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Rep. Robyn Gabel
Filed: 4/13/2016
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1 | | AMENDMENT TO HOUSE BILL 4364
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2 | | AMENDMENT NO. ______. Amend House Bill 4364 by replacing |
3 | | everything after the enacting clause with the following:
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4 | | "Section 1. Short title. This Act may be cited as the Home |
5 | | Birth Safety Act. |
6 | | Section 5. Purpose. The practice of midwifery in |
7 | | out-of-hospital settings is hereby declared to affect the |
8 | | public health, safety, and welfare and to be subject to |
9 | | regulation in the public interest. The purpose of this Act is |
10 | | to protect and benefit the public by setting standards for the |
11 | | qualifications, education, training, and experience of those |
12 | | who seek to obtain licensure as a licensed certified |
13 | | professional midwife, including a requirement to work |
14 | | collaboratively with hospital-based and privileged health care |
15 | | professionals to promote high standards of professional |
16 | | performance for those licensed to practice midwifery in |
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1 | | out-of-hospital settings in this State, to promote a |
2 | | collaborative and integrated maternity care delivery system in |
3 | | Illinois with agreed-upon consulting, transfer and transport |
4 | | protocols in use by all health care professionals and licensed |
5 | | midwives across all health care settings to maximize patient |
6 | | safety and positive outcomes, to support accredited education |
7 | | and training as a prerequisite to licensure and to protect the |
8 | | public from unprofessional conduct by persons licensed to |
9 | | practice midwifery, as defined in this Act. This Act shall be |
10 | | liberally construed to best carry out these purposes. |
11 | | Section 10. Exemptions. |
12 | | (a) This Act does not prohibit a person licensed under any |
13 | | other Act in this State from engaging in the practice for which |
14 | | he or she is licensed or from delegating services as provided |
15 | | for under that other Act. |
16 | | (b) Nothing in this Act shall be construed to prohibit or |
17 | | require licensing under this Act with regard to: |
18 | | (1) the rendering of services by a birth attendant, if |
19 | | such attendance is in accordance with the birth attendant's |
20 | | cultural traditions or religious faith and is rendered only |
21 | | to women and families in that distinct cultural or |
22 | | religious group as an exercise and enjoyment of their |
23 | | religious freedom; and |
24 | | (2) a student midwife working under the direction of a |
25 | | licensed certified professional midwife. |
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1 | | Section 15. Definitions. In this Act: |
2 | | "Board" means the Illinois Midwifery Board, as specified in |
3 | | this Act. |
4 | | "Certified Professional Midwife" or "CPM" means a person |
5 | | who has met the standards for certification as a Certified |
6 | | Professional Midwife set by the North American Registry of |
7 | | Midwives or its successor, including successful completion of a |
8 | | comprehensive written examination administered in a university |
9 | | testing center contracted by the North American Registry of |
10 | | Midwives. |
11 | | "Department" means the Department of Financial and |
12 | | Professional Regulation. |
13 | | "Health care practitioner" means physician licensed to |
14 | | practice medicine in all its branches or an advanced practice |
15 | | nurse who is a certified nurse midwife. |
16 | | "Licensed certified professional midwife" or "LCPM" means |
17 | | a person who has successfully met the requirements under |
18 | | Section 30 of this Act. |
19 | | "Midwifery Bridge Certificate" means the certificate |
20 | | issued by the North American Registry of Midwives that |
21 | | documents completion of 50 hours of accredited continuing |
22 | | education specific to content in emergency skills for |
23 | | pregnancy, birth, and newborn care, along with other midwifery |
24 | | topics addressing the core competencies established by the |
25 | | International Confederation of Midwives or its successor. |
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1 | | Bridge topics shall include 14 hours of obstetric emergency |
2 | | skills training, such as birth emergency skills training (BEST) |
3 | | or an advanced life-saving in obstetrics (ALSO) course. The |
4 | | remaining 36 hours shall be divided among and include hours in |
5 | | the areas of pharmacology, lab interpretations of pregnancy, |
6 | | antepartum complications, intra-partum complications, |
7 | | postpartum complications, and neonatal care or any additional |
8 | | requirements subsequently required by the North American |
9 | | Registry of Midwives or its successor. |
10 | | "MEAC" means the Midwifery Education and Accreditation |
11 | | Council, or its successor. |
12 | | "NARM" means the North American Registry of Midwives, or |
13 | | any successor organization, that has established and has |
14 | | continued to administer certification for the credentialing of |
15 | | Certified Professional Midwives. |
16 | | "Patient" means a woman or newborn for whom a licensed |
17 | | certified professional midwife provides services. |
18 | | "Postpartum period" means the first 6 weeks after delivery. |
19 | | "Practice of midwifery" means, consistent with current |
20 | | national standards, this Act, and rules adopted by the |
21 | | Department, providing the necessary supervision, care, |
22 | | education, and advice to people with low-risk pregnancies |
23 | | during the antepartum, intra-partum, and postpartum period, |
24 | | conducting deliveries, and caring for the newborn, with such |
25 | | care including preventative measures, the detection of |
26 | | abnormal conditions in the mother and the child, the |
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1 | | identification, referral and procurement of medical assistance |
2 | | when necessary care is beyond the scope of certified |
3 | | professional midwifery practice, and the execution of |
4 | | emergency measures in the absence of medical help. "Practice of |
5 | | midwifery" includes breastfeeding education, non-prescriptive |
6 | | family planning, and basic well-woman care limited to sexually |
7 | | transmitted infection screenings. |
8 | | "Secretary" means the Secretary of Financial and |
9 | | Professional Regulation. |
10 | | Section 20. Unlicensed practice. Beginning on January 1, |
11 | | 2017, no person may practice, attempt to practice, or hold |
12 | | himself or herself out to practice as a licensed certified |
13 | | professional midwife unless he or she is licensed under this |
14 | | Act. |
15 | | Section 25. Powers and duties of the Department; rules. |
16 | | (a) The Department shall exercise the powers and duties |
17 | | prescribed by the Civil Administrative Code of Illinois for the |
18 | | administration of licensing Acts and shall exercise such other |
19 | | powers and duties necessary for effectuating the purposes of |
20 | | this Act. |
21 | | (b) The Department shall adopt rules under the Illinois |
22 | | Administrative Procedure Act for the administration and |
23 | | enforcement of the Act and for the payment of fees connected to |
24 | | the Act and may prescribe forms that shall be issued in |
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1 | | connection with the Act. In addition, the Department shall |
2 | | adopt rules establishing uniform State forms that licensed |
3 | | certified professional midwives must (1) provide to clients |
4 | | consistent with the Act, including informed consent forms, (2) |
5 | | complete and submit to the Board in each case in which the |
6 | | transport of a patient occurs in accordance with transport |
7 | | protocols recommended by the Board and adopted by the |
8 | | Department by rule, and (3) complete to report patient outcomes |
9 | | to the Board. |
10 | | (c) The rules adopted by the Department under this Section |
11 | | may not authorize a licensed certified professional midwife to |
12 | | practice beyond the scope of practice set forth in Section 45. |
13 | | (d) The Department shall consult with the Board in adopting |
14 | | rules. Notice of proposed rulemaking shall be transmitted to |
15 | | the Board and the Department shall review the Board's response |
16 | | and any recommendations made. The Department shall notify the |
17 | | Board in writing of deviations from the Board's recommendations |
18 | | and responses. |
19 | | (e) The Department may at any time seek the advice and the |
20 | | expert knowledge of the Board on any matter relating to the |
21 | | administration of this Act. |
22 | | (f) The Department shall issue quarterly a report to the |
23 | | Board of the status of all complaints related to the profession |
24 | | filed with the Department. |
25 | | (g) Administration by the Department of this Act must be |
26 | | consistent with standards regarding the practice of midwifery |
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1 | | established by the National Association of Certified |
2 | | Professional Midwives or a successor organization, this Act and |
3 | | rules adopted pursuant to this Act. |
4 | | Section 27. Requirements for schools. Schools providing |
5 | | education for licensed certified professional midwives shall |
6 | | provide a program of education that is accredited by the |
7 | | Midwifery Education and Accreditation Council and that |
8 | | includes, but is not limited to, classes on the following |
9 | | topics: |
10 | | (1) the community and social determinants of health, |
11 | | including income, literacy, education, water supply and |
12 | | sanitation, housing, environmental hazards, food security, |
13 | | disease patterns, and common threats to health; |
14 | | (2) principles of community-based primary care using |
15 | | health promotion and disease prevention and control |
16 | | strategies; |
17 | | (3) direct and indirect causes of maternal and neonatal |
18 | | mortality and morbidity and strategies for reducing them; |
19 | | (4) methodology for conducting maternal death review |
20 | | and near-miss audits; |
21 | | (5) principles of epidemiology and community |
22 | | diagnosis, including water and sanitation, and how to use |
23 | | these in care provision; |
24 | | (6) methods of infection prevention and control |
25 | | appropriate to the service being provided; |
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1 | | (7) principles of research, evidenced-based practice, |
2 | | critical interpretation of professional literature, and |
3 | | the interpretation of vital statistics and research |
4 | | findings; |
5 | | (8) indicators of quality health care services; |
6 | | (9) principles of health education; |
7 | | (10) national and local health services and |
8 | | infrastructures supporting the continuum of care through |
9 | | organizations and referral systems, and how to access |
10 | | needed resources for midwifery care; |
11 | | (11) relevant national or local programs or |
12 | | initiatives that provide services or knowledge of how to |
13 | | assist community members to access services, such as |
14 | | immunization and prevention or treatment of health |
15 | | conditions prevalent in the country or locality; |
16 | | (12) the concept of alarm or preparedness, the protocol |
17 | | for referral to higher health facility levels, and |
18 | | appropriate communication during transport and emergency |
19 | | care; |
20 | | (13) the legal and regulatory framework governing |
21 | | reproductive health for women of all ages, including laws, |
22 | | policies, protocols, and professional guidelines; |
23 | | (14) human rights and their effects on the health of |
24 | | individuals, including, but not limited to, health |
25 | | disparities, domestic partner violence, and female genital |
26 | | mutilation or cutting; |
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1 | | (15) advocacy and empowerment strategies for women; |
2 | | (16) the history of childbirth practices and the |
3 | | midwifery profession; |
4 | | (17) unique healthcare needs of women from distinct |
5 | | ethnic or cultural backgrounds or a variety of family |
6 | | structures and sexual orientations; |
7 | | (18) culturally sensitive care; |
8 | | (19) traditional and modern health practices that are |
9 | | beneficial, neutral, or harmful; |
10 | | (20) benefits and risks of available birth settings; |
11 | | (21) strategies for advocating with women for a variety |
12 | | of safe birth settings; |
13 | | (22) the purpose and role of national and local |
14 | | midwifery organizations that provide guidelines for |
15 | | professional behaviors, which include that the midwife: |
16 | | (A) is responsible and accountable for clinical |
17 | | decisions and actions; |
18 | | (B) acts consistently in accordance with |
19 | | professional ethics, values, and human rights as |
20 | | defined by national and local professional midwifery |
21 | | organizations; |
22 | | (C) acts consistently in accordance with standards |
23 | | of practice as defined by national and local |
24 | | professional midwifery organizations; |
25 | | (D) maintains and updates knowledge and skills in |
26 | | order to remain current in practice; |
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1 | | (E) uses standard or universal precautions, |
2 | | infection prevention and control strategies, and clean |
3 | | technique; |
4 | | (F) behaves in a courteous, non-judgmental, |
5 | | non-discriminatory, and culturally appropriate manner |
6 | | with all clients; |
7 | | (G) is respectful of individuals and their culture |
8 | | and customs, regardless of socioeconomic status, race, |
9 | | ethnic origin, sexual orientation, gender, physical |
10 | | ability, cognitive ability, or religious belief; |
11 | | (H) maintains the confidentiality of all |
12 | | information shared by the woman and communicates |
13 | | essential information among other health care |
14 | | providers or family members only with explicit |
15 | | permission from the woman and in situations of |
16 | | compelling need; |
17 | | (I) uses shared decision-making in partnership |
18 | | with women and their families to enable and support |
19 | | them in making informed choices about their health, |
20 | | including the need or desire for referral or transfer |
21 | | to other health care providers or facilities for |
22 | | continued care when health care needs exceed the |
23 | | abilities of the licensed certified professional |
24 | | midwife, and their right to refuse testing or |
25 | | intervention; |
26 | | (J) works collaboratively with other health care |
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1 | | workers to improve the delivery of services to women |
2 | | and families; |
3 | | (K) follows appropriate protocol and etiquette for |
4 | | transport or transfer of care of the mother or newborn |
5 | | from home or birth center to the hospital during |
6 | | pregnancy, in labor, or postpartum; and |
7 | | (L) provides opportunity for client feedback; |
8 | | (23) classes ensuring that the midwife has the skill or |
9 | | ability to: |
10 | | (A) engage in health education discussions with |
11 | | and for women and their families; |
12 | | (B) use appropriate communication and listening |
13 | | skills across all domains of competency; |
14 | | (C) assemble, use, and maintain equipment and |
15 | | supplies appropriate to setting of practice; |
16 | | (D) document and interpret relevant findings for |
17 | | services provided across all domains of competency, |
18 | | including what was done and what needs follow-up |
19 | | according to current best practices; |
20 | | (E) comply with all local regulations for birth and |
21 | | death registration, mandatory reporting for physical |
22 | | abuse, and infectious disease reporting; |
23 | | (F) take a leadership role in the practice arena |
24 | | based on professional beliefs and values; and |
25 | | (G) assume administration and management tasks and |
26 | | activities, including, but not limited to, compliance |
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1 | | with privacy and protected health information |
2 | | regulations, such as compliance with the requirements |
3 | | of the Health Insurance Portability and Accountability |
4 | | Act, and compliance with workplace safety regulations, |
5 | | including compliance with regulations of the |
6 | | Occupational Safety and Health Administration; |
7 | | (24) anatomy and physiology of the human body; |
8 | | (25) the biology of human reproduction, the menstrual |
9 | | cycle, and the process of conception; |
10 | | (26) the growth and development of the unborn baby; |
11 | | (27) signs and symptoms of pregnancy; |
12 | | (28) examinations and tests for confirmation of |
13 | | pregnancy; |
14 | | (29) signs and symptoms and methods for diagnosis of an |
15 | | ectopic pregnancy; |
16 | | (30) principles of dating pregnancy by menstrual |
17 | | history, size of uterus, fundal growth patterns, and use of |
18 | | ultrasound; |
19 | | (31) components of a health history and focused |
20 | | physical examination for antenatal visits; |
21 | | (32) manifestations of various degrees of female |
22 | | genital mutilation or cutting and their potential; |
23 | | (33) factors involved in decisions relating to |
24 | | unintended or mistimed pregnancies; |
25 | | (34) normal findings or results of basic screening |
26 | | laboratory tests, including, but not limited to, (i) |
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1 | | routine pregnancy blood work, (ii) urine dipstick, (iii) |
2 | | fetal screening, such as genetic testing, biophysical |
3 | | profiles, first and second trimester screen, non-stress |
4 | | test, and ultrasound, (iv) glucose tolerance screen, (v) |
5 | | pre-eclampsia screening tests, and (vi) Group B |
6 | | streptococcus vaginal or rectal culture; |
7 | | (35) normal progression of pregnancy, such as body |
8 | | changes, common discomforts, expected fundal growth |
9 | | patterns, and weight gain; |
10 | | (36) implications of deviation from expected fundal |
11 | | growth patterns, including intrauterine growth retardation |
12 | | or restriction, oligohydramnios and polyhydramnios, and |
13 | | multiple fetuses; |
14 | | (37) fetal risk factors requiring transfer of women to |
15 | | higher levels of care prior to labor and birth; |
16 | | (38) normal psychological changes in pregnancy, |
17 | | indicators of psychosocial stress, and impact of pregnancy |
18 | | on the woman and the family; |
19 | | (39) safe locally available non-pharmacological |
20 | | methods for the relief of common discomforts of pregnancy; |
21 | | (40) how to determine fetal well-being during |
22 | | pregnancy, including fetal heart rate and activity |
23 | | patterns, amniocentesis, and ultrasound technology; |
24 | | (41) components of a healthy diet and the nutritional |
25 | | requirements of the pregnant woman and fetus, including the |
26 | | appropriate use of vitamin and mineral supplements; |
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1 | | (42) health education needs in pregnancy, such as |
2 | | information about relief of common discomforts, hygiene, |
3 | | sexuality, and work inside and outside the home; |
4 | | (43) basic principles of pharmacokinetics of drugs |
5 | | prescribed, dispensed, or furnished to women during |
6 | | pregnancy; |
7 | | (44) effects of prescribed medications, ultrasound, |
8 | | street drugs, traditional medicines, and over-the-counter |
9 | | drugs on pregnancy and the fetus; |
10 | | (45) effects of smoking, alcohol abuse, and illicit |
11 | | drug use on the pregnant woman and fetus; |
12 | | (46) effects of environmental exposures, food-borne |
13 | | illnesses, or certain activities on the pregnant woman and |
14 | | fetus, such as heavy metals, listeriosis, pesticides, food |
15 | | additives, saunas, and toxoplasmosis; |
16 | | (47) the essential elements of birth planning, |
17 | | including, but not limited to, preparation for labor and |
18 | | birth and emergency preparedness; |
19 | | (48) the physical preparation for labor; |
20 | | (49) the components of preparation of the home and |
21 | | family for the newborn; |
22 | | (50) techniques for increasing relaxation and pain |
23 | | relief measures available for labor; |
24 | | (51) signs, symptoms, and potential effects of |
25 | | conditions that are life-threatening to the pregnant woman |
26 | | or her fetus, including, but not limited to, (i) |
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1 | | pre-eclampsia or eclampsia, (ii) vaginal bleeding, (iii) |
2 | | premature labor, (iv) Rh isoimmunization, and (v) |
3 | | syphilis; |
4 | | (52) means and methods of advising about care, |
5 | | treatment, and support for the HIV-positive pregnant |
6 | | woman, including measures to prevent maternal-to-child |
7 | | transmission (PMTCT) and feeding options; |
8 | | (53) signs, symptoms, and indications for referral of |
9 | | selected complications and conditions of pregnancy that |
10 | | affect either the mother or the fetus, including, but not |
11 | | limited to, (i) anemia, (ii) asthma, (iii) HIV infection, |
12 | | (iv) thyroid disorders, (v) diabetes, (vi) cardiac |
13 | | conditions, (vii) malpresentations and abnormal lie, |
14 | | (viii) placental disorders, (ix) pre-term labor, (x) |
15 | | post-dates pregnancy, and (xi) hydatidiform mole; |
16 | | (54) the prenatal methods for encouraging optimal |
17 | | positioning at term, including external manual version; |
18 | | (55) the physiology of lactation and methods to prepare |
19 | | women for breastfeeding; |
20 | | (56) classes ensuring that the midwife has the skill or |
21 | | ability to: |
22 | | (A) take an initial history and perform an ongoing |
23 | | history for each antenatal visit; |
24 | | (B) perform a complete physical examination and |
25 | | explain the findings to the woman; |
26 | | (C) take and assess maternal vital signs, |
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1 | | including temperature, blood pressure, and pulse; |
2 | | (D) draw blood and collect urine and vaginal |
3 | | culture specimens for laboratory testing; |
4 | | (E) assess maternal nutrition and its relationship |
5 | | to fetal growth and give appropriate advice on the |
6 | | nutritional requirements of pregnancy and how to |
7 | | achieve them; |
8 | | (F) perform a complete abdominal assessment |
9 | | including measuring fundal height, lie, position, and |
10 | | presentation; |
11 | | (G) assess fetal growth using manual measurements; |
12 | | (H) evaluate fetal growth, placental location, and |
13 | | amniotic fluid volume by using manual measurements or |
14 | | techniques and by referring for ultrasound |
15 | | visualization and measurement; |
16 | | (I) listen to the fetal heart rate, palpate the |
17 | | uterus for fetal activity, and interpret findings; |
18 | | (J) monitor fetal heart rate with Doppler; |
19 | | (K) perform a pelvic examination, including sizing |
20 | | the uterus, if indicated and when appropriate during |
21 | | the course of pregnancy; |
22 | | (L) perform clinical pelvimetry (evaluation of |
23 | | bony pelvis) to determine the adequacy of the bony |
24 | | structures; |
25 | | (M) calculate the estimated date of birth and |
26 | | assess gestational period through query about the last |
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1 | | menstrual period, bimanual examination, urine |
2 | | pregnancy testing, or any combination thereof; |
3 | | (N) provide health education to adolescents, |
4 | | women, and families about normal pregnancy |
5 | | progression, danger signs and symptoms, and when and |
6 | | how to contact the midwife; |
7 | | (O) teach or demonstrate measures to decrease |
8 | | common discomforts of pregnancy; |
9 | | (P) provide guidance and basic preparation for |
10 | | labor, birth, and parenting; |
11 | | (Q) provide education regarding avoidance of |
12 | | potentially harmful environmental exposures, |
13 | | food-borne illnesses, or activities; |
14 | | (R) identify variations during the course of the |
15 | | pregnancy and institute appropriate first-line |
16 | | independent or collaborative management based upon |
17 | | evidence-based guidelines, local standards, and |
18 | | available resources for (i) low or inadequate maternal |
19 | | nutrition, including eating disorders and pica; (ii) |
20 | | anemia; (iii) ectopic pregnancy; (iv) hyperemesis |
21 | | gravidarum; (v) genital herpes; (vi) inadequate or |
22 | | excessive uterine growth, including suspected |
23 | | oligohydramnios or polyhydramnios, and molar |
24 | | pregnancy; (vii) gestational diabetes; (viii) |
25 | | insufficient cervix; (ix) elevated blood pressure, |
26 | | proteinuria, presence of significant edema, severe |
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1 | | frontal headaches, visual changes, and epigastric pain |
2 | | associated with elevated blood pressure; (x) vaginal |
3 | | bleeding with or without cramping; (xi) multiple |
4 | | gestation and abnormal lie or malpresentation at term; |
5 | | (xii) intrauterine fetal death; (xiii) rupture of |
6 | | membranes prior to term; (xiv) post term pregnancy; |
7 | | (xv) exposure to or contraction of infectious disease, |
8 | | such as HIV, Hepatitis B and Hepatitis C, Varicella, |
9 | | Rubella, and cytomegalovirus; (xvi) Group B |
10 | | streptococcus positive vaginal or rectal culture; |
11 | | (xvii) Toxoplasmosis; and (xviii) depression; |
12 | | (S) identify deviations from normal during the |
13 | | course of pregnancy and initiate the referral process |
14 | | for conditions that require higher levels of |
15 | | intervention; |
16 | | (T) dispense, furnish, or administer (however |
17 | | authorized to do so in the jurisdiction of practice) |
18 | | selected, life-saving drugs, such as antibiotics, |
19 | | anticonvulsants, antimalarials, antihypertensives, and |
20 | | antiretrovirals, to women in need because of a |
21 | | presenting condition; and |
22 | | (U) provide individualized care according to the |
23 | | needs and desires of each woman; |
24 | | (57) physiology of the first, second, and third stages |
25 | | of labor; |
26 | | (58) anatomy of the fetal skull, critical diameters, |
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1 | | and landmarks; |
2 | | (59) psychological and cultural aspects of labor and |
3 | | birth; |
4 | | (60) indicators of the latent phase and the onset of |
5 | | active labor; |
6 | | (61) indications for stimulation of the onset of labor, |
7 | | and augmentation of uterine contractility; |
8 | | (62) normal progression of labor; |
9 | | (63) how to use the partograph, including, but not |
10 | | limited to, completing the record and interpreting |
11 | | information to determine timely and appropriate labor |
12 | | management; |
13 | | (64) measures to assess fetal well-being in labor; |
14 | | (65) measures to assess maternal well-being in labor; |
15 | | (66) process of fetal passage or descent through the |
16 | | pelvis during labor and birth, mechanisms of labor in |
17 | | various fetal presentations, and positions; |
18 | | (67) comfort measures in the first and second stages of |
19 | | labor, such as family presence or assistance, positioning |
20 | | for labor and birth, hydration, emotional support, and |
21 | | non-pharmacological methods of pain relief; |
22 | | (68) pharmacological measures for management and |
23 | | control of labor pain, including the relative risks, |
24 | | disadvantages, and safety of specific methods of pain |
25 | | management and their effect on the normal physiology of |
26 | | labor; |
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1 | | (69) signs and symptoms of complications in labor, |
2 | | including, but not limited to, (i) bleeding, (ii) labor |
3 | | arrest or dysfunction, (iii) malpresentation, (iv) |
4 | | eclampsia, (v) maternal distress, (vi) fetal distress, |
5 | | (vii) infection, and (viii) prolapsed cord; |
6 | | (70) the benefits, risks, criteria for risk |
7 | | assessment, and midwifery management of vaginal birth |
8 | | after a cesarean; |
9 | | (71) indicators, risk factors, special needs, and |
10 | | prenatal management of a pregnant woman with a multiple |
11 | | gestation; |
12 | | (72) principles of prevention of pelvic floor damage |
13 | | and perineal tears; |
14 | | (73) indications for performing an episiotomy; |
15 | | (74) principles of expectant (physiologic) management |
16 | | of the third stage of labor; |
17 | | (75) principles of active management of the third stage |
18 | | of labor; |
19 | | (76) principles underpinning the technique for repair |
20 | | of perineal tears and episiotomy; |
21 | | (77) indicators of need for emergency management, |
22 | | referral, or transfer for obstetric emergencies, |
23 | | including, but not limited to, cord prolapse, shoulder |
24 | | dystocia, placental abruption, uterine rupture, uterine |
25 | | bleeding, and retained placenta; |
26 | | (78) indicators of need for operative deliveries, |
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1 | | vacuum extraction, and use of forceps, including, but not |
2 | | limited to, fetal distress and cephalopelvic |
3 | | disproportion; |
4 | | (79) indicators of need for and appropriate |
5 | | administration of the following pharmacologic agents: |
6 | | lidocaine/xylocaine for suturing, oxygen, methergine, |
7 | | oxytocin (Pitocin) for postpartum hemorrhage, rhogam, |
8 | | vitamin K, antibiotics for group B strep prophylaxis, |
9 | | intravenous fluids, and newborn eye prophylaxis; and |
10 | | (80) classes to ensure that the midwife has the skill |
11 | | or ability to: |
12 | | (A) take a specific history and maternal vital |
13 | | signs in labor; |
14 | | (B) perform a focused physical examination in |
15 | | labor; |
16 | | (C) perform a complete abdominal assessment for |
17 | | fetal position and descent; |
18 | | (D) time and assess the effectiveness of uterine |
19 | | contractions; |
20 | | (E) perform a complete and accurate pelvic |
21 | | examination for dilatation, effacement, descent, |
22 | | presenting part, position, status of membranes, and |
23 | | adequacy of pelvis for birth of baby vaginally; |
24 | | (F) monitor and chart progress of labor; |
25 | | (G) provide physical and psychological support for |
26 | | woman and family and promote normal birth, including |
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1 | | encouragement of adequate rest and sleep; |
2 | | (H) facilitate the presence of a support person |
3 | | during labor and birth; |
4 | | (I) provide adequate hydration, nutrition, and |
5 | | non-pharmacological comfort measures during labor and |
6 | | birth; |
7 | | (J) provide for bladder care, including |
8 | | performance of urinary catheterization when indicated; |
9 | | (K) promptly identify abnormal labor patterns or |
10 | | progress and initiate appropriate and timely |
11 | | intervention or referral, including, but not limited |
12 | | to, occiput posterior position, asynclitism, pendulous |
13 | | abdomen, maternal exhaustion, and maternal |
14 | | dehydration; |
15 | | (L) stimulate or augment uterine contractility |
16 | | using non-pharmacologic agents; |
17 | | (M) administer local anaesthetic to the perineum |
18 | | when episiotomy is anticipated or perineal repair is |
19 | | required; |
20 | | (N) perform an episiotomy if needed; |
21 | | (O) perform appropriate hand maneuvers for a |
22 | | vertex birth; |
23 | | (P) perform appropriate hand maneuvers for face |
24 | | and breech deliveries; |
25 | | (Q) manage the birth of multiples; |
26 | | (R) recognize the various severities of meconium |
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1 | | stained amniotic fluid and perform suctioning of the |
2 | | airway, as appropriate; |
3 | | (S) clamp and cut the cord; |
4 | | (T) institute immediate life-saving interventions |
5 | | in obstetrical emergencies to save the life of the |
6 | | fetus while requesting medical attention, awaiting |
7 | | transfer, or both, including, but not limited to, (i) |
8 | | prolapsed cord, (ii) placental abruption, (iii) |
9 | | uterine rupture, (iv) malpresentation, (v) shoulder |
10 | | dystocia, and (vi) fetal distress; |
11 | | (U) manage a nuchal cord or arm at birth; |
12 | | (V) support expectant (physiologic) management of |
13 | | the third stage of labor; |
14 | | (W) assess the need for and conduct active |
15 | | management of the third stage of labor, following the |
16 | | most current evidence-based protocol; |
17 | | (X) inspect the placenta and membranes for |
18 | | completeness; |
19 | | (Y) perform fundal massage to stimulate postpartum |
20 | | uterine contraction and uterine tone; |
21 | | (Z) provide a safe environment for mother and |
22 | | infant to promote attachment or bonding; |
23 | | (AA) estimate and record maternal blood loss; |
24 | | (BB) inspect the vagina and cervix for |
25 | | lacerations; |
26 | | (CC) repair an episiotomy, if needed; |
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1 | | (DD) repair first and second degree perineal or |
2 | | vaginal lacerations; |
3 | | (EE) manage postpartum bleeding and hemorrhage |
4 | | using appropriate techniques and uterotonic agents as |
5 | | indicated; |
6 | | (FF) dispense, furnish, or administer (however |
7 | | authorized to do so in the jurisdiction of practice) |
8 | | selected, life-saving drugs, including antibiotics and |
9 | | antihemorrhagics, to women in need because of a |
10 | | presenting condition; |
11 | | (GG) perform manual removal of placenta; |
12 | | (HH) perform internal and external bimanual |
13 | | compression of the uterus to control hemorrhage; |
14 | | (II) perform aortic compression; |
15 | | (JJ) identify and manage shock; |
16 | | (KK) insert an intravenous line, administer |
17 | | fluids, and draw blood for laboratory testing; |
18 | | (LL) arrange for and undertake timely referral and |
19 | | transfer of women with serious complications to a |
20 | | higher level health facility, taking appropriate drugs |
21 | | and equipment and arranging for a companion caregiver |
22 | | on the journey in order to continue giving emergency |
23 | | care as required; and |
24 | | (MM) perform adult cardiopulmonary resuscitation. |
25 | | Section 30. Qualifications for licensed certified |
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1 | | professional midwives. |
2 | | (a) Each applicant who successfully meets the requirements |
3 | | of this Section shall be licensed as a licensed certified |
4 | | professional midwife. |
5 | | (b) An applicant for licensure as a licensed certified |
6 | | professional midwife must do each of the following: |
7 | | (1) Submit a completed written application, on forms |
8 | | provided by the Department, and fees, as established by the |
9 | | Department. |
10 | | (2) Be at least 21 years old. |
11 | | (3) Be a high school graduate or have completed |
12 | | equivalent education. |
13 | | (4) Successfully complete one of the following formal |
14 | | midwifery education and training programs: |
15 | | (A) Accredited Educational Pathway: |
16 | | (i) Applicants who are Certified Professional |
17 | | Midwives and who have successfully completed an |
18 | | educational program or pathway accredited by the |
19 | | MEAC are eligible for licensure as a licensed |
20 | | certified professional midwife. |
21 | | (ii) After January 1, 2020, all new applicants |
22 | | for licensure as a licensed certified professional |
23 | | midwife must have graduated from an educational |
24 | | program or pathway accredited by MEAC. |
25 | | (B) Non-accredited Educational Pathway: |
26 | | (i) Applicants who are Certified Professional |
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1 | | Midwives before January 1, 2020, and who have |
2 | | completed non-accredited education pathways will |
3 | | be required to obtain the NARM Midwifery Bridge |
4 | | Certificate in order to become licensed as a |
5 | | licensed certified professional midwife. |
6 | | (ii) Applicants who have maintained licensure |
7 | | in a state that does not require accredited |
8 | | education, regardless of the date of their |
9 | | certification, shall obtain the NARM Midwifery |
10 | | Bridge Certificate to be eligible for licensure as |
11 | | a licensed certified professional midwife. |
12 | | (5) Hold a current valid Certified Professional |
13 | | Midwife Credential granted by NARM or its successor |
14 | | organization. |
15 | | (6) Hold current cardiopulmonary resuscitation (CPR) |
16 | | certification for health care professionals or providers |
17 | | issued by the American Red Cross or the American Heart |
18 | | Association. |
19 | | (7) Within the last 2 years have successfully completed |
20 | | the American Academy of Pediatric/American Heart |
21 | | Association neonatal resuscitation program (NRP). |
22 | | (8) Have not violated the provisions of this Act |
23 | | concerning the grounds for disciplinary action. The |
24 | | Department may take into consideration any felony |
25 | | conviction of the applicant, but such a conviction may not |
26 | | operate as an absolute bar to licensure as a licensed |
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1 | | certified professional midwife. |
2 | | (9) Submit to the criminal history records check |
3 | | required under Section 35 of this Act. |
4 | | (10) Meet all other requirements established by the |
5 | | Department by rule. |
6 | | Section 35. Criminal history records background check. |
7 | | Each applicant for licensure by examination or restoration |
8 | | shall submit his or her fingerprints to the Department of State |
9 | | Police in an electronic format that complies with the form and |
10 | | manner for requesting and furnishing criminal history record |
11 | | information prescribed by the Department of State Police. These |
12 | | fingerprints shall be checked against the Department of State |
13 | | Police and Federal Bureau of Investigation criminal history |
14 | | record databases now and hereafter filed. The Department of |
15 | | State Police shall charge applicants a fee for conducting the |
16 | | criminal history records check, which shall be deposited into |
17 | | the State Police Services Fund and shall not exceed the actual |
18 | | cost of the records check. The Department of State Police shall |
19 | | furnish, pursuant to positive identification, records of |
20 | | Illinois convictions to the Department and shall forward the |
21 | | national crime history record information to the Department. |
22 | | The Department may require applicants to pay a separate |
23 | | fingerprinting fee, either to the Department or to a vendor. |
24 | | The Department, in its discretion, may allow an applicant who |
25 | | does not have reasonable access to a designated vendor to |
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1 | | provide his or her fingerprints in an alternative manner. The |
2 | | Department may adopt any rules necessary to implement this |
3 | | Section. |
4 | | Section 40. Title. Only a licensed certified professional |
5 | | midwife may identify himself or herself as a "licensed |
6 | | certified professional midwife" or use the abbreviation |
7 | | "LCPM". |
8 | | Section 45. Scope of practice of licensed certified |
9 | | professional midwives. |
10 | | (a) "Practice of midwifery" means: |
11 | | (1) providing maternity care that is consistent with a |
12 | | midwife's training, education, and experience; and |
13 | | (2) identifying and referring patients who require |
14 | | medical care to an appropriate health care provider. |
15 | | (b) The practice of midwifery includes: |
16 | | (1) Providing the necessary supervision, care, and |
17 | | advice to a patient during a low-risk pregnancy, labor, |
18 | | delivery, and postpartum period. |
19 | | (2) Newborn care that is provided in a manner that is: |
20 | | (A) consistent with national certified |
21 | | professional midwifery standards; and |
22 | | (B) based on the acquisition of clinical skills |
23 | | necessary for the care of pregnant women and newborns, |
24 | | including antepartum, intra-partum, and postpartum |
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1 | | care. |
2 | | (3) Obtaining informed consent to provide services to |
3 | | the patient in accordance with Section 50 of this Act. |
4 | | (4) Discussing: |
5 | | (A) any general risk factors associated with the |
6 | | services to be provided; |
7 | | (B) any specific risk factors pertaining to the |
8 | | health and circumstances of the individual patient; |
9 | | (C) conditions that preclude care by a licensed |
10 | | certified professional midwife; and |
11 | | (D) the conditions under which consultation, |
12 | | transfer of care, or transport of the patient must be |
13 | | implemented. |
14 | | (5) Obtaining a health history of the patient and |
15 | | performing a physical examination. |
16 | | (6) Developing a written plan of care specific to the |
17 | | patient, to ensure continuity of care throughout the |
18 | | antepartum, intra-partum, and postpartum periods, that |
19 | | includes: |
20 | | (A) a plan for the management of any specific risk |
21 | | factors pertaining to the individual health and |
22 | | circumstances of the individual patient; and |
23 | | (B) a plan to be followed in the event of an |
24 | | emergency; including a plan for transportation. |
25 | | (7) Evaluating the results of patient care and |
26 | | reporting patient outcomes to the Department on a uniform |
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1 | | State form in accordance with rules. |
2 | | (8) Consulting and collaborating with a health care |
3 | | practitioner regarding the care of a patient, and referring |
4 | | and transferring care to a health care practitioner, as |
5 | | required. |
6 | | (9) Referral of all patients, within 72 hours after |
7 | | delivery, to a pediatric health care practitioner for care |
8 | | of the newborn. |
9 | | (10) Obtaining and administering appropriate |
10 | | medications and using equipment and devices. |
11 | | (11) Obtaining appropriate screening and testing, |
12 | | including laboratory tests, urinalysis, and ultrasound. |
13 | | (12) Providing prenatal care during the antepartum |
14 | | period, with consultation or referral as required. |
15 | | (13) Providing care during the intra-partum period, |
16 | | including: |
17 | | (A) monitoring and evaluating the condition of the |
18 | | patient and fetus; |
19 | | (B) performing emergency procedures, including: |
20 | | (i) administering approved medications; |
21 | | (ii) administering intravenous fluids for |
22 | | stabilization; |
23 | | (iii) performing an emergency episiotomy; and |
24 | | (iv) providing care while on the way to a |
25 | | hospital under circumstances in which emergency |
26 | | medical services have not been activated; |
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1 | | (C) activating emergency medical services for an |
2 | | emergency; and |
3 | | (D) delivering in an out-of-hospital setting. |
4 | | (14) Participating in mandatory peer review in cases |
5 | | involving transfers of patients in accordance with rules |
6 | | adopted by the Department, and peer review of any patient's |
7 | | care upon request. |
8 | | (15) Providing care during the postpartum period, |
9 | | including: |
10 | | (A) suturing of first and second degree perineal or |
11 | | labial lacerations, or suturing of an episiotomy with |
12 | | the administration of a local anesthetic; and |
13 | | (B) making further contact with the patient within |
14 | | 48 hours, within 2 weeks, and at 6 weeks after the |
15 | | delivery to assess for hemorrhage, preeclampsia, |
16 | | thrombo-embolism, infection, and emotional well-being. |
17 | | (16) Providing routine care for the newborn for up to |
18 | | 72 hours after delivery, exclusive of administering |
19 | | immunizations, including: |
20 | | (A) immediate care at birth, including |
21 | | resuscitating as needed, performing a newborn |
22 | | examination, and administering intramuscular vitamin K |
23 | | and eye ointment for prevention of ophthalmia |
24 | | neonatorium; |
25 | | (B) assessing newborn feeding and hydration; |
26 | | (C) performing metabolic screening and reporting |
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1 | | on the screening in accordance with the regulations |
2 | | related to newborn screenings that are adopted by the |
3 | | Department; |
4 | | (D) performing critical congenital heart disease |
5 | | screening and reporting on the screening in accordance |
6 | | with the regulations related to newborn screenings |
7 | | that are adopted by the Department; and |
8 | | (E) referring the infant to an audiologist for a |
9 | | hearing screening in accordance with the regulations |
10 | | related to newborn screenings that are adopted by the |
11 | | Department. |
12 | | (17) Within 24 hours after delivery notifying a |
13 | | pediatric health care practitioner of the delivery. |
14 | | (18) Within 72 hours after delivery: |
15 | | (A) transferring health records to the pediatric |
16 | | health care practitioner, including documentation of |
17 | | the performance of the screenings required under |
18 | | subparagraphs (C) and (D) of paragraph (16) of this |
19 | | subsection (b); and |
20 | | (B) referring the newborn to a pediatric health |
21 | | care practitioner. |
22 | | (19) Providing the following care of the newborn beyond |
23 | | the first 72 hours after delivery: |
24 | | (A) weight checks and general observation of the |
25 | | newborn's activity, with abnormal findings |
26 | | communicated to the newborn's pediatric health care |
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1 | | practitioner; |
2 | | (B) assessment of newborn feeding and hydration; |
3 | | and |
4 | | (C) breastfeeding support and counseling. |
5 | | (20) Providing limited services to the patient after |
6 | | the postpartum period, including: |
7 | | (A) breastfeeding support and counseling; and |
8 | | (B) counseling and referral for all family |
9 | | planning methods. |
10 | | (21) Providing a copy of all newborn care records to |
11 | | the designated health care provider after the birth of the |
12 | | baby at time of transfer of care. The licensed certified |
13 | | professional midwife shall obtain consent for the transfer |
14 | | of records per the Health Insurance Portability and |
15 | | Accountability Act of 1996. |
16 | | (22) Distributing Illinois Department of Public Health |
17 | | materials about metabolic and hearing screenings for |
18 | | newborns if such materials are available. |
19 | | (c) The practice of midwifery does not include: |
20 | | (1) Out-of-hospital care to a woman who has had a |
21 | | caesarean section. |
22 | | (2) Out-of-hospital care in cases of multifetal |
23 | | gestation. |
24 | | (3) Out-of-hospital care in cases involving breech |
25 | | delivery. |
26 | | (4) Administering prescription pharmacological agents |
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1 | | intended to induce or augment labor or artificial rupture |
2 | | of membranes prior to onset of labor. |
3 | | (5) Administering prescription pharmacological agents |
4 | | to provide pain management or anesthetic except for the |
5 | | administration of a local anesthetic. |
6 | | (6) Using vacuum extractors or forceps. |
7 | | (7) Prescribing medications. |
8 | | (8) Performing surgical procedures, including, but not |
9 | | limited to, abortions, cesarean sections and |
10 | | circumcisions, except for an emergency episiotomy. |
11 | | (9) Knowingly accepting responsibility for prenatal or |
12 | | intra-partum care of a patient with any of the following |
13 | | risk factors: |
14 | | (A) previous uterine surgery, including a cesarean |
15 | | section or myomectomy; |
16 | | (B) chronic significant maternal cardiac, |
17 | | pulmonary, renal, or hepatic disease; |
18 | | (C) malignant disease in an active phase; |
19 | | (D) significant hematological disorders or |
20 | | coagulopathies or pulmonary embolism; |
21 | | (E) diabetes mellitus requiring insulin; |
22 | | (F) known maternal congenital abnormalities |
23 | | affecting childbirth; |
24 | | (G) confirmed isoimmunization, Rh disease with |
25 | | positive titer levels; |
26 | | (H) active tuberculosis; |
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1 | | (I) active syphilis or gonorrhea; |
2 | | (J) active genital herpes infection 2 weeks prior |
3 | | to labor or during labor; |
4 | | (K) pelvic or uterine abnormalities affecting |
5 | | normal vaginal births, including tumors and |
6 | | malformations; |
7 | | (L) alcoholism or abuse; |
8 | | (M) drug addiction or abuse; |
9 | | (N) confirmed HIV or AIDS status; |
10 | | (O) uncontrolled current serious psychiatric |
11 | | illness; |
12 | | (P) social or familial conditions unsatisfactory |
13 | | for out-of-hospital maternity care services; |
14 | | (Q) fetus with suspected or diagnosed congenital |
15 | | abnormalities that may require immediate medical |
16 | | intervention; |
17 | | (R) indications that the fetus has died in utero; |
18 | | or |
19 | | (S) premature labor (gestation less than 37 |
20 | | weeks). |
21 | | (10) Continuing to provide care for conditions for |
22 | | which a transfer is required under subsection (c) of |
23 | | Section 60. |
24 | | (11) Administering drugs other than those listed in |
25 | | Section 60 of this Act. |
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1 | | Section 50. Informed consent. |
2 | | (a) A licensed certified professional midwife shall, at an |
3 | | initial consultation with a patient, disclose to the patient |
4 | | orally and in writing on a Department-specified uniform |
5 | | informed consent form all of the following: |
6 | | (1) The licensed certified professional midwife's |
7 | | experience and training. |
8 | | (2) The general risk factors associated with the |
9 | | services to be provided. |
10 | | (3) The definition of the "practice of midwifery" in |
11 | | this Act. |
12 | | (4) That the client is retaining a licensed certified |
13 | | professional midwife, not an advanced practice nurse who is |
14 | | a certified nurse midwife, and that the licensed certified |
15 | | professional midwife is not supervised by a physician or |
16 | | nurse. |
17 | | (5) The licensed certified professional midwife's |
18 | | current licensure status and license number. |
19 | | (6) The practice settings in which the licensed |
20 | | certified professional midwife practices. |
21 | | (7) A description of the procedures, benefits and risks |
22 | | of home births, including those conditions that may arise |
23 | | during delivery. |
24 | | (8) That there are conditions that are outside of the |
25 | | scope of practice of a licensed certified professional |
26 | | midwife that will result in a referral for a consultation |
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1 | | from, or transfer of care to, a health care practitioner. |
2 | | (9) That there may be benefits to pre-registration at |
3 | | the nearest hospital. |
4 | | (10) The specific arrangements for the referral of |
5 | | complications to a health care practitioner for |
6 | | consultation. The licensed certified professional midwife |
7 | | shall not be required to identify a specific health care |
8 | | practitioner. |
9 | | (11) Instructions for filing a complaint with the |
10 | | Department. |
11 | | (12) That if, during the course of care, the client is |
12 | | informed that she has or may have a condition indicating |
13 | | the need for a mandatory transfer, the licensed certified |
14 | | professional midwife shall initiate the transfer. |
15 | | (13) A written protocol for the handling of both |
16 | | patient's and newborn's medical emergencies, including |
17 | | transportation to a hospital, particular to each client, |
18 | | complete with identification of the appropriate hospital, |
19 | | the estimated travel time to the hospital, and the identity |
20 | | of obstetric and pediatric health care practitioners who |
21 | | will be notified. A verbal report of the care provided must |
22 | | be provided to emergency services providers and a copy of |
23 | | the client records shall be sent with the client at the |
24 | | time of any transfer to a hospital. |
25 | | (b) A copy of the informed consent document, signed and |
26 | | dated by the patient, must be kept in each patient's chart. All |
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1 | | patients' charts and records of services provided shall be |
2 | | maintained for a minimum of 10 years after the last patient |
3 | | visit. |
4 | | Section 55. Midwife requirements. A licensed certified |
5 | | professional midwife shall do all of the following: |
6 | | (a) Prior to labor, develop a written plan of care specific |
7 | | to the patient, including specific risk factors pertaining to |
8 | | the individual health and circumstances of the patient, to |
9 | | ensure continuity of antepartum, intra-partum, and postpartum |
10 | | care. The plan shall include: |
11 | | (1) twenty-four hour, on-call availability by a |
12 | | licensed certified professional midwife, advanced practice |
13 | | nurse who is a certified nurse midwife, or licensed |
14 | | physician throughout pregnancy, intra-partum, and 6 weeks |
15 | | postpartum; |
16 | | (2) appropriate screening and testing, including |
17 | | laboratory tests, urinalysis, and ultrasound; and |
18 | | (3) labor support, fetal monitoring, and routine |
19 | | assessment of vital signs once active labor is established. |
20 | | (b) Perform emergency procedures including: administering |
21 | | approved medications; administering intravenous fluids for |
22 | | stabilization; performing an emergency episiotomy; providing |
23 | | care while on the way to a hospital under circumstances in |
24 | | which emergency medical services have not been activated; and |
25 | | activating emergency medical services for an emergency. |
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1 | | (c) Supervise delivery of infant and placenta, assess |
2 | | newborn and maternal well-being in immediate postpartum, and |
3 | | perform Apgar tests. |
4 | | (d) Provide immediate care at birth, including |
5 | | resuscitating as needed, performing a newborn examination, and |
6 | | administering intramuscular vitamin K and eye ointment for the |
7 | | prevention of blindness. |
8 | | (e) Perform routine cord management and inspect for the |
9 | | appropriate number of vessels. |
10 | | (f) Inspect the placenta and membranes for completeness. |
11 | | (g) Inspect the perineum and vagina postpartum for |
12 | | lacerations and stabilize suturing of first and second degree |
13 | | perineal or labial lacerations or suturing of an episiotomy |
14 | | with administration of a local anesthetic. |
15 | | (h) Observe mother and newborn postpartum until stable |
16 | | condition is achieved, but in no event for less than 2 hours to |
17 | | assess for hemorrhage, preeclampsia, thromboembolism, |
18 | | infection, and emotional well-being. |
19 | | (i) Instruct the mother, father, and other support persons, |
20 | | both verbally and in writing, of the special care and |
21 | | precautions for both mother and newborn in the immediate |
22 | | postpartum period. |
23 | | (j) Reevaluate maternal and newborn well-being within 36 |
24 | | hours of delivery. |
25 | | (k) Use universal precautions with all biohazard |
26 | | materials. |
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1 | | (l) Ensure that a birth certificate is accurately completed |
2 | | and filed in accordance with State law. |
3 | | (m) Within 24 hours after delivery, notify a pediatric |
4 | | health care professional of the delivery including |
5 | | transferring health records to the pediatric health |
6 | | practitioner documenting performance of the required newborn |
7 | | screenings. |
8 | | (n) Within 24 to 36 hours after delivery, submit a blood |
9 | | sample in accordance with metabolic screening requirements for |
10 | | newborns. |
11 | | (o) Within one week after delivery, perform newborn weight |
12 | | checks and general observation of the newborn's activities with |
13 | | abnormal findings communicated to the newborn's pediatric |
14 | | health care practitioner, assessment of newborn feeding and |
15 | | hydration, offer a newborn hearing screening to every newborn |
16 | | or refer the parents to a facility with a newborn hearing |
17 | | screening program. |
18 | | (p) Provide services to the patient after the post-partum |
19 | | period limited to breastfeeding support and counseling and |
20 | | counseling and referral for family planning. |
21 | | (q) Maintain adequate antenatal and perinatal records of |
22 | | each client and provide records to consulting licensed |
23 | | physicians and advanced practice nurses who are certified nurse |
24 | | midwives in accordance with federal Health Insurance |
25 | | Portability and Accountability Act regulations and State law. |
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1 | | Section 60. Administration of drugs. |
2 | | (a) A licensed certified professional midwife may |
3 | | administer the following agents during the practice of |
4 | | midwifery: |
5 | | (1) oxygen for the treatment of fetal distress; |
6 | | (2) eye prophylactics - 0.5% erythromycin ophthalmic |
7 | | ointment for the prevention of neonatal ophthalmia; |
8 | | (3) oxytocin (Pitocin) as a postpartum antihemorrhagic |
9 | | agent or as prophylaxis for hemorrhage; |
10 | | (4) Methyl-ergonovine or Methergine for the treatment |
11 | | of postpartum hemorrhage; |
12 | | (5) Misoprostol (Cytotec) for the treatment of |
13 | | postpartum hemorrhage; |
14 | | (6) Vitamin K for the prophylaxis for hemorrhagic |
15 | | disease of the newborn; |
16 | | (7) RHo(D) immune globulin for the prevention for |
17 | | RHo(D) sensitization in RHo(D) negative women; |
18 | | (8) intravenous fluids for maternal stabilization, |
19 | | including lactated Ringer's solution, or with 5% dextrose |
20 | | (D5LR), unless unavailable or impractical, in which case |
21 | | 0.9% sodium chloride may be administered; |
22 | | (9) Lidocaine injection as a local anesthetic for |
23 | | perineal repair; |
24 | | (10) sterile water subcutaneous injections as a |
25 | | non-pharmacological form of pain relief during the first |
26 | | and second stages of labor; and |
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1 | | (11) ibuprofen for postpartum pain relief. |
2 | | (b) The medication indications, dose, route of |
3 | | administration, and duration of treatment relating to the |
4 | | administration of drugs and procedures identified under this |
5 | | Section shall be determined by rule as the Department deems |
6 | | necessary to be in keeping with current evidence-based practice |
7 | | standards. The Department may approve additional medications, |
8 | | agents, or procedures based upon updated evidence-based |
9 | | obstetrical guidelines or based upon limited availability of |
10 | | standard medications or agents. |
11 | | (c) A licensed certified professional midwife shall not |
12 | | administer Schedule II-V drugs. |
13 | | Section 65. Consultation, referral, and transfer. |
14 | | (a) A licensed certified professional midwife shall |
15 | | consult with a licensed physician concentrating in obstetrics, |
16 | | a licensed physician concentrating in a family practice who |
17 | | performs deliveries, or an advanced practice nurse who is a |
18 | | certified nurse midwife providing obstetrical care whenever |
19 | | there are significant deviations, including abnormal |
20 | | laboratory results, relative to a patient's pregnancy or to a |
21 | | neonate. If a referral to a physician or advanced practice |
22 | | nurse who is a certified midwife is needed, the licensed |
23 | | certified professional midwife shall refer the patient to a |
24 | | physician concentrating in obstetrics or to a physician |
25 | | concentrating in family practice who performs deliveries, and, |
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1 | | if possible, remain in consultation with the physician or nurse |
2 | | until resolution of the concern. Consultation does not preclude |
3 | | the possibility of an out-of-hospital birth. It is appropriate |
4 | | for the licensed certified professional midwife to maintain |
5 | | care of the patient to the greatest degree possible, in |
6 | | accordance with the patient's wishes, during the pregnancy and, |
7 | | if possible, during labor, birth, and the postpartum period. |
8 | | (b) The midwife shall document during prenatal care the |
9 | | health care practitioner the parents have chosen to provide |
10 | | pediatric care for the newborn in the weeks immediately |
11 | | following the birth. If no pediatric health care practitioner |
12 | | has been chosen by 36 weeks of pregnancy, the licensed |
13 | | certified professional midwife shall provide a referral. |
14 | | (c) A licensed certified professional midwife shall |
15 | | consult with a licensed physician concentrating in obstetrics, |
16 | | a licensed physician concentrating in family practice who |
17 | | performs deliveries, or an advanced practice nurse who is a |
18 | | certified nurse midwife with regard to any patient who presents |
19 | | with or develops the following risk factors, or presents with |
20 | | or develops other risk factors that, in the judgment of the |
21 | | licensed certified professional midwife, warrant consultation: |
22 | | (1) Antepartum. |
23 | | (A) Pregnancy-induced hypertension, as evidenced |
24 | | by a blood pressure of 140/90 on 2 occasions greater |
25 | | than 6 hours apart. |
26 | | (B) Persistent, severe headaches, epigastric pain, |
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1 | | or visual disturbances. |
2 | | (C) Persistent symptoms of urinary tract |
3 | | infection. |
4 | | (D) Significant vaginal bleeding before the onset |
5 | | of labor not associated with uncomplicated spontaneous |
6 | | abortion. |
7 | | (E) Rupture of membranes prior to the 37th week of |
8 | | gestation. |
9 | | (F) Noted abnormal decrease in or cessation of |
10 | | fetal movement. |
11 | | (G) Anemia resistant to supplemental therapy. |
12 | | (H) Fever of 102 degrees Fahrenheit or 39 degrees |
13 | | Celsius or greater for more than 24 hours. |
14 | | (I) Non-vertex presentation after 36 weeks |
15 | | gestation. |
16 | | (J) Hyperemesis or significant dehydration. |
17 | | (K) Isoimmunization, Rh-negative sensitized, |
18 | | positive titers, or any other positive antibody titer, |
19 | | which may have a detrimental effect on mother or fetus. |
20 | | (L) Elevated blood glucose levels unresponsive to |
21 | | dietary management. |
22 | | (M) Positive HIV antibody test. |
23 | | (N) Primary genital herpes infection in pregnancy |
24 | | or active recurrent herpes infection within 2 weeks of |
25 | | labor. |
26 | | (O) Symptoms of malnutrition or anorexia or |
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1 | | protracted weight loss or failure to gain weight. |
2 | | (P) Suspected deep vein thrombosis. |
3 | | (Q) Documented placental anomaly or previa. |
4 | | (R) Labor prior to the 37th week of gestation. |
5 | | (S) Lie other than vertex at term. |
6 | | (T) Known fetal anomalies that may be affected by |
7 | | the site of birth. |
8 | | (U) Marked abnormal fetal heart tones. |
9 | | (V) Abnormal non-stress test or abnormal |
10 | | biophysical profile. |
11 | | (W) Marked or severe polyhydramnios or |
12 | | oligohydramnios. |
13 | | (X) Evidence of intrauterine growth restriction. |
14 | | (Y) Significant abnormal ultrasound findings. |
15 | | (Z) Gestation beyond 42 weeks by reliable |
16 | | confirmed dates. |
17 | | (AA) Controlled hypothyroidism, being treated with |
18 | | thyroid replacement and euthyroid, and with thyroid |
19 | | test numbers in the normal range. |
20 | | (BB) Previous obstetrical problems, including |
21 | | uterine abnormalities, placental abruption, placenta |
22 | | accreta, obstetric hemorrhage, incompetent cervix, or |
23 | | preterm delivery for any reason. |
24 | | (CC) Unforeseen multifetal gestation. |
25 | | (2) Intra-partum. |
26 | | (A) Rise in blood pressure above baseline, more |
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1 | | than 30/15 points or greater than 140/90. |
2 | | (B) Persistent, severe headaches, epigastric pain, |
3 | | or visual disturbances. |
4 | | (C) Significant proteinuria or ketonuria. |
5 | | (D) Fever over 100.6 degrees Fahrenheit or 38 |
6 | | degrees Celsius in absence of environmental factors. |
7 | | (E) Ruptured membranes without onset of |
8 | | established labor after 18 hours. |
9 | | (F) Significant bleeding prior to delivery or any |
10 | | abnormal bleeding, with or without abdominal pain, or |
11 | | evidence of placental abruption. |
12 | | (G) Fetal lie not compatible with spontaneous |
13 | | vaginal delivery or unstable fetal lie. |
14 | | (H) Failure to progress after 5 hours of active |
15 | | labor or following 2 hours of active second stage |
16 | | labor. |
17 | | (I) Signs or symptoms of maternal infection. |
18 | | (J) Active genital herpes at onset of labor or |
19 | | within 2 weeks of the onset of labor. |
20 | | (K) Fetal heart tones with non-reassuring |
21 | | patterns. |
22 | | (L) Signs or symptoms of fetal distress. |
23 | | (M) Thick meconium or frank bleeding with birth not |
24 | | imminent. |
25 | | (N) Patient or licensed certified professional |
26 | | midwife desires physician or advanced practice nurse |
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1 | | consultation or transfer. |
2 | | (3) Postpartum. |
3 | | (A) Failure to void within 6 hours of birth. |
4 | | (B) Signs or symptoms of maternal shock. |
5 | | (C) Fever of 102 degrees Fahrenheit or 39 degrees |
6 | | Celsius and unresponsive to therapy for 12 hours. |
7 | | (D) Abnormal lochia or signs or symptoms of uterine |
8 | | sepsis. |
9 | | (E) Suspected deep vein thrombosis. |
10 | | (F) Signs of clinically significant depression. |
11 | | (G) Retained placenta. |
12 | | (H) Patient with a third or fourth degree |
13 | | laceration or a laceration beyond the licensed |
14 | | certified professional midwife's ability to repair. |
15 | | (d) A licensed certified professional midwife shall |
16 | | consult with a licensed physician with a concentration in |
17 | | obstetrics, a licensed physician with a concentration in |
18 | | pediatrics, a licensed physician with a concentration in family |
19 | | practice who performs deliveries, or an advanced practice nurse |
20 | | who is a certified nurse midwife with regard to any neonate who |
21 | | is born with or develops the following risk factors: |
22 | | (1) Apgar score of 6 or less at 5 minutes without |
23 | | significant improvement by 10 minutes. |
24 | | (2) Persistent grunting respirations or retractions. |
25 | | (3) Persistent cardiac irregularities. |
26 | | (4) Persistent central cyanosis or pallor. |
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1 | | (5) Persistent lethargy or poor muscle tone. |
2 | | (6) Abnormal cry. |
3 | | (7) Birth weight less than 2,300 grams. |
4 | | (8) Jitteriness or seizures. |
5 | | (9) Jaundice occurring before 24 hours or outside of |
6 | | normal range. |
7 | | (10) Failure to urinate within 24 hours of birth. |
8 | | (11) Failure to pass meconium within 48 hours of birth. |
9 | | (12) Edema. |
10 | | (13) Prolonged temperature instability. |
11 | | (14) Significant signs or symptoms of infection. |
12 | | (15) Significant clinical evidence of glycemic |
13 | | instability. |
14 | | (16) Abnormal, bulging, or depressed fontanel. |
15 | | (17) Significant clinical evidence of prematurity. |
16 | | (18) Medically significant congenital anomalies. |
17 | | (19) Significant or suspected birth injury. |
18 | | (20) Persistent inability to suck. |
19 | | (21) Diminished consciousness. |
20 | | (22) Clinically significant abnormalities in vital |
21 | | signs, muscle tone, or behavior. |
22 | | (23) Clinically significant color abnormality, |
23 | | cyanotic, or pale or abnormal perfusion. |
24 | | (24) Abdominal distension or projectile vomiting. |
25 | | (25) Signs of clinically significant dehydration or |
26 | | failure to thrive. |
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1 | | Section 70. Transfer. |
2 | | (a) Transport via private vehicle is an acceptable method |
3 | | of transport if it is the most expedient and safest method for |
4 | | accessing medical services. The licensed certified |
5 | | professional midwife shall initiate immediate transport |
6 | | according to the licensed certified professional midwife's |
7 | | emergency plan, provide emergency stabilization until |
8 | | emergency medical services arrive or transfer is completed, |
9 | | accompany the patient or follow the patient to a hospital in a |
10 | | timely fashion, provide pertinent information to the receiving |
11 | | facility, and complete an emergency transport record. The |
12 | | following conditions shall require immediate physician or |
13 | | advanced practice nurse notification and emergency transfer to |
14 | | a hospital: |
15 | | (1) Seizures or unconsciousness. |
16 | | (2) Respiratory distress or arrest. |
17 | | (3) Evidence of shock. |
18 | | (4) Psychosis. |
19 | | (5) Symptomatic chest pain or cardiac arrhythmias. |
20 | | (6) Prolapsed umbilical cord. |
21 | | (7) Shoulder dystocia not resolved by Advanced Life |
22 | | Support in Obstetrics (ALSO) protocol. |
23 | | (8) Symptoms of uterine rupture. |
24 | | (9) Preeclampsia or eclampsia. |
25 | | (10) Severe abdominal pain inconsistent with normal |
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1 | | labor. |
2 | | (11) Chorioamnionitis. |
3 | | (12) Clinically significant fetal heart rate patterns |
4 | | or other manifestation of fetal distress. |
5 | | (13) Presentation not compatible with spontaneous |
6 | | vaginal delivery. |
7 | | (14) Laceration greater than second degree perineal or |
8 | | any cervical. |
9 | | (15) Hemorrhage non-responsive to therapy. |
10 | | (16) Uterine prolapse or inversion. |
11 | | (17) Persistent uterine atony. |
12 | | (18) Anaphylaxis. |
13 | | (19) Failure to deliver placenta after one hour if |
14 | | there is no bleeding or fundus is firm. |
15 | | (20) Sustained instability or persistent abnormal |
16 | | vital signs. |
17 | | (21) Other conditions or symptoms that could threaten |
18 | | the life of the mother, fetus, or neonate. |
19 | | (b) If birth is imminent and the patient refuses to be |
20 | | transferred after the licensed certified professional midwife |
21 | | determines that a transfer is necessary, the licensed certified |
22 | | professional midwife shall: |
23 | | (1) call 9-1-1 and remain with the patient until |
24 | | emergency services personnel arrive; and |
25 | | (2) transfer care and give a verbal report of the care |
26 | | provided to the emergency medical services providers. |
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1 | | (c) For each patient who is transported under this section, |
2 | | the licensed certified professional midwife shall complete a |
3 | | standard transport reporting form and submit the completed form |
4 | | to the Department. |
5 | | (d) The Board shall develop and recommend to the Department |
6 | | for adoption in the rules implementing this Act a planned |
7 | | out-of-hospital birth transport protocol. |
8 | | Section 75. Annual reports. |
9 | | (a) A licensed certified professional midwife shall |
10 | | annually report to the Department by no later than March 31st |
11 | | of each year beginning in 2018, in a form specified by the |
12 | | Department, the following information regarding cases in which |
13 | | the licensed certified professional midwife assisted during |
14 | | the previous calendar year when the intended place of birth at |
15 | | the onset of care was an out-of-hospital setting: |
16 | | (1) the total number of patients served at the onset of |
17 | | care; |
18 | | (2) the number, by county, of live births attended; |
19 | | (3) the number, by county, of cases of fetal demise, |
20 | | infant deaths, and maternal deaths attended at the |
21 | | discovery of the demise or death; |
22 | | (4) the number of women whose care was transferred to |
23 | | another health care practitioner during the antepartum |
24 | | period and the reason for transfer; |
25 | | (5) the number, reason for, and outcome of each |
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1 | | nonemergency hospital transfer during the intra-partum or |
2 | | postpartum period; |
3 | | (6) the number, reason for, and outcome of each urgent |
4 | | or emergency transport of an expectant mother in the |
5 | | antepartum period; |
6 | | (7) the number, reason for, and outcome of each urgent |
7 | | or emergency transport of an infant or mother during the |
8 | | intra-partum or immediate postpartum period; |
9 | | (8) the number of planned out-of-hospital births at the |
10 | | onset of labor and the number of births completed in an |
11 | | out-of-hospital setting; |
12 | | (9) a brief description of any complications resulting |
13 | | in the morbidity or mortality of a mother or a neonate; and |
14 | | (10) any other information required by rule by the |
15 | | Department. |
16 | | (b) The Department shall send a written notice of |
17 | | noncompliance to each licensee who fails to meet the reporting |
18 | | requirements under subsection (a) of this Section. |
19 | | (c) A licensed certified professional midwife who fails to |
20 | | comply with the reporting requirements under this Section shall |
21 | | be prohibited from license renewal until the information |
22 | | required under subsection (a) of this Section is reported. |
23 | | (d) The Committee shall maintain the confidentiality of any |
24 | | report under subsection (f) of this Section. |
25 | | (e) Notwithstanding any other provision of law, a licensed |
26 | | certified professional midwife shall be subject to the same |
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1 | | reporting requirements as other health care practitioners who |
2 | | provide care to individuals. |
3 | | (f) All reports required shall be submitted to the |
4 | | Department in a timely fashion. Unless otherwise provided in |
5 | | this Section, the reports shall be filed in writing within 60 |
6 | | days after a determination that a report is required under this |
7 | | Act. |
8 | | The Department may also exercise the power under Section |
9 | | 165 of this Act to subpoena copies of hospital or medical |
10 | | records in cases concerning death or permanent bodily injury. |
11 | | Rules shall be adopted by the Department to implement this |
12 | | Section. |
13 | | Nothing contained in this Section shall act to in any way |
14 | | waive or modify the confidentiality of reports and committee |
15 | | reports to the extent provided by law. Any information reported |
16 | | or disclosed shall be kept for the confidential use of the |
17 | | Department, its attorneys, the investigative staff, and |
18 | | authorized clerical staff, as provided in this Act, and shall |
19 | | be afforded the same status as is provided information |
20 | | concerning medical studies in Part 21 of Article VIII of the |
21 | | Code of Civil Procedure, except that the Department may |
22 | | disclose information and documents to a federal, state, or |
23 | | local law enforcement agency pursuant to a subpoena in an |
24 | | ongoing criminal investigation or to a health care licensing |
25 | | body or midwifery licensing authority of another state or |
26 | | jurisdiction pursuant to an official request made by that |
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1 | | licensing body or authority. Furthermore, information and |
2 | | documents disclosed to a federal, state, or local law |
3 | | enforcement agency may be used by that agency only for the |
4 | | investigation and prosecution of a criminal offense, or, in the |
5 | | case of disclosure to a health care licensing body or medical |
6 | | licensing authority, only for investigations and disciplinary |
7 | | action proceedings with regard to a license. Information and |
8 | | documents disclosed to the Department of Public Health may be |
9 | | used by that Department only for investigation and disciplinary |
10 | | action regarding the license of a health care institution |
11 | | licensed by the Department of Public Health. |
12 | | Section 80. Illinois Certified Professional Midwifery |
13 | | Board. |
14 | | (a) There is created under the authority of the Department |
15 | | the Illinois Certified Professional Midwifery Board, which |
16 | | shall consist of the following 9 members appointed by the |
17 | | Secretary: |
18 | | Three of whom shall be licensed certified professional |
19 | | midwives who currently practice midwifery; except that the |
20 | | initial appointees shall be Certified Professional |
21 | | Midwives who have at least 3 years of experience in the |
22 | | practice of midwifery in an out-of-hospital setting, and |
23 | | otherwise meet the qualifications for licensure set forth |
24 | | in this Act. |
25 | | One of whom shall be a licensed physician concentrating |
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1 | | in obstetrics. |
2 | | One of whom shall be a licensed physician concentrating |
3 | | in a family practice who performs deliveries. |
4 | | One of whom shall be a licensed physician who |
5 | | concentrates in pediatrics. |
6 | | Two of whom shall be advanced practice nurses who are |
7 | | certified nurse midwives. |
8 | | One of whom shall be a knowledgeable public member who |
9 | | has given birth with the assistance of a licensed certified |
10 | | professional midwife or a Certified Professional Midwife |
11 | | in an out-of-hospital birth setting. |
12 | | Board members shall serve 4-year terms, except that in the |
13 | | case of initial appointments, terms shall be staggered as |
14 | | follows: 4 members shall serve for 4 years, and 5 members shall |
15 | | serve for 2 years. The Board shall annually elect a chairperson |
16 | | and vice chairperson. |
17 | | (b) Any appointment made to fill a vacancy shall be for the |
18 | | unexpired portion of the term. Appointments to fill vacancies |
19 | | shall be made in the same manner as original appointments. No |
20 | | Board member may be reappointed for a term that would cause his |
21 | | or her continuous service on the Board to exceed 9 years. |
22 | | (c) Board membership must have reasonable representation |
23 | | from different geographic areas of this State. |
24 | | (d) The members of the Board shall serve without |
25 | | compensation but may be reimbursed for all legitimate, |
26 | | necessary, and authorized expenses incurred in attending the |
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1 | | meetings of the Board if funds are available for such purposes. |
2 | | (e) The Secretary may remove any member of the Board for |
3 | | misconduct, incapacity, or neglect of duty at any time prior to |
4 | | the expiration of his or her term. |
5 | | (f) Five Board members shall constitute a quorum. A vacancy |
6 | | in the membership of the Board shall not impair the right of a |
7 | | quorum to perform all of the duties of the Board. |
8 | | (g) The Board shall provide the Department with |
9 | | recommendations concerning the administration of this Act and |
10 | | may perform each of the following duties: |
11 | | (1) Recommend to the Department from time to time |
12 | | revisions to any rules that may be necessary to carry out |
13 | | the provisions of this Act, including those that are |
14 | | designed to protect the health, safety, and welfare of the |
15 | | public. |
16 | | (2) Conduct hearings and disciplinary conferences on |
17 | | disciplinary charges of licensees. |
18 | | (3) Report to the Department, upon completion of a |
19 | | hearing, the disciplinary actions recommended to be taken |
20 | | against a person found in violation of this Act. |
21 | | (4) Recommend the approval, denial of approval, or |
22 | | withdrawal of approval of required education and |
23 | | continuing educational programs. |
24 | | (h) The Secretary shall give due consideration to all |
25 | | recommendations of the Board. If the Secretary takes action |
26 | | contrary to a recommendation of the Board, the Secretary must |
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1 | | promptly provide a written explanation of that action. |
2 | | (i) The Board may recommend to the Secretary that one or |
3 | | more licensed certified professional midwives be selected by |
4 | | the Secretary to assist in any investigation under this Act. |
5 | | Travel expenses shall be provided to any licensee who provides |
6 | | assistance under this subsection (i), in an amount determined |
7 | | by the Secretary, if funds are available for such purposes. |
8 | | (j) Members of the Board shall be immune from suit in an |
9 | | action based upon a disciplinary proceeding or other activity |
10 | | performed in good faith as a member of the Board, except for |
11 | | willful or wanton misconduct. |
12 | | (k) Members of the Board may participate in and act at any |
13 | | meeting of the Illinois Midwifery Board through the use of any |
14 | | real-time Internet or telephone communication media, by means |
15 | | of which all persons participating in the meeting can |
16 | | communicate with each other. Participation in such meeting |
17 | | shall constitute attendance and presence in person at the |
18 | | meeting of the person or persons so participating. |
19 | | Section 85. Continuing education for certified |
20 | | professional midwife licensees. |
21 | | The Department shall adopt rules of continuing education |
22 | | for licensed certified professional midwives that require a |
23 | | total of 24 hours of continuing education per 2-year license |
24 | | renewal cycle. Four hours of continuing education shall consist |
25 | | of successful completion of peer review in accordance with NARM |
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1 | | standards for official peer review. The rules shall address |
2 | | variances in part or in whole for good cause, including without |
3 | | limitation illness or hardship. The continuing education rules |
4 | | must ensure that licensees are given the opportunity to |
5 | | participate in programs sponsored by or through their State or |
6 | | national professional associations, hospitals, or other |
7 | | providers of continuing education. Each licensee is |
8 | | responsible for maintaining records of completion of |
9 | | continuing education and shall produce the records when |
10 | | requested by the Department. |
11 | | Section 90. Vicarious liability. |
12 | | (a) No physician, advanced practice nurse, nurse, |
13 | | hospital, emergency room personnel, emergency medical |
14 | | technician, or ambulance personnel shall be liable in any civil |
15 | | action arising out of any injury resulting from an act or |
16 | | omission of a licensed certified professional midwife, even if |
17 | | the health care practitioner has consulted with or accepted a |
18 | | referral from the licensed certified professional midwife. A |
19 | | physician or advanced practice nurse who consults with a |
20 | | licensed certified professional midwife but who does not |
21 | | examine or treat a client of the licensed certified |
22 | | professional midwife shall not be deemed to have created a |
23 | | physician-patient or advanced practice nurse-patient |
24 | | relationship with such client. |
25 | | (b) Consultation with a physician or advanced practice |
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1 | | nurse does not alone create a physician-patient or advanced |
2 | | practice nurse-patient relationship or any other relationship |
3 | | with the physician or advanced practice nurse. The informed |
4 | | consent shall specifically state that the licensed certified |
5 | | professional midwife and any consulting physician or advanced |
6 | | practice nurse are not employees, partners, associates, |
7 | | agents, or principals of one another. The licensed certified |
8 | | professional midwife shall inform the patient that he or she is |
9 | | independently licensed and practicing midwifery and in that |
10 | | regard is solely responsible for the services he or she |
11 | | provides. |
12 | | Section 95. Advertising. |
13 | | (a) Any person licensed under this Act may advertise the |
14 | | availability of midwifery services in the public media or on |
15 | | premises where services are rendered, if the advertising is |
16 | | truthful and not misleading and is in conformity with any rules |
17 | | regarding the practice of a licensed certified professional |
18 | | midwife. |
19 | | (b) A licensee must include in every advertisement for |
20 | | midwifery services regulated under this Act his or her title as |
21 | | it appears on the license or the initials authorized under this |
22 | | Act. |
23 | | Section 100. Social Security Number on application. In |
24 | | addition to any other information required to be contained in |
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1 | | the application, every application for an original, renewal, |
2 | | reinstated, or restored license under this Act shall include |
3 | | the applicant's Social Security Number. |
4 | | Section 105. Renewal of licensure. |
5 | | (a) Licensed certified professional midwives shall renew |
6 | | their license biannually at the discretion of the Department. |
7 | | (b) Rules adopted under this Act shall require the licensed |
8 | | certified professional midwife to maintain CPM certification |
9 | | by meeting all the continuing education requirements and other |
10 | | requirements set forth by the North American Registry of |
11 | | Midwives. |
12 | | Section 110. Inactive status. |
13 | | (a) A licensed certified professional midwife who notifies |
14 | | the Department in writing on forms prescribed by the Department |
15 | | may elect to place his or her license on an inactive status and |
16 | | shall be excused from payment of renewal fees until he or she |
17 | | notifies the Department in writing of his or her intent to |
18 | | restore the license. |
19 | | (b) A licensed certified professional midwife whose |
20 | | license is on inactive status may not practice licensed |
21 | | certified professional midwifery in the State of Illinois. |
22 | | (c) A licensed certified professional midwife requesting |
23 | | restoration from inactive status shall be required to pay the |
24 | | current renewal fee and to restore his or her license, as |
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1 | | provided by the Department. |
2 | | (d) Any licensee who engages in the practice of midwifery |
3 | | while his or her license is lapsed or on inactive status shall |
4 | | be considered to be practicing without a license, which shall |
5 | | be grounds for discipline. |
6 | | Section 115. Renewal, reinstatement, or restoration of |
7 | | licensure; military service. |
8 | | (a) The expiration date and renewal period for each license |
9 | | issued under this Act shall be set by the Department. |
10 | | (b) All renewal applicants shall provide proof of having |
11 | | maintained CPM certification by meeting continuing education |
12 | | requirements and other requirements set forth by the North |
13 | | American Registry of Midwives and current CPR certification |
14 | | required under Section 30. |
15 | | (c) Any licensed certified professional midwife who has |
16 | | permitted his or her license to expire or who has had his or |
17 | | her license on inactive status may have his or her license |
18 | | restored by making application to the Department and filing |
19 | | proof acceptable to the Department of fitness to have the |
20 | | license restored and by paying the required fees. Proof of |
21 | | fitness may include evidence attesting to active lawful |
22 | | practice in another jurisdiction. |
23 | | (d) The Department shall determine, by an evaluation |
24 | | program, fitness for restoration of a license under this |
25 | | Section and shall establish procedures and requirements for |
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1 | | restoration. |
2 | | (e) Any licensed certified professional midwife whose |
3 | | license expired while he or she was (i) in federal service on |
4 | | active duty with the Armed Forces of the United States or the |
5 | | State Militia and called into service or training or (ii) |
6 | | received education under the supervision of the United States |
7 | | preliminary to induction into the military service may have his |
8 | | or her license restored without paying any lapsed renewal fees, |
9 | | if, within 2 years after honorable termination of service, |
10 | | training, or education, he or she furnishes the Department with |
11 | | satisfactory evidence to the effect that he or she has been so |
12 | | engaged. |
13 | | Section 120. Roster. The Department shall maintain a roster |
14 | | of the names and addresses of all licensees and of all persons |
15 | | whose licenses have been suspended or revoked. This roster |
16 | | shall be available upon written request and payment of the |
17 | | required fee. |
18 | | Section 125. Fees. |
19 | | (a) The Department shall provide for a schedule of fees for |
20 | | the administration and enforcement of this Act, including |
21 | | without limitation original licensure, renewal, and |
22 | | restoration, which fees shall be nonrefundable. |
23 | | (b) All fees collected under this Act shall be deposited |
24 | | into the General Professions Dedicated Fund and appropriated to |
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1 | | the Department for the ordinary and contingent expenses of the |
2 | | Department in the administration of this Act. |
3 | | Section 130. Returned checks; fines. Any person who |
4 | | delivers a check or other payment to the Department that is |
5 | | returned to the Department unpaid by the financial institution |
6 | | upon which it is drawn shall pay to the Department, in addition |
7 | | to the amount already owed to the Department, a fine of $50. |
8 | | The fines imposed by this Section are in addition to any other |
9 | | discipline provided under this Act for unlicensed practice or |
10 | | practice on a non-renewed license. The Department shall notify |
11 | | the person that fees and fines shall be paid to the Department |
12 | | by certified check or money order within 30 calendar days after |
13 | | the notification. If, after the expiration of 30 days from the |
14 | | date of the notification, the person has failed to submit the |
15 | | necessary remittance, the Department shall automatically |
16 | | terminate the license or deny the application, without hearing. |
17 | | If, after termination or denial, the person seeks a license, he |
18 | | or she shall apply to the Department for restoration or |
19 | | issuance of the license and pay all fees and fines due to the |
20 | | Department. The Department may establish a fee for the |
21 | | processing of an application for restoration of a license to |
22 | | defray all expenses of processing the application. The |
23 | | Secretary may waive the fines due under this Section in |
24 | | individual cases where the Secretary finds that the fines would |
25 | | be unreasonable or unnecessarily burdensome. |
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1 | | Section 135. Unlicensed practice; civil penalty. Any |
2 | | person who practices, offers to practice, attempts to practice, |
3 | | or holds himself or herself out to practice certified |
4 | | professional midwifery or as a midwife without being licensed |
5 | | under this Act shall, in addition to any other penalty provided |
6 | | by law, pay a civil penalty to the Department in an amount not |
7 | | to exceed $5,000 for each offense, as determined by the |
8 | | Department. The civil penalty shall be assessed by the |
9 | | Department after a hearing is held in accordance with the |
10 | | provisions set forth in this Act regarding the provision of a |
11 | | hearing for the discipline of a licensee. The civil penalty |
12 | | shall be paid within 60 days after the effective date of the |
13 | | order imposing the civil penalty. The order shall constitute a |
14 | | judgment and may be filed and execution had thereon in the same |
15 | | manner as any judgment from any court of record. The Department |
16 | | may investigate any unlicensed activity. |
17 | | Section 140. Grounds for disciplinary action. |
18 | | (a) The Department may refuse to issue or to renew or may |
19 | | revoke, suspend, place on probation, reprimand, or take other |
20 | | disciplinary action as the Department may deem proper, |
21 | | including fines not to exceed $5,000 for each violation, with |
22 | | regard to any licensee or license for any one or combination of |
23 | | the following causes: |
24 | | (1) Violations of this Act or its rules. |
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1 | | (2) Material misstatement in furnishing information to |
2 | | the Department. |
3 | | (3) Conviction of any crime under the laws of any U.S. |
4 | | jurisdiction that is (i) a felony, (ii) a misdemeanor, an |
5 | | essential element of which is dishonesty, or (iii) directly |
6 | | related to the practice of the profession. |
7 | | (4) Making any misrepresentation for the purpose of |
8 | | obtaining a license. |
9 | | (5) Professional incompetence or gross negligence. |
10 | | (6) Gross malpractice. |
11 | | (7) Aiding or assisting another person in violating any |
12 | | provision of this Act or its rules. |
13 | | (8) Failing to provide information within 60 days in |
14 | | response to a written request made by the Department. |
15 | | (9) Engaging in dishonorable, unethical, or |
16 | | unprofessional conduct of a character likely to deceive, |
17 | | defraud, or harm the public. |
18 | | (10) Habitual or excessive use or addiction to alcohol, |
19 | | narcotics, stimulants, or any other chemical agent or drug |
20 | | that results in the inability to practice with reasonable |
21 | | judgment, skill, or safety. |
22 | | (11) Discipline by another U.S. jurisdiction or |
23 | | foreign nation if at least one of the grounds for the |
24 | | discipline is the same or substantially equivalent to those |
25 | | set forth in this Act. |
26 | | (12) Directly or indirectly giving to or receiving from |
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1 | | any person, firm, corporation, partnership, or association |
2 | | any fee, commission, rebate, or other form of compensation |
3 | | for any professional services not actually or personally |
4 | | rendered. This shall not be deemed to include rent or other |
5 | | remunerations paid to an individual, partnership, or |
6 | | corporation by a licensed certified professional midwife |
7 | | for the lease, rental, or use of space, owned or controlled |
8 | | by the individual, partnership, corporation, or |
9 | | association. |
10 | | (13) A finding by the Department that the licensee, |
11 | | after having his or her license placed on probationary |
12 | | status, has violated the terms of probation. |
13 | | (14) Abandonment of a patient. |
14 | | (15) Willfully making or filing false records or |
15 | | reports relating to a licensee's practice, including, but |
16 | | not limited to, false records filed with State agencies or |
17 | | departments. |
18 | | (16) Physical illness or mental illness, including, |
19 | | but not limited to, deterioration through the aging process |
20 | | or loss of motor skill that results in the inability to |
21 | | practice the profession with reasonable judgment, skill, |
22 | | or safety. |
23 | | (17) Failure to provide a patient with a copy of his or |
24 | | her record upon the written request of the patient. |
25 | | (18) Conviction by any court of competent |
26 | | jurisdiction, either within or without this State, of any |
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1 | | violation of any law governing the practice of licensed |
2 | | certified professional midwifery or conviction in this or |
3 | | another state of any crime that is a felony under the laws |
4 | | of this State or conviction of a felony in a federal court, |
5 | | if the Department determines, after investigation, that |
6 | | the person has not been sufficiently rehabilitated to |
7 | | warrant the public trust. |
8 | | (19) A finding that licensure has been applied for or |
9 | | obtained by fraudulent means. |
10 | | (20) Being named as a perpetrator in an indicated |
11 | | report by the Department of Children and Family Services |
12 | | under the Abused and Neglected Child Reporting Act and upon |
13 | | proof by clear and convincing evidence that the licensee |
14 | | has caused a child to be an abused child or a neglected |
15 | | child, as defined in Section 3 of the Abused and Neglected |
16 | | Child Reporting Act. |
17 | | (21) Practicing or attempting to practice under a name |
18 | | other than the full name shown on a license issued under |
19 | | this Act. |
20 | | (22) Immoral conduct in the commission of any act, such |
21 | | as sexual abuse, sexual misconduct, or sexual |
22 | | exploitation, related to the licensee's practice. |
23 | | (23) Maintaining a professional relationship with any |
24 | | person, firm, or corporation when the licensed certified |
25 | | professional midwife knows or should know that a person, |
26 | | firm, or corporation is violating this Act. |
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1 | | (24) Failure to provide satisfactory proof of having |
2 | | participated in approved continuing education programs as |
3 | | determined by the Board and approved by the Secretary. |
4 | | Exceptions for extreme hardships are to be defined by the |
5 | | Department. |
6 | | (b) The Department may refuse to issue or may suspend the |
7 | | license of any person who fails to (i) file a tax return or to |
8 | | pay the tax, penalty, or interest shown in a filed return or |
9 | | (ii) pay any final assessment of the tax, penalty, or interest, |
10 | | as required by any tax Act administered by the Illinois |
11 | | Department of Revenue, until the time that the requirements of |
12 | | that tax Act are satisfied. |
13 | | (c) The determination by a circuit court that a licensee is |
14 | | subject to involuntary admission or judicial admission as |
15 | | provided in the Mental Health and Developmental Disabilities |
16 | | Code operates as an automatic suspension. The suspension shall |
17 | | end only upon a finding by a court that the patient is no |
18 | | longer subject to involuntary admission or judicial admission, |
19 | | the issuance of an order so finding and discharging the |
20 | | patient, and the recommendation of the Board to the Secretary |
21 | | that the licensee be allowed to resume his or her practice. |
22 | | (d) In enforcing this Section, the Department, upon a |
23 | | showing of a possible violation, may compel any person licensed |
24 | | to practice under this Act or who has applied for licensure or |
25 | | certification pursuant to this Act to submit to a mental or |
26 | | physical examination, or both, as required by and at the |
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1 | | expense of the Department. The examining physicians shall be |
2 | | those specifically designated by the Department. The |
3 | | Department may order an examining physician to present |
4 | | testimony concerning the mental or physical examination of the |
5 | | licensee or applicant. No information shall be excluded by |
6 | | reason of any common law or statutory privilege relating to |
7 | | communications between the licensee or applicant and the |
8 | | examining physician. The person to be examined may have, at his |
9 | | or her own expense, another physician of his or her choice |
10 | | present during all aspects of the examination. Failure of any |
11 | | person to submit to a mental or physical examination when |
12 | | directed shall be grounds for suspension of a license until the |
13 | | person submits to the examination if the Department finds, |
14 | | after notice and hearing, that the refusal to submit to the |
15 | | examination was without reasonable cause. |
16 | | If the Department finds an individual unable to practice |
17 | | because of the reasons set forth in this subsection (d), the |
18 | | Department may require that individual to submit to care, |
19 | | counseling, or treatment by physicians approved or designated |
20 | | by the Department, as a condition, term, or restriction for |
21 | | continued, reinstated, or renewed licensure to practice or, in |
22 | | lieu of care, counseling, or treatment, the Department may file |
23 | | a complaint to immediately suspend, revoke, or otherwise |
24 | | discipline the license of the individual. Any person whose |
25 | | license was granted, reinstated, renewed, disciplined, or |
26 | | supervised subject to such terms, conditions, or restrictions |
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1 | | and who fails to comply with such terms, conditions, or |
2 | | restrictions shall be referred to the Secretary for a |
3 | | determination as to whether or not the person shall have his or |
4 | | her license suspended immediately, pending a hearing by the |
5 | | Department. |
6 | | In instances in which the Secretary immediately suspends a |
7 | | person's license under this Section, a hearing on that person's |
8 | | license must be convened by the Department within 15 days after |
9 | | the suspension and completed without appreciable delay. The |
10 | | Department may review the person's record of treatment and |
11 | | counseling regarding the impairment, to the extent permitted by |
12 | | applicable federal statutes and regulations safeguarding the |
13 | | confidentiality of medical records. |
14 | | A person licensed under this Act and affected under this |
15 | | subsection (d) shall be afforded an opportunity to demonstrate |
16 | | to the Department that he or she can resume practice in |
17 | | compliance with acceptable and prevailing standards under the |
18 | | provisions of his or her license. |
19 | | Section 145. Failure to pay restitution. The Department, |
20 | | without further process or hearing, shall suspend the license |
21 | | or other authorization to practice of any person issued under |
22 | | this Act who has been certified by court order as not having |
23 | | paid restitution to a person under Section 8A-3.5 of the |
24 | | Illinois Public Aid Code, under Section 46-1 of the Criminal |
25 | | Code of 1961, or under Sections 17-8.5 or 17-10.5 of the |
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1 | | Criminal Code of 2012. A person whose license or other |
2 | | authorization to practice is suspended under this Section is |
3 | | prohibited from practicing until restitution is paid in full. |
4 | | Section 150. Injunction; cease and desist order. |
5 | | (a) If a person violates any provision of this Act, the |
6 | | Secretary may, in the name of the People of the State of |
7 | | Illinois, through the Attorney General or the State's Attorney |
8 | | of any county in which the action is brought, petition for an |
9 | | order enjoining the violation or enforcing compliance with this |
10 | | Act. Upon the filing of a verified petition in court, the court |
11 | | may issue a temporary restraining order, without notice or |
12 | | bond, and may preliminarily and permanently enjoin the |
13 | | violation. If it is established that the person has violated or |
14 | | is violating the injunction, the court may punish the offender |
15 | | for contempt of court. Proceedings under this Section shall be |
16 | | in addition to, and not in lieu of, all other remedies and |
17 | | penalties provided by this Act. |
18 | | (b) If any person practices as a licensed certified |
19 | | professional midwife or holds himself or herself out as a |
20 | | licensed certified professional midwife without being licensed |
21 | | under the provisions of this Act, then any licensed certified |
22 | | professional midwife, any interested party, or any person |
23 | | injured thereby may, in addition to the Secretary, petition for |
24 | | relief as provided in subsection (a) of this Section. |
25 | | (c) Whenever, in the opinion of the Department, any person |
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1 | | violates any provision of this Act, the Department may issue a |
2 | | rule to show cause why an order to cease and desist should not |
3 | | be entered against that person. The rule shall clearly set |
4 | | forth the grounds relied upon by the Department and shall |
5 | | provide a period of 7 days after the date of the rule to file an |
6 | | answer to the satisfaction of the Department. Failure to answer |
7 | | to the satisfaction of the Department shall cause an order to |
8 | | cease and desist to be issued immediately. |
9 | | Section 155. Violation; criminal penalty. |
10 | | (a) Whoever knowingly practices or offers to practice |
11 | | midwifery in this State without being licensed for that purpose |
12 | | or exempt under this Act shall be guilty of a Class A |
13 | | misdemeanor; and shall be guilty of a Class 4 felony for a |
14 | | second or subsequent violation. |
15 | | (b) Notwithstanding any other provision of this Act, all |
16 | | criminal fines, moneys, or other property collected or received |
17 | | by the Department under this Section or any other State or |
18 | | federal statute, including, but not limited to, property |
19 | | forfeited to the Department under Section 505 of the Illinois |
20 | | Controlled Substances Act or Section 85 of the Methamphetamine |
21 | | Control and Community Protection Act, shall be deposited into |
22 | | the Professional Regulation Evidence Fund. |
23 | | Section 160. Investigation; notice; hearing. The |
24 | | Department may investigate the actions of any applicant or of |
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1 | | any person or persons holding or claiming to hold a license |
2 | | under this Act. Before refusing to issue or to renew or taking |
3 | | any disciplinary action regarding a license, the Department |
4 | | shall, at least 30 days prior to the date set for the hearing, |
5 | | notify in writing the applicant or licensee of the nature of |
6 | | any charges and that a hearing shall be held on a date |
7 | | designated. The Department shall direct the applicant or |
8 | | licensee to file a written answer with the Board under oath |
9 | | within 20 days after the service of the notice and inform the |
10 | | applicant or licensee that failure to file an answer shall |
11 | | result in default being taken against the applicant or licensee |
12 | | and that the license may be suspended, revoked, or placed on |
13 | | probationary status or that other disciplinary action may be |
14 | | taken, including limiting the scope, nature, or extent of |
15 | | practice, as the Secretary may deem proper. Written notice may |
16 | | be served by personal delivery or certified or registered mail |
17 | | to the respondent at the address of his or her last |
18 | | notification to the Department. If the person fails to file an |
19 | | answer after receiving notice, his or her license may, in the |
20 | | discretion of the Department, be suspended, revoked, or placed |
21 | | on probationary status, or the Department may take any |
22 | | disciplinary action deemed proper, including limiting the |
23 | | scope, nature, or extent of the person's practice or the |
24 | | imposition of a fine, without a hearing, if the act or acts |
25 | | charged constitute sufficient grounds for such action under |
26 | | this Act. At the time and place fixed in the notice, the Board |
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1 | | shall proceed to hear the charges and the parties or their |
2 | | counsel shall be accorded ample opportunity to present such |
3 | | statements, testimony, evidence, and argument as may be |
4 | | pertinent to the charges or to their defense. The Board may |
5 | | continue a hearing from time to time. |
6 | | Section 165. Formal hearing; preservation of record. The |
7 | | Department, at its expense, shall preserve a record of all |
8 | | proceedings at the formal hearing of any case. The notice of |
9 | | hearing, complaint, and all other documents in the nature of |
10 | | pleadings and written motions filed in the proceedings, the |
11 | | transcript of testimony, the report of the Board or hearing |
12 | | officer, and order of the Department shall be the record of the |
13 | | proceeding. The Department shall furnish a transcript of the |
14 | | record to any person interested in the hearing upon payment of |
15 | | the fee required under Section 2105-115 of the Department of |
16 | | Professional Regulation Law. |
17 | | Section 170. Witnesses; production of documents; contempt. |
18 | | Any circuit court may upon application of the Department or its |
19 | | designee or of the applicant or licensee against whom |
20 | | proceedings under Section 95 of this Act are pending, enter an |
21 | | order requiring the attendance of witnesses and their testimony |
22 | | and the production of documents, papers, files, books, and |
23 | | records in connection with any hearing or investigation. The |
24 | | court may compel obedience to its order by proceedings for |
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1 | | contempt. |
2 | | Section 175. Subpoena; oaths. The Department shall have the |
3 | | power to subpoena and bring before it any person in this State |
4 | | and to take testimony either orally or by deposition or both |
5 | | with the same fees and mileage and in the same manner as |
6 | | prescribed in civil cases in circuit courts of this State. The |
7 | | Secretary, the designated hearing officer, and every member of |
8 | | the Board has the power to administer oaths to witnesses at any |
9 | | hearing that the Department is authorized to conduct and any |
10 | | other oaths authorized in any Act administered by the |
11 | | Department. Any circuit court may, upon application of the |
12 | | Department or its designee or upon application of the person |
13 | | against whom proceedings under this Act are pending, enter an |
14 | | order requiring the attendance of witnesses and their |
15 | | testimony, and the production of documents, papers, files, |
16 | | books, and records in connection with any hearing or |
17 | | investigation. The court may compel obedience to its order by |
18 | | proceedings for contempt. |
19 | | Section 180. Findings of fact, conclusions of law, and |
20 | | recommendations. At the conclusion of the hearing the Board |
21 | | shall present to the Secretary a written report of its findings |
22 | | of fact, conclusions of law, and recommendations. The report |
23 | | shall contain a finding as to whether or not the accused person |
24 | | violated this Act or failed to comply with the conditions |
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1 | | required under this Act. The Board shall specify the nature of |
2 | | the violation or failure to comply and shall make its |
3 | | recommendations to the Secretary. |
4 | | The report of findings of fact, conclusions of law, and |
5 | | recommendations of the Board shall be the basis for the |
6 | | Department's order. If the Secretary disagrees in any regard |
7 | | with the report of the Board, the Secretary may issue an order |
8 | | in contravention of the report. The finding is not admissible |
9 | | in evidence against the person in a criminal prosecution |
10 | | brought for the violation of this Act, but the hearing and |
11 | | findings are not a bar to a criminal prosecution brought for |
12 | | the violation of this Act. |
13 | | Section 185. Hearing officer. The Secretary may appoint any |
14 | | attorney duly licensed to practice law in the State of Illinois |
15 | | to serve as the hearing officer in any action for departmental |
16 | | refusal to issue, renew, or license an applicant or for |
17 | | disciplinary action against a licensee. The hearing officer |
18 | | shall have full authority to conduct the hearing. The hearing |
19 | | officer shall report his or her findings of fact, conclusions |
20 | | of law, and recommendations to the Board and the Secretary. The |
21 | | Board shall have 60 calendar days after receipt of the report |
22 | | to review the report of the hearing officer and present its |
23 | | findings of fact, conclusions of law, and recommendations to |
24 | | the Secretary. If the Board fails to present its report within |
25 | | the 60-day period, the Secretary may issue an order based on |
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1 | | the report of the hearing officer. If the Secretary disagrees |
2 | | with the recommendation of the Board or the hearing officer, he |
3 | | or she may issue an order in contravention of that |
4 | | recommendation. |
5 | | Section 190. Service of report; motion for rehearing. In |
6 | | any case involving the discipline of a license, a copy of the |
7 | | Board's report shall be served upon the respondent by the |
8 | | Department, either personally or as provided in this Act for |
9 | | the service of the notice of hearing. Within 20 days after the |
10 | | service, the respondent may present to the Department a motion |
11 | | in writing for a rehearing that shall specify the particular |
12 | | grounds for rehearing. If no motion for rehearing is filed, |
13 | | then upon the expiration of the time specified for filing a |
14 | | motion, or if a motion for rehearing is denied, then upon the |
15 | | denial, the Secretary may enter an order in accordance with |
16 | | this Act. If the respondent orders from the reporting service |
17 | | and pays for a transcript of the record within the time for |
18 | | filing a motion for rehearing, the 20-day period within which |
19 | | the motion may be filed shall commence upon the delivery of the |
20 | | transcript to the respondent. |
21 | | Section 195. Rehearing. Whenever the Secretary is |
22 | | satisfied that substantial justice has not been done in the |
23 | | revocation, suspension, or refusal to issue or renew a license, |
24 | | the Secretary may order a rehearing by the same or another |
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1 | | hearing officer or by the Board. |
2 | | Section 200. Prima facie proof. An order or a certified |
3 | | copy thereof, over the seal of the Department and purporting to |
4 | | be signed by the Secretary, shall be prima facie proof of the |
5 | | following: |
6 | | (1) that the signature is the genuine signature of the |
7 | | Secretary; |
8 | | (2) that such Secretary is duly appointed and qualified; |
9 | | (3) that the Board and its members are qualified to act; |
10 | | and |
11 | | (4) that the findings and conclusions set forth therein are |
12 | | prima facie true and correct. |
13 | | Section 205. Restoration of license. At any time after the |
14 | | suspension or revocation of any license, the Department may |
15 | | restore the license to the accused person, unless after an |
16 | | investigation and a hearing the Department determines that |
17 | | restoration is not in the public interest. |
18 | | Section 210. Surrender of license. Upon the revocation or |
19 | | suspension of any license, the licensee shall immediately |
20 | | surrender the license to the Department. If the licensee fails |
21 | | to do so, the Department shall have the right to seize the |
22 | | license. |
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1 | | Section 215. Summary suspension. The Secretary may |
2 | | summarily suspend the license of a licensee under this Act |
3 | | without a hearing, simultaneously with the institution of |
4 | | proceedings for a hearing provided for in this Act, if the |
5 | | Secretary finds that evidence in his or her possession |
6 | | indicates that continuation in practice would constitute an |
7 | | imminent danger to the public. In the event that the Secretary |
8 | | summarily suspends a license without a hearing, a hearing by |
9 | | the Department must be held within 30 days after the suspension |
10 | | has occurred. |
11 | | Section 220. Certificate of record. The Department shall |
12 | | not be required to certify any record to the court or file any |
13 | | answer in court or otherwise appear in any court in a judicial |
14 | | review proceeding, unless there is filed in the court, with the |
15 | | complaint, a receipt from the Department acknowledging payment |
16 | | of the costs of furnishing and certifying the record. Failure |
17 | | on the part of the plaintiff to file a receipt in court shall |
18 | | be grounds for dismissal of the action. |
19 | | Section 225. Administrative Review Law. All final |
20 | | administrative decisions of the Department are subject to |
21 | | judicial review under the Administrative Review Law and its |
22 | | rules. The term "administrative decision" is defined as in |
23 | | Section 3-101 of the Code of Civil Procedure. |
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1 | | Section 230. Illinois Administrative Procedure Act. The |
2 | | Illinois Administrative Procedure Act is hereby expressly |
3 | | adopted and incorporated in this Act as if all of the |
4 | | provisions of such Act were included in this Act, except that |
5 | | the provision of subsection (d) of Section 10-65 of the |
6 | | Illinois Administrative Procedure Act that provides that at |
7 | | hearings the licensee has the right to show compliance with all |
8 | | lawful requirements for retention, continuation, or renewal of |
9 | | the license is specifically excluded. For purposes of this Act, |
10 | | the notice required under Section 10-25 of the Illinois |
11 | | Administrative Procedure Act is deemed sufficient when mailed |
12 | | to the last known address of a party. |
13 | | Section 235. Home rule. The regulation and licensing of |
14 | | midwives are exclusive powers and functions of the State. A |
15 | | home rule unit may not regulate or license midwives. This |
16 | | Section is a denial and limitation of home rule powers and |
17 | | functions under subsection (h) of Section 6 of Article VII of |
18 | | the Illinois Constitution. |
19 | | Section 240. Severability. The provisions of this Act are |
20 | | severable under Section 1.31 of the Statute on Statutes. |
21 | | Section 245. The Regulatory Sunset Act is amended by adding |
22 | | Section 4.37 as follows: |
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1 | | (5 ILCS 80/4.37 new) |
2 | | Sec. 4.37. Act repealed on January 1, 2027. The following |
3 | | Act is repealed on January 1, 2027: |
4 | | The Home Birth Safety Act. |
5 | | Section 250. The Medical Practice Act of 1987 is amended by |
6 | | changing Section 4 as follows:
|
7 | | (225 ILCS 60/4) (from Ch. 111, par. 4400-4)
|
8 | | (Section scheduled to be repealed on December 31, 2016)
|
9 | | Sec. 4. Exemptions. This Act does not apply to the |
10 | | following:
|
11 | | (1) persons lawfully carrying on their particular |
12 | | profession or business
under any valid existing regulatory |
13 | | Act of this State , including without limitation persons |
14 | | engaged in the practice of midwifery who are licensed under |
15 | | the Home Birth Safety Act ;
|
16 | | (2) persons rendering gratuitous services in cases of |
17 | | emergency; or
|
18 | | (3) persons treating human ailments by prayer or |
19 | | spiritual means as an
exercise or enjoyment of religious |
20 | | freedom.
|
21 | | (Source: P.A. 96-7, eff. 4-3-09; 97-622, eff. 11-23-11 .)
|
22 | | Section 255. The Nurse Practice Act is amended by changing |
23 | | Section 50-15 as follows:
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1 | | (225 ILCS 65/50-15)
(was 225 ILCS 65/5-15)
|
2 | | (Section scheduled to be repealed on January 1, 2018)
|
3 | | Sec. 50-15. Policy; application of Act. |
4 | | (a) For the protection of life and the
promotion of health, |
5 | | and the prevention of illness and communicable diseases,
any |
6 | | person practicing or offering to practice advanced,
|
7 | | professional, or practical
nursing in Illinois shall submit |
8 | | evidence that he or she is qualified to
practice, and shall be |
9 | | licensed as provided under this Act. No person shall
practice |
10 | | or offer to practice advanced, professional, or practical |
11 | | nursing in Illinois or
use any title, sign, card or device to |
12 | | indicate that such a person is
practicing professional or |
13 | | practical nursing unless such person has been
licensed under |
14 | | the provisions of this Act.
|
15 | | (b) This Act does not prohibit the following:
|
16 | | (1) The practice of nursing in Federal employment in |
17 | | the discharge of the
employee's duties by a person who is |
18 | | employed by the United States
government or any bureau, |
19 | | division or agency thereof and is a legally
qualified and |
20 | | licensed nurse of another state or territory and not in
|
21 | | conflict with Sections 50-50, 55-10, 60-10, and 70-5 of |
22 | | this
Act.
|
23 | | (2) Nursing that is included in the program of study by
|
24 | | students
enrolled in programs of nursing or in current |
25 | | nurse practice update courses
approved by the Department.
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1 | | (3) The furnishing of nursing assistance in an |
2 | | emergency.
|
3 | | (4) The practice of nursing by a nurse who holds an |
4 | | active license in
another state when providing services to |
5 | | patients in Illinois during a bonafide
emergency or in |
6 | | immediate preparation for or during interstate
transit.
|
7 | | (5) The incidental care of the sick by members of the |
8 | | family, domestic
servants or housekeepers, or care of the |
9 | | sick where treatment is by prayer
or spiritual means.
|
10 | | (6) Persons from being employed as unlicensed |
11 | | assistive personnel in private homes, long term care |
12 | | facilities,
nurseries, hospitals or other institutions.
|
13 | | (7) The practice of practical nursing by one who is a |
14 | | licensed practical
nurse under the laws of another U.S. |
15 | | jurisdiction and has applied in writing
to the Department, |
16 | | in form and substance satisfactory to the Department,
for a |
17 | | license as a licensed practical nurse and who is qualified |
18 | | to receive
such license under this Act, until (i) the |
19 | | expiration of 6 months after
the filing of such written |
20 | | application, (ii) the withdrawal of such application,
or |
21 | | (iii) the denial of such application by the Department.
|
22 | | (8) The practice of advanced practice nursing by one |
23 | | who is an advanced practice nurse under the laws of another |
24 | | state, territory of the United States, or country and has |
25 | | applied in writing to the Department, in form and substance |
26 | | satisfactory to the Department, for a license as an |
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1 | | advanced practice nurse and who is qualified to receive |
2 | | such license under this Act, until (i) the expiration of 6 |
3 | | months after the filing of such written application, (ii) |
4 | | the withdrawal of such application, or (iii) the denial of |
5 | | such application by the Department.
|
6 | | (9) The practice of professional nursing by one who is |
7 | | a registered
professional nurse under the laws of another |
8 | | state, territory of the United
States or country and has |
9 | | applied in writing to the Department, in form and
substance |
10 | | satisfactory to the Department, for a license as a |
11 | | registered
professional nurse and who is qualified to |
12 | | receive such license under
Section 55-10, until (1) the |
13 | | expiration of 6 months after the filing of
such written |
14 | | application, (2) the withdrawal of such application, or (3)
|
15 | | the denial of such application by the Department.
|
16 | | (10) The practice of professional nursing that is |
17 | | included in a program of
study by one who is a registered |
18 | | professional nurse under the laws of
another state or |
19 | | territory of the United States or foreign country,
|
20 | | territory or province and who is enrolled in a graduate |
21 | | nursing education
program or a program for the completion |
22 | | of a baccalaureate nursing degree in
this State, which |
23 | | includes clinical supervision by faculty as
determined by |
24 | | the educational institution offering the program and the
|
25 | | health care organization where the practice of nursing |
26 | | occurs.
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1 | | (11) Any person licensed in this State under any other |
2 | | Act from engaging
in the practice for which she or he is |
3 | | licensed , including without limitation any person engaged |
4 | | in the practice of midwifery who is licensed under the Home |
5 | | Birth Safety Act .
|
6 | | (12) Delegation to authorized direct care staff |
7 | | trained under Section 15.4
of the Mental Health and
|
8 | | Developmental Disabilities Administrative Act consistent |
9 | | with the policies of the Department.
|
10 | | (13) The practice, services, or activities of persons |
11 | | practicing the specified occupations set forth in |
12 | | subsection (a) of, and pursuant to a licensing exemption |
13 | | granted in subsection (b) or (d) of, Section 2105-350 of |
14 | | the Department of Professional Regulation Law of the Civil |
15 | | Administrative Code of Illinois, but only for so long as |
16 | | the 2016 Olympic and Paralympic Games Professional |
17 | | Licensure Exemption Law is operable. |
18 | | (14) County correctional personnel from delivering |
19 | | prepackaged medication for self-administration to an |
20 | | individual detainee in a correctional facility. |
21 | | Nothing in this Act shall be construed to limit the |
22 | | delegation of tasks or duties by a physician, dentist, or |
23 | | podiatric physician to a licensed practical nurse, a registered |
24 | | professional nurse, or other persons.
|
25 | | (Source: P.A. 98-214, eff. 8-9-13.)
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1 | | Section 260. The Illinois Public Aid Code is amended by |
2 | | changing Section 5-5 as follows:
|
3 | | (305 ILCS 5/5-5) (from Ch. 23, par. 5-5)
|
4 | | (Text of Section before amendment by P.A. 99-407 ) |
5 | | Sec. 5-5. Medical services. The Illinois Department, by |
6 | | rule, shall
determine the quantity and quality of and the rate |
7 | | of reimbursement for the
medical assistance for which
payment |
8 | | will be authorized, and the medical services to be provided,
|
9 | | which may include all or part of the following: (1) inpatient |
10 | | hospital
services; (2) outpatient hospital services; (3) other |
11 | | laboratory and
X-ray services; (4) skilled nursing home |
12 | | services; (5) physicians'
services whether furnished in the |
13 | | office, the patient's home, a
hospital, a skilled nursing home, |
14 | | or elsewhere; (6) medical care, or any
other type of remedial |
15 | | care furnished by licensed practitioners , including the |
16 | | services of licensed certified professional midwives pursuant |
17 | | to the Home Birth Safety Act ; (7)
home health care services; |
18 | | (8) private duty nursing service; (9) clinic
services; (10) |
19 | | dental services, including prevention and treatment of |
20 | | periodontal disease and dental caries disease for pregnant |
21 | | women, provided by an individual licensed to practice dentistry |
22 | | or dental surgery; for purposes of this item (10), "dental |
23 | | services" means diagnostic, preventive, or corrective |
24 | | procedures provided by or under the supervision of a dentist in |
25 | | the practice of his or her profession; (11) physical therapy |
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1 | | and related
services; (12) prescribed drugs, dentures, and |
2 | | prosthetic devices; and
eyeglasses prescribed by a physician |
3 | | skilled in the diseases of the eye,
or by an optometrist, |
4 | | whichever the person may select; (13) other
diagnostic, |
5 | | screening, preventive, and rehabilitative services, including |
6 | | to ensure that the individual's need for intervention or |
7 | | treatment of mental disorders or substance use disorders or |
8 | | co-occurring mental health and substance use disorders is |
9 | | determined using a uniform screening, assessment, and |
10 | | evaluation process inclusive of criteria, for children and |
11 | | adults; for purposes of this item (13), a uniform screening, |
12 | | assessment, and evaluation process refers to a process that |
13 | | includes an appropriate evaluation and, as warranted, a |
14 | | referral; "uniform" does not mean the use of a singular |
15 | | instrument, tool, or process that all must utilize; (14)
|
16 | | transportation and such other expenses as may be necessary; |
17 | | (15) medical
treatment of sexual assault survivors, as defined |
18 | | in
Section 1a of the Sexual Assault Survivors Emergency |
19 | | Treatment Act, for
injuries sustained as a result of the sexual |
20 | | assault, including
examinations and laboratory tests to |
21 | | discover evidence which may be used in
criminal proceedings |
22 | | arising from the sexual assault; (16) the
diagnosis and |
23 | | treatment of sickle cell anemia; and (17)
any other medical |
24 | | care, and any other type of remedial care recognized
under the |
25 | | laws of this State, but not including abortions, or induced
|
26 | | miscarriages or premature births, unless, in the opinion of a |
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1 | | physician,
such procedures are necessary for the preservation |
2 | | of the life of the
woman seeking such treatment, or except an |
3 | | induced premature birth
intended to produce a live viable child |
4 | | and such procedure is necessary
for the health of the mother or |
5 | | her unborn child. The Illinois Department,
by rule, shall |
6 | | prohibit any physician from providing medical assistance
to |
7 | | anyone eligible therefor under this Code where such physician |
8 | | has been
found guilty of performing an abortion procedure in a |
9 | | wilful and wanton
manner upon a woman who was not pregnant at |
10 | | the time such abortion
procedure was performed. The term "any |
11 | | other type of remedial care" shall
include nursing care and |
12 | | nursing home service for persons who rely on
treatment by |
13 | | spiritual means alone through prayer for healing.
|
14 | | Notwithstanding any other provision of this Section, a |
15 | | comprehensive
tobacco use cessation program that includes |
16 | | purchasing prescription drugs or
prescription medical devices |
17 | | approved by the Food and Drug Administration shall
be covered |
18 | | under the medical assistance
program under this Article for |
19 | | persons who are otherwise eligible for
assistance under this |
20 | | Article.
|
21 | | Notwithstanding any other provision of this Code, the |
22 | | Illinois
Department may not require, as a condition of payment |
23 | | for any laboratory
test authorized under this Article, that a |
24 | | physician's handwritten signature
appear on the laboratory |
25 | | test order form. The Illinois Department may,
however, impose |
26 | | other appropriate requirements regarding laboratory test
order |
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1 | | documentation.
|
2 | | Upon receipt of federal approval of an amendment to the |
3 | | Illinois Title XIX State Plan for this purpose, the Department |
4 | | shall authorize the Chicago Public Schools (CPS) to procure a |
5 | | vendor or vendors to manufacture eyeglasses for individuals |
6 | | enrolled in a school within the CPS system. CPS shall ensure |
7 | | that its vendor or vendors are enrolled as providers in the |
8 | | medical assistance program and in any capitated Medicaid |
9 | | managed care entity (MCE) serving individuals enrolled in a |
10 | | school within the CPS system. Under any contract procured under |
11 | | this provision, the vendor or vendors must serve only |
12 | | individuals enrolled in a school within the CPS system. Claims |
13 | | for services provided by CPS's vendor or vendors to recipients |
14 | | of benefits in the medical assistance program under this Code, |
15 | | the Children's Health Insurance Program, or the Covering ALL |
16 | | KIDS Health Insurance Program shall be submitted to the |
17 | | Department or the MCE in which the individual is enrolled for |
18 | | payment and shall be reimbursed at the Department's or the |
19 | | MCE's established rates or rate methodologies for eyeglasses. |
20 | | On and after July 1, 2012, the Department of Healthcare and |
21 | | Family Services may provide the following services to
persons
|
22 | | eligible for assistance under this Article who are |
23 | | participating in
education, training or employment programs |
24 | | operated by the Department of Human
Services as successor to |
25 | | the Department of Public Aid:
|
26 | | (1) dental services provided by or under the |
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1 | | supervision of a dentist; and
|
2 | | (2) eyeglasses prescribed by a physician skilled in the |
3 | | diseases of the
eye, or by an optometrist, whichever the |
4 | | person may select.
|
5 | | Notwithstanding any other provision of this Code and |
6 | | subject to federal approval, the Department may adopt rules to |
7 | | allow a dentist who is volunteering his or her service at no |
8 | | cost to render dental services through an enrolled |
9 | | not-for-profit health clinic without the dentist personally |
10 | | enrolling as a participating provider in the medical assistance |
11 | | program. A not-for-profit health clinic shall include a public |
12 | | health clinic or Federally Qualified Health Center or other |
13 | | enrolled provider, as determined by the Department, through |
14 | | which dental services covered under this Section are performed. |
15 | | The Department shall establish a process for payment of claims |
16 | | for reimbursement for covered dental services rendered under |
17 | | this provision. |
18 | | The Illinois Department, by rule, may distinguish and |
19 | | classify the
medical services to be provided only in accordance |
20 | | with the classes of
persons designated in Section 5-2.
|
21 | | The Department of Healthcare and Family Services must |
22 | | provide coverage and reimbursement for amino acid-based |
23 | | elemental formulas, regardless of delivery method, for the |
24 | | diagnosis and treatment of (i) eosinophilic disorders and (ii) |
25 | | short bowel syndrome when the prescribing physician has issued |
26 | | a written order stating that the amino acid-based elemental |
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1 | | formula is medically necessary.
|
2 | | The Illinois Department shall authorize the provision of, |
3 | | and shall
authorize payment for, screening by low-dose |
4 | | mammography for the presence of
occult breast cancer for women |
5 | | 35 years of age or older who are eligible
for medical |
6 | | assistance under this Article, as follows: |
7 | | (A) A baseline
mammogram for women 35 to 39 years of |
8 | | age.
|
9 | | (B) An annual mammogram for women 40 years of age or |
10 | | older. |
11 | | (C) A mammogram at the age and intervals considered |
12 | | medically necessary by the woman's health care provider for |
13 | | women under 40 years of age and having a family history of |
14 | | breast cancer, prior personal history of breast cancer, |
15 | | positive genetic testing, or other risk factors. |
16 | | (D) A comprehensive ultrasound screening of an entire |
17 | | breast or breasts if a mammogram demonstrates |
18 | | heterogeneous or dense breast tissue, when medically |
19 | | necessary as determined by a physician licensed to practice |
20 | | medicine in all of its branches. |
21 | | (E) A screening MRI when medically necessary, as |
22 | | determined by a physician licensed to practice medicine in |
23 | | all of its branches. |
24 | | All screenings
shall
include a physical breast exam, |
25 | | instruction on self-examination and
information regarding the |
26 | | frequency of self-examination and its value as a
preventative |
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1 | | tool. For purposes of this Section, "low-dose mammography" |
2 | | means
the x-ray examination of the breast using equipment |
3 | | dedicated specifically
for mammography, including the x-ray |
4 | | tube, filter, compression device,
and image receptor, with an |
5 | | average radiation exposure delivery
of less than one rad per |
6 | | breast for 2 views of an average size breast.
The term also |
7 | | includes digital mammography.
|
8 | | On and after January 1, 2016, the Department shall ensure |
9 | | that all networks of care for adult clients of the Department |
10 | | include access to at least one breast imaging Center of Imaging |
11 | | Excellence as certified by the American College of Radiology. |
12 | | On and after January 1, 2012, providers participating in a |
13 | | quality improvement program approved by the Department shall be |
14 | | reimbursed for screening and diagnostic mammography at the same |
15 | | rate as the Medicare program's rates, including the increased |
16 | | reimbursement for digital mammography. |
17 | | The Department shall convene an expert panel including |
18 | | representatives of hospitals, free-standing mammography |
19 | | facilities, and doctors, including radiologists, to establish |
20 | | quality standards for mammography. |
21 | | On and after January 1, 2017, providers participating in a |
22 | | breast cancer treatment quality improvement program approved |
23 | | by the Department shall be reimbursed for breast cancer |
24 | | treatment at a rate that is no lower than 95% of the Medicare |
25 | | program's rates for the data elements included in the breast |
26 | | cancer treatment quality program. |
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1 | | The Department shall convene an expert panel, including |
2 | | representatives of hospitals, free standing breast cancer |
3 | | treatment centers, breast cancer quality organizations, and |
4 | | doctors, including breast surgeons, reconstructive breast |
5 | | surgeons, oncologists, and primary care providers to establish |
6 | | quality standards for breast cancer treatment. |
7 | | Subject to federal approval, the Department shall |
8 | | establish a rate methodology for mammography at federally |
9 | | qualified health centers and other encounter-rate clinics. |
10 | | These clinics or centers may also collaborate with other |
11 | | hospital-based mammography facilities. By January 1, 2016, the |
12 | | Department shall report to the General Assembly on the status |
13 | | of the provision set forth in this paragraph. |
14 | | The Department shall establish a methodology to remind |
15 | | women who are age-appropriate for screening mammography, but |
16 | | who have not received a mammogram within the previous 18 |
17 | | months, of the importance and benefit of screening mammography. |
18 | | The Department shall work with experts in breast cancer |
19 | | outreach and patient navigation to optimize these reminders and |
20 | | shall establish a methodology for evaluating their |
21 | | effectiveness and modifying the methodology based on the |
22 | | evaluation. |
23 | | The Department shall establish a performance goal for |
24 | | primary care providers with respect to their female patients |
25 | | over age 40 receiving an annual mammogram. This performance |
26 | | goal shall be used to provide additional reimbursement in the |
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1 | | form of a quality performance bonus to primary care providers |
2 | | who meet that goal. |
3 | | The Department shall devise a means of case-managing or |
4 | | patient navigation for beneficiaries diagnosed with breast |
5 | | cancer. This program shall initially operate as a pilot program |
6 | | in areas of the State with the highest incidence of mortality |
7 | | related to breast cancer. At least one pilot program site shall |
8 | | be in the metropolitan Chicago area and at least one site shall |
9 | | be outside the metropolitan Chicago area. On or after July 1, |
10 | | 2016, the pilot program shall be expanded to include one site |
11 | | in western Illinois, one site in southern Illinois, one site in |
12 | | central Illinois, and 4 sites within metropolitan Chicago. An |
13 | | evaluation of the pilot program shall be carried out measuring |
14 | | health outcomes and cost of care for those served by the pilot |
15 | | program compared to similarly situated patients who are not |
16 | | served by the pilot program. |
17 | | The Department shall require all networks of care to |
18 | | develop a means either internally or by contract with experts |
19 | | in navigation and community outreach to navigate cancer |
20 | | patients to comprehensive care in a timely fashion. The |
21 | | Department shall require all networks of care to include access |
22 | | for patients diagnosed with cancer to at least one academic |
23 | | commission on cancer-accredited cancer program as an |
24 | | in-network covered benefit. |
25 | | Any medical or health care provider shall immediately |
26 | | recommend, to
any pregnant woman who is being provided prenatal |
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1 | | services and is suspected
of drug abuse or is addicted as |
2 | | defined in the Alcoholism and Other Drug Abuse
and Dependency |
3 | | Act, referral to a local substance abuse treatment provider
|
4 | | licensed by the Department of Human Services or to a licensed
|
5 | | hospital which provides substance abuse treatment services. |
6 | | The Department of Healthcare and Family Services
shall assure |
7 | | coverage for the cost of treatment of the drug abuse or
|
8 | | addiction for pregnant recipients in accordance with the |
9 | | Illinois Medicaid
Program in conjunction with the Department of |
10 | | Human Services.
|
11 | | All medical providers providing medical assistance to |
12 | | pregnant women
under this Code shall receive information from |
13 | | the Department on the
availability of services under the Drug |
14 | | Free Families with a Future or any
comparable program providing |
15 | | case management services for addicted women,
including |
16 | | information on appropriate referrals for other social services
|
17 | | that may be needed by addicted women in addition to treatment |
18 | | for addiction.
|
19 | | The Illinois Department, in cooperation with the |
20 | | Departments of Human
Services (as successor to the Department |
21 | | of Alcoholism and Substance
Abuse) and Public Health, through a |
22 | | public awareness campaign, may
provide information concerning |
23 | | treatment for alcoholism and drug abuse and
addiction, prenatal |
24 | | health care, and other pertinent programs directed at
reducing |
25 | | the number of drug-affected infants born to recipients of |
26 | | medical
assistance.
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1 | | Neither the Department of Healthcare and Family Services |
2 | | nor the Department of Human
Services shall sanction the |
3 | | recipient solely on the basis of
her substance abuse.
|
4 | | The Illinois Department shall establish such regulations |
5 | | governing
the dispensing of health services under this Article |
6 | | as it shall deem
appropriate. The Department
should
seek the |
7 | | advice of formal professional advisory committees appointed by
|
8 | | the Director of the Illinois Department for the purpose of |
9 | | providing regular
advice on policy and administrative matters, |
10 | | information dissemination and
educational activities for |
11 | | medical and health care providers, and
consistency in |
12 | | procedures to the Illinois Department.
|
13 | | The Illinois Department may develop and contract with |
14 | | Partnerships of
medical providers to arrange medical services |
15 | | for persons eligible under
Section 5-2 of this Code. |
16 | | Implementation of this Section may be by
demonstration projects |
17 | | in certain geographic areas. The Partnership shall
be |
18 | | represented by a sponsor organization. The Department, by rule, |
19 | | shall
develop qualifications for sponsors of Partnerships. |
20 | | Nothing in this
Section shall be construed to require that the |
21 | | sponsor organization be a
medical organization.
|
22 | | The sponsor must negotiate formal written contracts with |
23 | | medical
providers for physician services, inpatient and |
24 | | outpatient hospital care,
home health services, treatment for |
25 | | alcoholism and substance abuse, and
other services determined |
26 | | necessary by the Illinois Department by rule for
delivery by |
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1 | | Partnerships. Physician services must include prenatal and
|
2 | | obstetrical care. The Illinois Department shall reimburse |
3 | | medical services
delivered by Partnership providers to clients |
4 | | in target areas according to
provisions of this Article and the |
5 | | Illinois Health Finance Reform Act,
except that:
|
6 | | (1) Physicians participating in a Partnership and |
7 | | providing certain
services, which shall be determined by |
8 | | the Illinois Department, to persons
in areas covered by the |
9 | | Partnership may receive an additional surcharge
for such |
10 | | services.
|
11 | | (2) The Department may elect to consider and negotiate |
12 | | financial
incentives to encourage the development of |
13 | | Partnerships and the efficient
delivery of medical care.
|
14 | | (3) Persons receiving medical services through |
15 | | Partnerships may receive
medical and case management |
16 | | services above the level usually offered
through the |
17 | | medical assistance program.
|
18 | | Medical providers shall be required to meet certain |
19 | | qualifications to
participate in Partnerships to ensure the |
20 | | delivery of high quality medical
services. These |
21 | | qualifications shall be determined by rule of the Illinois
|
22 | | Department and may be higher than qualifications for |
23 | | participation in the
medical assistance program. Partnership |
24 | | sponsors may prescribe reasonable
additional qualifications |
25 | | for participation by medical providers, only with
the prior |
26 | | written approval of the Illinois Department.
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1 | | Nothing in this Section shall limit the free choice of |
2 | | practitioners,
hospitals, and other providers of medical |
3 | | services by clients.
In order to ensure patient freedom of |
4 | | choice, the Illinois Department shall
immediately promulgate |
5 | | all rules and take all other necessary actions so that
provided |
6 | | services may be accessed from therapeutically certified |
7 | | optometrists
to the full extent of the Illinois Optometric |
8 | | Practice Act of 1987 without
discriminating between service |
9 | | providers.
|
10 | | The Department shall apply for a waiver from the United |
11 | | States Health
Care Financing Administration to allow for the |
12 | | implementation of
Partnerships under this Section.
|
13 | | The Illinois Department shall require health care |
14 | | providers to maintain
records that document the medical care |
15 | | and services provided to recipients
of Medical Assistance under |
16 | | this Article. Such records must be retained for a period of not |
17 | | less than 6 years from the date of service or as provided by |
18 | | applicable State law, whichever period is longer, except that |
19 | | if an audit is initiated within the required retention period |
20 | | then the records must be retained until the audit is completed |
21 | | and every exception is resolved. The Illinois Department shall
|
22 | | require health care providers to make available, when |
23 | | authorized by the
patient, in writing, the medical records in a |
24 | | timely fashion to other
health care providers who are treating |
25 | | or serving persons eligible for
Medical Assistance under this |
26 | | Article. All dispensers of medical services
shall be required |
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1 | | to maintain and retain business and professional records
|
2 | | sufficient to fully and accurately document the nature, scope, |
3 | | details and
receipt of the health care provided to persons |
4 | | eligible for medical
assistance under this Code, in accordance |
5 | | with regulations promulgated by
the Illinois Department. The |
6 | | rules and regulations shall require that proof
of the receipt |
7 | | of prescription drugs, dentures, prosthetic devices and
|
8 | | eyeglasses by eligible persons under this Section accompany |
9 | | each claim
for reimbursement submitted by the dispenser of such |
10 | | medical services.
No such claims for reimbursement shall be |
11 | | approved for payment by the Illinois
Department without such |
12 | | proof of receipt, unless the Illinois Department
shall have put |
13 | | into effect and shall be operating a system of post-payment
|
14 | | audit and review which shall, on a sampling basis, be deemed |
15 | | adequate by
the Illinois Department to assure that such drugs, |
16 | | dentures, prosthetic
devices and eyeglasses for which payment |
17 | | is being made are actually being
received by eligible |
18 | | recipients. Within 90 days after September 16, 1984 ( the |
19 | | effective date of Public Act 83-1439)
this amendatory Act of |
20 | | 1984 , the Illinois Department shall establish a
current list of |
21 | | acquisition costs for all prosthetic devices and any
other |
22 | | items recognized as medical equipment and supplies |
23 | | reimbursable under
this Article and shall update such list on a |
24 | | quarterly basis, except that
the acquisition costs of all |
25 | | prescription drugs shall be updated no
less frequently than |
26 | | every 30 days as required by Section 5-5.12.
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1 | | The rules and regulations of the Illinois Department shall |
2 | | require
that a written statement including the required opinion |
3 | | of a physician
shall accompany any claim for reimbursement for |
4 | | abortions, or induced
miscarriages or premature births. This |
5 | | statement shall indicate what
procedures were used in providing |
6 | | such medical services.
|
7 | | Notwithstanding any other law to the contrary, the Illinois |
8 | | Department shall, within 365 days after July 22, 2013 (the |
9 | | effective date of Public Act 98-104), establish procedures to |
10 | | permit skilled care facilities licensed under the Nursing Home |
11 | | Care Act to submit monthly billing claims for reimbursement |
12 | | purposes. Following development of these procedures, the |
13 | | Department shall, by July 1, 2016, test the viability of the |
14 | | new system and implement any necessary operational or |
15 | | structural changes to its information technology platforms in |
16 | | order to allow for the direct acceptance and payment of nursing |
17 | | home claims. |
18 | | Notwithstanding any other law to the contrary, the Illinois |
19 | | Department shall, within 365 days after August 15, 2014 (the |
20 | | effective date of Public Act 98-963), establish procedures to |
21 | | permit ID/DD facilities licensed under the ID/DD Community Care |
22 | | Act and MC/DD facilities licensed under the MC/DD Act to submit |
23 | | monthly billing claims for reimbursement purposes. Following |
24 | | development of these procedures, the Department shall have an |
25 | | additional 365 days to test the viability of the new system and |
26 | | to ensure that any necessary operational or structural changes |
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1 | | to its information technology platforms are implemented. |
2 | | The Illinois Department shall require all dispensers of |
3 | | medical
services, other than an individual practitioner or |
4 | | group of practitioners,
desiring to participate in the Medical |
5 | | Assistance program
established under this Article to disclose |
6 | | all financial, beneficial,
ownership, equity, surety or other |
7 | | interests in any and all firms,
corporations, partnerships, |
8 | | associations, business enterprises, joint
ventures, agencies, |
9 | | institutions or other legal entities providing any
form of |
10 | | health care services in this State under this Article.
|
11 | | The Illinois Department may require that all dispensers of |
12 | | medical
services desiring to participate in the medical |
13 | | assistance program
established under this Article disclose, |
14 | | under such terms and conditions as
the Illinois Department may |
15 | | by rule establish, all inquiries from clients
and attorneys |
16 | | regarding medical bills paid by the Illinois Department, which
|
17 | | inquiries could indicate potential existence of claims or liens |
18 | | for the
Illinois Department.
|
19 | | Enrollment of a vendor
shall be
subject to a provisional |
20 | | period and shall be conditional for one year. During the period |
21 | | of conditional enrollment, the Department may
terminate the |
22 | | vendor's eligibility to participate in, or may disenroll the |
23 | | vendor from, the medical assistance
program without cause. |
24 | | Unless otherwise specified, such termination of eligibility or |
25 | | disenrollment is not subject to the
Department's hearing |
26 | | process.
However, a disenrolled vendor may reapply without |
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1 | | penalty.
|
2 | | The Department has the discretion to limit the conditional |
3 | | enrollment period for vendors based upon category of risk of |
4 | | the vendor. |
5 | | Prior to enrollment and during the conditional enrollment |
6 | | period in the medical assistance program, all vendors shall be |
7 | | subject to enhanced oversight, screening, and review based on |
8 | | the risk of fraud, waste, and abuse that is posed by the |
9 | | category of risk of the vendor. The Illinois Department shall |
10 | | establish the procedures for oversight, screening, and review, |
11 | | which may include, but need not be limited to: criminal and |
12 | | financial background checks; fingerprinting; license, |
13 | | certification, and authorization verifications; unscheduled or |
14 | | unannounced site visits; database checks; prepayment audit |
15 | | reviews; audits; payment caps; payment suspensions; and other |
16 | | screening as required by federal or State law. |
17 | | The Department shall define or specify the following: (i) |
18 | | by provider notice, the "category of risk of the vendor" for |
19 | | each type of vendor, which shall take into account the level of |
20 | | screening applicable to a particular category of vendor under |
21 | | federal law and regulations; (ii) by rule or provider notice, |
22 | | the maximum length of the conditional enrollment period for |
23 | | each category of risk of the vendor; and (iii) by rule, the |
24 | | hearing rights, if any, afforded to a vendor in each category |
25 | | of risk of the vendor that is terminated or disenrolled during |
26 | | the conditional enrollment period. |
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1 | | To be eligible for payment consideration, a vendor's |
2 | | payment claim or bill, either as an initial claim or as a |
3 | | resubmitted claim following prior rejection, must be received |
4 | | by the Illinois Department, or its fiscal intermediary, no |
5 | | later than 180 days after the latest date on the claim on which |
6 | | medical goods or services were provided, with the following |
7 | | exceptions: |
8 | | (1) In the case of a provider whose enrollment is in |
9 | | process by the Illinois Department, the 180-day period |
10 | | shall not begin until the date on the written notice from |
11 | | the Illinois Department that the provider enrollment is |
12 | | complete. |
13 | | (2) In the case of errors attributable to the Illinois |
14 | | Department or any of its claims processing intermediaries |
15 | | which result in an inability to receive, process, or |
16 | | adjudicate a claim, the 180-day period shall not begin |
17 | | until the provider has been notified of the error. |
18 | | (3) In the case of a provider for whom the Illinois |
19 | | Department initiates the monthly billing process. |
20 | | (4) In the case of a provider operated by a unit of |
21 | | local government with a population exceeding 3,000,000 |
22 | | when local government funds finance federal participation |
23 | | for claims payments. |
24 | | For claims for services rendered during a period for which |
25 | | a recipient received retroactive eligibility, claims must be |
26 | | filed within 180 days after the Department determines the |
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1 | | applicant is eligible. For claims for which the Illinois |
2 | | Department is not the primary payer, claims must be submitted |
3 | | to the Illinois Department within 180 days after the final |
4 | | adjudication by the primary payer. |
5 | | In the case of long term care facilities, within 5 days of |
6 | | receipt by the facility of required prescreening information, |
7 | | data for new admissions shall be entered into the Medical |
8 | | Electronic Data Interchange (MEDI) or the Recipient |
9 | | Eligibility Verification (REV) System or successor system, and |
10 | | within 15 days of receipt by the facility of required |
11 | | prescreening information, admission documents shall be |
12 | | submitted through MEDI or REV or shall be submitted directly to |
13 | | the Department of Human Services using required admission |
14 | | forms. Effective September
1, 2014, admission documents, |
15 | | including all prescreening
information, must be submitted |
16 | | through MEDI or REV. Confirmation numbers assigned to an |
17 | | accepted transaction shall be retained by a facility to verify |
18 | | timely submittal. Once an admission transaction has been |
19 | | completed, all resubmitted claims following prior rejection |
20 | | are subject to receipt no later than 180 days after the |
21 | | admission transaction has been completed. |
22 | | Claims that are not submitted and received in compliance |
23 | | with the foregoing requirements shall not be eligible for |
24 | | payment under the medical assistance program, and the State |
25 | | shall have no liability for payment of those claims. |
26 | | To the extent consistent with applicable information and |
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1 | | privacy, security, and disclosure laws, State and federal |
2 | | agencies and departments shall provide the Illinois Department |
3 | | access to confidential and other information and data necessary |
4 | | to perform eligibility and payment verifications and other |
5 | | Illinois Department functions. This includes, but is not |
6 | | limited to: information pertaining to licensure; |
7 | | certification; earnings; immigration status; citizenship; wage |
8 | | reporting; unearned and earned income; pension income; |
9 | | employment; supplemental security income; social security |
10 | | numbers; National Provider Identifier (NPI) numbers; the |
11 | | National Practitioner Data Bank (NPDB); program and agency |
12 | | exclusions; taxpayer identification numbers; tax delinquency; |
13 | | corporate information; and death records. |
14 | | The Illinois Department shall enter into agreements with |
15 | | State agencies and departments, and is authorized to enter into |
16 | | agreements with federal agencies and departments, under which |
17 | | such agencies and departments shall share data necessary for |
18 | | medical assistance program integrity functions and oversight. |
19 | | The Illinois Department shall develop, in cooperation with |
20 | | other State departments and agencies, and in compliance with |
21 | | applicable federal laws and regulations, appropriate and |
22 | | effective methods to share such data. At a minimum, and to the |
23 | | extent necessary to provide data sharing, the Illinois |
24 | | Department shall enter into agreements with State agencies and |
25 | | departments, and is authorized to enter into agreements with |
26 | | federal agencies and departments, including but not limited to: |
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1 | | the Secretary of State; the Department of Revenue; the |
2 | | Department of Public Health; the Department of Human Services; |
3 | | and the Department of Financial and Professional Regulation. |
4 | | Beginning in fiscal year 2013, the Illinois Department |
5 | | shall set forth a request for information to identify the |
6 | | benefits of a pre-payment, post-adjudication, and post-edit |
7 | | claims system with the goals of streamlining claims processing |
8 | | and provider reimbursement, reducing the number of pending or |
9 | | rejected claims, and helping to ensure a more transparent |
10 | | adjudication process through the utilization of: (i) provider |
11 | | data verification and provider screening technology; and (ii) |
12 | | clinical code editing; and (iii) pre-pay, pre- or |
13 | | post-adjudicated predictive modeling with an integrated case |
14 | | management system with link analysis. Such a request for |
15 | | information shall not be considered as a request for proposal |
16 | | or as an obligation on the part of the Illinois Department to |
17 | | take any action or acquire any products or services. |
18 | | The Illinois Department shall establish policies, |
19 | | procedures,
standards and criteria by rule for the acquisition, |
20 | | repair and replacement
of orthotic and prosthetic devices and |
21 | | durable medical equipment. Such
rules shall provide, but not be |
22 | | limited to, the following services: (1)
immediate repair or |
23 | | replacement of such devices by recipients; and (2) rental, |
24 | | lease, purchase or lease-purchase of
durable medical equipment |
25 | | in a cost-effective manner, taking into
consideration the |
26 | | recipient's medical prognosis, the extent of the
recipient's |
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1 | | needs, and the requirements and costs for maintaining such
|
2 | | equipment. Subject to prior approval, such rules shall enable a |
3 | | recipient to temporarily acquire and
use alternative or |
4 | | substitute devices or equipment pending repairs or
|
5 | | replacements of any device or equipment previously authorized |
6 | | for such
recipient by the Department.
|
7 | | The Department shall execute, relative to the nursing home |
8 | | prescreening
project, written inter-agency agreements with the |
9 | | Department of Human
Services and the Department on Aging, to |
10 | | effect the following: (i) intake
procedures and common |
11 | | eligibility criteria for those persons who are receiving
|
12 | | non-institutional services; and (ii) the establishment and |
13 | | development of
non-institutional services in areas of the State |
14 | | where they are not currently
available or are undeveloped; and |
15 | | (iii) notwithstanding any other provision of law, subject to |
16 | | federal approval, on and after July 1, 2012, an increase in the |
17 | | determination of need (DON) scores from 29 to 37 for applicants |
18 | | for institutional and home and community-based long term care; |
19 | | if and only if federal approval is not granted, the Department |
20 | | may, in conjunction with other affected agencies, implement |
21 | | utilization controls or changes in benefit packages to |
22 | | effectuate a similar savings amount for this population; and |
23 | | (iv) no later than July 1, 2013, minimum level of care |
24 | | eligibility criteria for institutional and home and |
25 | | community-based long term care; and (v) no later than October |
26 | | 1, 2013, establish procedures to permit long term care |
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1 | | providers access to eligibility scores for individuals with an |
2 | | admission date who are seeking or receiving services from the |
3 | | long term care provider. In order to select the minimum level |
4 | | of care eligibility criteria, the Governor shall establish a |
5 | | workgroup that includes affected agency representatives and |
6 | | stakeholders representing the institutional and home and |
7 | | community-based long term care interests. This Section shall |
8 | | not restrict the Department from implementing lower level of |
9 | | care eligibility criteria for community-based services in |
10 | | circumstances where federal approval has been granted.
|
11 | | The Illinois Department shall develop and operate, in |
12 | | cooperation
with other State Departments and agencies and in |
13 | | compliance with
applicable federal laws and regulations, |
14 | | appropriate and effective
systems of health care evaluation and |
15 | | programs for monitoring of
utilization of health care services |
16 | | and facilities, as it affects
persons eligible for medical |
17 | | assistance under this Code.
|
18 | | The Illinois Department shall report annually to the |
19 | | General Assembly,
no later than the second Friday in April of |
20 | | 1979 and each year
thereafter, in regard to:
|
21 | | (a) actual statistics and trends in utilization of |
22 | | medical services by
public aid recipients;
|
23 | | (b) actual statistics and trends in the provision of |
24 | | the various medical
services by medical vendors;
|
25 | | (c) current rate structures and proposed changes in |
26 | | those rate structures
for the various medical vendors; and
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1 | | (d) efforts at utilization review and control by the |
2 | | Illinois Department.
|
3 | | The period covered by each report shall be the 3 years |
4 | | ending on the June
30 prior to the report. The report shall |
5 | | include suggested legislation
for consideration by the General |
6 | | Assembly. The filing of one copy of the
report with the |
7 | | Speaker, one copy with the Minority Leader and one copy
with |
8 | | the Clerk of the House of Representatives, one copy with the |
9 | | President,
one copy with the Minority Leader and one copy with |
10 | | the Secretary of the
Senate, one copy with the Legislative |
11 | | Research Unit, and such additional
copies
with the State |
12 | | Government Report Distribution Center for the General
Assembly |
13 | | as is required under paragraph (t) of Section 7 of the State
|
14 | | Library Act shall be deemed sufficient to comply with this |
15 | | Section.
|
16 | | Rulemaking authority to implement Public Act 95-1045, if |
17 | | any, is conditioned on the rules being adopted in accordance |
18 | | with all provisions of the Illinois Administrative Procedure |
19 | | Act and all rules and procedures of the Joint Committee on |
20 | | Administrative Rules; any purported rule not so adopted, for |
21 | | whatever reason, is unauthorized. |
22 | | On and after July 1, 2012, the Department shall reduce any |
23 | | rate of reimbursement for services or other payments or alter |
24 | | any methodologies authorized by this Code to reduce any rate of |
25 | | reimbursement for services or other payments in accordance with |
26 | | Section 5-5e. |
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1 | | Because kidney transplantation can be an appropriate, cost |
2 | | effective
alternative to renal dialysis when medically |
3 | | necessary and notwithstanding the provisions of Section 1-11 of |
4 | | this Code, beginning October 1, 2014, the Department shall |
5 | | cover kidney transplantation for noncitizens with end-stage |
6 | | renal disease who are not eligible for comprehensive medical |
7 | | benefits, who meet the residency requirements of Section 5-3 of |
8 | | this Code, and who would otherwise meet the financial |
9 | | requirements of the appropriate class of eligible persons under |
10 | | Section 5-2 of this Code. To qualify for coverage of kidney |
11 | | transplantation, such person must be receiving emergency renal |
12 | | dialysis services covered by the Department. Providers under |
13 | | this Section shall be prior approved and certified by the |
14 | | Department to perform kidney transplantation and the services |
15 | | under this Section shall be limited to services associated with |
16 | | kidney transplantation. |
17 | | Notwithstanding any other provision of this Code to the |
18 | | contrary, on or after July 1, 2015, all FDA approved forms of |
19 | | medication assisted treatment prescribed for the treatment of |
20 | | alcohol dependence or treatment of opioid dependence shall be |
21 | | covered under both fee for service and managed care medical |
22 | | assistance programs for persons who are otherwise eligible for |
23 | | medical assistance under this Article and shall not be subject |
24 | | to any (1) utilization control, other than those established |
25 | | under the American Society of Addiction Medicine patient |
26 | | placement criteria,
(2) prior authorization mandate, or (3) |
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1 | | lifetime restriction limit
mandate. |
2 | | On or after July 1, 2015, opioid antagonists prescribed for |
3 | | the treatment of an opioid overdose, including the medication |
4 | | product, administration devices, and any pharmacy fees related |
5 | | to the dispensing and administration of the opioid antagonist, |
6 | | shall be covered under the medical assistance program for |
7 | | persons who are otherwise eligible for medical assistance under |
8 | | this Article. As used in this Section, "opioid antagonist" |
9 | | means a drug that binds to opioid receptors and blocks or |
10 | | inhibits the effect of opioids acting on those receptors, |
11 | | including, but not limited to, naloxone hydrochloride or any |
12 | | other similarly acting drug approved by the U.S. Food and Drug |
13 | | Administration. |
14 | | (Source: P.A. 98-104, Article 9, Section 9-5, eff. 7-22-13; |
15 | | 98-104, Article 12, Section 12-20, eff. 7-22-13; 98-303, eff. |
16 | | 8-9-13; 98-463, eff. 8-16-13; 98-651, eff. 6-16-14; 98-756, |
17 | | eff. 7-16-14; 98-963, eff. 8-15-14; 99-78, eff. 7-20-15; |
18 | | 99-180, eff. 7-29-15; 99-236, eff. 8-3-15; 99-433, eff. |
19 | | 8-21-15; 99-480, eff. 9-9-15; revised 10-13-15.) |
20 | | (Text of Section after amendment by P.A. 99-407 ) |
21 | | Sec. 5-5. Medical services. The Illinois Department, by |
22 | | rule, shall
determine the quantity and quality of and the rate |
23 | | of reimbursement for the
medical assistance for which
payment |
24 | | will be authorized, and the medical services to be provided,
|
25 | | which may include all or part of the following: (1) inpatient |
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1 | | hospital
services; (2) outpatient hospital services; (3) other |
2 | | laboratory and
X-ray services; (4) skilled nursing home |
3 | | services; (5) physicians'
services whether furnished in the |
4 | | office, the patient's home, a
hospital, a skilled nursing home, |
5 | | or elsewhere; (6) medical care, or any
other type of remedial |
6 | | care furnished by licensed practitioners , including the |
7 | | services of licensed certified professional midwives pursuant |
8 | | to the Home Birth Safety Act ; (7)
home health care services; |
9 | | (8) private duty nursing service; (9) clinic
services; (10) |
10 | | dental services, including prevention and treatment of |
11 | | periodontal disease and dental caries disease for pregnant |
12 | | women, provided by an individual licensed to practice dentistry |
13 | | or dental surgery; for purposes of this item (10), "dental |
14 | | services" means diagnostic, preventive, or corrective |
15 | | procedures provided by or under the supervision of a dentist in |
16 | | the practice of his or her profession; (11) physical therapy |
17 | | and related
services; (12) prescribed drugs, dentures, and |
18 | | prosthetic devices; and
eyeglasses prescribed by a physician |
19 | | skilled in the diseases of the eye,
or by an optometrist, |
20 | | whichever the person may select; (13) other
diagnostic, |
21 | | screening, preventive, and rehabilitative services, including |
22 | | to ensure that the individual's need for intervention or |
23 | | treatment of mental disorders or substance use disorders or |
24 | | co-occurring mental health and substance use disorders is |
25 | | determined using a uniform screening, assessment, and |
26 | | evaluation process inclusive of criteria, for children and |
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1 | | adults; for purposes of this item (13), a uniform screening, |
2 | | assessment, and evaluation process refers to a process that |
3 | | includes an appropriate evaluation and, as warranted, a |
4 | | referral; "uniform" does not mean the use of a singular |
5 | | instrument, tool, or process that all must utilize; (14)
|
6 | | transportation and such other expenses as may be necessary; |
7 | | (15) medical
treatment of sexual assault survivors, as defined |
8 | | in
Section 1a of the Sexual Assault Survivors Emergency |
9 | | Treatment Act, for
injuries sustained as a result of the sexual |
10 | | assault, including
examinations and laboratory tests to |
11 | | discover evidence which may be used in
criminal proceedings |
12 | | arising from the sexual assault; (16) the
diagnosis and |
13 | | treatment of sickle cell anemia; and (17)
any other medical |
14 | | care, and any other type of remedial care recognized
under the |
15 | | laws of this State, but not including abortions, or induced
|
16 | | miscarriages or premature births, unless, in the opinion of a |
17 | | physician,
such procedures are necessary for the preservation |
18 | | of the life of the
woman seeking such treatment, or except an |
19 | | induced premature birth
intended to produce a live viable child |
20 | | and such procedure is necessary
for the health of the mother or |
21 | | her unborn child. The Illinois Department,
by rule, shall |
22 | | prohibit any physician from providing medical assistance
to |
23 | | anyone eligible therefor under this Code where such physician |
24 | | has been
found guilty of performing an abortion procedure in a |
25 | | wilful and wanton
manner upon a woman who was not pregnant at |
26 | | the time such abortion
procedure was performed. The term "any |
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1 | | other type of remedial care" shall
include nursing care and |
2 | | nursing home service for persons who rely on
treatment by |
3 | | spiritual means alone through prayer for healing.
|
4 | | Notwithstanding any other provision of this Section, a |
5 | | comprehensive
tobacco use cessation program that includes |
6 | | purchasing prescription drugs or
prescription medical devices |
7 | | approved by the Food and Drug Administration shall
be covered |
8 | | under the medical assistance
program under this Article for |
9 | | persons who are otherwise eligible for
assistance under this |
10 | | Article.
|
11 | | Notwithstanding any other provision of this Code, the |
12 | | Illinois
Department may not require, as a condition of payment |
13 | | for any laboratory
test authorized under this Article, that a |
14 | | physician's handwritten signature
appear on the laboratory |
15 | | test order form. The Illinois Department may,
however, impose |
16 | | other appropriate requirements regarding laboratory test
order |
17 | | documentation.
|
18 | | Upon receipt of federal approval of an amendment to the |
19 | | Illinois Title XIX State Plan for this purpose, the Department |
20 | | shall authorize the Chicago Public Schools (CPS) to procure a |
21 | | vendor or vendors to manufacture eyeglasses for individuals |
22 | | enrolled in a school within the CPS system. CPS shall ensure |
23 | | that its vendor or vendors are enrolled as providers in the |
24 | | medical assistance program and in any capitated Medicaid |
25 | | managed care entity (MCE) serving individuals enrolled in a |
26 | | school within the CPS system. Under any contract procured under |
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1 | | this provision, the vendor or vendors must serve only |
2 | | individuals enrolled in a school within the CPS system. Claims |
3 | | for services provided by CPS's vendor or vendors to recipients |
4 | | of benefits in the medical assistance program under this Code, |
5 | | the Children's Health Insurance Program, or the Covering ALL |
6 | | KIDS Health Insurance Program shall be submitted to the |
7 | | Department or the MCE in which the individual is enrolled for |
8 | | payment and shall be reimbursed at the Department's or the |
9 | | MCE's established rates or rate methodologies for eyeglasses. |
10 | | On and after July 1, 2012, the Department of Healthcare and |
11 | | Family Services may provide the following services to
persons
|
12 | | eligible for assistance under this Article who are |
13 | | participating in
education, training or employment programs |
14 | | operated by the Department of Human
Services as successor to |
15 | | the Department of Public Aid:
|
16 | | (1) dental services provided by or under the |
17 | | supervision of a dentist; and
|
18 | | (2) eyeglasses prescribed by a physician skilled in the |
19 | | diseases of the
eye, or by an optometrist, whichever the |
20 | | person may select.
|
21 | | Notwithstanding any other provision of this Code and |
22 | | subject to federal approval, the Department may adopt rules to |
23 | | allow a dentist who is volunteering his or her service at no |
24 | | cost to render dental services through an enrolled |
25 | | not-for-profit health clinic without the dentist personally |
26 | | enrolling as a participating provider in the medical assistance |
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1 | | program. A not-for-profit health clinic shall include a public |
2 | | health clinic or Federally Qualified Health Center or other |
3 | | enrolled provider, as determined by the Department, through |
4 | | which dental services covered under this Section are performed. |
5 | | The Department shall establish a process for payment of claims |
6 | | for reimbursement for covered dental services rendered under |
7 | | this provision. |
8 | | The Illinois Department, by rule, may distinguish and |
9 | | classify the
medical services to be provided only in accordance |
10 | | with the classes of
persons designated in Section 5-2.
|
11 | | The Department of Healthcare and Family Services must |
12 | | provide coverage and reimbursement for amino acid-based |
13 | | elemental formulas, regardless of delivery method, for the |
14 | | diagnosis and treatment of (i) eosinophilic disorders and (ii) |
15 | | short bowel syndrome when the prescribing physician has issued |
16 | | a written order stating that the amino acid-based elemental |
17 | | formula is medically necessary.
|
18 | | The Illinois Department shall authorize the provision of, |
19 | | and shall
authorize payment for, screening by low-dose |
20 | | mammography for the presence of
occult breast cancer for women |
21 | | 35 years of age or older who are eligible
for medical |
22 | | assistance under this Article, as follows: |
23 | | (A) A baseline
mammogram for women 35 to 39 years of |
24 | | age.
|
25 | | (B) An annual mammogram for women 40 years of age or |
26 | | older. |
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1 | | (C) A mammogram at the age and intervals considered |
2 | | medically necessary by the woman's health care provider for |
3 | | women under 40 years of age and having a family history of |
4 | | breast cancer, prior personal history of breast cancer, |
5 | | positive genetic testing, or other risk factors. |
6 | | (D) A comprehensive ultrasound screening of an entire |
7 | | breast or breasts if a mammogram demonstrates |
8 | | heterogeneous or dense breast tissue, when medically |
9 | | necessary as determined by a physician licensed to practice |
10 | | medicine in all of its branches. |
11 | | (E) A screening MRI when medically necessary, as |
12 | | determined by a physician licensed to practice medicine in |
13 | | all of its branches. |
14 | | All screenings
shall
include a physical breast exam, |
15 | | instruction on self-examination and
information regarding the |
16 | | frequency of self-examination and its value as a
preventative |
17 | | tool. For purposes of this Section, "low-dose mammography" |
18 | | means
the x-ray examination of the breast using equipment |
19 | | dedicated specifically
for mammography, including the x-ray |
20 | | tube, filter, compression device,
and image receptor, with an |
21 | | average radiation exposure delivery
of less than one rad per |
22 | | breast for 2 views of an average size breast.
The term also |
23 | | includes digital mammography and includes breast |
24 | | tomosynthesis. As used in this Section, the term "breast |
25 | | tomosynthesis" means a radiologic procedure that involves the |
26 | | acquisition of projection images over the stationary breast to |
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1 | | produce cross-sectional digital three-dimensional images of |
2 | | the breast.
|
3 | | On and after January 1, 2016, the Department shall ensure |
4 | | that all networks of care for adult clients of the Department |
5 | | include access to at least one breast imaging Center of Imaging |
6 | | Excellence as certified by the American College of Radiology. |
7 | | On and after January 1, 2012, providers participating in a |
8 | | quality improvement program approved by the Department shall be |
9 | | reimbursed for screening and diagnostic mammography at the same |
10 | | rate as the Medicare program's rates, including the increased |
11 | | reimbursement for digital mammography. |
12 | | The Department shall convene an expert panel including |
13 | | representatives of hospitals, free-standing mammography |
14 | | facilities, and doctors, including radiologists, to establish |
15 | | quality standards for mammography. |
16 | | On and after January 1, 2017, providers participating in a |
17 | | breast cancer treatment quality improvement program approved |
18 | | by the Department shall be reimbursed for breast cancer |
19 | | treatment at a rate that is no lower than 95% of the Medicare |
20 | | program's rates for the data elements included in the breast |
21 | | cancer treatment quality program. |
22 | | The Department shall convene an expert panel, including |
23 | | representatives of hospitals, free standing breast cancer |
24 | | treatment centers, breast cancer quality organizations, and |
25 | | doctors, including breast surgeons, reconstructive breast |
26 | | surgeons, oncologists, and primary care providers to establish |
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1 | | quality standards for breast cancer treatment. |
2 | | Subject to federal approval, the Department shall |
3 | | establish a rate methodology for mammography at federally |
4 | | qualified health centers and other encounter-rate clinics. |
5 | | These clinics or centers may also collaborate with other |
6 | | hospital-based mammography facilities. By January 1, 2016, the |
7 | | Department shall report to the General Assembly on the status |
8 | | of the provision set forth in this paragraph. |
9 | | The Department shall establish a methodology to remind |
10 | | women who are age-appropriate for screening mammography, but |
11 | | who have not received a mammogram within the previous 18 |
12 | | months, of the importance and benefit of screening mammography. |
13 | | The Department shall work with experts in breast cancer |
14 | | outreach and patient navigation to optimize these reminders and |
15 | | shall establish a methodology for evaluating their |
16 | | effectiveness and modifying the methodology based on the |
17 | | evaluation. |
18 | | The Department shall establish a performance goal for |
19 | | primary care providers with respect to their female patients |
20 | | over age 40 receiving an annual mammogram. This performance |
21 | | goal shall be used to provide additional reimbursement in the |
22 | | form of a quality performance bonus to primary care providers |
23 | | who meet that goal. |
24 | | The Department shall devise a means of case-managing or |
25 | | patient navigation for beneficiaries diagnosed with breast |
26 | | cancer. This program shall initially operate as a pilot program |
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1 | | in areas of the State with the highest incidence of mortality |
2 | | related to breast cancer. At least one pilot program site shall |
3 | | be in the metropolitan Chicago area and at least one site shall |
4 | | be outside the metropolitan Chicago area. On or after July 1, |
5 | | 2016, the pilot program shall be expanded to include one site |
6 | | in western Illinois, one site in southern Illinois, one site in |
7 | | central Illinois, and 4 sites within metropolitan Chicago. An |
8 | | evaluation of the pilot program shall be carried out measuring |
9 | | health outcomes and cost of care for those served by the pilot |
10 | | program compared to similarly situated patients who are not |
11 | | served by the pilot program. |
12 | | The Department shall require all networks of care to |
13 | | develop a means either internally or by contract with experts |
14 | | in navigation and community outreach to navigate cancer |
15 | | patients to comprehensive care in a timely fashion. The |
16 | | Department shall require all networks of care to include access |
17 | | for patients diagnosed with cancer to at least one academic |
18 | | commission on cancer-accredited cancer program as an |
19 | | in-network covered benefit. |
20 | | Any medical or health care provider shall immediately |
21 | | recommend, to
any pregnant woman who is being provided prenatal |
22 | | services and is suspected
of drug abuse or is addicted as |
23 | | defined in the Alcoholism and Other Drug Abuse
and Dependency |
24 | | Act, referral to a local substance abuse treatment provider
|
25 | | licensed by the Department of Human Services or to a licensed
|
26 | | hospital which provides substance abuse treatment services. |
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1 | | The Department of Healthcare and Family Services
shall assure |
2 | | coverage for the cost of treatment of the drug abuse or
|
3 | | addiction for pregnant recipients in accordance with the |
4 | | Illinois Medicaid
Program in conjunction with the Department of |
5 | | Human Services.
|
6 | | All medical providers providing medical assistance to |
7 | | pregnant women
under this Code shall receive information from |
8 | | the Department on the
availability of services under the Drug |
9 | | Free Families with a Future or any
comparable program providing |
10 | | case management services for addicted women,
including |
11 | | information on appropriate referrals for other social services
|
12 | | that may be needed by addicted women in addition to treatment |
13 | | for addiction.
|
14 | | The Illinois Department, in cooperation with the |
15 | | Departments of Human
Services (as successor to the Department |
16 | | of Alcoholism and Substance
Abuse) and Public Health, through a |
17 | | public awareness campaign, may
provide information concerning |
18 | | treatment for alcoholism and drug abuse and
addiction, prenatal |
19 | | health care, and other pertinent programs directed at
reducing |
20 | | the number of drug-affected infants born to recipients of |
21 | | medical
assistance.
|
22 | | Neither the Department of Healthcare and Family Services |
23 | | nor the Department of Human
Services shall sanction the |
24 | | recipient solely on the basis of
her substance abuse.
|
25 | | The Illinois Department shall establish such regulations |
26 | | governing
the dispensing of health services under this Article |
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1 | | as it shall deem
appropriate. The Department
should
seek the |
2 | | advice of formal professional advisory committees appointed by
|
3 | | the Director of the Illinois Department for the purpose of |
4 | | providing regular
advice on policy and administrative matters, |
5 | | information dissemination and
educational activities for |
6 | | medical and health care providers, and
consistency in |
7 | | procedures to the Illinois Department.
|
8 | | The Illinois Department may develop and contract with |
9 | | Partnerships of
medical providers to arrange medical services |
10 | | for persons eligible under
Section 5-2 of this Code. |
11 | | Implementation of this Section may be by
demonstration projects |
12 | | in certain geographic areas. The Partnership shall
be |
13 | | represented by a sponsor organization. The Department, by rule, |
14 | | shall
develop qualifications for sponsors of Partnerships. |
15 | | Nothing in this
Section shall be construed to require that the |
16 | | sponsor organization be a
medical organization.
|
17 | | The sponsor must negotiate formal written contracts with |
18 | | medical
providers for physician services, inpatient and |
19 | | outpatient hospital care,
home health services, treatment for |
20 | | alcoholism and substance abuse, and
other services determined |
21 | | necessary by the Illinois Department by rule for
delivery by |
22 | | Partnerships. Physician services must include prenatal and
|
23 | | obstetrical care. The Illinois Department shall reimburse |
24 | | medical services
delivered by Partnership providers to clients |
25 | | in target areas according to
provisions of this Article and the |
26 | | Illinois Health Finance Reform Act,
except that:
|
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1 | | (1) Physicians participating in a Partnership and |
2 | | providing certain
services, which shall be determined by |
3 | | the Illinois Department, to persons
in areas covered by the |
4 | | Partnership may receive an additional surcharge
for such |
5 | | services.
|
6 | | (2) The Department may elect to consider and negotiate |
7 | | financial
incentives to encourage the development of |
8 | | Partnerships and the efficient
delivery of medical care.
|
9 | | (3) Persons receiving medical services through |
10 | | Partnerships may receive
medical and case management |
11 | | services above the level usually offered
through the |
12 | | medical assistance program.
|
13 | | Medical providers shall be required to meet certain |
14 | | qualifications to
participate in Partnerships to ensure the |
15 | | delivery of high quality medical
services. These |
16 | | qualifications shall be determined by rule of the Illinois
|
17 | | Department and may be higher than qualifications for |
18 | | participation in the
medical assistance program. Partnership |
19 | | sponsors may prescribe reasonable
additional qualifications |
20 | | for participation by medical providers, only with
the prior |
21 | | written approval of the Illinois Department.
|
22 | | Nothing in this Section shall limit the free choice of |
23 | | practitioners,
hospitals, and other providers of medical |
24 | | services by clients.
In order to ensure patient freedom of |
25 | | choice, the Illinois Department shall
immediately promulgate |
26 | | all rules and take all other necessary actions so that
provided |
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1 | | services may be accessed from therapeutically certified |
2 | | optometrists
to the full extent of the Illinois Optometric |
3 | | Practice Act of 1987 without
discriminating between service |
4 | | providers.
|
5 | | The Department shall apply for a waiver from the United |
6 | | States Health
Care Financing Administration to allow for the |
7 | | implementation of
Partnerships under this Section.
|
8 | | The Illinois Department shall require health care |
9 | | providers to maintain
records that document the medical care |
10 | | and services provided to recipients
of Medical Assistance under |
11 | | this Article. Such records must be retained for a period of not |
12 | | less than 6 years from the date of service or as provided by |
13 | | applicable State law, whichever period is longer, except that |
14 | | if an audit is initiated within the required retention period |
15 | | then the records must be retained until the audit is completed |
16 | | and every exception is resolved. The Illinois Department shall
|
17 | | require health care providers to make available, when |
18 | | authorized by the
patient, in writing, the medical records in a |
19 | | timely fashion to other
health care providers who are treating |
20 | | or serving persons eligible for
Medical Assistance under this |
21 | | Article. All dispensers of medical services
shall be required |
22 | | to maintain and retain business and professional records
|
23 | | sufficient to fully and accurately document the nature, scope, |
24 | | details and
receipt of the health care provided to persons |
25 | | eligible for medical
assistance under this Code, in accordance |
26 | | with regulations promulgated by
the Illinois Department. The |
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1 | | rules and regulations shall require that proof
of the receipt |
2 | | of prescription drugs, dentures, prosthetic devices and
|
3 | | eyeglasses by eligible persons under this Section accompany |
4 | | each claim
for reimbursement submitted by the dispenser of such |
5 | | medical services.
No such claims for reimbursement shall be |
6 | | approved for payment by the Illinois
Department without such |
7 | | proof of receipt, unless the Illinois Department
shall have put |
8 | | into effect and shall be operating a system of post-payment
|
9 | | audit and review which shall, on a sampling basis, be deemed |
10 | | adequate by
the Illinois Department to assure that such drugs, |
11 | | dentures, prosthetic
devices and eyeglasses for which payment |
12 | | is being made are actually being
received by eligible |
13 | | recipients. Within 90 days after September 16, 1984 ( the |
14 | | effective date of Public Act 83-1439)
this amendatory Act of |
15 | | 1984 , the Illinois Department shall establish a
current list of |
16 | | acquisition costs for all prosthetic devices and any
other |
17 | | items recognized as medical equipment and supplies |
18 | | reimbursable under
this Article and shall update such list on a |
19 | | quarterly basis, except that
the acquisition costs of all |
20 | | prescription drugs shall be updated no
less frequently than |
21 | | every 30 days as required by Section 5-5.12.
|
22 | | The rules and regulations of the Illinois Department shall |
23 | | require
that a written statement including the required opinion |
24 | | of a physician
shall accompany any claim for reimbursement for |
25 | | abortions, or induced
miscarriages or premature births. This |
26 | | statement shall indicate what
procedures were used in providing |
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1 | | such medical services.
|
2 | | Notwithstanding any other law to the contrary, the Illinois |
3 | | Department shall, within 365 days after July 22, 2013 (the |
4 | | effective date of Public Act 98-104), establish procedures to |
5 | | permit skilled care facilities licensed under the Nursing Home |
6 | | Care Act to submit monthly billing claims for reimbursement |
7 | | purposes. Following development of these procedures, the |
8 | | Department shall, by July 1, 2016, test the viability of the |
9 | | new system and implement any necessary operational or |
10 | | structural changes to its information technology platforms in |
11 | | order to allow for the direct acceptance and payment of nursing |
12 | | home claims. |
13 | | Notwithstanding any other law to the contrary, the Illinois |
14 | | Department shall, within 365 days after August 15, 2014 (the |
15 | | effective date of Public Act 98-963), establish procedures to |
16 | | permit ID/DD facilities licensed under the ID/DD Community Care |
17 | | Act and MC/DD facilities licensed under the MC/DD Act to submit |
18 | | monthly billing claims for reimbursement purposes. Following |
19 | | development of these procedures, the Department shall have an |
20 | | additional 365 days to test the viability of the new system and |
21 | | to ensure that any necessary operational or structural changes |
22 | | to its information technology platforms are implemented. |
23 | | The Illinois Department shall require all dispensers of |
24 | | medical
services, other than an individual practitioner or |
25 | | group of practitioners,
desiring to participate in the Medical |
26 | | Assistance program
established under this Article to disclose |
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1 | | all financial, beneficial,
ownership, equity, surety or other |
2 | | interests in any and all firms,
corporations, partnerships, |
3 | | associations, business enterprises, joint
ventures, agencies, |
4 | | institutions or other legal entities providing any
form of |
5 | | health care services in this State under this Article.
|
6 | | The Illinois Department may require that all dispensers of |
7 | | medical
services desiring to participate in the medical |
8 | | assistance program
established under this Article disclose, |
9 | | under such terms and conditions as
the Illinois Department may |
10 | | by rule establish, all inquiries from clients
and attorneys |
11 | | regarding medical bills paid by the Illinois Department, which
|
12 | | inquiries could indicate potential existence of claims or liens |
13 | | for the
Illinois Department.
|
14 | | Enrollment of a vendor
shall be
subject to a provisional |
15 | | period and shall be conditional for one year. During the period |
16 | | of conditional enrollment, the Department may
terminate the |
17 | | vendor's eligibility to participate in, or may disenroll the |
18 | | vendor from, the medical assistance
program without cause. |
19 | | Unless otherwise specified, such termination of eligibility or |
20 | | disenrollment is not subject to the
Department's hearing |
21 | | process.
However, a disenrolled vendor may reapply without |
22 | | penalty.
|
23 | | The Department has the discretion to limit the conditional |
24 | | enrollment period for vendors based upon category of risk of |
25 | | the vendor. |
26 | | Prior to enrollment and during the conditional enrollment |
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1 | | period in the medical assistance program, all vendors shall be |
2 | | subject to enhanced oversight, screening, and review based on |
3 | | the risk of fraud, waste, and abuse that is posed by the |
4 | | category of risk of the vendor. The Illinois Department shall |
5 | | establish the procedures for oversight, screening, and review, |
6 | | which may include, but need not be limited to: criminal and |
7 | | financial background checks; fingerprinting; license, |
8 | | certification, and authorization verifications; unscheduled or |
9 | | unannounced site visits; database checks; prepayment audit |
10 | | reviews; audits; payment caps; payment suspensions; and other |
11 | | screening as required by federal or State law. |
12 | | The Department shall define or specify the following: (i) |
13 | | by provider notice, the "category of risk of the vendor" for |
14 | | each type of vendor, which shall take into account the level of |
15 | | screening applicable to a particular category of vendor under |
16 | | federal law and regulations; (ii) by rule or provider notice, |
17 | | the maximum length of the conditional enrollment period for |
18 | | each category of risk of the vendor; and (iii) by rule, the |
19 | | hearing rights, if any, afforded to a vendor in each category |
20 | | of risk of the vendor that is terminated or disenrolled during |
21 | | the conditional enrollment period. |
22 | | To be eligible for payment consideration, a vendor's |
23 | | payment claim or bill, either as an initial claim or as a |
24 | | resubmitted claim following prior rejection, must be received |
25 | | by the Illinois Department, or its fiscal intermediary, no |
26 | | later than 180 days after the latest date on the claim on which |
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1 | | medical goods or services were provided, with the following |
2 | | exceptions: |
3 | | (1) In the case of a provider whose enrollment is in |
4 | | process by the Illinois Department, the 180-day period |
5 | | shall not begin until the date on the written notice from |
6 | | the Illinois Department that the provider enrollment is |
7 | | complete. |
8 | | (2) In the case of errors attributable to the Illinois |
9 | | Department or any of its claims processing intermediaries |
10 | | which result in an inability to receive, process, or |
11 | | adjudicate a claim, the 180-day period shall not begin |
12 | | until the provider has been notified of the error. |
13 | | (3) In the case of a provider for whom the Illinois |
14 | | Department initiates the monthly billing process. |
15 | | (4) In the case of a provider operated by a unit of |
16 | | local government with a population exceeding 3,000,000 |
17 | | when local government funds finance federal participation |
18 | | for claims payments. |
19 | | For claims for services rendered during a period for which |
20 | | a recipient received retroactive eligibility, claims must be |
21 | | filed within 180 days after the Department determines the |
22 | | applicant is eligible. For claims for which the Illinois |
23 | | Department is not the primary payer, claims must be submitted |
24 | | to the Illinois Department within 180 days after the final |
25 | | adjudication by the primary payer. |
26 | | In the case of long term care facilities, within 5 days of |
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1 | | receipt by the facility of required prescreening information, |
2 | | data for new admissions shall be entered into the Medical |
3 | | Electronic Data Interchange (MEDI) or the Recipient |
4 | | Eligibility Verification (REV) System or successor system, and |
5 | | within 15 days of receipt by the facility of required |
6 | | prescreening information, admission documents shall be |
7 | | submitted through MEDI or REV or shall be submitted directly to |
8 | | the Department of Human Services using required admission |
9 | | forms. Effective September
1, 2014, admission documents, |
10 | | including all prescreening
information, must be submitted |
11 | | through MEDI or REV. Confirmation numbers assigned to an |
12 | | accepted transaction shall be retained by a facility to verify |
13 | | timely submittal. Once an admission transaction has been |
14 | | completed, all resubmitted claims following prior rejection |
15 | | are subject to receipt no later than 180 days after the |
16 | | admission transaction has been completed. |
17 | | Claims that are not submitted and received in compliance |
18 | | with the foregoing requirements shall not be eligible for |
19 | | payment under the medical assistance program, and the State |
20 | | shall have no liability for payment of those claims. |
21 | | To the extent consistent with applicable information and |
22 | | privacy, security, and disclosure laws, State and federal |
23 | | agencies and departments shall provide the Illinois Department |
24 | | access to confidential and other information and data necessary |
25 | | to perform eligibility and payment verifications and other |
26 | | Illinois Department functions. This includes, but is not |
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1 | | limited to: information pertaining to licensure; |
2 | | certification; earnings; immigration status; citizenship; wage |
3 | | reporting; unearned and earned income; pension income; |
4 | | employment; supplemental security income; social security |
5 | | numbers; National Provider Identifier (NPI) numbers; the |
6 | | National Practitioner Data Bank (NPDB); program and agency |
7 | | exclusions; taxpayer identification numbers; tax delinquency; |
8 | | corporate information; and death records. |
9 | | The Illinois Department shall enter into agreements with |
10 | | State agencies and departments, and is authorized to enter into |
11 | | agreements with federal agencies and departments, under which |
12 | | such agencies and departments shall share data necessary for |
13 | | medical assistance program integrity functions and oversight. |
14 | | The Illinois Department shall develop, in cooperation with |
15 | | other State departments and agencies, and in compliance with |
16 | | applicable federal laws and regulations, appropriate and |
17 | | effective methods to share such data. At a minimum, and to the |
18 | | extent necessary to provide data sharing, the Illinois |
19 | | Department shall enter into agreements with State agencies and |
20 | | departments, and is authorized to enter into agreements with |
21 | | federal agencies and departments, including but not limited to: |
22 | | the Secretary of State; the Department of Revenue; the |
23 | | Department of Public Health; the Department of Human Services; |
24 | | and the Department of Financial and Professional Regulation. |
25 | | Beginning in fiscal year 2013, the Illinois Department |
26 | | shall set forth a request for information to identify the |
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1 | | benefits of a pre-payment, post-adjudication, and post-edit |
2 | | claims system with the goals of streamlining claims processing |
3 | | and provider reimbursement, reducing the number of pending or |
4 | | rejected claims, and helping to ensure a more transparent |
5 | | adjudication process through the utilization of: (i) provider |
6 | | data verification and provider screening technology; and (ii) |
7 | | clinical code editing; and (iii) pre-pay, pre- or |
8 | | post-adjudicated predictive modeling with an integrated case |
9 | | management system with link analysis. Such a request for |
10 | | information shall not be considered as a request for proposal |
11 | | or as an obligation on the part of the Illinois Department to |
12 | | take any action or acquire any products or services. |
13 | | The Illinois Department shall establish policies, |
14 | | procedures,
standards and criteria by rule for the acquisition, |
15 | | repair and replacement
of orthotic and prosthetic devices and |
16 | | durable medical equipment. Such
rules shall provide, but not be |
17 | | limited to, the following services: (1)
immediate repair or |
18 | | replacement of such devices by recipients; and (2) rental, |
19 | | lease, purchase or lease-purchase of
durable medical equipment |
20 | | in a cost-effective manner, taking into
consideration the |
21 | | recipient's medical prognosis, the extent of the
recipient's |
22 | | needs, and the requirements and costs for maintaining such
|
23 | | equipment. Subject to prior approval, such rules shall enable a |
24 | | recipient to temporarily acquire and
use alternative or |
25 | | substitute devices or equipment pending repairs or
|
26 | | replacements of any device or equipment previously authorized |
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1 | | for such
recipient by the Department.
|
2 | | The Department shall execute, relative to the nursing home |
3 | | prescreening
project, written inter-agency agreements with the |
4 | | Department of Human
Services and the Department on Aging, to |
5 | | effect the following: (i) intake
procedures and common |
6 | | eligibility criteria for those persons who are receiving
|
7 | | non-institutional services; and (ii) the establishment and |
8 | | development of
non-institutional services in areas of the State |
9 | | where they are not currently
available or are undeveloped; and |
10 | | (iii) notwithstanding any other provision of law, subject to |
11 | | federal approval, on and after July 1, 2012, an increase in the |
12 | | determination of need (DON) scores from 29 to 37 for applicants |
13 | | for institutional and home and community-based long term care; |
14 | | if and only if federal approval is not granted, the Department |
15 | | may, in conjunction with other affected agencies, implement |
16 | | utilization controls or changes in benefit packages to |
17 | | effectuate a similar savings amount for this population; and |
18 | | (iv) no later than July 1, 2013, minimum level of care |
19 | | eligibility criteria for institutional and home and |
20 | | community-based long term care; and (v) no later than October |
21 | | 1, 2013, establish procedures to permit long term care |
22 | | providers access to eligibility scores for individuals with an |
23 | | admission date who are seeking or receiving services from the |
24 | | long term care provider. In order to select the minimum level |
25 | | of care eligibility criteria, the Governor shall establish a |
26 | | workgroup that includes affected agency representatives and |
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1 | | stakeholders representing the institutional and home and |
2 | | community-based long term care interests. This Section shall |
3 | | not restrict the Department from implementing lower level of |
4 | | care eligibility criteria for community-based services in |
5 | | circumstances where federal approval has been granted.
|
6 | | The Illinois Department shall develop and operate, in |
7 | | cooperation
with other State Departments and agencies and in |
8 | | compliance with
applicable federal laws and regulations, |
9 | | appropriate and effective
systems of health care evaluation and |
10 | | programs for monitoring of
utilization of health care services |
11 | | and facilities, as it affects
persons eligible for medical |
12 | | assistance under this Code.
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13 | | The Illinois Department shall report annually to the |
14 | | General Assembly,
no later than the second Friday in April of |
15 | | 1979 and each year
thereafter, in regard to:
|
16 | | (a) actual statistics and trends in utilization of |
17 | | medical services by
public aid recipients;
|
18 | | (b) actual statistics and trends in the provision of |
19 | | the various medical
services by medical vendors;
|
20 | | (c) current rate structures and proposed changes in |
21 | | those rate structures
for the various medical vendors; and
|
22 | | (d) efforts at utilization review and control by the |
23 | | Illinois Department.
|
24 | | The period covered by each report shall be the 3 years |
25 | | ending on the June
30 prior to the report. The report shall |
26 | | include suggested legislation
for consideration by the General |
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1 | | Assembly. The filing of one copy of the
report with the |
2 | | Speaker, one copy with the Minority Leader and one copy
with |
3 | | the Clerk of the House of Representatives, one copy with the |
4 | | President,
one copy with the Minority Leader and one copy with |
5 | | the Secretary of the
Senate, one copy with the Legislative |
6 | | Research Unit, and such additional
copies
with the State |
7 | | Government Report Distribution Center for the General
Assembly |
8 | | as is required under paragraph (t) of Section 7 of the State
|
9 | | Library Act shall be deemed sufficient to comply with this |
10 | | Section.
|
11 | | Rulemaking authority to implement Public Act 95-1045, if |
12 | | any, is conditioned on the rules being adopted in accordance |
13 | | with all provisions of the Illinois Administrative Procedure |
14 | | Act and all rules and procedures of the Joint Committee on |
15 | | Administrative Rules; any purported rule not so adopted, for |
16 | | whatever reason, is unauthorized. |
17 | | On and after July 1, 2012, the Department shall reduce any |
18 | | rate of reimbursement for services or other payments or alter |
19 | | any methodologies authorized by this Code to reduce any rate of |
20 | | reimbursement for services or other payments in accordance with |
21 | | Section 5-5e. |
22 | | Because kidney transplantation can be an appropriate, cost |
23 | | effective
alternative to renal dialysis when medically |
24 | | necessary and notwithstanding the provisions of Section 1-11 of |
25 | | this Code, beginning October 1, 2014, the Department shall |
26 | | cover kidney transplantation for noncitizens with end-stage |
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1 | | renal disease who are not eligible for comprehensive medical |
2 | | benefits, who meet the residency requirements of Section 5-3 of |
3 | | this Code, and who would otherwise meet the financial |
4 | | requirements of the appropriate class of eligible persons under |
5 | | Section 5-2 of this Code. To qualify for coverage of kidney |
6 | | transplantation, such person must be receiving emergency renal |
7 | | dialysis services covered by the Department. Providers under |
8 | | this Section shall be prior approved and certified by the |
9 | | Department to perform kidney transplantation and the services |
10 | | under this Section shall be limited to services associated with |
11 | | kidney transplantation. |
12 | | Notwithstanding any other provision of this Code to the |
13 | | contrary, on or after July 1, 2015, all FDA approved forms of |
14 | | medication assisted treatment prescribed for the treatment of |
15 | | alcohol dependence or treatment of opioid dependence shall be |
16 | | covered under both fee for service and managed care medical |
17 | | assistance programs for persons who are otherwise eligible for |
18 | | medical assistance under this Article and shall not be subject |
19 | | to any (1) utilization control, other than those established |
20 | | under the American Society of Addiction Medicine patient |
21 | | placement criteria,
(2) prior authorization mandate, or (3) |
22 | | lifetime restriction limit
mandate. |
23 | | On or after July 1, 2015, opioid antagonists prescribed for |
24 | | the treatment of an opioid overdose, including the medication |
25 | | product, administration devices, and any pharmacy fees related |
26 | | to the dispensing and administration of the opioid antagonist, |
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1 | | shall be covered under the medical assistance program for |
2 | | persons who are otherwise eligible for medical assistance under |
3 | | this Article. As used in this Section, "opioid antagonist" |
4 | | means a drug that binds to opioid receptors and blocks or |
5 | | inhibits the effect of opioids acting on those receptors, |
6 | | including, but not limited to, naloxone hydrochloride or any |
7 | | other similarly acting drug approved by the U.S. Food and Drug |
8 | | Administration. |
9 | | (Source: P.A. 98-104, Article 9, Section 9-5, eff. 7-22-13; |
10 | | 98-104, Article 12, Section 12-20, eff. 7-22-13; 98-303, eff. |
11 | | 8-9-13; 98-463, eff. 8-16-13; 98-651, eff. 6-16-14; 98-756, |
12 | | eff. 7-16-14; 98-963, eff. 8-15-14; 99-78, eff. 7-20-15; |
13 | | 99-180, eff. 7-29-15; 99-236, eff. 8-3-15; 99-407 (see Section |
14 | | 99 of P.A. 99-407 for its effective date); 99-433, eff. |
15 | | 8-21-15; 99-480, eff. 9-9-15; revised 10-13-15.)
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16 | | Section 995. No acceleration or delay. Where this Act makes |
17 | | changes in a statute that is represented in this Act by text |
18 | | that is not yet or no longer in effect (for example, a Section |
19 | | represented by multiple versions), the use of that text does |
20 | | not accelerate or delay the taking effect of (i) the changes |
21 | | made by this Act or (ii) provisions derived from any other |
22 | | Public Act. |
23 | | Section 999. Effective date. This Act takes effect upon |
24 | | becoming law.".
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