SB1561 EnrolledLRB103 27713 CPF 54090 b

1    AN ACT concerning health.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. "An Act concerning regulation", approved
5January 13, 2023, Public Act 102-1117, is amended by changing
6Section 99-99 as follows:
 
7    (P.A. 102-1117, Sec. 99-99)
8    Sec. 99-99. Effective date. This Act takes effect upon
9becoming law, except that Article 16 takes effect on January
101, 2025.
11(Source: P.A. 102-1117, eff. 1-13-23.)
 
12    Section 10. The State Employees Group Insurance Act of
131971 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
17Code requirements. The program of health benefits shall
18provide the post-mastectomy care benefits required to be
19covered by a policy of accident and health insurance under
20Section 356t of the Illinois Insurance Code. The program of
21health benefits shall provide the coverage required under

 

 

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1Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x,
2356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10,
3356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22,
4356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
5356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
6356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and
7356z.62 of the Illinois Insurance Code. The program of health
8benefits must comply with Sections 155.22a, 155.37, 355b,
9356z.19, 370c, and 370c.1 and Article XXXIIB of the Illinois
10Insurance Code. The Department of Insurance shall enforce the
11requirements of this Section with respect to Sections 370c and
12370c.1 of the Illinois Insurance Code; all other requirements
13of this Section shall be enforced by the Department of Central
14Management Services.
15    Rulemaking authority to implement Public Act 95-1045, if
16any, is conditioned on the rules being adopted in accordance
17with all provisions of the Illinois Administrative Procedure
18Act and all rules and procedures of the Joint Committee on
19Administrative Rules; any purported rule not so adopted, for
20whatever reason, is unauthorized.
21(Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20;
22101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff.
231-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103,
24eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
25102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
261-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,

 

 

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1eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
2revised 12-13-22.)
 
3    (Text of Section after amendment by P.A. 102-768)
4    Sec. 6.11. Required health benefits; Illinois Insurance
5Code requirements. The program of health benefits shall
6provide the post-mastectomy care benefits required to be
7covered by a policy of accident and health insurance under
8Section 356t of the Illinois Insurance Code. The program of
9health benefits shall provide the coverage required under
10Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x,
11356z.2, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10,
12356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.17, 356z.22,
13356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
14356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
15356z.53, 356z.54, 356z.55, 356z.56, 356z.57, 356z.59, and
16356z.60, and 356z.62 of the Illinois Insurance Code. The
17program of health benefits must comply with Sections 155.22a,
18155.37, 355b, 356z.19, 370c, and 370c.1 and Article XXXIIB of
19the Illinois Insurance Code. The Department of Insurance shall
20enforce the requirements of this Section with respect to
21Sections 370c and 370c.1 of the Illinois Insurance Code; all
22other requirements of this Section shall be enforced by the
23Department of Central Management Services.
24    Rulemaking authority to implement Public Act 95-1045, if
25any, is conditioned on the rules being adopted in accordance

 

 

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1with all provisions of the Illinois Administrative Procedure
2Act and all rules and procedures of the Joint Committee on
3Administrative Rules; any purported rule not so adopted, for
4whatever reason, is unauthorized.
5(Source: P.A. 101-13, eff. 6-12-19; 101-281, eff. 1-1-20;
6101-393, eff. 1-1-20; 101-452, eff. 1-1-20; 101-461, eff.
71-1-20; 101-625, eff. 1-1-21; 102-30, eff. 1-1-22; 102-103,
8eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22;
9102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
101-1-23; 102-768, eff. 1-1-24; 102-804, eff. 1-1-23; 102-813,
11eff. 5-13-22; 102-816, eff. 1-1-23; 102-860, eff. 1-1-23;
12102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23.)
 
13    Section 15. The Criminal Identification Act is amended by
14changing 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
17operating a medical facility, or any physician or nurse as
18soon as treatment permits to notify the local law enforcement
19agency of that jurisdiction upon the application for treatment
20of a person who is not accompanied by a law enforcement
21officer, when it reasonably appears that the person requesting
22treatment 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
4harmless from any civil liability for their reasonable
5compliance with the provisions of this Section.
6    (b) Notwithstanding subsection (a), nothing in this
7Section shall be construed to require the reporting of lawful
8health care activity, whether such activity may constitute a
9violation 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,
3receiving, assisting in seeking, providing, or receiving,
4providing material support for, or traveling to obtain lawful
5health care.
6(Source: P.A. 102-1117, eff. 1-13-23.)
 
7    Section 20. The Counties Code is amended by changing
8Section 5-1069.3 as follows:
 
9    (55 ILCS 5/5-1069.3)
10    Sec. 5-1069.3. Required health benefits. If a county,
11including a home rule county, is a self-insurer for purposes
12of providing health insurance coverage for its employees, the
13coverage shall include coverage for the post-mastectomy care
14benefits required to be covered by a policy of accident and
15health insurance under Section 356t and the coverage required
16under Sections 356g, 356g.5, 356g.5-1, 356q, 356u, 356w, 356x,
17356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11,
18356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26,
19356z.29, 356z.30a, 356z.32, 356z.33, 356z.36, 356z.40,
20356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53,
21356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and 356z.62
22of the Illinois Insurance Code. The coverage shall comply with
23Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
24Insurance Code. The Department of Insurance shall enforce the

 

 

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1requirements of this Section. The requirement that health
2benefits be covered as provided in this Section is an
3exclusive power and function of the State and is a denial and
4limitation under Article VII, Section 6, subsection (h) of the
5Illinois Constitution. A home rule county to which this
6Section applies must comply with every provision of this
7Section.
8    Rulemaking authority to implement Public Act 95-1045, if
9any, is conditioned on the rules being adopted in accordance
10with all provisions of the Illinois Administrative Procedure
11Act and all rules and procedures of the Joint Committee on
12Administrative Rules; any purported rule not so adopted, for
13whatever reason, is unauthorized.
14(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
15101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
161-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
17eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22;
18102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
191-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
20eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
21102-1117, eff. 1-13-23.)
 
22    Section 25. The Illinois Municipal Code is amended by
23changing 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
2municipality, including a home rule municipality, is a
3self-insurer for purposes of providing health insurance
4coverage for its employees, the coverage shall include
5coverage for the post-mastectomy care benefits required to be
6covered by a policy of accident and health insurance under
7Section 356t and the coverage required under Sections 356g,
8356g.5, 356g.5-1, 356q, 356u, 356w, 356x, 356z.4, 356z.4a,
9356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
10356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29,
11356z.30a, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41,
12356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54,
13356z.56, 356z.57, 356z.59, and 356z.60, and 356z.62 of the
14Illinois Insurance Code. The coverage shall comply with
15Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
16Insurance Code. The Department of Insurance shall enforce the
17requirements of this Section. The requirement that health
18benefits be covered as provided in this is an exclusive power
19and function of the State and is a denial and limitation under
20Article VII, Section 6, subsection (h) of the Illinois
21Constitution. A home rule municipality to which this Section
22applies must comply with every provision of this Section.
23    Rulemaking authority to implement Public Act 95-1045, if
24any, is conditioned on the rules being adopted in accordance
25with all provisions of the Illinois Administrative Procedure
26Act and all rules and procedures of the Joint Committee on

 

 

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1Administrative Rules; any purported rule not so adopted, for
2whatever reason, is unauthorized.
3(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
4101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
51-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
6eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff. 1-1-22;
7102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731, eff.
81-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816,
9eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
10102-1117, eff. 1-13-23.)
 
11    Section 30. The School Code is amended by changing Section
1210-22.3f as follows:
 
13    (105 ILCS 5/10-22.3f)
14    Sec. 10-22.3f. Required health benefits. Insurance
15protection and benefits for employees shall provide the
16post-mastectomy care benefits required to be covered by a
17policy of accident and health insurance under Section 356t and
18the coverage required under Sections 356g, 356g.5, 356g.5-1,
19356q, 356u, 356w, 356x, 356z.4, 356z.4a, 356z.6, 356z.8,
20356z.9, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22,
21356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
22356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
23356z.53, 356z.54, 356z.56, 356z.57, 356z.59, and 356z.60, and
24356z.62 of the Illinois Insurance Code. Insurance policies

 

 

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1shall comply with Section 356z.19 of the Illinois Insurance
2Code. The coverage shall comply with Sections 155.22a, 355b,
3and 370c of the Illinois Insurance Code. The Department of
4Insurance shall enforce the requirements of this Section.
5    Rulemaking authority to implement Public Act 95-1045, if
6any, is conditioned on the rules being adopted in accordance
7with all provisions of the Illinois Administrative Procedure
8Act and all rules and procedures of the Joint Committee on
9Administrative Rules; any purported rule not so adopted, for
10whatever reason, is unauthorized.
11(Source: P.A. 101-81, eff. 7-12-19; 101-281, eff. 1-1-20;
12101-393, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625, eff.
131-1-21; 102-30, eff. 1-1-22; 102-103, eff. 1-1-22; 102-203,
14eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff. 1-1-22;
15102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-804, eff.
161-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860,
17eff. 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
19changing Section 356z.4 and by adding Section 356z.62 as
20follows:
 
21    (215 ILCS 5/356z.4)
22    Sec. 356z.4. Coverage for contraceptives.
23    (a)(1) The General Assembly hereby finds and declares all
24of 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,
21examinations, procedures, and medical services related to the
22use of contraceptive methods (including natural family
23planning) 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
26severity of side effects, differences in permanence and

 

 

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1reversibility of contraceptive, and ability to adhere to the
2appropriate use of the item or service, as determined by the
3attending provider.
4    "Therapeutic equivalent version" means drugs, devices, or
5products that can be expected to have the same clinical effect
6and safety profile when administered to patients under the
7conditions specified in the labeling and satisfy the following
8general 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
24insurance amended, delivered, issued, or renewed in this State
25after the effective date of this amendatory Act of the 99th
26General Assembly shall provide coverage for all of the

 

 

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1following 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
17policy subject to this subsection (a) shall not impose a
18deductible, coinsurance, copayment, or any other cost-sharing
19requirement on the coverage provided. The provisions of this
20paragraph do not apply to coverage of voluntary male
21sterilization procedures to the extent such coverage would
22disqualify a high-deductible health plan from eligibility for
23a health savings account pursuant to the federal Internal
24Revenue 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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1the coverage required under this subsection (a).
2    (6) If, at any time, the Secretary of the United States
3Department of Health and Human Services, or its successor
4agency, promulgates rules or regulations to be published in
5the Federal Register or publishes a comment in the Federal
6Register or issues an opinion, guidance, or other action that
7would require the State, pursuant to any provision of the
8Patient Protection and Affordable Care Act (Public Law
9111-148), including, but not limited to, 42 U.S.C.
1018031(d)(3)(B) or any successor provision, to defray the cost
11of any coverage outlined in this subsection (a), then this
12subsection (a) is inoperative with respect to all coverage
13outlined in this subsection (a) other than that authorized
14under Section 1902 of the Social Security Act, 42 U.S.C.
151396a, and the State shall not assume any obligation for the
16cost of the coverage set forth in this subsection (a).
17    (b) This subsection (b) shall become operative if and only
18if subsection (a) becomes inoperative.
19    An individual or group policy of accident and health
20insurance amended, delivered, issued, or renewed in this State
21after the date this subsection (b) becomes operative that
22provides coverage for outpatient services and outpatient
23prescription drugs or devices must provide coverage for the
24insured and any dependent of the insured covered by the policy
25for all outpatient contraceptive services and all outpatient
26contraceptive drugs and devices approved by the Food and Drug

 

 

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1Administration. Coverage required under this Section may not
2impose any deductible, coinsurance, waiting period, or other
3cost-sharing or limitation that is greater than that required
4for any outpatient service or outpatient prescription drug or
5device otherwise covered by the policy.
6    Nothing in this subsection (b) shall be construed to
7require an insurance company to cover services related to
8permanent sterilization that requires a surgical procedure.
9    As used in this subsection (b), "outpatient contraceptive
10service" means consultations, examinations, procedures, and
11medical services, provided on an outpatient basis and related
12to the use of contraceptive methods (including natural family
13planning) to prevent an unintended pregnancy.
14    (c) (Blank).
15    (d) If a plan or issuer utilizes a network of providers,
16nothing in this Section shall be construed to require coverage
17or to prohibit the plan or issuer from imposing cost-sharing
18for items or services described in this Section that are
19provided or delivered by an out-of-network provider, unless
20the plan or issuer does not have in its network a provider who
21is able to or is willing to provide the applicable items or
22services.
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
2individual health insurance coverage as defined in Section 5
3of the Illinois Health Insurance Portability and
4Accountability Act shall, at a minimum, provide coverage for
5and shall not impose any cost-sharing requirements, including
6a 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
26other provision of State law, recommendations of the United

 

 

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1States Preventive Services Task Force regarding breast cancer
2screening, mammography, and prevention issued in or around
3November 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
26that is one year after the date the recommendation or

 

 

SB1561 Enrolled- 19 -LRB103 27713 CPF 54090 b

1guideline is issued. If a recommendation or guideline is in
2effect on the first day of the plan or policy year, the policy
3shall cover the items and services specified in the
4recommendation or guideline through the last day of the plan
5or 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
10reasonable medical management techniques to determine the
11frequency, method, treatment, or setting for an item or
12service described in subsection (a) to the extent not
13specified in the recommendation or guideline.
14    (g) Nothing in this Section shall be construed to prohibit
15a policy from providing coverage for items or services in
16addition to those required under subsection (a) or from
17denying coverage for items or services that are not required
18under subsection (a). Unless prohibited by other law, a policy
19may impose cost-sharing requirements for a treatment not
20described in subsection (a) even if the treatment results from
21an item or service described in subsection (a). Nothing in
22this Section shall be construed to limit coverage requirements
23provided under other law.
24    (h) The Director may develop guidelines to permit a
25company to utilize value-based insurance designs. In the
26absence of guidelines developed by the Director, any such

 

 

SB1561 Enrolled- 21 -LRB103 27713 CPF 54090 b

1guidelines developed by the Secretary of the U.S. Department
2of Health and Human Services that are in force under 42 U.S.C.
3300gg-13 shall apply.
4    (i) For student health insurance coverage as defined at 45
5CFR 147.145, student administrative health fees are not
6considered cost-sharing requirements with respect to
7preventive services specified under subsection (a). As used in
8this subsection, "student administrative health fee" means a
9fee charged by an institution of higher education on a
10periodic basis to its students to offset the cost of providing
11health care through health clinics regardless of whether the
12students utilize the health clinics or enroll in student
13health insurance coverage.
14    (j) For any recommendation or guideline specifically
15referring to women or men, a company shall not deny or limit
16the coverage required or a claim made under subsection (a)
17based solely on the individual's recorded sex or actual or
18perceived gender identity, or for the reason that the
19individual is gender nonconforming, intersex, transgender, or
20has undergone, or is in the process of undergoing, gender
21transition, if, notwithstanding the sex or gender assigned at
22birth, the covered individual meets the conditions for the
23recommendation or guideline at the time the item or service is
24furnished.
25    (k) This Section does not apply to grandfathered health
26plans, excepted benefits, or short-term, limited-duration

 

 

SB1561 Enrolled- 22 -LRB103 27713 CPF 54090 b

1health insurance coverage.
 
2    Section 40. The Health Maintenance Organization Act is
3amended 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
7the provisions of Sections 133, 134, 136, 137, 139, 140,
8141.1, 141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153,
9154, 154.5, 154.6, 154.7, 154.8, 155.04, 155.22a, 355.2,
10355.3, 355b, 355c, 356g.5-1, 356m, 356q, 356v, 356w, 356x,
11356y, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5, 356z.6,
12356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13, 356z.14,
13356z.15, 356z.17, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25,
14356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.33,
15356z.35, 356z.36, 356z.40, 356z.41, 356z.46, 356z.47, 356z.48,
16356z.50, 356z.51, 356z.53 256z.53, 356z.54, 356z.56, 356z.57,
17356z.59, 356z.60, 356z.62, 364, 364.01, 364.3, 367.2, 367.2-5,
18367i, 368a, 368b, 368c, 368d, 368e, 370c, 370c.1, 401, 401.1,
19402, 403, 403A, 408, 408.2, 409, 412, 444, and 444.1,
20paragraph (c) of subsection (2) of Section 367, and Articles
21IIA, VIII 1/2, XII, XII 1/2, XIII, XIII 1/2, XXV, XXVI, and
22XXXIIB of the Illinois Insurance Code.
23    (b) For purposes of the Illinois Insurance Code, except
24for Sections 444 and 444.1 and Articles XIII and XIII 1/2,

 

 

SB1561 Enrolled- 23 -LRB103 27713 CPF 54090 b

1Health Maintenance Organizations in the following categories
2are 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
14acquisition of control of a Health Maintenance Organization
15pursuant 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
21Insurance Code and this Section 5-3 shall apply to the sale by
22any health maintenance organization of greater than 10% of its
23enrollee population (including without limitation the health
24maintenance organization's right, title, and interest in and
25to its health care certificates).
26    (e) In considering any management contract or service

 

 

SB1561 Enrolled- 25 -LRB103 27713 CPF 54090 b

1agreement subject to Section 141.1 of the Illinois Insurance
2Code, the Director (i) shall, in addition to the criteria
3specified in Section 141.2 of the Illinois Insurance Code,
4take into account the effect of the management contract or
5service agreement on the continuation of benefits to enrollees
6and the financial condition of the health maintenance
7organization to be managed or serviced, and (ii) need not take
8into account the effect of the management contract or service
9agreement on competition.
10    (f) Except for small employer groups as defined in the
11Small Employer Rating, Renewability and Portability Health
12Insurance Act and except for medicare supplement policies as
13defined in Section 363 of the Illinois Insurance Code, a
14Health Maintenance Organization may by contract agree with a
15group or other enrollment unit to effect refunds or charge
16additional 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
13statement in the evidence of coverage issued to each enrollee
14describing the possibility of a refund or additional premium,
15and upon request of any group or enrollment unit, provide to
16the group or enrollment unit a description of the method used
17to calculate (1) the Health Maintenance Organization's
18profitable experience with respect to the group or enrollment
19unit and the resulting refund to the group or enrollment unit
20or (2) the Health Maintenance Organization's unprofitable
21experience with respect to the group or enrollment unit and
22the resulting additional premium to be paid by the group or
23enrollment unit.
24    In no event shall the Illinois Health Maintenance
25Organization Guaranty Association be liable to pay any
26contractual obligation of an insolvent organization to pay any

 

 

SB1561 Enrolled- 27 -LRB103 27713 CPF 54090 b

1refund authorized under this Section.
2    (g) Rulemaking authority to implement Public Act 95-1045,
3if any, is conditioned on the rules being adopted in
4accordance with all provisions of the Illinois Administrative
5Procedure Act and all rules and procedures of the Joint
6Committee on Administrative Rules; any purported rule not so
7adopted, for whatever reason, is unauthorized.
8(Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19;
9101-281, eff. 1-1-20; 101-371, eff. 1-1-20; 101-393, eff.
101-1-20; 101-452, eff. 1-1-20; 101-461, eff. 1-1-20; 101-625,
11eff. 1-1-21; 102-30, eff. 1-1-22; 102-34, eff. 6-25-21;
12102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff.
131-1-22; 102-589, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665,
14eff. 10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22;
15102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff.
161-1-23; 102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093,
17eff. 1-1-23; 102-1117, eff. 1-13-23; revised 1-22-23.)
 
18    Section 45. The Voluntary Health Services Plans Act is
19amended 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
22services plan corporations and all persons interested therein
23or dealing therewith shall be subject to the provisions of
24Articles IIA and XII 1/2 and Sections 3.1, 133, 136, 139, 140,

 

 

SB1561 Enrolled- 28 -LRB103 27713 CPF 54090 b

1143, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3, 355b,
2356g, 356g.5, 356g.5-1, 356q, 356r, 356t, 356u, 356v, 356w,
3356x, 356y, 356z.1, 356z.2, 356z.3a, 356z.4, 356z.4a, 356z.5,
4356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12, 356z.13,
5356z.14, 356z.15, 356z.18, 356z.19, 356z.21, 356z.22, 356z.25,
6356z.26, 356z.29, 356z.30, 356z.30a, 356z.32, 356z.33,
7356z.40, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53, 356z.54,
8356z.56, 356z.57, 356z.59, 356z.60, 356z.62, 364.01, 364.3,
9367.2, 368a, 401, 401.1, 402, 403, 403A, 408, 408.2, and 412,
10and paragraphs (7) and (15) of Section 367 of the Illinois
11Insurance Code.
12    Rulemaking authority to implement Public Act 95-1045, if
13any, is conditioned on the rules being adopted in accordance
14with all provisions of the Illinois Administrative Procedure
15Act and all rules and procedures of the Joint Committee on
16Administrative Rules; any purported rule not so adopted, for
17whatever reason, is unauthorized.
18(Source: P.A. 101-13, eff. 6-12-19; 101-81, eff. 7-12-19;
19101-281, eff. 1-1-20; 101-393, eff. 1-1-20; 101-625, eff.
201-1-21; 102-30, eff. 1-1-22; 102-203, eff. 1-1-22; 102-306,
21eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, eff. 10-8-21;
22102-731, eff. 1-1-23; 102-775, eff. 5-13-22; 102-804, eff.
231-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-860,
24eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093, eff. 1-1-23;
25102-1117, eff. 1-13-23.)
 

 

 

SB1561 Enrolled- 29 -LRB103 27713 CPF 54090 b

1    Section 50. The Medical Practice Act of 1987 is amended by
2changing 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
6permits.
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
18successfully pass a general competency examination authorized
19by the Department by rule, unless he or she was issued an
20initial visiting professor permit on or after January 1, 2007,
21but 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.
 

 

 

SB1561 Enrolled- 36 -LRB103 27713 CPF 54090 b

1    (D) Postgraduate training exemption period; visiting
2rotations. A person may participate in visiting rotations in
3an approved postgraduate training program, not to exceed a
4total of 90 days for all rotations, if the following
5information is submitted in writing or electronically to the
6Department by the patient care clinics or facilities where the
7person will be performing the training or by an affiliated
8program:
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

 

 

SB1561 Enrolled- 37 -LRB103 27713 CPF 54090 b

1changes in a statute that is represented in this Act by text
2that is not yet or no longer in effect (for example, a Section
3represented by multiple versions), the use of that text does
4not accelerate or delay the taking effect of (i) the changes
5made by this Act or (ii) provisions derived from any other
6Public Act.
 
7    Section 99. Effective date. This Act takes effect upon
8becoming law.