Clark Kaericher | Executive Director, Healthcare Council & Sr. VP of Government Affairs | 618-806-1501
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October 4, 2023
The purpose of the Healthcare Council is to develop and take actions to achieve affordable, accessible, efficient, high-quality healthcare options for the employers and residents of our state. We advocate for market-based solutions that encourage innovation in healthcare delivery – and work against costly mandates and burdensome regulations. Through quarterly meetings, the Council brings together the diverse voices of the healthcare community and provides a forum to interact with government and private sector leaders at the highest levels.
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My wife and I recently watched the Golden Bachelor (I know, I know...). It's just as bad as you can imagine. That's my way of saying I'm desperately in need of television show recommendations, if you have any to share.
I'm going to be in Chicago presenting on a BIPA panel the rest of this week (more information below) so the newsletter is a few days early this week.
Upcoming Subject Matter Hearings
Last week, the House Healthcare Licensing Committee heard more than two hours of testimony about concerns in the excessive delay of licensing processes at the Department of Financial and Professional Regulations (IDFPR). The delays have resulted in people losing jobs, a potential shortage in personnel for hospitals, and various hardships for licensed persons. The Secretary of IDFPR testified that the agency is aware of the extensive delays and has worked to address them, but technological issues and staffing concerns have made it difficult. A new state procurement for a licensing system is being undertaken.
The second hearing was held on Wednesday. It was a joint hearing of the House Healthcare Licenses Committee and the House Labor and Commerce Committee. This one examined healthcare staffing ratios. The Illinois Hospital Association put on a fantastic panel talking about the real-world impact of nursing shortages. There was also a push by various unions for Rep. Mah’s staffing ratio bill.
New Bills of Interest
In preparation for the Upcoming Veto Session, I’ve reviewed every bill and resolution introduced since June 1st. Here are the notable ones:
HB 4154 (Harper) - Amends the Medical Patient Rights Act. Provides that a patient who is covered under a policy of accident and health insurance, dental plan, or vision care plan is entitled to receive medical, dental, or eye care services without being required to pay an amount in excess of the estimated cost share, copayment, or deductible before those services are provided if such services are typically covered under the policy of accident and health insurance, dental plan, or vision care plan.
HB 4142 (Syed) - Amends the Genetic Information Privacy Act. Provides that an insurer may not seek information derived from genetic testing for use in connection with a policy of life insurance. Provides that an insurer may consider the results of genetic testing in connection with a policy of life insurance if the individual voluntarily submits the results and the results are favorable to the individual. Amends the Illinois Insurance Code. Provides that an insurer must comply with the provisions of the Genetic Information Privacy Act in connection with the amendment, delivery, issuance, or renewal of a life insurance policy; claims for or denial of coverage under a life insurance policy; or the determination of premiums or rates under a life insurance policy.
HB 4117 (Hammond) - Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Children and Family Services to pay for all inpatient stays at a hospital beginning on the 3rd day a child is in the hospital beyond medical necessity, and the parent or caregiver has denied the child access to the home and has refused or failed to make provisions for another living arrangement for the child or the child's discharge is being delayed due to a pending inquiry or investigation by the Department of Children and Family Services. In a provision requiring the Department of Children and Family Services to pay the DCFS per diem rate for inpatient psychiatric stays at a free-standing psychiatric hospital or a hospital with a pediatric or adolescent inpatient psychiatric unit, requires the Department to pay the DCFS per diem rate effective the 3rd day (rather than the 11th day) when a child is in the hospital beyond medical necessity.
HB 4126 (Scherer) - Amends the Illinois Insurance Code. Adds provisions concerning market analysis and market conduct actions. Makes changes to provisions concerning market conduct and non-financial examinations, examination reports, insurance compliance self-evaluative privilege, confidentiality, fees and charges, examination, and fiduciary and bonding requirements. Amends the Network Adequacy and Transparency Act. Adds definitions. Establishes minimum ratios of providers to beneficiaries for network plans issued, delivered, amended, or renewed during 2024. Makes changes to provisions concerning network adequacy, notice of nonrenewal or termination, transition of services, network transparency, administration and enforcement, and provider requirements. Amends the Managed Care Reform and Patient Rights Act. Makes changes to provisions concerning notice of nonrenewal or termination and transition of services. Amends the Illinois Administrative Procedure Act to authorize the Department of Insurance to adopt emergency rules implementing federal standards for provider ratios, time and distance, or appointment wait times when such standards apply to health insurance coverage regulated by the Department of Insurance and are more stringent than the State standards extant at the time the final federal standards are published. Effective immediately.
Annual Meeting A Success
Thank you to everyone that sponsored and/or attended our annual luncheon last week. We had a sold out crowd with over 500 attendees. This event is our biggest of the year and we would not be able to advocate for pro-business policies without the success of events like last week. We hope to see you next year!
Rulemaking
Rx Monitoring The DEPARTMENT OF HUMAN SERVICES adopted amendments to Electronic Prescription Monitoring Program (77 IAC 2080; 46 Ill Reg 16961) effective 9/8/23 that implement Public Acts 100125, 100-564, 100-1093, and 101414, along with other updates in program administration and procedure. The rulemaking, which has undergone numerous revisions since 1st Notice, updates the definition of the Illinois Prescription Monitoring Program (ILPMP) as an electronic database that collects, tracks, and stores information regarding retail prescriptions of controlled substances (Schedule II through V) and other drugs of interest and also removes a 12-month limit on retaining prescription information. Medications that interact with controlled substances, but are not themselves controlled substances, may also be included in the ILPMP. Every prescriber who possesses an Illinois Controlled Substance License must register with the ILPMP, and facilities that dispense or administer controlled substances may participate in additional data sharing with ILPMP to identify patients at risk of addiction. A prescriber or dispenser may appoint up to 5 (changed since 1st Notice from 3) designees to access the ILPMP, who must be registered nurses, licensed practical nurses, pharmacy technicians, certified medical assistants, dental hygenists, student pharmacists, or dental assistants (the latter two have been added since 1st Notice). Hospitals, long term care facilities, opioid treatment facilities and other facilities are not limited in the number of designees they may appoint for this purpose. Dispensers must transmit required ILPMP data for each prescription (or a zero report if no prescriptions were dispensed that day) by the end of the business day, and hospitals must also report any discharge or outpatient prescription for a 72-hour or greater supply of medication by the end of the business day (formerly, the reporting deadline for all prescriptions was the following business day). The $100 per day fine for willful noncompliance with ILPMP reporting requirements shall) be assessed by DHS on a monthly basis. (Since 1st Notice, DHS added provisions for warning and notifying prescribers and software vendors of impending fines for noncompliance.) The fine for failure to comply with electronic health records (EHR)-to-ILPMP integration requirements on the environment can include a documented training program for management and human resources personnel on supporting employees in recovery; engagement in community-based prevention or recovery-focused activities at least once a year; or certification as a recovery supportive workplace by a nonprofit, third-party recovery organization. An eligible employee must work for the employer at least 500 hours per calendar year. Documentation of an eligible employee’s recovery must be maintained confidentially by the employer and may be requested by DHS for audit purposes. Applications for credits will be received between 1/1 and 3/1 annually and will apply to taxes paid for that calendar year. The certificate verifying eligibility for the credit must be attached to the employer’s income tax return submitted to the Department of Revenue. The credit cannot reduce the taxpaying employer’s liability to less than zero and the total credits awarded by DHS per year cannot exceed $2 million. Businesses that hire or have recently hired eligible individuals are affected by this rulemaking. Questions/requests for copies/ comments through 11/6/23: Tracie Drew, DHS, 100 S. Grand Ave. East, 3rd Fl., Springfield IL 62762, 217/785-9772, DHS.AdministrativeRules@illinois.gov
Birth Centers The DEPARTMENT OF PUBLIC HEALTH adopted a new Part titled Birth Center Licensing Code (77 IAC 264; 47 Ill Reg 1846) effective 9/8/23, implementing PA 102-518, the Birth Center Licensing Act [210 ILCS 170] and PA 102-964, which establishes licensing for certified professional midwives. The Part requires all birth centers in existence as of 8/20/21 (the effective date of the Birth Center Licensing Act) to obtain a license under this Part by 9/1/25, and to obtain accreditation from The Joint Commission or the Commission for Accreditation of Birth Centers within 2 years after becoming licensed. Birth centers are defined in the Act and in this Part as nonhospital sites with 10 or fewer beds, in which births are planned to occur following uncomplicated, full-term, low-risk pregnancies, and in which clients and newborns stay for 48 hours or less following delivery. Each birth center must also have a transfer agreement with a hospital that allows clients and/or infants who develop complications or require an emergency cesarean section to be admitted to the hospital within 30 minutes
Happy Birthday BIPA Event
This Friday, the 15th birthday of BIPA, I’ll be speaking on a panel about BIPA and the potential for much needed reform. I’ll be joined by Jake Parker from the Security Industry Association. Also scheduled to speak is Congressman Bill Foster on the “Improving Digital Identity Act” and several industry CEOs.
The event will be held from 10-3 at the Security Innovation Hub in Chicago (1302 Kilbourn Ave). You can find more information HERE.
The event is free, but only open to the first 100 registrants. Register HERE.
Veto Session Dates
Veto Session will be here before you realize. Lawmakers announced the 2023 dates for October 24-26 and November 7-9. View the calendar here.
Articles of Interest
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