisions concerning uninsured patient discounts for specified income levels. Prohibits hospitals from making the availability of a discount under the Act contingent upon the uninsured patient first applying for coverage under public health insurance programs. Provides that patients may not be denied a discount under the Act on the basis of citizenship or immigration status or assets or prospective assets. Makes other changes concerning uninsured patient discounts, outsourcing health care services, and patient responsibilities. Effective immediately.

Amends the Emergency Medical Services (EMS) Systems Act. Provides that the Department of Public Health shall issue an annual Freestanding Emergency Center license to a facility if the facility complies with specified requirements, except that: (i) the Freestanding Emergency Center may be located in a municipality with a population greater than 50,000 inhabitants and (ii) the Freestanding Emergency Center may, if operated as provider-based under specified federal regulations, describe itself or hold itself out to the general public as a hospital emergency department in its advertising and marketing activities.

Amends the Medical Assistance Article of the Illinois Public Aid Code. Removes provisions requiring the Department of Healthcare and Family Services to: (i) establish benchmarks for hospitals to measure and align payments to reduce potentially preventable hospital readmissions, inpatient complications, and unnecessary emergency room visits; (ii) publish provider-specific historical readmission data and anticipated potentially preventable targets 60 days prior to the start of the program; and (iii) adopt policies and rates of reimbursement for readmission services and other payments.

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 Ambulatory Surgical Treatment Center Act and the Hospital Licensing Act. Removes the requirement that an anesthesiologist must remain physically present during the delivery of anesthesia services. Amends the Medical Practice Act of 1987. In provisions concerning delegation of authority, removes the requirement that an anesthesiologist or physician must remain physically present during the delivery of anesthesia services by a certified registered nurse anesthetist. Amends the Nurse Practice Act. Removes the requirement that an anesthesiologist, physician, dentist, or podiatric physician must remain physically present during the delivery of anesthesia services by a certified registered nurse anesthetist.