New Laws Related to Medicine that Took Effect January 1
January 6, 2023
Illinois kicked off the new year with 185 new laws that became effective on Jan. 1, 2023. ISMS has compiled some of the notable health-related bills that would be of interest to members:
- Flat-Dollar Copayment Structure for Prescriptions: House Bill 01745 / 102-0391 Requires all health insurance carriers that cover prescription drugs to implement a flat-dollar copayment structure to the entire drug benefits for individual and group plans on a phased-in basis.
- Advance Notice for Non-Routine Changes to Insurer's Fee Schedule: House Bill 04941 / 102-0957 Requires health insurers to provide 60 days advance notice to healthcare professionals for non-routine changes to the insurer's fee schedule, except for Medicaid managed care organizations – they remain subject to the notice requirements already established by Illinois’ Healthcare and Family Services (HFS).
- Analysis of Marketplace Premiums: House Bill 00836 / 102-0900 Requires the Department of Insurance to conduct an actuarial analysis of health insurance plans on the Illinois individual marketplace to determine whether premiums are properly aligned with the requirements of the Affordable Care Act.
- Genetic Testing to Detect Cancer Risks: House Bill 05334 / 102-0979 Requires health insurance plans to cover costs for genetic testing of the BRCA1 and BRCA2 genes to detect risks for breast and ovarian cancers, if recommended by a healthcare professional.
- Prostate Cancer Screenings: House Bill 05318 / 102-1073 Requires health insurance to cover annual prostate cancer screenings upon the recommendation of a physician.
- Glucose Monitors: Senate Bill 02969 / 102-1093 Requires all insurance plans regulated by the state to include coverage for continuous glucose monitors when medically necessary for individuals with Type 1 or Type 2 diabetes beginning Jan. 1, 2024.
- Prenatal Vitamins: House Bill 04338 / 102-0930 Expands insurance coverage for prescription drugs to include prenatal vitamins after Jan. 1, 2024.
- Breast Reduction Surgery: House Bill 04271 / 102-0731 Requires medically necessary breast reduction surgery to be covered by state-regulated private insurance.
- Hormone Therapy Treatments: House Bill 05254 / 102-0804 Requires health insurance plans to cover medically necessary hormone therapy treatments for women who have induced menopause by undergoing a hysterectomy.
- Overprescribing: House Bill 03596 / 102-0490 While this was signed into law in 2021 for implementation in 2023, ISMS was successful in delaying until Jan. 1 2024. The law will require prescribers issue an electronic prescription for controlled substances, as the majority of states currently require. The delay provides ISMS time to lobby and negotiate for appropriate exemptions and or waivers similar to what other states have.
- Naloxone Hydrochloride: House Bill 04408 / 102-1038 Prohibits insurers and Medicaid from imposing a copayment for the opioid suppressant naloxone hydrochloride.
Prescription Monitoring Program (PMP)
- Increasing Access to the PMP: Senate Bill 03024 / 102-0751 Allows a medical director or a public health administrator to have access to the Prescription Monitoring Program database.
Equity in Medicine
- Loan Repayments and Scholarships for Health Professionals: House Bill 04645 / 102-0942 Creates an Equity and Representation in Health Care Workforce Repayment Program to provide loan repayments and scholarships for healthcare professionals who serve in Illinois medical facilities for a specified period of time. Prioritizes increasing diversity in medically underserved areas.
Scope of Practice
- Physician Assistants: Senate Bill 00145 / 102-0735 Amends the Physician Assistant Practice Act to reduce the amount of paperwork PAs need to file for licensure. It does not include any expansion of their scope of practice or open the door to independent practice.
- Physician Assistants: Senate Bill 03498 / 102-0844 Allows a medical certification of death to be completed and signed by a physician assistant.
- Licensed Physical Therapists: Senate Bill 03216 / 102-1011 Changes the Illinois Vehicle Code by adding licensed physical therapists to the list of persons who can determine that a person has a physical disability for purposes under the Vehicle Code.
- International Healthcare Professionals: House Bill 05465 / 102-0812 Creates the Task Force on Internationally-Licensed Health Care Professionals Act. Focuses on providing more expedient pathways for health professionals who are already licensed and practicing in another country who are seeking to work in Illinois.
Illinois Power of Attorney for Healthcare
- Digital Documents: House Bill 05047 / 102-0794 Clarifies that in the event a person needs to delegate powers of attorney to an agent in a healthcare setting, the agent may present an electronic copy of the document creating the healthcare agency as proof of the delegation and the healthcare provider must accept the digital document.
- Men’s Health: House Bill 04589 / 102-0938 Creates the division of Men’s Health to raise awareness for issues pertaining to men's health like prostate cancer, testicular cancer, smoking cessation, etc.