SB3688 104TH GENERAL ASSEMBLY

LRB104 19957 BAB 33407 b

104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
SB3688

Introduced 2/5/2026, by Sen. Meg Loughran Cappel

SYNOPSIS AS INTRODUCED:

215 ILCS 5/356z.88 new
225 ILCS 60/20	from Ch. 111, par. 4400-20
225 ILCS 65/65-60	was 225 ILCS 65/15-45
225 ILCS 95/11.5

Amends the Illinois Insurance Code. Prohibits a group or individual policy of accident and health insurance issued or renewed in this State from imposing prior authorization or step therapy requirements on menopause therapy under specified conditions. Amends the Medical Practice Act of 1987, the Nurse Practice Act, and the Physician Assistant Practice Act of 1987 to establish provisions concerning continuing education on perimenopause and menopause recognition and management for physicians, advanced practice registered nurses, and physician assistants. Effective January 1, 2027.

A BILL FOR

AN ACT concerning regulation.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Illinois Insurance Code is amended by adding Section 356z.88 as follows:

(215 ILCS 5/356z.88 new)

Sec. 356z.88. Menopause therapy utilization management protections.

(a) In this Section:

"Guideline-supported" means consistent with clinical practice guidelines or consensus statements issued by nationally recognized medical organizations.

"Menopause therapy" means any hormonal or nonhormonal therapy approved by the United States Food and Drug Administration for the treatment of perimenopausal or menopausal symptoms.

"Qualified clinician" means a physician licensed under the Medical Practice Act of 1987, an advanced practice registered nurse licensed under the Nurse Practice Act, or a physician assistant licensed under the Physician Assistant Practice Act of 1987 acting within the scope of the clinician's license.

(b) A group or individual policy of accident and health insurance issued or renewed in this State shall not impose prior authorization or step therapy requirements on menopause therapy when all of the following conditions are met:

(1) the therapy is approved by the United States Food and Drug Administration;

(2) the therapy is guideline-supported; and

(3) the therapy is prescribed by a qualified clinician for the treatment of perimenopausal or menopausal symptoms.

(c) Nothing in this Section shall be construed to prohibit:

(1) formulary tiering if access to guideline-supported menopause therapy is not unreasonably restricted; or

(2) utilization management based on documented patient-specific safety concerns, contraindications, or drug interactions.

(d) The Department shall enforce this Section and may adopt rules necessary to implement this Section.

Section 10. The Medical Practice Act of 1987 is amended by changing Section 20 as follows:

(225 ILCS 60/20) (from Ch. 111, par. 4400-20)

(Section scheduled to be repealed on January 1, 2027)

Sec. 20. Continuing education.

(a) The Department shall promulgate rules of continuing education for persons licensed under this Act that require an average of 50 hours of continuing education per license year. These rules shall be consistent with requirements of relevant professional associations, specialty societies, or boards. The rules shall also address variances in part or in whole for good cause, including, but not limited to, temporary illness or hardship. In establishing these rules, the Department shall consider educational requirements for medical staffs, requirements for specialty society board certification or for continuing education requirements as a condition of membership in societies representing the 2 categories of licensee under this Act. These rules shall assure that licensees are given the opportunity to participate in those programs sponsored by or through their professional associations or hospitals which are relevant to their practice. Each licensee is responsible for maintaining records of completion of continuing education and shall be prepared to produce the records when requested by the Department.

(b) The Department shall require physicians licensed under this Act to complete continuing medical education on perimenopause and menopause recognition and management. This education shall:

(1) not exceed 2 hours per renewal cycle;

(2) count toward existing continuing medical education requirements; and

(3) not increase the total number of continuing education hours required for license renewal.

The continuing education required under this subsection shall include instruction in:

(i) common and atypical symptom patterns of perimenopause and menopause and appropriate differential diagnosis;

(ii) appropriate and limited use of laboratory testing, including when testing is not clinically indicated;

(iii) evidence-based treatment options and referral standards; and

(iv) mental health considerations and culturally competent care related to perimenopause and menopause.

The Department shall approve qualifying continuing education courses and may adopt rules necessary to implement this subsection.

(Source: P.A. 97-622, eff. 11-23-11.)

Section 15. The Nurse Practice Act is amended by changing Section 65-60 as follows:

(225 ILCS 65/65-60) (was 225 ILCS 65/15-45)

(Section scheduled to be repealed on January 1, 2028)

Sec. 65-60. Continuing education.

(a) The Department shall adopt rules of continuing education for persons licensed under this Article as advanced practice registered nurses that require 80 hours of continuing education per 2-year license renewal cycle. Completion of the 80 hours of continuing education shall be deemed to satisfy the continuing education requirements for renewal of a registered professional nurse license as required by this Act.

(b) The 80 hours of continuing education required under this Section shall be completed as follows:

(1) A minimum of 50 hours of the continuing education shall be obtained in continuing education programs as determined by rule that shall include no less than 20 hours of pharmacotherapeutics, including 10 hours of opioid prescribing or substance abuse education. Continuing education programs may be conducted or endorsed by educational institutions, hospitals, specialist associations, facilities, or other organizations approved to offer continuing education under this Act or rules and shall be in the advanced practice registered nurse's specialty.

(2) A maximum of 30 hours of credit may be obtained by presentations in the advanced practice registered nurse's clinical specialty, evidence-based practice, or quality improvement projects, publications, research projects, or preceptor hours as determined by rule.

(c) The Department shall require advanced practice registered nurses to complete continuing education on perimenopause and menopause recognition and management. This education shall:

(1) not exceed 2 hours per renewal cycle;

(2) count toward existing continuing education requirements; and

(3) not increase the total number of continuing education hours required for license renewal.

The continuing education required under this subsection shall include instruction in:

(i) common and atypical symptom patterns of perimenopause and menopause and appropriate differential diagnosis;

(ii) appropriate and limited use of laboratory testing, including when testing is not clinically indicated;

(iii) evidence-based treatment options and referral standards; and

(iv) mental health considerations and culturally competent care related to perimenopause and menopause.

The Department shall approve qualifying continuing education courses and may adopt rules necessary to implement this subsection.

(c) The rules adopted regarding continuing education shall be consistent to the extent possible with requirements of relevant national certifying bodies or State or national professional associations.

The rules shall not be inconsistent with requirements of relevant national certifying bodies or State or national professional associations. The rules shall also address variances in part or in whole for good cause, including but not limited to illness or hardship. The continuing education rules shall assure that licensees are given the opportunity to participate in programs sponsored by or through their State or national professional associations, hospitals, or other providers of continuing education. Each licensee is responsible for maintaining records of completion of continuing education and shall be prepared to produce the records when requested by the Department.

(Source: P.A. 100-513, eff. 1-1-18.)

Section 20. The Physician Assistant Practice Act of 1987 is amended by changing Section 11.5 as follows:

(225 ILCS 95/11.5)

(Section scheduled to be repealed on January 1, 2028)

Sec. 11.5. Continuing education.

(a) The Department shall adopt rules for continuing education for persons licensed under this Act that require 50 hours of continuing education per 2-year license renewal cycle. Completion of the 50 hours of continuing education shall be deemed to satisfy the continuing education requirements for renewal of a physician assistant license as required by this Act. The rules shall not be inconsistent with requirements of relevant national certifying bodies or State or national professional associations. The rules shall also address variances in part or in whole for good cause, including, but not limited to, illness or hardship. The continuing education rules shall ensure that licensees are given the opportunity to participate in programs sponsored by or through their State or national professional associations, hospitals, or other providers of continuing education. Each licensee is responsible for maintaining records of completion of continuing education and shall be prepared to produce the records when requested by the Department.

(b) The Department shall require physician assistants to complete continuing education on perimenopause and menopause recognition and management. This education shall:

(1) not exceed 2 hours per renewal cycle;

(2) count toward existing continuing education requirements; and

(3) not increase the total number of continuing education hours required for license renewal.

The continuing education required under this Section shall include instruction in:

(i) common and atypical symptom patterns of perimenopause and menopause and appropriate differential diagnosis;

(ii) appropriate and limited use of laboratory testing, including when testing is not clinically indicated;

(iii) evidence-based treatment options and referral standards; and

(iv) mental health considerations and culturally competent care related to perimenopause and menopause.

The Department shall approve qualifying continuing education courses and may adopt rules necessary to implement this subsection.

(Source: P.A. 100-453, eff. 8-25-17.)

Section 99. Effective date. This Act takes effect January 1, 2027.