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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. The Illinois Insurance Code is amended by | ||||||
5 | adding Section 356z.71 as follows: | ||||||
6 | (215 ILCS 5/356z.71 new) | ||||||
7 | Sec. 356z.71. Coverage for home test kits for sexually | ||||||
8 | transmitted infections (STIs). | ||||||
9 | (a) As used in this Section, "home test kit" means a | ||||||
10 | product used for a test recommended by the federal Centers for | ||||||
11 | Disease Control and Prevention guidelines or the United States | ||||||
12 | Preventive Services Task Force that has received a certificate | ||||||
13 | of waiver under the Clinical Laboratory Improvement Amendments | ||||||
14 | to the federal Public Health Services Act, has been cleared or | ||||||
15 | approved by the United States Food and Drug Administration, or | ||||||
16 | has been developed by a laboratory in accordance with | ||||||
17 | established regulations and quality standards, to allow | ||||||
18 | individuals to self-collect specimens for STIs, including HIV, | ||||||
19 | remotely at a location outside of a clinical setting. | ||||||
20 | (b) An individual or group policy of accident and health | ||||||
21 | insurance amended, delivered, issued, or renewed in this State | ||||||
22 | after January 1, 2026 shall provide coverage for home test | ||||||
23 | kits for sexually transmitted infections, including any |
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1 | laboratory costs of processing the kit, that are deemed | ||||||
2 | medically necessary or appropriate and ordered directly by a | ||||||
3 | clinician for patient use based on clinical guidelines and | ||||||
4 | individual patient health needs. | ||||||
5 | (1) A commercial health care plan is required to cover | ||||||
6 | the services outlined in this subsection when ordered for | ||||||
7 | an enrollee by an in-network provider. | ||||||
8 | (2) Except as otherwise provided in this subsection, a | ||||||
9 | policy subject to this subsection shall not impose a | ||||||
10 | deductible, coinsurance, copayment, or any other | ||||||
11 | cost-sharing requirement on the coverage provided. The | ||||||
12 | provisions of this subsection do not apply to coverage of | ||||||
13 | procedures to the extent such coverage would disqualify a | ||||||
14 | high-deductible health plan from eligibility for a health | ||||||
15 | savings account pursuant to the federal Internal Revenue | ||||||
16 | Code, 26 U.S.C. 223. | ||||||
17 | (3) Except as otherwise authorized under this Section, | ||||||
18 | a policy shall not impose any restrictions or delays on | ||||||
19 | the coverage required under this Section. | ||||||
20 | (4) If a plan or issuer uses a network of providers, | ||||||
21 | nothing in this Section shall be construed to require | ||||||
22 | coverage or to prohibit the plan or issuer from imposing | ||||||
23 | cost-sharing for items or services described in this | ||||||
24 | Section that are provided or delivered by an | ||||||
25 | out-of-network provider, unless the plan or issuer does | ||||||
26 | not have in its network a provider who is able to or is |
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1 | willing to provide the applicable items or services. | ||||||
2 | Section 10. The Illinois Public Aid Code is amended by | ||||||
3 | changing Section 5-16.8 as follows: | ||||||
4 | (305 ILCS 5/5-16.8) | ||||||
5 | Sec. 5-16.8. Required health benefits. The medical | ||||||
6 | assistance program shall (i) provide the post-mastectomy care | ||||||
7 | benefits required to be covered by a policy of accident and | ||||||
8 | health insurance under Section 356t and the coverage required | ||||||
9 | under Sections 356g.5, 356q, 356u, 356w, 356x, 356z.6, | ||||||
10 | 356z.26, 356z.29, 356z.32, 356z.33, 356z.34, 356z.35, 356z.46, | ||||||
11 | 356z.47, 356z.51, 356z.53, 356z.56, 356z.59, 356z.60, and | ||||||
12 | 356z.61 , 356z.64, 356z.67, and 356z.71 of the Illinois | ||||||
13 | Insurance Code, (ii) be subject to the provisions of Sections | ||||||
14 | 356z.19, 356z.44, 356z.49, 364.01, 370c, and 370c.1 of the | ||||||
15 | Illinois Insurance Code, and (iii) be subject to the | ||||||
16 | provisions of subsection (d-5) of Section 10 of the Network | ||||||
17 | Adequacy and Transparency Act. | ||||||
18 | The Department, by rule, shall adopt a model similar to | ||||||
19 | the requirements of Section 356z.39 of the Illinois Insurance | ||||||
20 | Code. | ||||||
21 | On and after July 1, 2012, the Department shall reduce any | ||||||
22 | rate of reimbursement for services or other payments or alter | ||||||
23 | any methodologies authorized by this Code to reduce any rate | ||||||
24 | of reimbursement for services or other payments in accordance |
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1 | with Section 5-5e. | ||||||
2 | To ensure full access to the benefits set forth in this | ||||||
3 | Section, on and after January 1, 2016, the Department shall | ||||||
4 | ensure that provider and hospital reimbursement for | ||||||
5 | post-mastectomy care benefits required under this Section are | ||||||
6 | no lower than the Medicare reimbursement rate. | ||||||
7 | (Source: P.A. 102-30, eff. 1-1-22; 102-144, eff. 1-1-22; | ||||||
8 | 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-530, eff. | ||||||
9 | 1-1-22; 102-642, eff. 1-1-22; 102-804, eff. 1-1-23; 102-813, | ||||||
10 | eff. 5-13-22; 102-816, eff. 1-1-23; 102-1093, eff. 1-1-23; | ||||||
11 | 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91, eff. | ||||||
12 | 1-1-24; 103-420, eff. 1-1-24; revised 12-15-23.) | ||||||
13 | Section 15. The AIDS Confidentiality Act is amended by | ||||||
14 | adding Section 5.6 as follows: | ||||||
15 | (410 ILCS 305/5.6 new) | ||||||
16 | Sec. 5.6. Illinois AIDS Drug Assistance Program. | ||||||
17 | (a) The purpose of this Section is to expand and assist | ||||||
18 | with implementation of the Rapid Start for HIV treatment | ||||||
19 | model. The pilot sites will allow the development of a | ||||||
20 | coordinated system of health care services to provide timely | ||||||
21 | and quality HIV treatment. This will occur by increasing the | ||||||
22 | capacity of the Department of Public Health and build toward | ||||||
23 | establishing the Rapid Start model as the standard of care for | ||||||
24 | HIV treatment. This program shall be known as the Illinois |
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1 | AIDS Drug Assistance Program or Illinois ADAP. | ||||||
2 | (b) In this Section: | ||||||
3 | "Conditional approval" means Illinois ADAP approval within | ||||||
4 | one business day after submission of documentation of Illinois | ||||||
5 | residency, a program agreement form, and an attestation of | ||||||
6 | remaining eligibility requirements. | ||||||
7 | "Rapid Start for HIV Treatment" means initiating | ||||||
8 | antiretroviral therapy within 7 days after initial diagnosis | ||||||
9 | or within 7 days after referral to HIV medical care as defined | ||||||
10 | by the Centers for Disease Control and Prevention | ||||||
11 | recommendations for HIV treatment. | ||||||
12 | (c) Beginning January 1, 2026, Illinois ADAP shall | ||||||
13 | establish a pathway for conditional approval of Illinois ADAP | ||||||
14 | enrollment for new applicants seeking to enter or reenter | ||||||
15 | medical care. Applicants receiving conditional approval on or | ||||||
16 | after January 1, 2026 will have 30 days to submit a complete | ||||||
17 | Illinois ADAP application, addressing all remaining | ||||||
18 | eligibility requirements. | ||||||
19 | (d) The Department of Public Health shall establish one | ||||||
20 | Rapid Start for HIV Treatment pilot site per HIV Care Connect | ||||||
21 | Region. The Department may implement processes and adopt rules | ||||||
22 | to implement this pilot program in accordance with industry | ||||||
23 | standards informed by the most current Centers for Disease | ||||||
24 | Control and Prevention and Health Resources and Services | ||||||
25 | Administration guidance on HIV care and treatment. | ||||||
26 | (e) The pilot sites shall abide by the following |
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1 | principles: | ||||||
2 | (1) Nothing About Us Without Us: Pilot site programs | ||||||
3 | and services shall be formulated with transparency, | ||||||
4 | community involvement, and direct ongoing input by people | ||||||
5 | living with and vulnerable to HIV. | ||||||
6 | (2) Equity: Pilot site programs and services shall | ||||||
7 | provide equitable support, services, and resources to all | ||||||
8 | participants and ensure accessibility to the greatest | ||||||
9 | extent possible. | ||||||
10 | (3) Self-Determination: Pilot site programs and | ||||||
11 | services shall prioritize individual dignity and autonomy | ||||||
12 | in decision-making while encouraging people to connect | ||||||
13 | with additional services that promote health and | ||||||
14 | well-being. | ||||||
15 | (4) Reduce Stigma: Pilot site programs and services | ||||||
16 | shall affirm the humanity and dignity of people living | ||||||
17 | with or vulnerable to HIV and shall operate in a way that | ||||||
18 | is welcoming to reduce stigma and build trust. | ||||||
19 | (5) Safe Spaces: Pilot site programs and services | ||||||
20 | shall prioritize relationship-building and trust among | ||||||
21 | partners, staff, and participants to create safe spaces. | ||||||
22 | (f) The Department shall compile reports from each of the | ||||||
23 | pilot sites on the operation of the pilot program upon | ||||||
24 | completion of the pilot period. The Department shall share a | ||||||
25 | comprehensive report summarizing the findings of the pilot | ||||||
26 | period with the General Assembly and the Governor's Office and |
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1 | shall make it publicly available on its Internet website. The | ||||||
2 | report may include: | ||||||
3 | (1) the number offers made for enrollment; | ||||||
4 | (2) the number of enrolled participants; | ||||||
5 | (3) the number and reasons of patients declined for | ||||||
6 | service, when available; and | ||||||
7 | (4) the length of time from initial diagnosis or | ||||||
8 | referral to the start of HIV treatment, and, when | ||||||
9 | available, the length of time participants were able to | ||||||
10 | achieve an undetectable viral load. | ||||||
11 | Data shall also include demographic data on the race, | ||||||
12 | ethnicity, age, sex, disability status, sexual orientation, | ||||||
13 | gender identity, and primary or preferred language of program | ||||||
14 | participants in accordance with the Data Governance and | ||||||
15 | Organization to Support Equity and Racial Justice Act. The | ||||||
16 | reports shall inform the Department's decisions concerning the | ||||||
17 | continued operation of the Rapid Start for HIV treatment pilot | ||||||
18 | program and its expansion, modification, discontinuation, or | ||||||
19 | progress towards becoming the standard of care for HIV | ||||||
20 | treatment. The contents of the report shall be in accordance | ||||||
21 | with the AIDS Confidentiality Act. | ||||||
22 | Implementation of this Section is subject to | ||||||
23 | appropriations made to the Illinois Department of Public | ||||||
24 | Health for that purpose. | ||||||
25 | Section 20. The County Jail Act is amended by changing |
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1 | Section 17.10 as follows: | ||||||
2 | (730 ILCS 125/17.10) | ||||||
3 | Sec. 17.10. Requirements in connection with HIV/AIDS. | ||||||
4 | (a) In each county other than Cook, during the medical | ||||||
5 | admissions exam, the warden of the jail, a correctional | ||||||
6 | officer at the jail, or a member of the jail medical staff must | ||||||
7 | provide the prisoner with appropriate written information | ||||||
8 | concerning human immunodeficiency virus (HIV) and acquired | ||||||
9 | immunodeficiency syndrome (AIDS). The Department of Public | ||||||
10 | Health and community-based organizations certified to provide | ||||||
11 | HIV/AIDS testing must provide these informational materials to | ||||||
12 | the warden at no cost to the county. The warden, a correctional | ||||||
13 | officer, or a member of the jail medical staff must inform the | ||||||
14 | prisoner of the option of being tested for infection with HIV | ||||||
15 | by a certified local community-based agency or other available | ||||||
16 | medical provider at no charge to the prisoner. | ||||||
17 | (b) In Cook County, during the medical admissions exam, an | ||||||
18 | employee of the Cook County Health & Hospitals System must | ||||||
19 | provide the prisoner with appropriate information in writing, | ||||||
20 | verbally or by video or other electronic means concerning | ||||||
21 | human immunodeficiency virus (HIV) and acquired | ||||||
22 | immunodeficiency syndrome (AIDS) and must also provide the | ||||||
23 | prisoner with option of testing for infection with HIV or any | ||||||
24 | other identified causative agent of AIDS, as well as | ||||||
25 | counseling in connection with such testing. The Cook County |
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1 | Health & Hospitals System may provide the inmate with opt-out | ||||||
2 | human immunodeficiency virus (HIV) testing, as defined in | ||||||
3 | Section 4 of the AIDS Confidentiality Act, unless the inmate | ||||||
4 | refuses. If opt-out HIV testing is conducted, the Cook County | ||||||
5 | Health & Hospitals System shall place signs in English, | ||||||
6 | Spanish, and other languages as needed in multiple, highly | ||||||
7 | visible locations in the area where HIV testing is conducted | ||||||
8 | informing inmates that they will be tested for HIV unless they | ||||||
9 | refuse, and refusal or acceptance of testing shall be | ||||||
10 | documented in the inmate's medical record. Pre-test | ||||||
11 | information shall be provided to the inmate and informed | ||||||
12 | consent obtained from the inmate as required in subsection (q) | ||||||
13 | of Section 3 and Section 5 of the AIDS Confidentiality Act. The | ||||||
14 | Cook County Health & Hospitals System shall follow procedures | ||||||
15 | established by the Department of Public Health to conduct HIV | ||||||
16 | testing and testing to confirm positive HIV test results. All | ||||||
17 | aspects of HIV testing shall comply with the requirements of | ||||||
18 | the AIDS Confidentiality Act, including delivery of test | ||||||
19 | results, as determined by the Cook County Health & Hospitals | ||||||
20 | System in consultation with the Illinois Department of Public | ||||||
21 | Health. Nothing in this Section shall require the Cook County | ||||||
22 | Health & Hospitals System to offer HIV testing to inmates who | ||||||
23 | are known to be infected with HIV. The Department of Public | ||||||
24 | Health and community-based organizations certified to provide | ||||||
25 | HIV/AIDS testing may provide these informational materials to | ||||||
26 | the Bureau at no cost to the county. The testing provided under |
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1 | this subsection (b) shall consist of a test approved by the | ||||||
2 | Illinois Department of Public Health to determine the presence | ||||||
3 | of HIV infection, based upon recommendations of the United | ||||||
4 | States Centers for Disease Control and Prevention. If the test | ||||||
5 | result is positive, a reliable supplemental test based upon | ||||||
6 | recommendations of the United States Centers for Disease | ||||||
7 | Control and Prevention shall be administered. | ||||||
8 | (b-5) The Department of Corrections shall include the | ||||||
9 | following information in the annual adult correctional | ||||||
10 | facility public inspection report for each county: | ||||||
11 | (1) whether the warden of the jail, a correctional | ||||||
12 | officer at the jail, or a member of the jail medical staff | ||||||
13 | provide the prisoner with appropriate written information | ||||||
14 | concerning HIV and AIDS during the medical admissions | ||||||
15 | exam; | ||||||
16 | (2) whether the warden, a correctional officer, or a | ||||||
17 | member of the jail medical staff informs the prisoner of | ||||||
18 | the option of being tested for infection with HIV by a | ||||||
19 | certified local community-based agency or other available | ||||||
20 | medical provider at no charge to the prisoner; | ||||||
21 | (3) whether the warden of the jail makes appropriate | ||||||
22 | written information or visual aids concerning HIV/AIDS | ||||||
23 | available to every visitor to the jail; | ||||||
24 | (4) for Cook County, whether an employee of the Cook | ||||||
25 | County Health and Hospitals System provides the prisoner | ||||||
26 | with appropriate information in writing, verbally, or by |
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1 | video or other electronic means concerning HIV and AIDS | ||||||
2 | during the medical admissions exam; and | ||||||
3 | (5) for Cook County, whether an employee of the Cook | ||||||
4 | County Health and Hospitals System provides the prisoner | ||||||
5 | with the option of testing for infection with HIV or any | ||||||
6 | other identified causative agent of AIDS, as well as | ||||||
7 | counseling in connection with such testing. | ||||||
8 | The Department of Public Health and community-based | ||||||
9 | organizations certified to provide HIV/AIDS testing shall | ||||||
10 | provide these informational materials to the warden at no cost | ||||||
11 | to the office of the county sheriff. | ||||||
12 | (c) In each county, the warden of the jail must make | ||||||
13 | appropriate written information concerning HIV/AIDS available | ||||||
14 | to every visitor to the jail. This information must include | ||||||
15 | information concerning persons or entities to contact for | ||||||
16 | local counseling and testing. The Department of Public Health | ||||||
17 | and community-based organizations certified to provide | ||||||
18 | HIV/AIDS testing must provide these informational materials to | ||||||
19 | the warden at no cost to the office of the county sheriff. | ||||||
20 | (d) Implementation of this Section is subject to | ||||||
21 | appropriation. | ||||||
22 | (Source: P.A. 97-244, eff. 8-4-11; 97-323, eff. 8-12-11; | ||||||
23 | 97-813, eff. 7-13-12; 98-1046, eff. 1-1-15 .) |