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1		AN ACT concerning health.
2		Be it enacted by the People of the State of Illinois,
3		represented in the General Assembly:
4		Section 5. "An Act concerning regulation", approved
5		January 13, 2023, Public Act 102-1117, is amended by changing
6		Section 99-99 as follows:
7		(P.A. 102-1117, Sec. 99-99)
8		Sec. 99-99. Effective date. This Act takes effect upon
9		becoming law, except that Article 16 takes effect on January
10		1, 2025.
11		(Source: P.A. 102-1117, eff. 1-13-23.)
12		Section 10. The State Employees Group Insurance Act of
13		1971 is amended by changing Section 6.11 as follows:
14		(5 ILCS 375/6.11)
15		(Text of Section before amendment by P.A. 102-768)
16		Sec. 6.11. Required health benefits; Illinois Insurance
17		Code requirements. The program of health benefits shall
18		provide the post-mastectomy care benefits required to be
19		covered by a policy of accident and health insurance under
20		Section 356t of the Illinois Insurance Code. The program of
21		health benefits shall provide the coverage required under

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1		Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x,
2		356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10,
3		356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22,
4		356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
5		356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
6		356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and
7		356z.62 of the Illinois Insurance Code. The program of health
8		benefits must comply with Sections 155.22a, 155.37, 355b,
9		356z.19, 370c, and 370c.1 and Article XXXIIB of the Illinois
10		Insurance Code. The Department of Insurance shall enforce the
11		requirements of this Section with respect to Sections 370c and
12		370c.1 of the Illinois Insurance Code; all other requirements
13		of this Section shall be enforced by the Department of Central
14		Management Services.
15		Rulemaking authority to implement Public Act 95-1045, if
16		any, is conditioned on the rules being adopted in accordance
17		with all provisions of the Illinois Administrative Procedure
18		Act and all rules and procedures of the Joint Committee on
19		Administrative Rules; any purported rule not so adopted, for
20		whatever reason, is unauthorized.
21		(Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20;
22		101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff.
23		1-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103,
24		eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
25		102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
26		1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,

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1		eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
2		revised 12-13-22.)
3		(Text of Section after amendment by P.A. 102-768)
4		Sec. 6.11. Required health benefits; Illinois Insurance
5		Code requirements. The program of health benefits shall
6		provide the post-mastectomy care benefits required to be
7		covered by a policy of accident and health insurance under
8		Section 356t of the Illinois Insurance Code. The program of
9		health benefits shall provide the coverage required under
10		Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x,
11		356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10,
12		356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22,
13		356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
14		356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
15		356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.59, and
16		356z.60, and 356z.62 of the Illinois Insurance Code. The
17		program of health benefits must comply with Sections 155.22a,
18		155.37, 355b, 356z.19, 370c, and 370c.1 and Article XXXIIB of
19		the Illinois Insurance Code. The Department of Insurance shall
20		enforce the requirements of this Section with respect to
21		Sections 370c and 370c.1 of the Illinois Insurance Code; all
22		other requirements of this Section shall be enforced by the
23		Department of Central Management Services.
24		Rulemaking authority to implement Public Act 95-1045, if
25		any, is conditioned on the rules being adopted in accordance

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1		with all provisions of the Illinois Administrative Procedure
2		Act and all rules and procedures of the Joint Committee on
3		Administrative Rules; any purported rule not so adopted, for
4		whatever reason, is unauthorized.
5		(Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20;
6		101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff.
7		1-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103,
8		eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
9		102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
10		1-1-23; 102-768, eff. 1-1-24; 102-804, eff. 1-1-23; 102-813,
11		eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, eff. 1-1-23;
12		102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
13		Section 15. The Criminal Identification Act is amended by
14		changing Section 3.2 as follows:
15		(20 ILCS 2630/3.2) (from Ch. 38, par. 206-3.2)
16		Sec. 3.2. (a) It is the duty of any person conducting or
17		operating a medical facility, or any physician or nurse as
18		soon as treatment permits to notify the local law enforcement
19		agency of that jurisdiction upon the application for treatment
20		of a person who is not accompanied by a law enforcement
21		officer, when it reasonably appears that the person requesting
22		treatment has received:
23		(1) any injury resulting from the discharge of a
24		firearm; or

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1		(2) any injury sustained in the commission of or as a
2		victim of a criminal offense.
3		Any hospital, physician or nurse shall be forever held
4		harmless from any civil liability for their reasonable
5		compliance with the provisions of this Section.
6		(b) Notwithstanding subsection (a), nothing in this
7		Section shall be construed to require the reporting of lawful
8		health care activity, whether such activity may constitute a
9		violation of another state's law.
10		(c) As used in this Section:
11		"Lawful health care" means:
12		(1) reproductive health care that is not unlawful
13		under the laws of this State or was not unlawful under the
14		laws of this State as of January 13, 2023 (the effective
15		date of Public Act 102-1117), including on any theory of
16		vicarious, joint, several, or conspiracy liability; or
17		(2) the treatment of gender dysphoria or the
18		affirmation of an individual's gender identity or gender
19		expression, including but not limited to, all supplies,
20		care, and services of a medical, behavioral health, mental
21		health, surgical, psychiatric, therapeutic, diagnostic,
22		preventative, rehabilitative, or supportive nature that is
23		not unlawful under the laws of this State or was not
24		unlawful under the laws of this State as of January 13,
25		2023 (the effective date of Public Act 102-1117),
26		including on any theory of vicarious, joint, several, or

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1		conspiracy liability.
2		"Lawful health care activity" means seeking, providing,
3		receiving, assisting in seeking, providing, or receiving,
4		providing material support for, or traveling to obtain lawful
5		health care.
6		(Source: P.A. 102-1117, eff. 1-13-23.)
7		Section 20. The Counties Code is amended by changing
8		Section 5-1069.3 as follows:
9		(55 ILCS 5/5-1069.3)
10		Sec. 5-1069.3. Required health benefits. If a county,
11		including a home rule county, is a self-insurer for purposes
12		of providing health insurance coverage for its employees, the
13		coverage shall include coverage for the post-mastectomy care
14		benefits required to be covered by a policy of accident and
15		health insurance under Section 356t and the coverage required
16		under Sections 356g, 356g.5, 356g.5-1, 356q, 356u, 356w, 356x,
17		356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11,
18		356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26,
19		356z.29, 356z.30a, 356z.32, 356z.33, 356z.36, 356z.40,
20		356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53,
21		356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and 356z.62
22		of the Illinois Insurance Code. The coverage shall comply with
23		Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
24		Insurance Code. The Department of Insurance shall enforce the

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1		requirements of this Section. The requirement that health
2		benefits be covered as provided in this Section is an
3		exclusive power and function of the State and is a denial and
4		limitation under Article VII, Section 6, subsection (h) of the
5		Illinois Constitution. A home rule county to which this
6		Section applies must comply with every provision of this
7		Section.
8		Rulemaking authority to implement Public Act 95-1045, if
9		any, is conditioned on the rules being adopted in accordance
10		with all provisions of the Illinois Administrative Procedure
11		Act and all rules and procedures of the Joint Committee on
12		Administrative Rules; any purported rule not so adopted, for
13		whatever reason, is unauthorized.
14		(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
15		101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
16		1-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
17		eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22;
18		102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
19		1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
20		eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
21		102-1117, eff. 1-13-23.)
22		Section 25. The Illinois Municipal Code is amended by
23		changing Section 10-4-2.3 as follows:
24		(65 ILCS 5/10-4-2.3)

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1		Sec. 10-4-2.3. Required health benefits. If a
2		municipality, including a home rule municipality, is a
3		self-insurer for purposes of providing health insurance
4		coverage for its employees, the coverage shall include
5		coverage for the post-mastectomy care benefits required to be
6		covered by a policy of accident and health insurance under
7		Section 356t and the coverage required under Sections 356g,
8		356g.5, 356g.5-1, 356q, 356u, 356w, 356x, 356z.4, 356z.4a,
9		356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
10		356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29,
11		356z.30a, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41,
12		356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54,
13		356z.56, 356z.57, 356z.59, and 356z.60, and 356z.62 of the
14		Illinois Insurance Code. The coverage shall comply with
15		Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
16		Insurance Code. The Department of Insurance shall enforce the
17		requirements of this Section. The requirement that health
18		benefits be covered as provided in this is an exclusive power
19		and function of the State and is a denial and limitation under
20		Article VII, Section 6, subsection (h) of the Illinois
21		Constitution. A home rule municipality to which this Section
22		applies must comply with every provision of this Section.
23		Rulemaking authority to implement Public Act 95-1045, if
24		any, is conditioned on the rules being adopted in accordance
25		with all provisions of the Illinois Administrative Procedure
26		Act and all rules and procedures of the Joint Committee on

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1		Administrative Rules; any purported rule not so adopted, for
2		whatever reason, is unauthorized.
3		(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
4		101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
5		1-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
6		eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22;
7		102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
8		1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
9		eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
10		102-1117, eff. 1-13-23.)
11		Section 30. The School Code is amended by changing Section
12		10-22.3f as follows:
13		(105 ILCS 5/10-22.3f)
14		Sec. 10-22.3f. Required health benefits. Insurance
15		protection and benefits for employees shall provide the
16		post-mastectomy care benefits required to be covered by a
17		policy of accident and health insurance under Section 356t and
18		the coverage required under Sections 356g, 356g.5, 356g.5-1,
19		356q, 356u, 356w, 356x, 356z.4, 356z.4a, 356z.6, 356z.8,
20		356z.9, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22,
21		356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
22		356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
23		356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and
24		356z.62 of the Illinois Insurance Code. Insurance policies

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1		shall comply with Section 356z.19 of the Illinois Insurance
2		Code. The coverage shall comply with Sections 155.22a, 355b,
3		and 370c of the Illinois Insurance Code. The Department of
4		Insurance shall enforce the requirements of this Section.
5		Rulemaking authority to implement Public Act 95-1045, if
6		any, is conditioned on the rules being adopted in accordance
7		with all provisions of the Illinois Administrative Procedure
8		Act and all rules and procedures of the Joint Committee on
9		Administrative Rules; any purported rule not so adopted, for
10		whatever reason, is unauthorized.
11		(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
12		101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
13		1-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
14		eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff. 1-1-22;
15		102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-804, eff.
16		1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860,
17		eff. 1-1-23; 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
18		Section 35. The Illinois Insurance Code is amended by
19		changing Section 356z.4 and by adding Section 356z.62 as
20		follows:
21		(215 ILCS 5/356z.4)
22		Sec. 356z.4. Coverage for contraceptives.
23		(a)(1) The General Assembly hereby finds and declares all
24		of the following:

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1		(A) Illinois has a long history of expanding timely
2		access to birth control to prevent unintended pregnancy.
3		(B) The federal Patient Protection and Affordable Care
4		Act includes a contraceptive coverage guarantee as part of
5		a broader requirement for health insurance to cover key
6		preventive care services without out-of-pocket costs for
7		patients.
8		(C) The General Assembly intends to build on existing
9		State and federal law to promote gender equity and women's
10		health and to ensure greater contraceptive coverage equity
11		and timely access to all federal Food and Drug
12		Administration approved methods of birth control for all
13		individuals covered by an individual or group health
14		insurance policy in Illinois.
15		(D) Medical management techniques such as denials,
16		step therapy, or prior authorization in public and private
17		health care coverage can impede access to the most
18		effective contraceptive methods.
19		(2) As used in this subsection (a):
20		"Contraceptive services" includes consultations,
21		examinations, procedures, and medical services related to the
22		use of contraceptive methods (including natural family
23		planning) to prevent an unintended pregnancy.
24		"Medical necessity", for the purposes of this subsection
25		(a), includes, but is not limited to, considerations such as
26		severity of side effects, differences in permanence and

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1		reversibility of contraceptive, and ability to adhere to the
2		appropriate use of the item or service, as determined by the
3		attending provider.
4		"Therapeutic equivalent version" means drugs, devices, or
5		products that can be expected to have the same clinical effect
6		and safety profile when administered to patients under the
7		conditions specified in the labeling and satisfy the following
8		general criteria:
9		(i) they are approved as safe and effective;
10		(ii) they are pharmaceutical equivalents in that they
11		(A) contain identical amounts of the same active drug
12		ingredient in the same dosage form and route of
13		administration and (B) meet compendial or other applicable
14		standards of strength, quality, purity, and identity;
15		(iii) they are bioequivalent in that (A) they do not
16		present a known or potential bioequivalence problem and
17		they meet an acceptable in vitro standard or (B) if they do
18		present such a known or potential problem, they are shown
19		to meet an appropriate bioequivalence standard;
20		(iv) they are adequately labeled; and
21		(v) they are manufactured in compliance with Current
22		Good Manufacturing Practice regulations.
23		(3) An individual or group policy of accident and health
24		insurance amended, delivered, issued, or renewed in this State
25		after the effective date of this amendatory Act of the 99th
26		General Assembly shall provide coverage for all of the

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1		following services and contraceptive methods:
2		(A) All contraceptive drugs, devices, and other
3		products approved by the United States Food and Drug
4		Administration. This includes all over-the-counter
5		contraceptive drugs, devices, and products approved by the
6		United States Food and Drug Administration, excluding male
7		condoms, except as provided in the current comprehensive
8		guidelines supported by the Health Resources and Services
9		Administration. The following apply:
10		(i) If the United States Food and Drug
11		Administration has approved one or more therapeutic
12		equivalent versions of a contraceptive drug, device,
13		or product, a policy is not required to include all
14		such therapeutic equivalent versions in its formulary,
15		so long as at least one is included and covered without
16		cost-sharing and in accordance with this Section.
17		(ii) If an individual's attending provider
18		recommends a particular service or item approved by
19		the United States Food and Drug Administration based
20		on a determination of medical necessity with respect
21		to that individual, the plan or issuer must cover that
22		service or item without cost sharing. The plan or
23		issuer must defer to the determination of the
24		attending provider.
25		(iii) If a drug, device, or product is not
26		covered, plans and issuers must have an easily

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1		accessible, transparent, and sufficiently expedient
2		process that is not unduly burdensome on the
3		individual or a provider or other individual acting as
4		a patient's authorized representative to ensure
5		coverage without cost sharing.
6		(iv) This coverage must provide for the dispensing
7		of 12 months' worth of contraception at one time.
8		(B) Voluntary sterilization procedures.
9		(C) Contraceptive services, patient education, and
10		counseling on contraception.
11		(D) Follow-up services related to the drugs, devices,
12		products, and procedures covered under this Section,
13		including, but not limited to, management of side effects,
14		counseling for continued adherence, and device insertion
15		and removal.
16		(4) Except as otherwise provided in this subsection (a), a
17		policy subject to this subsection (a) shall not impose a
18		deductible, coinsurance, copayment, or any other cost-sharing
19		requirement on the coverage provided. The provisions of this
20		paragraph do not apply to coverage of voluntary male
21		sterilization procedures to the extent such coverage would
22		disqualify a high-deductible health plan from eligibility for
23		a health savings account pursuant to the federal Internal
24		Revenue Code, 26 U.S.C. 223.
25		(5) Except as otherwise authorized under this subsection
26		(a), a policy shall not impose any restrictions or delays on

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1		the coverage required under this subsection (a).
2		(6) If, at any time, the Secretary of the United States
3		Department of Health and Human Services, or its successor
4		agency, promulgates rules or regulations to be published in
5		the Federal Register or publishes a comment in the Federal
6		Register or issues an opinion, guidance, or other action that
7		would require the State, pursuant to any provision of the
8		Patient Protection and Affordable Care Act (Public Law
9		111-148), including, but not limited to, 42 U.S.C.
10		18031(d)(3)(B) or any successor provision, to defray the cost
11		of any coverage outlined in this subsection (a), then this
12		subsection (a) is inoperative with respect to all coverage
13		outlined in this subsection (a) other than that authorized
14		under Section 1902 of the Social Security Act, 42 U.S.C.
15		1396a, and the State shall not assume any obligation for the
16		cost of the coverage set forth in this subsection (a).
17		(b) This subsection (b) shall become operative if and only
18		if subsection (a) becomes inoperative.
19		An individual or group policy of accident and health
20		insurance amended, delivered, issued, or renewed in this State
21		after the date this subsection (b) becomes operative that
22		provides coverage for outpatient services and outpatient
23		prescription drugs or devices must provide coverage for the
24		insured and any dependent of the insured covered by the policy
25		for all outpatient contraceptive services and all outpatient
26		contraceptive drugs and devices approved by the Food and Drug

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1		Administration. Coverage required under this Section may not
2		impose any deductible, coinsurance, waiting period, or other
3		cost-sharing or limitation that is greater than that required
4		for any outpatient service or outpatient prescription drug or
5		device otherwise covered by the policy.
6		Nothing in this subsection (b) shall be construed to
7		require an insurance company to cover services related to
8		permanent sterilization that requires a surgical procedure.
9		As used in this subsection (b), "outpatient contraceptive
10		service" means consultations, examinations, procedures, and
11		medical services, provided on an outpatient basis and related
12		to the use of contraceptive methods (including natural family
13		planning) to prevent an unintended pregnancy.
14		(c) (Blank).
15		(d) If a plan or issuer utilizes a network of providers,
16		nothing in this Section shall be construed to require coverage
17		or to prohibit the plan or issuer from imposing cost-sharing
18		for items or services described in this Section that are
19		provided or delivered by an out-of-network provider, unless
20		the plan or issuer does not have in its network a provider who
21		is able to or is willing to provide the applicable items or
22		services.
23		(Source: P.A. 100-1102, eff. 1-1-19; 101-13, eff. 6-12-19.)
24		(215 ILCS 5/356z.62 new)
25		Sec. 356z.62. Coverage of preventive health services.

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1		(a) A policy of group health insurance coverage or
2		individual health insurance coverage as defined in Section 5
3		of the Illinois Health Insurance Portability and
4		Accountability Act shall, at a minimum, provide coverage for
5		and shall not impose any cost-sharing requirements, including
6		a copayment, coinsurance, or deductible, for:
7		(1) evidence-based items or services that have in
8		effect a rating of "A" or "B" in the current
9		recommendations of the United States Preventive Services
10		Task Force;
11		(2) immunizations that have in effect a recommendation
12		from the Advisory Committee on Immunization Practices of
13		the Centers for Disease Control and Prevention with
14		respect to the individual involved;
15		(3) with respect to infants, children, and
16		adolescents, evidence-informed preventive care and
17		screenings provided for in the comprehensive guidelines
18		supported by the Health Resources and Services
19		Administration; and
20		(4) with respect to women, such additional preventive
21		care and screenings not described in paragraph (1) of this
22		subsection (a) as provided for in comprehensive guidelines
23		supported by the Health Resources and Services
24		Administration for purposes of this paragraph.
25		(b) For purposes of this Section, and for purposes of any
26		other provision of State law, recommendations of the United

SB1561 Enrolled - 18 - LRB103 27713 CPF 54090 b
1		States Preventive Services Task Force regarding breast cancer
2		screening, mammography, and prevention issued in or around
3		November 2009 are not considered to be current.
4		(c) For office visits:
5		(1) if an item or service described in subsection (a)
6		is billed separately or is tracked as individual encounter
7		data separately from an office visit, then a policy may
8		impose cost-sharing requirements with respect to the
9		office visit;
10		(2) if an item or service described in subsection (a)
11		is not billed separately or is not tracked as individual
12		encounter data separately from an office visit and the
13		primary purpose of the office visit is the delivery of
14		such an item or service, then a policy may not impose
15		cost-sharing requirements with respect to the office
16		visit; and
17		(3) if an item or service described in subsection (a)
18		is not billed separately or is not tracked as individual
19		encounter data separately from an office visit and the
20		primary purpose of the office visit is not the delivery of
21		such an item or service, then a policy may impose
22		cost-sharing requirements with respect to the office
23		visit.
24		(d) A policy must provide coverage pursuant to subsection
25		(a) for plan or policy years that begin on or after the date
26		that is one year after the date the recommendation or

SB1561 Enrolled - 19 - LRB103 27713 CPF 54090 b
1		guideline is issued. If a recommendation or guideline is in
2		effect on the first day of the plan or policy year, the policy
3		shall cover the items and services specified in the
4		recommendation or guideline through the last day of the plan
5		or policy year unless either:
6		(1) a recommendation under paragraph (1) of subsection
7		(a) is downgraded to a "D" rating; or
8		(2) the item or service is subject to a safety recall
9		or is otherwise determined to pose a significant safety
10		concern by a federal agency authorized to regulate the
11		item or service during the plan or policy year.
12		(e) Network limitations.
13		(1) Subject to paragraph (3) of this subsection,
14		nothing in this Section requires coverage for items or
15		services described in subsection (a) that are delivered by
16		an out-of-network provider under a health maintenance
17		organization health care plan, other than a
18		point-of-service contract, or under a voluntary health
19		services plan that generally excludes coverage for
20		out-of-network services except as otherwise required by
21		law.
22		(2) Subject to paragraph (3) of this subsection,
23		nothing in this Section precludes a policy with a
24		preferred provider program under Article XX-1/2 of this
25		Code, a health maintenance organization point-of-service
26		contract, or a similarly designed voluntary health

SB1561 Enrolled - 20 - LRB103 27713 CPF 54090 b
1		services plan from imposing cost-sharing requirements for
2		items or services described in subsection (a) that are
3		delivered by an out-of-network provider.
4		(3) If a policy does not have in its network a provider
5		who can provide an item or service described in subsection
6		(a), then the policy must cover the item or service when
7		performed by an out-of-network provider and it may not
8		impose cost-sharing with respect to the item or service.
9		(f) Nothing in this Section prevents a company from using
10		reasonable medical management techniques to determine the
11		frequency, method, treatment, or setting for an item or
12		service described in subsection (a) to the extent not
13		specified in the recommendation or guideline.
14		(g) Nothing in this Section shall be construed to prohibit
15		a policy from providing coverage for items or services in
16		addition to those required under subsection (a) or from
17		denying coverage for items or services that are not required
18		under subsection (a). Unless prohibited by other law, a policy
19		may impose cost-sharing requirements for a treatment not
20		described in subsection (a) even if the treatment results from
21		an item or service described in subsection (a). Nothing in
22		this Section shall be construed to limit coverage requirements
23		provided under other law.
24		(h) The Director may develop guidelines to permit a
25		company to utilize value-based insurance designs. In the
26		absence of guidelines developed by the Director, any such

SB1561 Enrolled - 21 - LRB103 27713 CPF 54090 b
1		guidelines developed by the Secretary of the U.S. Department
2		of Health and Human Services that are in force under 42 U.S.C.
3		300gg-13 shall apply.
4		(i) For student health insurance coverage as defined at 45
5		CFR 147.145, student administrative health fees are not
6		considered cost-sharing requirements with respect to
7		preventive services specified under subsection (a). As used in
8		this subsection, "student administrative health fee" means a
9		fee charged by an institution of higher education on a
10		periodic basis to its students to offset the cost of providing
11		health care through health clinics regardless of whether the
12		students utilize the health clinics or enroll in student
13		health insurance coverage.
14		(j) For any recommendation or guideline specifically
15		referring to women or men, a company shall not deny or limit
16		the coverage required or a claim made under subsection (a)
17		based solely on the individual's recorded sex or actual or
18		perceived gender identity, or for the reason that the
19		individual is gender nonconforming, intersex, transgender, or
20		has undergone, or is in the process of undergoing, gender
21		transition, if, notwithstanding the sex or gender assigned at
22		birth, the covered individual meets the conditions for the
23		recommendation or guideline at the time the item or service is
24		furnished.
25		(k) This Section does not apply to grandfathered health
26		plans, excepted benefits, or short-term, limited-duration

SB1561 Enrolled - 22 - LRB103 27713 CPF 54090 b
1		health insurance coverage.
2		Section 40. The Health Maintenance Organization Act is
3		amended by changing Section 5-3 as follows:
4		(215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)
5		Sec. 5-3. Insurance Code provisions.
6		(a) Health Maintenance Organizations shall be subject to
7		the provisions of Sections 133, 134, 136, 137, 139, 140,
8		141.1, 141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153,
9		154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 355.2,
10		355.3, 355b, 355c, 356g.5-1, 356m, 356q, 356v, 356w, 356x,
11		356y, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6,
12		356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14,
13		356z.15, 356z.17, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25,
14		356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.33,
15		356z.35, 356z.36, 356z.40, 356z.41, 356z.46, 356z.47, 356z.48,
16		356z.50, 356z.51, 356z.53 256z.53, 356z.54, 356z.56, 356z.57,
17		356z.59, 356z.60, 356z.62, 364, 364.01, 364.3, 367.2, 367.2-5,
18		367i, 368a, 368b, 368c, 368d, 368e, 370c, 370c.1, 401, 401.1,
19		402, 403, 403A, 408, 408.2, 409, 412, 444, and 444.1,
20		paragraph (c) of subsection (2) of Section 367, and Articles
21		IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and
22		XXXIIB of the Illinois Insurance Code.
23		(b) For purposes of the Illinois Insurance Code, except
24		for Sections 444 and 444.1 and Articles XIII and XIII 1/2,

SB1561 Enrolled - 23 - LRB103 27713 CPF 54090 b
1		Health Maintenance Organizations in the following categories
2		are deemed to be "domestic companies":
3		(1) a corporation authorized under the Dental Service
4		Plan Act or the Voluntary Health Services Plans Act;
5		(2) a corporation organized under the laws of this
6		State; or
7		(3) a corporation organized under the laws of another
8		state, 30% or more of the enrollees of which are residents
9		of this State, except a corporation subject to
10		substantially the same requirements in its state of
11		organization as is a "domestic company" under Article VIII
12		1/2 of the Illinois Insurance Code.
13		(c) In considering the merger, consolidation, or other
14		acquisition of control of a Health Maintenance Organization
15		pursuant to Article VIII 1/2 of the Illinois Insurance Code,
16		(1) the Director shall give primary consideration to
17		the continuation of benefits to enrollees and the
18		financial conditions of the acquired Health Maintenance
19		Organization after the merger, consolidation, or other
20		acquisition of control takes effect;
21		(2)(i) the criteria specified in subsection (1)(b) of
22		Section 131.8 of the Illinois Insurance Code shall not
23		apply and (ii) the Director, in making his determination
24		with respect to the merger, consolidation, or other
25		acquisition of control, need not take into account the
26		effect on competition of the merger, consolidation, or

SB1561 Enrolled - 24 - LRB103 27713 CPF 54090 b
1		other acquisition of control;
2		(3) the Director shall have the power to require the
3		following information:
4		(A) certification by an independent actuary of the
5		adequacy of the reserves of the Health Maintenance
6		Organization sought to be acquired;
7		(B) pro forma financial statements reflecting the
8		combined balance sheets of the acquiring company and
9		the Health Maintenance Organization sought to be
10		acquired as of the end of the preceding year and as of
11		a date 90 days prior to the acquisition, as well as pro
12		forma financial statements reflecting projected
13		combined operation for a period of 2 years;
14		(C) a pro forma business plan detailing an
15		acquiring party's plans with respect to the operation
16		of the Health Maintenance Organization sought to be
17		acquired for a period of not less than 3 years; and
18		(D) such other information as the Director shall
19		require.
20		(d) The provisions of Article VIII 1/2 of the Illinois
21		Insurance Code and this Section 5-3 shall apply to the sale by
22		any health maintenance organization of greater than 10% of its
23		enrollee population (including without limitation the health
24		maintenance organization's right, title, and interest in and
25		to its health care certificates).
26		(e) In considering any management contract or service

SB1561 Enrolled - 25 - LRB103 27713 CPF 54090 b
1		agreement subject to Section 141.1 of the Illinois Insurance
2		Code, the Director (i) shall, in addition to the criteria
3		specified in Section 141.2 of the Illinois Insurance Code,
4		take into account the effect of the management contract or
5		service agreement on the continuation of benefits to enrollees
6		and the financial condition of the health maintenance
7		organization to be managed or serviced, and (ii) need not take
8		into account the effect of the management contract or service
9		agreement on competition.
10		(f) Except for small employer groups as defined in the
11		Small Employer Rating, Renewability and Portability Health
12		Insurance Act and except for medicare supplement policies as
13		defined in Section 363 of the Illinois Insurance Code, a
14		Health Maintenance Organization may by contract agree with a
15		group or other enrollment unit to effect refunds or charge
16		additional premiums under the following terms and conditions:
17		(i) the amount of, and other terms and conditions with
18		respect to, the refund or additional premium are set forth
19		in the group or enrollment unit contract agreed in advance
20		of the period for which a refund is to be paid or
21		additional premium is to be charged (which period shall
22		not be less than one year); and
23		(ii) the amount of the refund or additional premium
24		shall not exceed 20% of the Health Maintenance
25		Organization's profitable or unprofitable experience with
26		respect to the group or other enrollment unit for the

SB1561 Enrolled - 26 - LRB103 27713 CPF 54090 b
1		period (and, for purposes of a refund or additional
2		premium, the profitable or unprofitable experience shall
3		be calculated taking into account a pro rata share of the
4		Health Maintenance Organization's administrative and
5		marketing expenses, but shall not include any refund to be
6		made or additional premium to be paid pursuant to this
7		subsection (f)). The Health Maintenance Organization and
8		the group or enrollment unit may agree that the profitable
9		or unprofitable experience may be calculated taking into
10		account the refund period and the immediately preceding 2
11		plan years.
12		The Health Maintenance Organization shall include a
13		statement in the evidence of coverage issued to each enrollee
14		describing the possibility of a refund or additional premium,
15		and upon request of any group or enrollment unit, provide to
16		the group or enrollment unit a description of the method used
17		to calculate (1) the Health Maintenance Organization's
18		profitable experience with respect to the group or enrollment
19		unit and the resulting refund to the group or enrollment unit
20		or (2) the Health Maintenance Organization's unprofitable
21		experience with respect to the group or enrollment unit and
22		the resulting additional premium to be paid by the group or
23		enrollment unit.
24		In no event shall the Illinois Health Maintenance
25		Organization Guaranty Association be liable to pay any
26		contractual obligation of an insolvent organization to pay any

SB1561 Enrolled - 27 - LRB103 27713 CPF 54090 b
1		refund authorized under this Section.
2		(g) Rulemaking authority to implement Public Act 95-1045,
3		if any, is conditioned on the rules being adopted in
4		accordance with all provisions of the Illinois Administrative
5		Procedure Act and all rules and procedures of the Joint
6		Committee on Administrative Rules; any purported rule not so
7		adopted, for whatever reason, is unauthorized.
8		(Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19;
9		101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-393, eff.
10		1-1-20; 101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625,
11		eff. 1-1-21; 102-30, eff. 1-1-22; 102-34, eff. 6-25-21;
12		102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff.
13		1-1-22; 102-589, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665,
14		eff. 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
15		102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff.
16		1-1-23; 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093,
17		eff. 1-1-23; 102-1117, eff. 1-13-23; revised 1-22-23.)
18		Section 45. The Voluntary Health Services Plans Act is
19		amended by changing Section 10 as follows:
20		(215 ILCS 165/10) (from Ch. 32, par. 604)
21		Sec. 10. Application of Insurance Code provisions. Health
22		services plan corporations and all persons interested therein
23		or dealing therewith shall be subject to the provisions of
24		Articles IIA and XII 1/2 and Sections 3.1, 133, 136, 139, 140,

SB1561 Enrolled - 28 - LRB103 27713 CPF 54090 b
1		143, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3, 355b,
2		356g, 356g.5, 356g.5-1, 356q, 356r, 356t, 356u, 356v, 356w,
3		356x, 356y, 356z.1, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5,
4		356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
5		356z.14, 356z.15, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25,
6		356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.33,
7		356z.40, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54,
8		356z.56, 356z.57, 356z.59, 356z.60, 356z.62, 364.01, 364.3,
9		367.2, 368a, 401, 401.1, 402, 403, 403A, 408, 408.2, and 412,
10		and paragraphs (7) and (15) of Section 367 of the Illinois
11		Insurance Code.
12		Rulemaking authority to implement Public Act 95-1045, if
13		any, is conditioned on the rules being adopted in accordance
14		with all provisions of the Illinois Administrative Procedure
15		Act and all rules and procedures of the Joint Committee on
16		Administrative Rules; any purported rule not so adopted, for
17		whatever reason, is unauthorized.
18		(Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19;
19		101-281, eff. 1-1-20; 101-393, eff. 1-1-20; 101-625, eff.
20		1-1-21; 102-30, eff. 1-1-22; 102-203, eff. 1-1-22; 102-306,
21		eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, eff. 10-8-21;
22		102-731, eff. 1-1-23; 102-775, eff. 5-13-22; 102-804, eff.
23		1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860,
24		eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093, eff. 1-1-23;
25		102-1117, eff. 1-13-23.)

SB1561 Enrolled - 29 - LRB103 27713 CPF 54090 b
1		Section 50. The Medical Practice Act of 1987 is amended by
2		changing Section 18 as follows:
3		(225 ILCS 60/18) (from Ch. 111, par. 4400-18)
4		(Section scheduled to be repealed on January 1, 2027)
5		Sec. 18. Visiting professor, physician, or resident
6		permits.
7		(A) Visiting professor permit.
8		(1) A visiting professor permit shall entitle a person
9		to practice medicine in all of its branches or to practice
10		the treatment of human ailments without the use of drugs
11		and without operative surgery provided:
12		(a) the person maintains an equivalent
13		authorization to practice medicine in all of its
14		branches or to practice the treatment of human
15		ailments without the use of drugs and without
16		operative surgery in good standing in his or her
17		native licensing jurisdiction during the period of the
18		visiting professor permit;
19		(b) the person has received a faculty appointment
20		to teach in a medical, osteopathic or chiropractic
21		school in Illinois; and
22		(c) the Department may prescribe the information
23		necessary to establish an applicant's eligibility for
24		a permit. This information shall include without
25		limitation (i) a statement from the dean of the

SB1561 Enrolled - 30 - LRB103 27713 CPF 54090 b
1		medical school at which the applicant will be employed
2		describing the applicant's qualifications and (ii) a
3		statement from the dean of the medical school listing
4		every affiliated institution in which the applicant
5		will be providing instruction as part of the medical
6		school's education program and justifying any clinical
7		activities at each of the institutions listed by the
8		dean.
9		(2) Application for visiting professor permits shall
10		be made to the Department, in writing, on forms prescribed
11		by the Department and shall be accompanied by the required
12		fee established by rule, which shall not be refundable.
13		Any application shall require the information as, in the
14		judgment of the Department, will enable the Department to
15		pass on the qualifications of the applicant.
16		(3) A visiting professor permit shall be valid for no
17		longer than 2 years from the date of issuance or until the
18		time the faculty appointment is terminated, whichever
19		occurs first, and may be renewed only in accordance with
20		subdivision (A)(6) of this Section.
21		(4) The applicant may be required to appear before the
22		Medical Board for an interview prior to, and as a
23		requirement for, the issuance of the original permit and
24		the renewal.
25		(5) Persons holding a permit under this Section shall
26		only practice medicine in all of its branches or practice

SB1561 Enrolled - 31 - LRB103 27713 CPF 54090 b
1		the treatment of human ailments without the use of drugs
2		and without operative surgery in the State of Illinois in
3		their official capacity under their contract within the
4		medical school itself and any affiliated institution in
5		which the permit holder is providing instruction as part
6		of the medical school's educational program and for which
7		the medical school has assumed direct responsibility.
8		(6) After the initial renewal of a visiting professor
9		permit, a visiting professor permit shall be valid until
10		the last day of the next physician license renewal period,
11		as set by rule, and may only be renewed for applicants who
12		meet the following requirements:
13		(i) have obtained the required continuing
14		education hours as set by rule; and
15		(ii) have paid the fee prescribed for a license
16		under Section 21 of this Act.
17		For initial renewal, the visiting professor must
18		successfully pass a general competency examination authorized
19		by the Department by rule, unless he or she was issued an
20		initial visiting professor permit on or after January 1, 2007,
21		but prior to July 1, 2007.
22		(B) Visiting physician permit.
23		(1) The Department may, in its discretion, issue a
24		temporary visiting physician permit, without examination,
25		provided:

SB1561 Enrolled - 32 - LRB103 27713 CPF 54090 b
1		(a) (blank);
2		(b) that the person maintains an equivalent
3		authorization to practice medicine in all of its
4		branches or to practice the treatment of human
5		ailments without the use of drugs and without
6		operative surgery in good standing in his or her
7		native licensing jurisdiction during the period of the
8		temporary visiting physician permit;
9		(c) that the person has received an invitation or
10		appointment to study, demonstrate, or perform a
11		specific medical, osteopathic, chiropractic or
12		clinical subject or technique in a medical,
13		osteopathic, or chiropractic school, a state or
14		national medical, osteopathic, or chiropractic
15		professional association or society conference or
16		meeting, a hospital licensed under the Hospital
17		Licensing Act, a hospital organized under the
18		University of Illinois Hospital Act, or a facility
19		operated pursuant to the Ambulatory Surgical Treatment
20		Center Act; and
21		(d) that the temporary visiting physician permit
22		shall only permit the holder to practice medicine in
23		all of its branches or practice the treatment of human
24		ailments without the use of drugs and without
25		operative surgery within the scope of the medical,
26		osteopathic, chiropractic, or clinical studies, or in

SB1561 Enrolled - 33 - LRB103 27713 CPF 54090 b
1		conjunction with the state or national medical,
2		osteopathic, or chiropractic professional association
3		or society conference or meeting, for which the holder
4		was invited or appointed.
5		(2) The application for the temporary visiting
6		physician permit shall be made to the Department, in
7		writing, on forms prescribed by the Department, and shall
8		be accompanied by the required fee established by rule,
9		which shall not be refundable. The application shall
10		require information that, in the judgment of the
11		Department, will enable the Department to pass on the
12		qualification of the applicant, and the necessity for the
13		granting of a temporary visiting physician permit.
14		(3) A temporary visiting physician permit shall be
15		valid for no longer than (i) 180 days from the date of
16		issuance or (ii) until the time the medical, osteopathic,
17		chiropractic, or clinical studies are completed, or the
18		state or national medical, osteopathic, or chiropractic
19		professional association or society conference or meeting
20		has concluded, whichever occurs first. The temporary
21		visiting physician permit may be issued multiple times to
22		a visiting physician under this paragraph (3) as long as
23		the total number of days it is active do not exceed 180
24		days within a 365-day period.
25		(4) The applicant for a temporary visiting physician
26		permit may be required to appear before the Medical Board

SB1561 Enrolled - 34 - LRB103 27713 CPF 54090 b
1		for an interview prior to, and as a requirement for, the
2		issuance of a temporary visiting physician permit.
3		(5) A limited temporary visiting physician permit
4		shall be issued to a physician licensed in another state
5		who has been requested to perform emergency procedures in
6		Illinois if he or she meets the requirements as
7		established by rule.
8		(C) Visiting resident permit.
9		(1) The Department may, in its discretion, issue a
10		temporary visiting resident permit, without examination,
11		provided:
12		(a) (blank);
13		(b) that the person maintains an equivalent
14		authorization to practice medicine in all of its
15		branches or to practice the treatment of human
16		ailments without the use of drugs and without
17		operative surgery in good standing in his or her
18		native licensing jurisdiction during the period of the
19		temporary visiting resident permit;
20		(c) that the applicant is enrolled in a
21		postgraduate clinical training program outside the
22		State of Illinois that is approved by the Department;
23		(d) that the individual has been invited or
24		appointed for a specific period of time to perform a
25		portion of that post graduate clinical training

SB1561 Enrolled - 35 - LRB103 27713 CPF 54090 b
1		program under the supervision of an Illinois licensed
2		physician in an Illinois patient care clinic or
3		facility that is affiliated with the out-of-State post
4		graduate training program; and
5		(e) that the temporary visiting resident permit
6		shall only permit the holder to practice medicine in
7		all of its branches or practice the treatment of human
8		ailments without the use of drugs and without
9		operative surgery within the scope of the medical,
10		osteopathic, chiropractic or clinical studies for
11		which the holder was invited or appointed.
12		(2) The application for the temporary visiting
13		resident permit shall be made to the Department, in
14		writing, on forms prescribed by the Department, and shall
15		be accompanied by the required fee established by rule.
16		The application shall require information that, in the
17		judgment of the Department, will enable the Department to
18		pass on the qualifications of the applicant.
19		(3) A temporary visiting resident permit shall be
20		valid for 180 days from the date of issuance or until the
21		time the medical, osteopathic, chiropractic, or clinical
22		studies are completed, whichever occurs first.
23		(4) The applicant for a temporary visiting resident
24		permit may be required to appear before the Medical Board
25		for an interview prior to, and as a requirement for, the
26		issuance of a temporary visiting resident permit.

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1		(D) Postgraduate training exemption period; visiting
2		rotations. A person may participate in visiting rotations in
3		an approved postgraduate training program, not to exceed a
4		total of 90 days for all rotations, if the following
5		information is submitted in writing or electronically to the
6		Department by the patient care clinics or facilities where the
7		person will be performing the training or by an affiliated
8		program:
9		(1) The person who has been invited or appointed to
10		perform a portion of their postgraduate clinical training
11		program in Illinois.
12		(2) The name and address of the primary patient care
13		clinic or facility, the date the training is to begin, and
14		the length of time of the invitation or appointment.
15		(3) The name and license number of the Illinois
16		physician who will be responsible for supervising the
17		trainee and the medical director or division director of
18		the department or facility.
19		(4) Certification from the postgraduate training
20		program that the person is approved and enrolled in an
21		graduate training program approved by the Department in
22		their home state.
23		(Source: P.A. 102-20, eff. 1-1-22.)
24		Section 95. No acceleration or delay. Where this Act makes

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1		changes in a statute that is represented in this Act by text
2		that is not yet or no longer in effect (for example, a Section
3		represented by multiple versions), the use of that text does
4		not accelerate or delay the taking effect of (i) the changes
5		made by this Act or (ii) provisions derived from any other
6		Public Act.