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Thursday, January 2, 2020

Changes to health care law in Illinois - Crain's Chicago Business

NEW LAWS TO WATCH FOR IN 2020: It’s a new year,  which brings a host of new laws in Illinois. The General Assembly and Gov. J.B. Pritzker put into law numerous health care measures, from mandating insurance coverage to adding to patients’ rights to enacting more stringent reporting requirements. These are among the laws now in effect: 

PAID COVERAGE OF SECOND MAMMOGRAMS: In a measure sought by the Illinois Public Health Administration and Susan G. Komen, many insurers must now cover, without any co-pay or cost sharing, a second mammogram ordered by a physician after an initial screening mammogram reveals dense breast tissue. About 10 percent of screening mammograms require a second, more comprehensive, ultrasound mammogram, “which can arguably be the most important test in the screening process,” state Senate sponsor Linda Holmes, D-Aurora, said in a statement. 

DONATED BREAST MILK COVERED: Private insurers and Illinois Medicaid must cover the cost of donated breast milk prescribed by a physician, under certain circumstances. The coverage mandate is for children up to 12 months old. Additionally, for Medicaid recipients, children who have spinal muscular atrophy and are older than 12 months must have prescribed donated milk covered. 

COVERAGE FOR KIDS’ INJECTORS AND MONITORS: Two statutes require insurance coverage for medically necessary items for those 18 and under. For such patients, insurers must cover epinephrine injectors; for those who have had a cardiopulmonary event, cardiopulmonary monitors must be covered. 

PAYING PROVIDERS FOR PSYCHIATRIC COLLABORATIVE CARE: The General Assembly also told insurers that they must reimburse providers for psychiatric care under the collaborative care model, in which formal arrangements for evidence-based, integrated behavioral health care are made between a patient’s primary care team and psychiatric consultants. 

GIVING PSYCHIATRIC NURSES POWER TO COMMIT PATIENTS: The state also is allowing advance practice psychiatric nurses to now order involuntary admissions, restraints or seclusion of a patient. It also authorizes video-conference psychiatric exams in the 24 hours in which an emergency commitment patient must be examined. 

PROTECTION FOR LIVING DONORS: Employers are prohibited from retaliating against employees requesting a leave of absence to donate blood, bone marrow or an organ. The law also protects living organ donors from being denied insurance coverage or facing higher premium costs for life insurance, disability insurance and long-term care insurance policies.  

CODIFYING PREGNANCY AND CHILDBIRTH RIGHTS: Illinois also amended the Medical Patient Rights Act to include a number of rights for women regarding pregnancy and childbirth. Among the rights a woman has under the amendment are:  

• The right to receive health care before, during and after pregnancy and childbirth. 

• The right to receive care consistent with generally accepted medical standards.

• The right to choose a certified nurse midwife as a maternity care professional and the right to choose birth setting. 

• The right to information about her condition and treatment options, including pain relief options. 

• The right to accept or refuse any treatment, to the extent medically possible. 

• The right to a health care professional who communicates in a language in which the patient can communicate and treats her appropriately regardless of ethnicity, sexual orientation or religion. 

MATERNAL MENTAL HEALTH: The Illinois Department of Human Services will produce maternal mental health educational materials for health care professionals and patients, which birthing hospitals must distribute to employees and incorporate into employee training by Jan. 1, 2021. A separate statute directs the Illinois Department of Public Health to investigate and apply for federal funding grants to support maternal mental health and requires the department to file a report with the General Assembly on or before Jan. 1, 2021 about its efforts. 

PROVIDING DOCS WITH NON-COMMERCIAL PRESCRIPTION DRUG ADVICE: The Department of Healthcare and Family Services will develop a program designed to give doctors objective information about drugs. In collaboration with the University of Illinois at Chicago, the department is to develop a program designed to provide prescribing physicians under the Medicaid program the latest evidence-based, non-commercial information about pharmaceuticals.

ALZHEIMER’S: The state created the full-time position of Dementia Coordinator at the Illinois Department of Public Health funded out of the Alzheimer’s Disease Research, Care and Support Fund and increased the number of voting members on the IDPH's Alzheimer’s Disease Advisory Committee from 16 to 17. The new member will be required to have medical or academic experience with early-onset Alzheimer’s. 

PUT A LITTLE HEALTH IN EVERY STATE POLICY: The University of Illinois at Chicago School of Public Health will work with the Illinois Department of Public Health to convene a workgroup to review legislation and make policy recommendations relating to the health of Illinois residents. The workgroup is to look at the health of people in the state and to find ways for local government and state agencies to collaborate in implementing policies meant to help residents' health. The workgroup will use a "health in all policies framework" to recommend how health considerations may be incorporated into the decision-making processes of government agencies and private stakeholders who interact with government agencies.


JOIN OUR ORTHOPEDIC HEALTH ROUNDTABLE: Calling expert panelists for Crain's upcoming virtual roundtable on Health Care: Orthopedic Health. Be recognized as a thought leader on the key issues and trends impacting your industry. Contact Sarah Chow for more information on this opportunity: [email protected]. 

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Changes to health care law in Illinois - Crain's Chicago Business
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