New Illinois Laws for Healthcare Practices to Know in 2020

The new year brings new laws governing the practice of healthcare in Illinois.  Here’s the roundup of the ones most likely to affect you.

In his first year in office, Governor J.B. Pritzker signed 591 pieces of new legislation into law, some of which went into effect in 2019, while the rest take effect as of January 1, 2020. 

This most recent session saw a host of more socially liberal legislation, with bills passed to expand health insurance coverage, confirm women’s reproductive rights, legalize recreational marijuana, and increase the minimum wage and protections against workplace harassment and violence. 

The following laws are most likely to impact your business and practice in the year ahead. Bookmark this page for reference as you adjust to the changes!

Business, Workplace, and Domestic Violence, and General Employment

With the passage of SB 1, the General Assembly took action to raise the wages for Illinoisans to $15 hourly by 2025, to be accomplished through incremental increases each year for the next six years.  Before the enactment of SB 1, the regular minimum wage for workers at least 18 years old had remained at $8.25 since 2010.  The bill also contains a corresponding withholding credit for small employers to offset the cost of these minimum wage increases.

Like in 2018, the General Assembly again passed legislation to protect workers from various forms of harassment and intimidation.  SB 1829, the Workplace Transparency Act, imposes restrictions and obligations on employers concerning workplace discrimination and harassment, such as forbidding employers from preventing employees or applicants from reporting alleged criminal activity or unlawful employment practices.  The bill also requires every employer with employees working in Illinois to provide sexual harassment training at least once a year. 

Lastly, HB 2118 extends the sunset from 2019 to 2022 for providing state benefits to foreign-born victims of human trafficking, torture, or other serious crimes, and HB 3396 requires a more rapid response by the courts and law enforcement in the issuance of stalking, domestic violence, and civil no-contact orders.

Mandatory Reporting Requirements

The General Assembly amended the Abused and Neglected Child Reporting Act by closing a loophole that allowed incidents of child abuse to go uninvestigated.  Specifically, SB 1239 requires the Department of Children and Family Services (DCFS) to take reports of and investigate alleged abuse by an individual other than the child’s parent, immediate family, a person responsible for the child’s welfare, an individual residing in the same home as the child, or a paramour of the child’s parament.  Before the passage of the bill, abuse from a child’s uncle or neighbor, for example, was out of the purview of DCFS.  SB 1239 closes that loophole.

SB 1778 also amended the Abused and Neglected Child Reporting Act to require that all mandated reporters report the same type of abuse and requires all mandated reporters to complete a training with in the first 3-6 months of becoming a mandated reporter and requires medical personnel who treat children to complete additional training every 6 years.   

HB 831 requires that if an investigation of alleged child abuser determines that no credible evidence of the alleged child abuse or neglect exists, the Child Protective Service Unit must send a copy of its final finding to the director of the Department of Public Health and the director of Healthcare and Family Services within 10 days after completing the investigation.

Telehealth

Last year, the General Assembly took several steps to expand the number of medical professionals who can be reimbursed by Medicaid for providing services through telehealth.  Broadband access is key to expanding telehealth in Illinois, especially in the state’s rural communities, yet 1 in 3 people living in rural communities lack access to broadband technologies.  This year, the Governor’s office allocated $400 million through Public Act 100-833 to build out broadband infrastructure in these rural areas and academic vicinities to increase access to telehealth and its numerous benefits.  

SB 1702 expands telehealth for mental health examinations.  Currently, when an inpatient mental health facility admits an individual on an emergency basis, the patient must be personally examined by a psychiatrist within 24 hours of their admission.  SB 1702 provides that such an examination may be performed in real-time via an Interactive Telecommunication System, but only when a psychiatrist is not on-site within those 24 hours.

SB 167 allows dentists to practice teledentistry and changes the requirements that must be met by a dental assistant before he or she performs certain procedures with respect to amalgam, composite, and interim restorations.  The bill also makes changes to the continuing education requirements for a permit to administer anesthesia and sedation. 

Prescription Drug and Controlled Substance Regulations

The General Assembly took action to increase transparency and accountability when determining which life-saving medications are provided to patients who have health coverage through the state-administered federal Medicaid program.  Specifically, HB 2259 increases transparency in the decision-making process of the Medicaid Drug and Therapeutics Board (Board), which with the Department of Healthcare and Family Services determines the fee-for-service medication formulary in the Illinois Medicaid program.  The bill also expands the membership of the Board to include at least one clinician who emphasizes the prevention and treatment of HIV and at least one clinician that serves individuals who are affected by chronic diseases that require significant pharmaceutical treatments.

HB 2665 aligns Illinois law with federal guidance on a minor’s ability to access preventative health care services, like PrEP, without parental consent.  Studies suggest that PreEP is nearly 100 percent effective at preventing HIV transmission when used consistently and correctly, and federal guidelines have expanded access to the drug to adolescents vulnerable to HIV who weigh at least 77 pounds.  HP 2665 conforms Illinois law with those federal guidelines.

To streamline the process for prior authorization for prescription drugs, the General Assembly passed HB2160 to create a task force that would develop a one-page uniform prior authorization (PA) form for providers.  Currently, private insurers and managed care organizations have multiple PA forms, causing prescribers to spend significant time figuring out what PA form must be used—time that they could otherwise use to see patients.

HB 465 puts pharmacy benefit managers (PBMs) under the regulation of the Illinois Department of Insurance and prohibits “gag clauses” whereby PBMs restrict pharmacists’ ability to disclose the availability of more affordable drugs.

The General Assembly also passed HB 1438, joining the District of Columbia and 10 other states that have legalized recreational marijuana.  Effective January 1, 2020, Illinois residents who are over the age of 21 and older may possess up to 30 grams of cannabis flower, 5 grams of concentrate, and 500 milligrams of THC in edible products.  The measure also provides for the expungement of approximately 800,000 criminal records for those who served time for the purchase of 30 grams of marijuana or less.

With the passage of HB 345, the General Assembly raised the age to buy cigarettes, e-cigarettes, chewing tobacco, and other products containing nicotine from 18 to 21, making Illinois the first Midwestern state to take such action.  Additionally, HB 2276 imposes a fine for people caught smoking in a car with one or more minors present.

SB 1828 creates the Needle and Hypodermic Syringe Access Program Act to legalize syringe exchange programs statewide under the auspices of the Illinois Department of Public Health and provides criminal immunity for individuals operating such programs.  

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

To improve a number of health care programs in the state, the General Assembly passed SB 1321, the Medicaid “Omnibus” bill, which streamlines many aspects of the state’s Medicaid managed care program.  In Illinois, 1 in 4 people enroll in Medicaid, but problems with the renewal process cause thousands of Illinoisans to lose their insurance coverage each year.  SB 1321 directs the Department of Healthcare and Family Services to streamline and simplify the redetermination process to ensure that children, families, seniors, and persons with disabilities do not lose their coverage due to procedural errors.

The General Assembly increased health insurance coverage for some procedures and medications.  SB 3113 requires health plans to cover one annually medically necessary screening for skin cancer that is not otherwise provided as part of a routine dermatology examination.  The bill would further prevent a deductible, coinsurance, copayment, or any other cost-sharing requirement from being imposed for this increased coverage.  SB 2085 would require private health insurance and managed care organizations to cover services provided through the “psychiatric collaborative care,” which is an evidence-based, integrated behavioral health service delivery method.  Lastly, HB 3435 requires health insurance providers to pay for medically necessary epinephrine injectors for those age 18 years of age or less.    

Several bills related to mental health issues were also passed in the 2019 legislative session.  HB 5 enhances mental and physical health services for pregnant and postpartum women and requires the Department of Public Health to establish a classification system for certain levels of maternal care, while HB 3511 requires birthing hospitals to distribute educational information about maternal mental health conditions to both health care professionals and patients at those hospitals.

The General Assembly also passed legislation to aid in the detection and early intervention of mental illness.  HB 2247 creates a community mental health awareness, education, and access pilot program focused on the prevention of mental illness and the promotion of mental wellness.  Additionally, HB 2154 increases insurance coverage for early treatment of serious mental illness in children and young adults.    

HB 2152 was passed to establish the Mental Health Early Action on Campus Act, which requires every public college and university in the state to establish peer-to-peer support programs for students living with mental health conditions, as well as implementing partnerships between college campuses and local mental health providers.

HB 2865 requires health insurance coverage for treatments for pediatric autoimmune, neuropsychiatric disorders associated with streptococcal infections, acute-onset neuropsychiatric syndrome, and intravenous immunoglobulin therapy plans administered after July 2017.

HB 1475 creates the Seizure Smart School Act, which requires the parent or guardian of a student with epilepsy who seeks assistance with epilepsy-related care in a school setting to submit a seizure action plan with the student’s school.  The law also requires a delegated care aid to perform the necessary tasks to execute the student’s seizure action plan.

Lastly, HB 3509 requires health insurance coverage for donated breast milk if prescribed by a patient’s healthcare provider.

Reproductive and General Women’s Health

In the 2019 legislative session, the General Assembly expanded access to late-term abortions through the passage of SB 25, the Reproductive Health Act (RHA).  The RHA repealed both the state’s Partial-Birth Abortion Ban Act and the Illinois Abortion Act of 1975, thereby lessening restrictions on abortions performed in later stages of pregnancy.  The bill also removed criminal penalties for physicians who perform such late-term abortions, as well as removing spousal consent and waiting period requirements.  The RHA also requires insurance coverage for abortion procedures and contraception.

The General Assembly also passed HB 2, which codifies a woman’s right to a certified nurse-midwife as her maternity care professional and the right to examine and receive an explanation of her total bill for services rendered.  Importantly, the bill does assert that it should not be construed to require a physician, health care professional, hospital, hospital affiliate, or healthcare provider in order to provide care inconsistent with generally accepted medical standards. 

Additionally, SB 1506 requires providers of mammography services to notify patients in their mammography report if they have dense breast tissue, as dense breast tissue can make it more challenging to uncover cancer on a mammogram and may be associated with an increased risk of breast cancer.

Licensure and Regulations

Last year, the General Assembly passed several bills related to licensure, physician shortage, and continuing education requirements, some of which are only now going into effect this year.  Although this legislative session did not see many bills passed in these areas, there were a couple of bills worthy of note. 

The General Assembly passed HB 2676, which changed the definition of “public health dental hygienist,” and specifies the number of hours of education required in certain advanced areas specific to public health dentistry, as well as other licensure requirements.

SB 1715 provides that pharmacists, in addition to physicians, may administer subsequent long-term substance use disorder treatments via injection, so long as there is a prescription from a physician and a physician-administered the initial injection.

Practice Act Changes

As expected, the General Assembly passed SB 1221 to extend the Illinois Medical Practice Act, which governs licensure qualifications for chiropractors and physicians to practice medicine, to January 1, 2022.

Miscellaneous

HB 2896 creates the Diversity in Health Care Professions Task Force and provides that the Director of Public Health shall serve as the chairperson of the Task Force. It shall be comprised of 2 dentists, 2 medical doctors, 2 nurses, 2 optometrists, 2 pharmacists, 2 physician assistants, 2 podiatrists, and 2 public health PR actioners, who are charged with creating an annual report on ways to increase the number of racial and ethnic minority students in medical school to ultimately increase workplace diversity.

HB 2146, the Health in All Policies Act, creates a workgroup within the Department of Public Health to review legislation and make new policy recommendations relating to the health of Illinois residents.

The General Assembly approved a constitutional amendment to ask voters next year if the state’s flat tax structure for income taxes should be replaced by progressive tax rates, requiring taxpayers making at least $250,000 a year to pay higher rates than the current 4.95 percent flat tax.  If passed, the new tax structure would raise approximately $3 billion for public services, including health care.

Conclusion

The slew of regulatory changes at the beginning of the new year may create questions about the new responsibilities of your new business.  While we hope this post helped you understand these changes, descriptions of these new requirements are only summaries and there may other parts of these bills relevant to you. 

If you have questions about what these changes mean for you, please reach out to us so that we can help you navigate through your new compliance requirements in the coming year.

This blog is made for educational purposes and is not intended to be specific legal advice to any particular person. It does not create an attorney-client relationship between our firm and the reader and should not be used as a substitute for competent legal advice from a licensed attorney in your jurisdiction.

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