2025 Legislative Report

Medicaid Uncertainty

Throughout this year’s legislative session, Illinois lawmakers attempted to understand and deal with the Trump administration’s plans to cut Medicaid funding to states, creating significant concerns about the future of Medicaid benefits for Illinois patients. Governor Pritzker’s office already moved forward with ending the health benefits program for undocumented immigrant adults due to the higher-than-anticipated costs. The benefits for undocumented immigrant adults are set to expire on July 1, affecting about 31,000 non-US citizens in Illinois. The program cost the state $1.6 billion since last summer.

In addition to cutting care for adult undocumented immigrants, about 770,000 Illinoisans could lose Medicaid coverage if Congress prevails in cutting the Affordable Care Act (ACA) Medicaid expansion. A per capita cap to limit Medicaid funding to the states would cause Illinois to lose $24 to $39 billion over 10 years. Imposing a work requirement on Medicaid enrollment for adults under 65 could cause about 250,000 Illinoisans to lose coverage. Another idea being floated at the federal level would change provider taxes, now used as assessments, to help fund the Medicaid program. Capping provider assessments at 5 percent would cost Illinois’ Medicaid program about $300 million.

The United States House of Representatives’ budget reconciliation bill reduces the federal Medicaid expansion match under ACA from 90 percent to 80 percent to any state that utilized Medicaid to provide health insurance to undocumented residents, which Illinois does.

Illinois’ “trigger law” cuts all state funding for Medicaid expansion if the federal match falls below 90 percent. If the budget proposal becomes effective, Illinois would either lose all Medicaid expansion federal funding and cut Medicaid benefits for those Illinoisans or find state funding to maintain benefits while no longer using state funds to pay Medicaid benefits for undocumented immigrants OR continue paying for immigrant benefits for undocumented children and seniors and keep the 90 percent Medicaid expansion match.

Illinois’ Department of Healthcare and Family Services (HFS) Director, Elizabeth Whitehorn, committed the agency to continuing with several health initiatives despite the uncertainty of federal support from the Trump Administration. HFS is focused on the Medicaid demonstration program supporting behavioral health facilities. Another initiative will implement recommendations to support access to sickle cell disease treatment and other high-cost drugs and treatments. The recently announced changes by federal CMS will not affect Illinois’ 1115 waiver.

In previous years, the Illinois General Assembly has passed Medicaid omnibus legislation that contained a large number of provisions that oftentimes had significant costs. Due to the uncertainty of Medicaid funding at both the federal and state levels, this year’s Medicaid omnibus bill was scaled back to deal with various provider issues for nursing homes and hospitals that had a minimum fiscal impact. The provisions passed in the Medicaid omnibus SB 2437 (Aquino/Moeller) include:

• Allowing Medicaid patients to have a certified doula accompany them to hospitals.
• Provides for certification that parents can be designated caregivers of medically fragile individuals.
• Pushes back Medicaid gold carding provisions from July 1, 2025, to January 1, 2026.
• Requires HFS and managed care organizations to report semi-annually on prior authorization mandates and utilization management tools for prescription drugs treating mental illness.

An additional Medicaid provision was attached to HB 2771 (Lily/Aquino) that would seek modifications to Illinois Hospital Assessment Program (HAP). HAP provides Illinois the authority to levy taxes and assessments on a wide range of provider types, including hospitals and nursing facilities to fund the state Medicaid share and garner federal matching funds to put back into the Medicaid system. This financing mechanism brings back over $2 billion annually to Illinois. Illinois wanted to secure these funds and have the proper framework in place as there are concerns that the Trump administration could limit assessment programs in the future. HB 2771 passed both chambers unanimously and will be signed into law this summer.

HEALTH INSURANCE REFORM

340B Program

HB 2371 (Sen. Koehler/Rep. Moeller) would prohibit pharmaceutical manufacturers from restricting or interfering with a local pharmacy that contracts with a 340B covered entity, such as a hospital or federally qualified health center (FQHC), to dispense medications acquired through the 340B program. ISMS heard from specialists and medical groups, such as oncologists and cancer care facilities, which rely on this program. The bill passed the Senate, but due to fierce opposition by drug manufacturers at the end of session, the bill was held in the House. We expect consideration in the House during the fall veto session.

AI Use in Health Insurance

HB 35 (Rep. Bob Morgan) and SB 1425 (Sen. Laura Fine) would create the Artificial Intelligence Systems Use in Health Insurance Act. The bills would limit how insurers use AI systems to make or support adverse determination that affect patients. The bills would prohibit insurers from issuing adverse consumer outcomes that result solely from the use of an AI system. ISMS supported the bill. HB 35 passed the House but remains in the Senate Executive Committee.

Expansion of the Healthcare Protection Act

HB 3019 (Rep. LaPointe/Sen. Fine), an initiative of Governor Pritzker, will do the following:

• Increase transparency regarding medical loss ratios, requiring health insurers to submit annual reports to the Department of Insurance (DOI) providing specific information.
• Strengthen coverage requirements for substance use disorder (SUD) treatment by:
  • Removing requirements that providers notify insurers within specified timeframes that SUD treatment has been initiated. Insurers retain the option to implement notification requirements (i.e., “shall” changed to “may”).
  • Prohibiting retrospective denial except in specified circumstances.
• Strengthen coverage requirements for mental health conditions by:
  • Prohibiting prior authorization requirements for outpatient or partial hospitalization services.
  • Allowing concurrent and retrospective review for outpatient or partial hospitalization services consistent with permissible notification requirements that may be placed on providers.
  • Prohibiting prior authorization requirements for inpatient mental health services.
  • Prohibiting concurrent review for 72 hours post admission if provider notifies insurer of admission and initial treatment plan within 48 hours.
  • Recommended level of care coverage shall be approved if the healthcare professional follows notification requirements and prepares fully developed discharge plan.
  • o Prohibiting retrospective denial of inpatient services for the first 72 hours except in specified circumstances.
• Strengthens provisions of Network Adequacy and Transparency Act by:
  • Requiring plans to give a network exemption to HMO beneficiaries and to notify beneficiaries that a referral has been granted a network exception based on preferred provider access deficiency (HMO beneficiaries were previously excluded from the requirement that plans provide out-of-network access to physicians when in-network coverage is not available).
  • Requiring that plans provide necessary exceptions if there are no in-network SUD or mental health providers or facilities that meet the time and distance standards.
  • Requiring plans to reimburse patients for travel, food and lodging and other costs associated with receiving care as a result of an exemption for SUD or mental health services (does not apply to Medicaid).

ISMS strongly supported this bill, which passed both chambers and is awaiting the governor’s signature.

Mental Health Parity

HB 1085 (Rep. LaPointe) and SB 55 (Sen. Villa) would establish reimbursement rates for mental health and substance use disorder treatment services for all policies. The bill reinforces mental health parity and attempts to address lack of network participation by mental health providers. HB 1085 passed the House but was held in the Senate.

Pharmacy Benefit Manager Regulation

HB 1697 (Sen. Koehler/Rep.), an initiative of Governor Pritzker, will increase transparency and oversight of pharmacy benefit managers (PBMs), particularly concerning patient access to medications and costs. Key provisions include prohibiting spread pricing, where PBMs charge higher amounts to insurance plans than they pay to pharmacies, and requiring PBMs to remit all rebates and discounts to the plan sponsor. Additionally, the bill prohibits PBMs from steering patients to their own pharmacies or affiliated networks.

Finally, a grant program is created with revenue generated by a fee on PBMs. This grant program will provide funding for pharmacies that exist in underserved areas of Illinois and/or those that treat a disproportionate number of Medicaid patients. The bill passed both chambers and awaits further action by the governor.

Reducing Prior Authorization Requirements

ISMS caused SB 2152 (Sen. Castro) to be introduced, which seeks to ban prior authorization for patients who have been diagnosed with one of the following chronic diseases and have been on a stable and successful prescribed treatments of at least one year: multiple sclerosis, rheumatoid arthritis, lupus, prediabetes, and diabetes types I and II. Due to the cost to the state and the state’s fiscal restraints, the bill did not advance.

General Anesthesia Coverage

HB 1141 (Rep. Hauter/Sen. Doris Turner) will prevent health insurance companies from putting time limits on anesthesia coverage. This comes after the fall of 2024, when Anthem Blue Cross Blue Shield tried to implement limitations in New York, Missouri, and Connecticut by tying payments to the length of time a patient was under anesthesia.

The bill passed both chambers and now heads to the governor’s desk for further action.

LICENSURE BILLS/SCOPE OF PRACTICE

Acupuncturists

HB 3344 (Rep. Mah) and SB 2452 (Sen. Jones) would redefine the practice of acupuncture to also include ordering laboratory tests to check, track, evaluate, and monitor the status and effectiveness of pain management, herbal medicinal plans, dietary and exercise plans. ISMS opposed these bills, which did not advance.

Anesthesiologist Assistants

SB 1482 (Sen. Castro) would license certified anesthesiologist assistants (CAAs), who would work as part of the anesthesia care team led by an anesthesiologist. CAAs would help balance and supplement the perioperative workforce and actively contribute to increased quality, decreased costs, and improved service line expansion efforts in patient care. ISMS joined the Illinois Society of Anesthesiologists (ISA) in support of this legislation. The association representing the certified nurse anesthetists (CRNAs) strongly opposed the bill, asserting that they would only remove their opposition if their bill for more independent practice advanced. SB 1482 did not advance.

The ISA and ISMS are pursuing a regulatory path with the Illinois Department of Financial and Professional Regulation (IDPFR) and the Illinois Department of Public Health (IDPH) that will allow CAAs to practice under the delegatory authority of an anesthesiologist until such time legislation providing for licensure passes the General Assembly.

Certified Registered Nurse Anesthetists (CRNAs) Independent Practice

HB 3728 (Rep. Moeller) and SB 239 (Sen. Collins) would grant CRNAs independent practice in ambulatory surgical treatment centers. The bill would also allow CRNAs with clinical privileges to perform acts of advanced assessment and diagnosis and practice without a collaborative agreement pursuant to certain criteria. In the hospital setting, it removes the requirement for a written anesthesia plan and would create a pathway for full practice authority for CRNAs. ISMS joined the ISA in their opposition to the bill, which was held in the Senate.

Certified Registered Nurse Midwives

HB 2688 (Rep. Morris/Sen. Collins) as introduced, would allow a certified nurse midwife to enter into a written collaborative agreement with an advanced practice registered nurse midwife with full practice authority.

ISMS opposed the bill as introduced. Working with the Illinois Chapter of the American College of Obstetricians and Gynecologists, ISMS negotiated the bill to allow a certified nurse midwife to provide home birth services within the scope of the certified nurse midwife's training and experience. If the collaborating physician does not provide home birth services, a certified nurse midwife may provide home birth services. Professional and civil immunity is provided to the collaborating physician.

In federally designated primary health professional shortage service areas with a score of twelve or greater, certified nurse midwives can enter into a collaborative agreement with a certified nurse midwife with full practice authority to provide out-of-hospital birth services.

ISMS was neutral on the amendment. HB 2688 passed both chambers and awaits further action by the governor.

Chiropractors/School Exams

HB 3033 (Rep Yang-Rohr) would allow chiropractors to provide health exams to student athletes. ISMS opposed this bill, which did not advance.

Hydrafacial Systems

SB 2154 (Sen. Castro/Rep Croake) was introduced in response to a 2024 IDPFR bulletin that prohibited estheticians and cosmetologists from performing procedures with hydrafacial machines. ISMS negotiated language that would provide limited use, ensuring that procedures are superficial and do not impact the living layers of the skin. Procedures such as chemical peels, dermabrasion, dermaplaning and microneedling are prohibited. ISMS was neutral on the amended language, which passed both chambers and awaits further action by the governor.

Licensure of Naturopaths

HB 3450 (Rep. Costa Howard) would license naturopaths in Illinois and allow them to provide a full range of naturopathic “medicine” to patients including providing pediatric care; treating and managing chronic conditions, such as diabetes and cancer; and providing specialty care, such as gynecological services. ISMS opposed the bill, which was held in committee.

Licensing Restrictions for Substance Use Disorder Treatment Facilities

HB 2652 (Rep. Tarver) would prohibit the Department of Human Services (DHS) from approving any initial or renewal application for the licensure of a facility where substance use disorder treatment or intervention services are provided if that facility is within 1,000 feet of: (i) any building or buildings or real property comprising a public or private elementary or secondary school, community college, college, or university, including any adjacent school yard, school playing field, or school playground; (ii) a public playground; or (iii) any public park building or real property comprising any public park. ISMS opposed this legislation, which was held in committee.

Medical License Review

HB 2769 (Rep. Hauter) and SB 2294 (Sen. Glowiak) would require IDFPR to review and issue a physician’s renewal application for a medical license concurrently with the physician’s application for a controlled substances license. IDFPR opposed these bills, claiming that much of this is already being done. These bills did not advance.

Physician Assistant Independent Practice

HB 2468 (Rep. Barbara Hernandez) and Senate Bill 271 (Sen. Cervantes) would grant physician assistants independent practice with full prescriptive authority. ISMS opposed these bills, which were held in committee.

Physician Assistant Licensure Compact

SB 209 (Sen. Rezin) would enter Illinois into the Physician Assistant Licensure Compact Act. The Compact seeks to allow participating states to develop a comprehensive process that complements the existing authority of state licensing boards to license and discipline physician assistants and to enhance the portability of a license to practice as a physician assistant. ISMS expressed concerns with the Compact because it was unclear if the Compact licensure rules would supersede Illinois’ licensure requirements. SB 209 was held in committee.

Psychologist Prescriptive Authority

SB 1743 (Rep. Collins) would remove a provision prohibiting a prescribing psychologist from prescribing medications to patients who are less than 17 years of age or over 65 years of age. Additionally, it would allow clinical psychologists to prescribe nonopioid Schedule II through V controlled substances (rather than any nonnarcotic Schedule III through V controlled substances).

ISMS opposed this bill. The sponsor agreed with our concerns and agreed to hold the bill.

State Funded Medical Residency Programs

HB 2351 (Rep. Hauter/Sen. Villivalam), an ISMS initiative, would develop a healthcare workforce planning commission to determine and recommend pathways to meet increased workforce demands and address the physician shortage, including ways to fund state-based residency positions. HB 2351 passed the House unanimously but was held in the Senate for fiscal reasons.

Volunteer Status for Retired Healthcare Professionals

HB 1270 (Rep. Hauter/Sen. Hilton) is an initiative of IDFPR to implement a law passed in 2015 providing for volunteer licenses. HB1270 allows a healthcare professional to be placed on volunteer status rather than being issued a separate volunteer license. ISMS supported this bill, which passed both chambers and is now sent to the governor for approval.

MANDATES

Child Abuse Pediatricians

SB 1684 (Sen. Lightford) and House Bill 3169 (Rep. Canty) would limit the effectiveness of child abuse pediatricians in Illinois. The legislation would require physicians to follow a specific limited script as they do medical evaluations on children who are suspected of being abused or neglected. ISMS joined the Illinois Chapter of the American Academy of Pediatrics in opposing the bill. Neither bill advanced.

CME/Training Mandated Topics

Data Privacy and Protection

HB 3041 (Rep. Rashid) would prohibit any entity from collecting, processing, or transferring data unless the collection, processing, or transfer is limited to what is reasonably necessary and proportionate. It provided that an entity and a service provider shall establish, implement, and maintain reasonable policies, practices, and procedures concerning the collection, processing, and transferring of covered data. It also contained provisions concerning retaliation; transparency; individual data rights; consent; data protection for children and minors; civil rights; data security; small business protections; executive responsibility; service providers and third parties; and enforcement, including a private right of action.

ISMS opposed the bill because it did not exempt out HIPAA regulated professionals and entities, and it failed to advance.

Healthcare Transparency

HB 2904 (Rep. Avelar) and Senate Bill 1679 (Sen. Aquino) would have required IDPH to identify reproductive health services, LGBTQ+ health services, and end-of-life care that might be denied for nonmedical reasons in the state. IDPH would create a form to show which services are available, which are restricted, and which have limitations on referrals.

The bills would have required not only healthcare facilities to disclose to patients the services that are not offered but would have also required the treating healthcare professionals to also disclose to their patients seeking certain healthcare services that the facility does not provide those services. ISMS opposed the bills as written, due to the mandates on the healthcare professionals. The bills did not advance.

Medical Patients’ Rights Act

SB 1579 (Sen. Villa) would amend the Medical Patient Rights Act to expand the definition of "patient" to include those receiving care at home and those receiving mental health treatment. It specifies that each patient has the right to be informed of their physician’s specialty and contact information; how to reach the facility administrator, outside advocate, interpreter, and legal services; receive facility policies, inspection findings; be treated with courtesy and respect, to have the patient's human and civil rights maintained, and to have the patient's basic human needs accommodated in a timely manner; have the patient's medical directives reviewed with the healthcare professional before any procedures are scheduled or decisions are made.

It would further require that physicians, healthcare facilities, health services corporations and insurance companies provide information regarding the patient’s diagnosis, treatment, alternatives, risks, and prognosis in writing to the patient or their legal guardian upon request.

The bill would expand a physician liability exposure—failure to provide information regarding the patient’s diagnosis, treatment, alternatives, risks, and prognosis in writing to the patient or their legal guardian upon request is a petty offense and the physician is subject to a $1,000 fine. It would also increase a physician’s burden to provide information regarding outside advocates, interpreters, and legal services, in addition to state “inspection findings.”

ISMS opposed this bill, which failed to advance.

Pediatric Exams and Gun Safety

HB 1374 (Rep. Gong-Gershowitz) and House Bill 1398 (Rep. Hirschauer) would have amended the Illinois School Code and in provisions concerning health examinations and immunizations, would require questions on the safe storage of firearms in a child's home to be included as a part of each health examination performed by physicians, PAs, or APRNs.

ISMS joined the Illinois Chapter of the American Academy of Pediatrics and Lurie Children’s Hospital in their opposition. This type of questioning is best left to the discretion of the physician.

Neither bill advanced in the House.

Reporting of Medical Abuse

HB 3711 (Rep. Cassidy/Sen. Villanueva) is an initiative of the Governor’s Office. As introduced, the bill would have required healthcare professionals, including physicians, to report “reportable misconduct.” This defined term includes “performing an intimate exam or service without explaining to the need for the examination or service” (which can occur when a patient is in an emergent circumstance and incapacitated); “causing death, great bodily harm, permanent disability, or disfigurement of an individual, regardless of whether the conduct is in the course of a professional service”; and “confining, detaining, or attempting to confine or detain an individual against his or her will, regardless of whether the conduct is in the course of a professional service.”

Healthcare professionals would have to report to IDFPR within 24 hours of 1) witnessing reportable misconduct themselves; 2) receiving a report from an individual alleging they witnessed reportable conduct; and 3) receiving a report directly or through a coworker not subject to reporting requirements, from a patient, or patient representative alleging reportable misconduct. A healthcare professional would have to report to the IDFPR within 24 hours when they acquire knowledge that they have been made the subject of an investigation by their employer for alleged reportable misconduct or by law enforcement for an alleged crime related to reportable misconduct.

The self-report must include a copy of the allegations, a brief description of the facts giving rise to the investigation, and any further pertinent information.

“Health institutions” are also considered “reporting organizations” required to report, such as those registered with the IDFPR as a professional service corporation, medical corporation, or professional limited liability corporation and those licensed by the IDPH. Reporting organizations must report within 24 hours of initiating an investigation, terminating its relationship with, suspending, placing on leave, or materially changing the privileges of a health professional following an allegation of reportable misconduct, or a health professional resigning, ceasing services, or accepting a material change in professional responsibilities following an allegation of reportable misconduct.

The Hospital Licensing Act is also amended. In Sec. 9.6, patient protection from abuse, the standard for employees or physicians who must report abuse is changed from when they have “reasonable cause to believe that any patient with whom he or she has direct contact has been subjected to abuse in the hospital” to any employee or physician must report where they are made aware of allegations that any patient has been subjected to abuse in the hospital.

In addition, the Medical Practice Act would have been amended to allow the IDFPR five years instead of two years from the receipt of the report to investigate and commence formal disciplinary proceedings in the event of settlement of any claim in favor of the claimant or reduction to final judgment of a civil action in favor of the plaintiff where such claim is grounded on the allegation that a physician was negligent in providing care.

ISMS considers this original draft a massive overreach. While at its outset, it appears focused on sexual misconduct, inclusion of certain language ignores the realities of medicine and appropriate professional behavior in certain circumstances. The requirement to report causing death or great bodily harm is also overly broad and vague: causes of death are determined by a coroner or practitioner completing a death certificate; proximate cause or cause in fact is determined by a court.

ISMS participated in lengthy negotiations for the duration of session with representatives from the Governor’s Office, representatives from IDFPR and IDPH, as well as the legislative sponsors of the bill.

The negotiations successfully concluded with several of the provisions, including the mandate to self-report, being either deleted from the bill or language was added acknowledging that in certain circumstances some of the listed violations, such as the use of restraints, is professionally necessary. ISMS was also able insert language that deaths and injuries that are not intentional or happens due to no fault of the physician cannot be considered misconduct. The bill passed out of the House, but did not advance in the Senate. This issue may be considered during the fall veto session.

Vaccinations

HB 1569 (Rep. Vella) would mandate that every healthcare professional authorized to provide vaccinations do so to a patient if: the patient has requested the specific vaccination to be administered; the healthcare professional has determined that the vaccination is medically necessary; and the healthcare provider has a stock of one or more doses of the vaccination that have not been reserved for another patient. It would prohibit healthcare professionals from preventing a medically necessary vaccination from being administered to a patient by keeping separate stocks of the vaccination for patients with private insurance and stocks of the vaccination for patients with Medicaid.

ISMS opposed this bill as it does not account for federal laws related to vaccines for pediatric patients, or account for vaccination shortages and how those shortages impact patients with underlying health conditions. After speaking to the sponsor about our concerns, he agreed to hold the bill. The bill did not advance.

MEDICAL PRACTICE & RECORDS & WORKFORCE ISSUES

AI Use in Psychotherapy

HB 1806 (Rep. Morgan/Sen. Villivalam), an initiative of the Illinois Chapter of the National Association of Social Workers, targets online AI chatbots that purport to provide mental health treatment and therapy.

As it relates to treatment of mental health, the bill does the following:

• Bans AI from making therapeutic decisions or detecting emotions.
• Allows AI to assist with administrative tasks.
• Requires patient consent if AI is used to transcribe or record therapy sessions.
• Ensures therapy session records that used AI are protected under Illinois confidentiality laws.
• Closes the loophole that allows unlicensed individuals, or former clinicians who lost their license, to continue offering therapy.

ISMS supported this bill, which passed both chambers and awaits further action by the governor.

Ban on Covenants Not to Compete for Maternal Care

HB 2561 (Rep. Faver Dias) is an initiative the Illinois Chapter of the American College of Obstetricians and Gynecologists (ACOG) and as introduced, would ban non-competes with respect to the provision of reproductive healthcare or maternity care provided by a healthcare professional if the enforcement of the covenant not to compete or covenant not to solicit is likely to reduce the availability of reproductive healthcare or maternity care.

ISMS negotiated the bill to clarify that non-competes should not be enforced in cases whereby a medical group or hospital system either discontinues obstetrical services and/or severely restricts reproductive care services. While ISMS’ amendment was accepted by the sponsor and the advocates, the Illinois Health and Hospital Association (IHA) remained opposed. The bill did not advance.

Ban on Covenants Not to Compete

HB 3213 (Rep. Moeller) would universally prohibit non-competes. ISMS offered an amendment to the sponsor reflecting ISMS’ policy that would prohibit hospital systems from enforcing non-competes. The sponsor accepted our amendment. The bill did not advance due to strong opposition by business groups and IHA.

Free Access to Medical Records

HB 1100 (Rep. Jed Davis) would provide free copies of electronic records of the patient's health information. ISMS opposed this bill, which did not advance.

Grants for Medical Students and Residents

SB 2441 (Sen. Sally Turner), an ISMS initiative, would, subject to appropriation, require the Illinois Student Assistance Commission to develop and administer a medical education grant program. The goal of the program is to attract students to the medical profession, increase the employment and retention of individuals who are receiving additional clinical training in medicine, and reduce financial barriers in the medical profession by awarding grants to eligible medical students and eligible resident or fellow physicians for the nontuition costs of attending a medical or osteopathic college or receiving specialty or residency training.

Due to Illinois’ fiscal constraints, the bill did not advance.

Health Care Workforce Task Force

SB 593 (Sen. Glowiak Hilton/Rep. Murray), an IHA initiative, will create a Health Care Workforce Task Force under the Illinois Department of Public Health.

The Task Force will be made up of members from various groups impacting healthcare including pertinent state agencies, legislators, hospitals, physicians, long-term care, organized labor, and nursing education. Representatives from both ISMS and the Illinois College of Emergency Physicians will be appointed to the task force

The Task Force will meet over a period of a year, looking at key issues impacting the healthcare workforce. These issues include:

• Regulatory burdens or duplication.
• Ways to address workplace violence against healthcare workers.
• Improve workforce recruitment and retention.
• Improve the healthcare workforce pipeline through grants, funding opportunities, and early outreach to Illinois youth to encourage a career in healthcare.
• Look for opportunities to increase seats at nursing schools.
• Build on already passed legislation to increase access to foreign trained healthcare providers.

A report will be developed and will include recommendations to the governor and General Assembly on ways to move forward to address these challenges. The bill passed both chambers unanimously and was sent to the governor for approval.

Health Facilities Planning Board

SB 798 (Sen. Aquino/Rep. Barbara Hernandez) as originally presented to ISMS, would have brought large non-hospital affiliated medical groups under the purview of the Illinois Facilities Planning Board and would have subjected any expansion under the Certificate of Needs process. ISMS strongly opposed this proposal. SB 798 was then amended to remove the objectionable language and instead only made technical changes.

ISMS was neutral on the bill, which passed both chambers and awaits further action by the governor.

Prenatal Syphilis Testing

SB 119 (Rep. Villa/Rep. Moeller) as originally presented to ISMS by IDPH, would have created a timeline of testing and treatment that in some circumstances would be difficult to meet as it did not consider patient compliance.

ISMS worked with IDPH on the language, and as passed by the General Assembly, the bill amends the Prenatal Syphilis Act clarifying when testing pregnant persons should take place, providing for appropriate flexibility. ISMS supported the bill, which now heads to the governor’s desk for action.

Healthcare Surrogate POLST

SB 1411 (Sen. Fine/Rep. Gong-Gershowitz) amends the Health Care Surrogate Act to provide that no physician, healthcare provider, employee, or facility shall require the execution of a POLST or other such form to put into effect a qualified patient’s living will declaration. Additionally, it provides that a healthcare professional or facility may rely on and shall comply with a qualified patient’s living will declaration where it is apparent and available, and that patient has been determined to be a qualified patient with a terminal illness. This passed both chambers and was sent to the governor for approval.

Prohibition on Telehealth Facility Fees

SB 1974 (Sen. Ellman) would have prohibited any healthcare professional, facility, or medical group from imposing or collecting a facility fee in connection with any telehealth services provided to Illinois patients unless those fees are related to in-person services. ISMS opposed this bill, which did not advance.

Prohibition on Late/Missed Appointment Fees

SB 1972 (Sen. Ventura) would prohibit healthcare professionals from charging a patient to pay a fee for a missed or late appointment and would have provided for a fine of $500 per violation. ISMS opposed this bill, which did not advance.

Reducing Violence in the Workplace

HB 3435 (Rep. Manley) is an initiative of the Illinois College of Emergency Physicians and supported by ISMS. As introduced, the bill would prohibit licensed healthcare facilities from discouraging a healthcare professional from contacting law enforcement or IDPH regarding workplace violence.

The bill would have expanded the state’s workplace violence prevention program to include a mandate on hospital systems to report incidents of violence to IDPH along with requiring each facility to identify the need for additional security and alarms, adequate exit routes, monitoring systems, barrier protections, lighting, entry procedures, and systems to identify and flag persons who have previously committed violent acts in the health care provider space. The bill would also establish standards for violent incident investigations, recordkeeping and reporting requirements.

This language did not advance due to strong opposition from IHA. IHA instead introduced SB 593, found on page 12 of this report, which creates a task force that is charged with discussing this important topic, along with other issues that create barriers to increasing Illinois’ healthcare workforce.

Workers Compensation Medical Fee Schedule

HB 2840 (Rep. Ugaste) would have made the current Workers Compensation Medical Fee inoperative and created a new one based on a percentage of Medicare. ISMS opposed this bill, which failed to advance.

PUBLIC HEALTH

End-of-Life Options Act

SB 1950 (Rep. Gabel/Sen. Holmes) would create the End-of-Life Options Act, allowing physicians to prescribe terminal patients a prescription to end his or her life. ISMS’ position on this issue changed from one of neutral to oppose in April. The bill did pass the House at the end of session. It was not called in the Senate.

Drug Reuse Opportunity Program Act

HB 2346 (Rep. Faver Dias/Sen. Edly Allen) is aimed at enhancing the Illinois Drug Reuse Opportunity Program, which helps provide unused medications to those in need.

HB 2346 seeks to improve the program by requiring the IDPH to do the following:

• Maintain and publish a list of participating pharmacies to increase accessibility.
• Educate pharmacies across Illinois on how they can voluntarily participate.
• Develop educational materials to inform the public about the program’s benefits.
• Release an annual report to the General Assembly, starting in 2026, to ensure transparency and track the program’s impact.

ISMS supported HB 2346, which passed both chambers and awaits further action by the governor.

Expanding Services for Victims of Human Trafficking

SB 2323 (Sen. Morrison/Rep. Ann Williams) was culmination of many meetings among a variety of stakeholders called together by the Illinois State Police in an effort to improve identifying and helping those persons, including minors, who may be victims of human trafficking.

SB 2323 establishes the Illinois Statewide Trauma-Informed Response to Human Trafficking Act, which aims to comprehensively address human trafficking in the state through a multi-agency approach. The bill requires several state departments to develop strategic plans, training programs, and protocols to identify, support, and protect human trafficking victims. Key provisions include establishing a human trafficking unit within the Department of Children and Family Services to coordinate services for youth at risk of or experiencing trafficking, mandating the Department of Human Services to create a statewide system for identifying and supporting trafficking survivors, and requiring the Illinois State Police to develop a strategic plan to improve law enforcement's response to human trafficking victims. The bill also introduces new training requirements for various professionals, including law enforcement, prosecutors, and social service providers, to ensure a trauma-informed and victim-centered approach.

ISMS’ participation stopped an effort to pass a broad-based CME mandate on healthcare professionals who are not in a position to recognize or report victims.

The bill also expands legal protections for trafficking victims, such as allowing minors who commit status offenses while being trafficked to use their trafficking status as an affirmative defense and extending the statute of limitations for related civil actions. The legislation aims to address the complex nature of human trafficking by providing comprehensive support, prevention, and response mechanisms across multiple state agencies.

ISMS supported the bill, which passed both chambers and awaits further action by the governor.

Legalization of Psilocybin

HB 1143 (Rep. Ford) and SB 2184 (Sen. Ventura) would have created the Illinois Psilocybin Advisory Board within IDFPR for the purpose of advising and making recommendations to IDPFR regarding the provision of psilocybin and psilocybin services. The bill would have allowed the IDPFR to receive applications for the licensing of persons to manufacture or test psilocybin products, operate service centers, or facilitate psilocybin services. The bill would remove psilocybin and psilocin from the list of Schedule I controlled substances. ISMS opposed this bill, which did not advance.

HB 2992 (Rep. Mah) would create the Healing Opportunities through Psilocybin Equity Pilot Program Act under which the Illinois Psilocybin Advisory Board would be created within IDPFR. This legislation seeks to create a framework for the legal manufacture, delivery, and possession of psilocybin products. ISMS opposed this bill. HB 2992 did not advance.

One Health Task Force

SB 291 (Sen. Morrison/Rep. Mussman) establishes the One Health Commission in IDPH for the purpose of developing a strategic plan to promote interdisciplinary communication and collaboration between physicians, veterinarians, and other scientific professionals and State agencies, with the goal of promoting the health and well-being of the State's residents, animals, and environment. The Commission is comprised of representatives from various state agencies, public health systems, veterinarians and two physicians licensed to practice medicine in all of its branches, with at one who is an expert in epidemiology or infectious disease surveillance.

ISMS supported this bill, which passed both chambers and awaits further action by the governor.

Tick Act

HB 1754 (Rep. Swanson/Sen. Hills) as originally introduced, would require IDPH to issue rules requiring medical professionals to report cases of alpha-gal syndrome and Lyme disease to the local health department and the Department of Public Health on the date of the diagnosis under the Control of Communicable Diseases Code.

ISMS opposed this bill as introduced and successfully amended the bill to create a public educational campaign on alpha-gal syndrome, removing the mandate to report it to local public health departments and IDPH.

Unregulated Hemp Products

SB 20 (Sen. Lightford) would have instituted strict regulations on intoxicating unregulated hemp products. While ISMS supported SB 20, the bill was held in the Senate due to strong opposition in the House. ISMS expects this issue to be reintroduced in 2026.

REGULATORY MATTERS

Medicaid Utilization Review Standards

Last year, language was adopted as part of the Medicaid Omnibus bill that created a task force to develop utilization standards that Medicaid MCOs must use when admitting patients into a hospital for mental health treatment. ISMS participated in the process. Our participation ensures that the regulatory framework will reflect many of the provisions of the Prior Authorization and Reform Act of 2021, including ensuring that in cases of denial or appeal, a physician (as opposed to any health care professional) of a similar specialty is reviewing the treating physician’s request.

Pharmacists’ Ability to Test and Treat

Last year, in the very last hours of the legislative session, language was put in the Medicaid Omnibus bill that allowed pharmacists to test and treat for COVID, strep A, influenza, adult head lice, and other declared public health emergency. ISMS is currently working through Illinois’ regulatory process to establish appropriate guardrails that include assessment, referrals, and notification of treatment to the patients’ treating healthcare professionals. ISMS is advocating for transparency for the benefit of patients so they are aware that being tested and treated in the pharmacy does not equate to a comprehensive medical examination and may not be appropriate for all patients, particularly those with underlying health conditions and minors.