IAFP Legislative Tracking

While IAFP tracks priority legislative and administrative actions during each legislative session, IAFP prepares each year for a range of advocacy issues, from scope of practice to tobacco cessation. This past year has also focused on a few particular areas of importance with ongoing regulatory interactions including healtchare equity, telehealth, and workforce development. Click here for an overview of this IAFP advocacy.

Priority Legislative & Administrative Actions Tracked by IAFP

House Bill 00062

Rep. Mary E. Flowers

Watch

Creates the Health Care for All Illinois Act. Provides that all individuals residing in this State are covered under the Illinois Health Services Program for health insurance. Sets forth requirements and qualifications of participating health care providers. Sets forth the specific standards for provider reimbursement. Provides that it is unlawful for private health insurers to sell health insurance coverage that duplicates the coverage of the program. Requires the State to establish the Illinois Health Services Trust to provide financing for the program. Sets forth the specific requirements for claims billed under the program. Provides that the program shall include funding for long-term care services and mental health services. Creates the Pharmaceutical and Durable Medical Goods Committee to negotiate the prices of pharmaceuticals and durable medical goods with suppliers or manufacturers on an open bid competitive basis. Provides that patients in the program shall have the same rights and privacy as they are entitled to under current State and federal law. Provides that the Commissioner, the Chief Medical Officer, the public State board members, and employees of the program shall be compensated in accordance with the current pay scale for State employees and as deemed professionally appropriate by the General Assembly. Effective July 1, 2021.

Comment: see AAFP Healthcare for All policy guidance; see also HB5442 affordability/feasibility study from 101st GA inserted into Public Act 101-649 & IAFP’s Study Submission

HB 00110

Rep. La Shawn K. Ford

Support

Creates the Safer Consumption Services Act. Provides that, notwithstanding any provision of law to the contrary, the Department of Public Health may approve an entity to operate a program in one or more jurisdictions upon satisfaction of specified requirements relating to, among other things, the safe and hygienic use of preobtained drugs. Requires the Department to establish standards for program approval and training and allows it to adopt any rules that are necessary to implement the Act. Requires the Department to approve or deny an application within 45 days after its receipt. Provides that a program approved by the Department must also be designated as an authorized needle and hypodermic syringe access program under the Overdose Prevention and Harm Reduction Act. Provides reporting requirements for entities operating programs under the Act. Provides that, except for criminal prosecution for any activities that are not conducted, permitted, and approved pursuant to the Act, specified persons related to a program shall not be subject to civil or criminal liability solely for participation or involvement in the program if it is approved by the Department under the Act.

Comment: monitor amendments for consistency with AAFP/IAFP policy regarding needle exchange and safe drug use

HB 00158

Rep. Camille Y. Lilly

(Sen. Mattie Hunter)

Public Act 102-0004

Support

Creates comprehensive additions and changes to healthcare related statutes with numerous areas of focus, including:

  • Access to Healthcare

  • Hospital Closures

  • Hospital Reform

  • Managed Care Organization (MCO) Reforms

  • Community Health Workers

  • Maternal & Infant Mortality

  • Mental & Substance Abuse Treatment

  • Medical Implicit Bias


Comment: contains comprehensive part of the Illinois Legislative Black Caucus 2020-21 healthcare package, see IAFP's full bill review; monitor amendments regarding implicit bias, hospital closings, behavioral health workforce consistency with the Synchronicity Report showcasing the Mental Health Collaborative Care Model, FQHC promotion to include family physicians, and dementia training for non-physicians; see also identical HB 00159

HB 00347

Rep. Robyn Gabel

(Sen. Michael Hastings)

Support

Amends the Illinois Public Aid Code. Provides that, to ensure full access to the benefits set forth in provisions regarding the Healthy Kids Program, on and after January 1, 2022, the Department of Healthcare and Family Services shall ensure that provider and hospital reimbursements for immunization as required under the provisions are no lower than the Medicare reimbursement rate. Amends the Immunization Data Registry Act. Provides that health care providers, physician's designees, or pharmacist's designees shall (rather than may) provide immunization data to be entered into the immunization data registry. Removes language providing that the immunization data need not be provided if the patient or the patient's parent or guardian, if the patient is less than 18 years of age, has completed and filed with the provider, physician's designee, or pharmacist's designee a written immunization data exemption form. Provides that the written information and the immunization data exemption forms must include information that the health care provider shall (rather than may) report immunization data to the Department of Public Health to be entered into the immunization data registry. Effective January 1, 2022.

Comment: Illinois Chapter of the American Academy of Pediatrics initiative; monitor ICARE mandate for IAFP Public Health committee, changed to opt-out with HFA2

HB 00591

Rep. La Shawn K. Ford

Support

Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to permit medical assistance recipients, including those enrolled in managed care, to obtain pharmacy services from the pharmacy of their choice if the pharmacy is licensed under the Pharmacy Practice Act and accepts the professional dispensing fee for pharmacy services as determined by the Department. Provides that no managed care organization that contracts with the Department to provide services to recipients may restrict a recipient's access to pharmacy services to a selected group of pharmacies. Provides that if a managed care organization merges with or is acquired by another entity, the resulting entity may not restrict a recipient's access to pharmacy services to a selected group of pharmacies. Permits the Department to renegotiate with the resulting entity the terms of the managed care contract the Department had with the original managed care organization prior to the merger or acquisition. Requires the Department to contract with an independent research organization to conduct a study and submit a report on those managed care organizations that are contracted to provide services to recipients. Requires the report to include an analysis of pharmacy access for medical assistance recipients with the aim of identifying "pharmacy deserts"; an analysis of the costs and benefits of having managed care organizations administer health care services, including pharmacy services, to recipients; and other matters. Prohibits the Department from entering into any new contract with a managed care organization before the report has been received and analyzed by the Department and posted on its website. Effective immediately.

Comment: response to Aetna Better Health of Illinois (ABHIL) Medicaid changes requiring use CVS vs. Walgreens pharmacies

HB 00601

Rep. La Shawn K. Ford

Support

Amends the Illinois Controlled Substances Act. Provides that the requirements for transmitting information to the central repository under the Prescription Monitoring Program also apply to opioid treatment programs that prescribe Schedule II, III, IV, or V controlled substances for the treatment of opioid use disorder.

Comment: identical language in HB158 healthcare package as introduced but not included in final version passed out of House chamber; refiling of HB3889 from 101st GA

HB 00707

Rep. Daniel Didech

Support

Amends the Illinois Insurance Code. In provisions concerning coverage for telehealth services, provides that if an individual or group policy of accident or health insurance provides coverage for telehealth services, reimbursement for services provided through telehealth services shall be equivalent to reimbursement for the same services provided through in-person consultation.

Comment: see telehealth coalition bill HB 3498 and fact sheet; see also Telehealth Executive Order 2020-09 issued on March 19, 2020

HB 00711

Rep. Gregory Harris

(note: companion Senate filings SB 00158 & SB 00177 - Sen. Linda Holmes)

Support

Prior authorization reform legislation, as introduced, seeks to accomplish the following:

  • Require payers to maintain and publicly post a list of services for which prior authorization is required;

  • Reduces the number of medically necessary services that are subjected to prior authorization requirements;

  • Establish important maximum timelines for urgent and non-urgent prior authorization requests;

  • Define qualifications of individuals designated to review and make prior authorization determination;

  • Ensure the request for prior authorization is using appropriate medically accepted, clinically valid, evidence based criteria;

  • Ensure that prior authorization approvals also include reasonably related supplies or services;

  • Requiring that prior authorization approvals remain in effect for the course of the treatment; and

  • Ensures that prior authorization approvals also confirm medical necessity requirements for payment of the health care service;

Comment: legislative activity to be coordinated with the Illinois State Medical Society; click here for Your Care Can't Wait coalition information; click here for the 2020 IAFP position statement, and click here for the 2020 coalition position statement; see companion SB158 & SB177; refiling of HB5510 & SB3822 from 101st GA (note: 2020 positions statements to be converted to 2021 references)

HB 01801

Rep. Terra Costa Howard

Oppose

Amends the Medical Practice Act of 1987. Provides for the licensure of naturopathic physicians. Makes conforming changes in various other Acts. Effective immediately


(Comment: see AAFP naturopathic practice policy; review with IDFPR)

HB 01826

Rep. Kathleen Willis

Oppose

Amends the Medical Practice Act of 1987. Provides that a physician licensed to practice medicine in all its branches may collaborate with a physician assistant if specified requirements are met for a collaborative agreement. Provides that a collaborative agreement shall be for services in the same area of practice or specialty as the collaborating physician in his or her clinical medical practice. Amends the Physician Assistant Practice Act of 1987. Deletes language requiring a collaborative agreement to be written for a physician assistant and changes requirements for the collaborative agreement. Provides that medical care provided by a physician assistant shall be consistent with the physician assistant's education, training, and experience. Makes changes to provisions concerning prescriptive authority of a physician assistant. Provides that in a hospital, hospital affiliate, or ambulatory surgical treatment center, the medical staff (instead of the attending physician) shall determine a physician assistant's role in providing care for patients. Changes the physician assistant advisory committee to the Physician Assistant Medical Licensing Board. Changes the membership and duties of the Board. Removes provisions concerning initial terms of office for Board members. Makes conforming and other changes. Effective January 1, 2022.


Comment: oppose physician assistant prescriptive authority and collaborative agreements (note: coordinate with ISMS; review pending amendment compromise; see companion SB145; refiling of HB4692/SB2758 from the 101st GA)

HB 02376

Rep. Theresa Mah

Oppose

Amends the Medical Practice Act of 1987. Provides that rules adopted by the Department of Financial and Professional Regulation establishing continuing education requirements shall require that licensees complete a course in maternal mental health that addresses specified topics. Effective immediately.


Comment: see AAFP Postpartum Depression in Primary Care Study & Postpartum Depression Toolkit; see also HB5226 from 101st GA

HB 03498

Rep. Deb Conroy

Support

Provides for the following:

  • Bars insurers from requiring patients to prove a hardship or access barrier in order to receive healthcare services through telehealth.

  • Prohibits geographic or facility restrictions on telehealth services, allowing patients to be treated via telehealth in their home.

  • Protects patient preference by establishing that a patient cannot be required to use telehealth services.

  • Ensures patients will not be required to use a separate panel of providers or practitioners to receive telehealth services.

  • Aligns telehealth practice with privacy laws for in-person practice, while giving healthcare providers the professional latitude to determine the appropriateness of specific sites and technology platforms for telehealth services.

  • Aligns telehealth coverage and payment with in-person care, making appropriate patient access to care the priority and removing harmful barriers that shift costs to the patient and healthcare provider.

  • Equal coverage eliminates policy loopholes that allow insurers to create separate telehealth networks which ship tax dollars to out-of-state providers that work outside of a patient’s care team.

  • Effective immediately.


(Comment: Telehealth Coalition initiative, see coalition policy statement and IAFP telehealth statement; see also HB3308 & HB707; review IAFP survey results; review sufficiency of reasonable-necessary and improper billing code insurance defenses)

HB 03139

Rep. Anna Moeller

(Sen. Emil Jones, III)

Support

House Floor Amendment No. 2:


Amends the Regulatory Sunset Act. Provides for the repeal of the Medical Practice Act of 1987 on January 1, 2027 (rather than January 1, 2022). In provisions amending the Medical Practice Act of 1987, restores language that was deleted by the introduced bill that provides that each order of revocation, suspension, or other disciplinary action shall contain a brief, concise statement of the ground or grounds upon which the Department of Financial and Professional Regulation's action is based, as well as the specific terms and conditions of such action. Provides that the document shall be retained as a permanent record by the Department (rather than the Disciplinary Board and the Secretary). Adds an immediate effective date for provisions amending the Regulatory Sunset Act.

House Resolution 00025

Rep. Mary E. Flowers

Support

Urges all branches of the medical profession to commit to eliminating racism and recognizing biases, all colleges and medical institutions that prepare students for careers in the medical profession to focus on the recruitment of more minorities, and the State Board of Higher Education to pursue and provide more scholarships opportunities for minority applicants seeking to enter all aspects of the medical profession.

Comment: see AAFP Center for Diversity & Equity & EveryONE Project

Senate Bill 00072

Sen. Don Harmon

(Rep. Jay Hoffman)

Oppose

House Amendment No. 2:

Replaces everything after the enacting clause. Amends the Code of Civil Procedure. Provides that in all actions brought to recover damages for personal injury or wrongful death resulting from or occasioned by the conduct of any other person or entity, whether by negligence, willful and wanton misconduct, intentional conduct, or strict liability of the other person or entity, the plaintiff shall recover prejudgment interest on specified damages and costs set forth in the judgment. Provides that neither the State nor a local public entity shall be liable to pay prejudgment interest. Provides that for any personal injury or wrongful death occurring before the effective date of the amendatory Act, the prejudgment interest shall begin to accrue on the later of the effective date of the amendatory Act or the date the action is filed. Effective July 1, 2021.

Comment: oppose House Amendments 1&2 re: prejudgment interest (note: coordinate with ISMS; HHA neutral)

SB 00086

Sen. Win Stoller

Oppose

Amends the Illinois Controlled Substances Act. Provides that when issuing a prescription for an opiate to a patient 18 years of age or older for outpatient use for the first time, a practitioner may not issue a prescription for more than a 7-day supply. Provides that a practitioner may not issue an opiate prescription to a person under 18 years of age for more than a 7-day supply at any time and shall discuss with the parent or guardian of the person under 18 years of age the risks associated with opiate use and the reasons why the prescription is necessary. Provides that notwithstanding this provision, if, in the professional medical judgment of a practitioner, more than a 7-day supply of an opiate is required to treat the patient's acute medical condition or is necessary for the treatment of chronic pain management, pain associated with a cancer diagnoses, or for palliative care, then the practitioner may issue a prescription for the quantity needed to treat that acute medical condition, chronic pain, pain associated with a cancer diagnosis, or pain experienced while the patient is in palliative care. Provides that the condition triggering the prescription of an opiate for more than a 7-day supply shall be documented in the patient's medical record and the practitioner shall indicate that a non-opiate alternative was not appropriate to address the medical condition. Provides that these provisions do not apply to medications designed for the treatment of substance abuse or opioid dependence. Effective immediately.

Comment: similar to HB4998 from 101st GA which applied 7-day limit to all opiate prescriptions without being conditioned on only youth and requiring documentation of necessity for prescriptions more than 7-day

SB 00105

Sen. Sara Feigenholtz

(Rep. Anna Moeller)

Watch

Amends the Nurse Practice Act. Removes language requiring that a collaborating physician attest to the completion of the clinical experience required for an advanced practice registered nurse to practice without a written collaborative agreement. Removes a provision that includes prescribing benzodiazepines or Schedule II narcotic drugs only in a consultation relationship with a physician within the scope of practice of an advanced practice registered nurse with full practice authority.

Senate Committee Amendment No. 1:

Replaces everything after the enacting clause. Reinserts the provisions of the introduced bill with the following changes: In a provision concerning clinical experience for an advanced practice registered nurse, provides that completion of the clinical experience must be attested to by the collaborating physician or physicians or employer (rather than the collaborating physician or physicians) and the advanced practice registered nurse. Provides that if the collaborating physician or physicians or employer is unable to attest to the completion of the clinical experience, the Department of Financial and Professional Regulation may accept other evidence of clinical experience as established by rule. Restores language concerning prescribing benzodiazepines or Schedule II narcotic drugs that was stricken in the introduced bill.

Comment: Oppose as introduced (note: disruption/overriding of existing agreement on APRN independence); coordinate with ISMS; Neutral on HCA1 replacement amendment regarding qualifications and final decision making responsibilities

SB 00145

Sen. Laura M. Murphy

Oppose

Amends the Medical Practice Act of 1987. Provides that a physician licensed to practice medicine in all its branches may collaborate with a physician assistant if specified requirements are met for a collaborative agreement. Provides that a collaborative agreement shall be for services in the same area of practice or specialty as the collaborating physician in his or her clinical medical practice. Amends the Physician Assistant Practice Act of 1987. Deletes language requiring a collaborative agreement to be written for a physician assistant and changes requirements for the collaborative agreement. Provides that medical care provided by a physician assistant shall be consistent with the physician assistant's education, training, and experience. Makes changes to provisions concerning prescriptive authority of a physician assistant. Provides that in a hospital, hospital affiliate, or ambulatory surgical treatment center, the medical staff (instead of the attending physician) shall determine a physician assistant's role in providing care for patients. Changes the physician assistant advisory committee to the Physician Assistant Medical Licensing Board. Changes the membership and duties of the Board. Removes provisions concerning initial terms of office for Board members. Makes conforming and other changes. Effective January 1, 2022.

Comment: oppose physician assistant prescriptive authority and collaborative agreements (note: coordinate with ISMS; review pending amendment compromise; see companion HB1826; refiling of SB2758/HB4692 from 101st GA)

SB 00677

Sen. Ram Villivalam

(Rep. Kathleen Willis)

Amend

Senate Committee Amendment No. 2:

Replaces everything after the enacting clause. Amends the Department of Professional Regulation Law of the Civil Administrative Code of Illinois. Provides that for license or registration renewals occurring on or after January 1, 2023, a health care professional who has continuing education requirements must complete at least a one-hour course in training on the diagnosis, treatment, and care of individuals with Alzheimer's disease and other dementias per renewal period. Provides that the training shall include, but not be limited to, assessment and diagnosis, effective communication strategies, and management and care planning. Provides that the requirement shall only apply to health care professionals who provide health care services to adult populations age 26 or older in the practice of their profession. Provides that a health care professional may count that one hour for completion of the course toward meeting the minimum credit hours required for continuing education. Provides that any training on Alzheimer's disease and other dementias applied to meet any other State licensure requirement, professional accreditation or certification requirement, or health care institutional practice agreement may count toward the continuing education requirement. Provides that the Department of Financial and Professional Regulation may adopt rules for the implementation of the continuing education requirement. Effective immediately.


Senate Floor Amendment No. 4:

Provides that the continuing education requirements shall only apply to health care professionals who provide health care services to, and have direct patient interactions with (rather than who provide health care services to), adult populations age 26 or older in the practice of their profession.

Comment: Oppose as introduced (note: amendments limit CME to one hour with exemption for pediatricians; as introduced, see similar HB335 and HB1823; initiative of Alzheimer's Association, supported by Lt. Gov; initiative of Illinois Alzheimer's Association, supported by Illinois Lt. Governor; possible alternatives in 101st GA ILBC legislation regarding “adult protective services dementia training,”; see AAFP Cognitive Care Kit; see IDPH 2016 Alzheimer's State Plan; see US Preventative Services Task Force: Cognitive Impairment Screening; see FY2022 $1million IDPH alzheimer's appropriation, see SB448 page 29, line 1; see ILBC IDOA dementia training mandate, see HB158 page 64, line 23; refiling of HB4725/3186 from 101st GA

SB 02008

Sen. David Koehler

Support

Synopsis As Introduced:

Amends the Illinois Insurance Code. Provides that if a generic equivalent for a brand name drug is approved by the federal Food and Drug Administration, plans that provide coverage for prescription drugs through the use of a drug formulary that are amended, delivered, issued, or renewed in the State on or after January 1, 2022 shall comply with specified requirements. Provides that the Department of Insurance may adopt rules to implement provisions concerning notice of change of drug formulary. In provisions concerning a contract between a health insurer and a pharmacy benefit manager, provides that a pharmacy benefit manager must update and publish maximum allowable cost pricing information according to specified requirements, must provide a reasonable administrative appeal procedure to allow pharmacies to challenge maximum allowable costs, and must comply with specified requirements if an appeal is denied. Sets forth provisions concerning pharmacy benefit manager contracts; specified requirements that a pharmacy benefit manager shall comply with; specified requirements that an auditing entity shall comply with when conducting a pharmacy audit; and specified requirements concerning pharmacy network access standards. Provides that a violation of specified provisions is an unfair method of competition and unfair and deceptive act or practice in the business of insurance. Sets forth provisions concerning applicability of the Pharmacy Benefit Managers Article of the Illinois Insurance Code, and provisions concerning fiduciary responsibility of a pharmacy benefit manager. Defines terms. Makes other changes. Amends the Illinois Public Aid Code. Sets forth provisions concerning reimbursement of professional dispensing fees and acquisition costs for pharmacy providers.


Senate Committee Amendment No. 1:

Replaces everything after the enacting clause with the provisions of the introduced bill with the following changes. Provides that a pharmacy may not be subject to a chargeback or recoupment for a clerical or recordkeeping error in a required document or record unless the pharmacy benefit manager can provide proof of intent to commit fraud or such error results in actual financial harm to the pharmacy benefit manager, a health plan managed by the pharmacy benefit manager, or a consumer. Removes various provisions concerning pharmacy benefit manager contracts. Defines "spread pricing". Removes various definitions. Amends the Network Adequacy and Transparency Act. In provisions concerning pharmacy payments under the Medical Assistance Article of the Illinois Public Aid Code, provides that the Department of Healthcare and Family Services may reimburse a pharmacy owned by an entity participating in the federal Drug Pricing Program under the federal Public Health Service Act, for drugs purchased under the Program, an amount equal to or greater than the ceiling price calculated under the federal Act. Provides that all Medicaid managed care organizations must reimburse a pharmacy participating in the federal Drug Pricing Program, for drugs purchased under the Program, an amount equal to or greater than the current national average drug acquisition cost listing for the pharmaceutical product. Provides that the Department, a Medicaid managed care organization, and a pharmacy benefit manager under contract with a Medicaid managed care provider to reimburse pharmacy providers shall not prohibit any entity or pharmacy participating in the federal Drug Pricing Program from using drugs purchased under the federal Act when submitting claims for pharmaceutical reimbursement. Makes other changes.


(Comment: Illinois Pharmacists Association initiative; ISMS supports as introduced; see companion SB2008; see also AAFP Patient-Centered Formularies Guidance and AAFP Drug Pricing Transparency Statement)

SB 02272

Sen. David Koehler

Oppose

Amends the Clinical Psychologist Licensing Act. In provisions concerning clinical training requirements for a prescribing psychologist license, makes changes to facility requirements for that clinical training. In language providing that a written delegation of prescriptive authority by a collaborating physician may only include medications for the treatment of mental health disease or illness the collaborating physician generally provides to his or her patients in the normal course of his or her clinical practice, deletes an exception for patients who are less than 17 years of age or over 65 years of age. In a provision concerning the delegation of prescriptive authority, removes language providing that no Schedule II controlled substance shall be delegated. Effective immediately.

Comment: oppose expanded scope of practice (note: IPS & ISMS oppose; see also HB1489)

Recent History Administrative Actions & Legislative Initiatives

Telehealth Executive Order 2020-09

(issued on March 19, 2020)

Support

Governor Pritzker issued an executive order with coinciding emergency rulemaking from the Department of Insurance, regarding the state's response to COVID-19, predominately around telehealth. The order covers non-ERISA commercial insurers and requires the following:

  • In-network coverage requirement for telehealth services

  • Prohibits unnecessary utilization control for telehealth

  • No cost-sharing for in-network telehealth (high-deductible plan exception)

  • Telehealth may be provided by any in-network provider regardless if they were previously designated as a telehealth provider

Comment: the accompanying emergency rules also require Medicaid providers to be reimbursed at the same rate at which they are reimbursed for in-person visits; click here for futher details; click here for 2020 IAFP telehealth statement

Healthcare Affordability & Feasability Study

(Public Act 101-649)

Support

"The Department of Healthcare and Family Services, in consultation with the Department of Insurance, shall oversee a feasibility study to explore options to make health insurance more affordable for low-income and middle-income residents. The study shall include policies targeted at increasing health care affordability and access, including policies being discussed in other states and nationally. The study shall follow the best practices of other states and include an Illinois-specific actuarial and economic analysis of demographic and market dynamics."

Comment: click here for IAFP's feasibility study submission and click here for DHFS-IDOI response

IDPH Immunization Standards

Pending Review

The 2020 proposed legislation intended to comprehensively address immunization standards and thresholds in Illinois:

  • Elimination of religious exemption

  • Strengthen medical objection

  • Mandate immunization registry by mandating all providers who administer vaccines in the state of Illinois to become a certified I-CARE user and enter specific data about their patients who receive the vaccines

  • Reduce age for consent by allowing minors 14 and over to seek out immunizations

Comment: see Senate Bill 3668 from the 101st General Assembly; further review necessary regarding I-Care programming efficiencies and application of data entry to all providers

Prescription Drug Affordability

Support

Comment: click here for the 2020 coalition fact sheet; watch for consideration of affordable vs. anti-competitive impacts; click here for February 25, 2020 press conference (subscription required)

Illinois Federally Qualified Health Centers Coverage

Support

Unfiled 2020 legislation was intended to clarify and update Illinois law regarding coverage through Federally Qualified Health Centers (FQHCs):

  • Provide needed protection and clarity in the federal 340B drug discount program

  • Establish rates that reimburse Illinois FQHCs at 100% of their reasonable costs

  • Direct HFS and IPHCA to collaborate in the development of a value-based Alternative Payment Methodology (APM) for FQHCs

  • Ensure FQHCs receive necessary supplemental or wrap-around payments

  • Allow FQHCs to bill vaccines at a FFS rate outside of their encounter rate, so that patients can receive their vaccines in the clinical setting

  • Require MCOs to reimburse FQHCs for services rendered to a Medicaid patient, regardless of whether they are empaneled with the FQHC

  • Prohibit Medicaid managed care organizations (MCOs) operating in Illinois from denying FQHC claims for medical and behavioral health services rendered on the same day

  • Establish $50 million in new state resources for provider student loan forgiveness

  • Allow licensed providers who are relocating to Illinois from other states to temporarily practice under their originating state license until the Illinois Department of Financial and Professional Registration process their Illinois license

Comment: legislative activity to be coordinated with the Illinois Primary Health Care Association; click here for the IPHCA summary of legislation

Support

The Governor's Office in conjunction with the state's Opioid Crisis Response Advisory Council created an Opioid Social Equity Committee as one of several sub-committees to make policy recommendations regarding how to address social and racial disparities in the opioid crisis response. They have also been tasked with establishing local recovery-oriented systems of care councils in communities that have been disproportionately impacted by the crisis in order to reach out to and engage individuals in all stages of recovery. For more information, click here regarding the Illinois Opioid Action Plan and click here for the executive order press release.

Support

Effective February 5, 2020, the Illinois Governor's office announced the release of $50 million in funding for the first round of matching grants of Connect Illinois, the state's $420 million statewide broadband expansion. "Applicants are anticipated to include internet service providers, rural cooperatives, nonprofits and local governments. Grant responses for the initial $50 million round of funding can be submitted through Friday, April 3, 2020. Up to $5 million per project will be available during the first round, and subsequent rounds will follow over the course of the next several years."

Underserved Physician Workforce Act

(Public Act 101-118)

Support

Creates the Act to the Underserved Physician Workforce Act. Provides that the Act applies to primary care physicians, general surgeons, emergency medicine physicians, or obstetricians (rather than primary care physicians and other eligible primary care providers). Defines "primary care physician". Makes conforming and other changes, including amending the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois, Nurses in Advancement Law, Private Medical Scholarship Agreement Act, and Illinois Public Aid Code.

Comment: click here for related information regarding Illinois Family Medicine Residency Programs; click here for IAFP's administrative rules submission.

Illinois Health Care Right of Conscience Act

(Public Act 99-690, eff. January 1, 2017)

Support

The Health Care Right of Conscience Act (HCRCA) in Illinois generally protects health care providers from liability and professional discipline for withholding care because of a religious or conscience-based belief. In 2016, the Illinois General Assembly amended HCRCA to require that health care providers have policies in place to ensure that patients receive enough information about their conditions and treatment options to make intelligent choices about their care. Unless such policies are adopted and followed, providers may not claim the protections of HCRCA when denial of treatment leads to injury. Litigation regarding the Illinois Health Care Right of Conscience Act is ongoing. Click here for more background and click here for the related ACLU amicus brief.