New Illinois Laws to Know for 2019

It’s a new year, and that means a host of new laws take effect in Illinois. We reviewed them and summarized the ones most likely to impact your healthcare practice.

As the new year begins, many laws passed by the Illinois General Assembly also take effect. Over 250 new laws become effective on January 1st, many of which are relevant to healthcare providers. This most recent legislative session saw bills pass related to telemedicine, insurance, licensing, children’s and mental health, domestic violence, sexual harassment, and elder care. The following laws are most likely to impact to your business and practice in the year ahead.

Telehealth

 In the 2018 legislative session, the Illinois General Assembly made a number of changes to its telehealth statutes, expanding the number of medical professionals who can be reimbursed by Medicaid. Previously, the statute only allowed psychiatrists to receive Medicaid reimbursement. Meant to increase access to mental healthcare, Senate Bill 3049 will now allow clinical psychologists, clinical social workers, advanced practice registered nurses certified in psychiatric and mental health nursing, and mental health professionals and clinicians authorized by state law to receive reimbursement for their services. Additionally, SB 3049 allows Medicaid-certified facilities or organizations, such as state-licensed substance abuse centers, to be reimbursed for telehealth services received by a patient at that location.

The General Assembly also added a requirement through HB 5351 that accident or health insurance policies covering telehealth services must also cover in-home counseling for senior diabetic patients by licensed dietitian nutritionists and certified diabetes educators. The statute points to the transportation barriers faced by these patients and the intent of this provision to alleviate this burden through in-home counseling.

The 2018 legislative session also saw a number of amendments to the Telehealth Act. SB 2587 and HB 5070 adds dentists, occupational therapists, pharmacists, physical therapists, clinical social workers, speech-language pathologists, audiologists, and hearing instrument dispensers to coverage of the Act. These practitioners are added to the physicians, physician assistants, optometrists, advanced practice registered nurses, clinical psychologists, and other mental health professionals and clinicians authorized to provide mental health services who were already covered by the Act. This bill allows more health care professionals to provide telehealth services to their patients.

Licensing, Records, and Insurance

The General Assembly also took steps to address the physician shortage in the state. SB 2904 increases the number of physician assistants with which a physician can collaborate to seven. Additionally, physicians practicing in a federal primary care health professional shortage area, as determined by the federal government, can collaborate with more than seven physician assistants. The physician must collect and maintain documentation showing this exemption has been met, and must make it available to the US Department of Health and Human Services upon request.

SB 2904 also adds inadequate collaboration as grounds for discipline for both physicians and physician assistants. Failure to adequately collaborate with collaborating physician assistants or physicians can result in disciplinary action up to revocation of license and fines of up to $10,000 per violation. For physicians, this includes entering into an excessive number of collaborative agreements.

 SB 3109 prohibits the Department of Financial and Professional Regulation (IDFPR) from denying a license, certificate, limited permit, or registration to qualified individuals based on their immigration status. Instead of requiring a social security number when applying for a license, individuals who meet all professional requirements can use a taxpayer identification number.

SB 2777 requires prescribers of controlled substances to complete three continuing education hours devoted to safe opioid prescribing practices. These hours must be offered or accredited by offered or accredited by a professional association, state government agency, or federal government agency. The bill empowers the Department of Financial and Professional Regulation to adopt rules governing this section, so there may be further developments on this requirement down the road.

Regarding records, HB 4848 requires all health care facilities and providers to provide a complete copy of a patient’s records at no cost if that patient is an indigent homeless veteran or the records are being used for the purpose of supporting that patient’s claim for federal veterans’ disability benefits. These records can be requested by the patient or a person, entity, or organization presenting a valid authorization for the release of records signed by the patient or the patient’s legally authorized representative. An update to a provider’s patient record release policies is important to ensure compliance with this law.

The General Assembly also made changes to the Illinois Insurance Code this legislative session. HB 4821 prohibits insurers from requiring step therapy for stage 4, advanced metastatic cancers. HB 2617 requires insurers to cover medically necessary expenses for fertility preservation services when a necessary treatment may directly or indirectly cause infertility to a patient. Because of the wide coverage of this bill, it is important that all of a patient’s medical care providers are aware of these requirements to aid the patient in deciding issues regarding their fertility.

Other changes regarding insurance involve treatment of substance use disorders. SB 1707 added new requirements to insurers, including prohibiting prior authorization and step therapy requirements for medication used to treat substance abuse disorders. SB 1707 adds reporting requirements to insurers regarding their mental, emotional, nervous, or substance use disorder or condition benefits and enables state enforcement of the federal Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008.

HB 5868 allows insurers to provide residential extended care services to people with substance use disorders and at risk of relapse, and SB 0682 requires substance use disorder treatment facilities or providers to notify the patient’s insurer when treatment has been initiated. Additionally, if an insurer determines that treatment is no longer medically necessary, SB 0682 provides the patient a right to an external review. Further, the law requires the provider or facility to notify the insurer in advance of the patient’s planned discharge.

Children’s, Mental, and Elder Health and Vulnerable Populations

To address concussion risks and warning for children, the General Assembly passed HB 4226 to require the Department of Public Health to develop, publish, and distribute a brochure to educate the public about those risks and how to identify concussion symptoms in children. Once this brochure is developed, pediatric healthcare providers should review and consider sharing it in their practices. Practitioners in the area of child concussions may also want to consider working with the Department to contribute to the development of this brochure.

Additionally, pediatric dentists may want to adjust their back-to-school staffing and marketing plan to accommodate the patients who need new dental examinations because of HB 4908. The bill expanded the dental exam requirement for public, private, or parochial school students entering kindergarten, second grade, and sixth grade to those entering ninth grade.

In HB 5109, the General Assembly took steps to provide loan repayment assistance to mental health professionals who practice in underserved areas. Starting on July 1, and depending on legislative appropriation, mental health and substance use professionals practicing in a community mental health center in an underserved or rural federally designated Mental Health Professional Shortage Area are eligible for the following grant amounts for a maximum of four years: $35,000 per year for a psychiatrist, $15,000 per year for an advanced practice registered nurse or a physician assistant, $12,000 per year for a psychologist who holds a doctoral degree, $6,500 per year for a licensed clinical social worker or a licensed clinical professional counselor, and $2,500 per year for a substance use professional.

Other bills concerning mental health passed by the General Assembly include HB 4658 which expands training for teachers to identify warnings signs of mental illness and suicidal behavior, and HB 4936, which seeks to recognize as mental health professionals those persons who have completed a psychiatric training certification program while in the U.S. military and with at least one year of experience in a mental health setting.

There was high activity this past legislative session in the area of elder care and vulnerable populations. HB 4440 requires the Department of Public Health to provide all nursing home facilities educational information on all CDC-recommended vaccines. HB 5558 requires mental health or developmental disabilities facilities to also post contact information in public areas for the Guardianship and Advocacy Commission and the agency designated by the Governor under the Protection and Advocacy for Persons with Developmental Disabilities Act. HB 4847 allows Adult Protective Services to investigate claims of abuse, neglect, or financial exploitation in situations where the suspected abuser is a non-employee, including family members, and if the abuse occurs outside of the assisted care facility.

SB 2265 and 2278 add individuals with developmental or intellectual disabilities and veterans who have mental or physical health conditions related to their service, respectively, to the Endangered Missing Person Advisory program. SB 3290 requires the Department of Healthcare and Family Services to provide nursing homes enrolled in one or more Medicaid managed care networks with patient credit files at the same time as those files are provided to the managed care organization to reduce the number of claim denials resulting from coverage plan errors.

The General Assembly also passed HB 4309, also known as the Frail Elderly Individual Family Visitation Protection Act. This Act prescribes the rights of family members to petition the courts to visit a frail elderly individual if the family caregiver unreasonably refuses the family member from visiting. If a petition is granted, the court may also require the family caregiver to make reasonable effort to notify the petitioner of the frail elderly individual’s hospitalization, admission to a healthcare facility, change in permanent residence, or death.

Prescription and Controlled Substance Regulations

SB 3170 allows prescriptions for medication other than a controlled substance to be valid for up to 15 months after the date the prescription is issued for the purpose of refills. However, this is only a default, and the prescription can provide for a different validity period.

In the area of cannabis regulation, SB 2341 added synthetic cannabinoids to the state Controlled Substances Act.

Domestic Violence, Workplace Violence, Sexual Harassment, and Stalking

The General Assembly created a host of new regulatory requirements in HB 4100, the Healthcare Violence Prevention Act. Introduced with the purpose of reducing violence against nurses, the final version of the Act covers nursing assistants, other support personnel, and any individual licensed under state law to provide health services. The bill explicitly includes dentists, dental hygienists, nurses and advanced practice registered nurses, occupational therapists, optometrists, pharmacists, physical therapists, physicians, physician assistants, podiatric physicians, clinical psychologists, clinical social workers, speech-language pathologists and audiologists, and hearing instrument dispensers under its coverage, but this is not an exhaustive list.

HB 4100 requires that any covered employee who contacts law enforcement or files a report to law enforcement against a patient or individual because of workplace violence to provide notice to management within three days of contacting law enforcement and prevents retaliation against the employee for exercising this right. Additionally, the law requires the employer to post a notice stating that notice stating that verbal aggression will not be tolerated and physical assault will be reported to law enforcement. HB 4100 further requires the employer to offer immediate post-incident services to an employee directly affected by the workplace violence incident and create workplace violence prevention program that complies with OSHA guidelines for preventing workplace violence for healthcare and social service workers.

To better address sexual assault issues, the General Assembly passed SB 3404. SB 3404 requires hospitals providing emergency and forensic services to sexual assault survivors to provide access for the survivor to a shower at no cost after a medical evidentiary or physical exam, unless those facilities are unavailable. The law also provides the right for an advocate, unless no advocate can be summoned in a reasonably timely manner, and an additional person for support to be present during the exam. The law also provides sexual assault survivors limited immunity from prosecution for the possession of certain controlled substances. A survivor is also provided limited immunity from arrest or prosecution if an alcohol offense is involved.

SB 2826 expands coverage of the Illinois Human Rights Act to prevent discrimination based on status of being protected by an order of protection issued under Article 112A of the Code of Criminal Procedure of 1963, the Stalking No Contact Order Act, the Civil No Contact Order Act. Previously, the law protected order of protection status based only on the Illinois Domestic Violence Act of 1986 or an order issued by an out-of-state court.

The General Assembly also changed its procurement and economic development statutes to help prevent sexual harassment. SB 0405 requires companies that bid for state contracts to have a sexual harassment policy that complies with the Illinois Human Rights Act to provide a copy of that policy to the contracting state agency upon request. Additionally, the bill requires companies claiming EDGE (Economic Development for a Growing Economy) tax credits to provide a copy of their sexual harassment policy in their annual report to the state. This policy must meet certain minimum requirements.

HB 4953 adds one hour of sexual harassment prevention training to continuing education requirements for licensed professionals. This law effects license renewals occurring on or after January 1, 2020, and the Department may adopt further rules to implement this legislation.

Massage establishments, organizers of public events that require a permit, and all primary and secondary schools will now also be required by HB 4340 to post notices informing employees and the public about an anti-human trafficking helpline.

This legislative session, the General Assembly also passed laws affecting firearms possession. Businesses can now petition the court for a no contact order against individuals stalking a workplace, the issuance of which could require the individual to give up their firearms and Firearm Owners Identification (FOID) card (SB 3411). This does not affect lawful free speech activities, protests, or picketing related to labor disputes. HB 4855 expands the definition of a “patient” who is ineligible to hold a FOID card. HB 2354 created the Firearms Restraining Order Act, which allows family members to petition the court for an order preventing the individual from possessing firearms for the period of time the order covers. A family member must show the court that the individual is an immediate and present danger to the individual or to others before the judge will issue the order.

Business and General Employment Issues

SB 2999 requires employers to reimburse employees for all necessary expenses or losses incurred by employees directly related to their work for the employer. This means that employers are now required to compensate employees for their personal cell phones and internet services if the employee uses them for work-related reasons. Employees are required to submit expenditures with the appropriate documentation, or a signed statement regarding those expenses, within 30 days of incurring the expense, unless the employer provides additional time in a written expenditure reimbursement policy. An employer is not required to reimburse expenses if the employer has a written expense reimbursement policy and the employee does not comply with that policy. It is important to update your employee handbook to comply with this and other workplace laws, or create a handbook if you do not yet have one.

SB 2516 requires the form signed by mandated reporters that confirms their understanding of their reporting responsibilities to also include information about available mandated reporter training provided by the Department of Children and Family Services.

Other changes by the General Assembly include reducing the late filing penalty for LLC annual reports from $300 to $100 (HB 4578), and removing the requirement that court pleadings, affidavits, or other documents be sworn before an authorized person (SB 3295).

Miscellaneous Issues

The General Assembly extended the statute of limitations for prosecuting certain types of healthcare fraud or kickbacks from three years to five years (SB 2891). With HB 4949, it also banned “patient brokering,” the use of false or misleading advertising to direct patients to out-of-state mental health or addiction recovery facilities. HB 4949 further creates new regulatory requirements for advertising mental health or substance disorder treatment to Illinois residents. Hospitals and hospital affiliates are exempted from this law.

Notice and publication of an intended name change is no longer required if the person seeking a name change files with the court a declaration and supporting evidence that publishing the name change would put the person at risk of physical harm or discrimination (SB 0574). Upon request, nursing mothers shall be excused from jury duty (HB 5745). All providers of mammography services are now required to notify patients if dense breast issue is found using a notice substantially similar to that provided for in the statute (HB 4392).

Finally, ambulatory surgical treatment facilities are now allowed to place a lien on any damages that may be paid to the patient for the injury that necessitated treatment of the patient by the facility (HB 4911).

Conclusion

The slew of regulatory changes at the beginning of the new year may create questions about the new responsibilities of your business. While we hope this post helped in understanding these changes, descriptions of these new requirements are only summaries and there may be other parts of these bills relevant to you. If you have questions about what these changes mean for you, please reach out to us here at Jackson LLP so we can help you navigate through your new compliance requirements in the coming year.