SB 3365 — MEDICARE/MEDICAID DUAL ELIGIBL

The Illinois Department may, however, impose other appropriate requirements regarding laboratory test order documentation.

SB3365 Enrolled - 5 - LRB104 18483 SSS 31925 b Upon receipt of federal approval of an amendment to the Illinois Title XIX State Plan for this purpose, the Department shall authorize the Chicago Public Schools (CPS) to procure a vendor or vendors to manufacture eyeglasses for individuals enrolled in a school within the CPS system.

CPS shall ensure that its vendor or vendors are enrolled as providers in the medical assistance program and in any capitated Medicaid managed care entity (MCE) serving individuals enrolled in a school within the CPS system.

Under any contract procured under this provision, the vendor or vendors must serve only individuals enrolled in a school within the CPS system.

Claims for services provided by CPS's vendor or vendors to recipients of benefits in the medical assistance program under this Code, the Children's Health Insurance Program, or the Covering ALL KIDS Health Insurance Program shall be submitted to the Department or the MCE in which the individual is enrolled for payment and shall be reimbursed at the Department's or the MCE's established rates or rate methodologies for eyeglasses.

On and after July 1, 2012, the Department of Healthcare and Family Services may provide the following services to persons eligible for assistance under this Article who are participating in education, training or employment programs operated by the Department of Human Services as successor to the Department of Public Aid:

(1) dental services provided by or under the supervision of a dentist;

and SB3365 Enrolled - 6 - LRB104 18483 SSS 31925 b (2) eyeglasses prescribed by a physician skilled in the diseases of the eye, or by an optometrist, whichever the person may select.

On and after July 1, 2018, the Department of Healthcare and Family Services shall provide dental services to any adult who is otherwise eligible for assistance under the medical assistance program.

As used in this paragraph, "dental services" means diagnostic, preventative, restorative, or corrective procedures, including procedures and services for the prevention and treatment of periodontal disease and dental caries disease, provided by an individual who is licensed to practice dentistry or dental surgery or who is under the supervision of a dentist in the practice of his or her profession.

On and after July 1, 2018, targeted dental services, as set forth in Exhibit D of the Consent Decree entered by the United States District Court for the Northern District of Illinois, Eastern Division, in the matter of Memisovski v.

Maram, Case No.

92 C 1982, that are provided to adults under the medical assistance program shall be established at no less than the rates set forth in the "New Rate" column in Exhibit D of the Consent Decree for targeted dental services that are provided to persons under the age of 18 under the medical assistance program.

Subject to federal approval, on and after January 1, 2025, the rates paid for sedation evaluation and the provision of SB3365 Enrolled - 7 - LRB104 18483 SSS 31925 b deep sedation and intravenous sedation for the purpose of dental services shall be increased by 33% above the rates in effect on December 31, 2024.

The rates paid for nitrous oxide sedation shall not be impacted by this paragraph and shall remain the same as the rates in effect on December 31, 2024.

Notwithstanding any other provision of this Code and subject to federal approval, the Department may adopt rules to allow a dentist who is volunteering his or her service at no cost to render dental services through an enrolled not-for-profit health clinic without the dentist personally enrolling as a participating provider in the medical assistance program.

A not-for-profit health clinic shall include a public health clinic or Federally Qualified Health Center or other enrolled provider, as determined by the Department, through which dental services covered under this Section are performed.

The Department shall establish a process for payment of claims for reimbursement for covered dental services rendered under this provision.

Subject to appropriation and to federal approval, the Department shall file administrative rules updating the Handicapping Labio-Lingual Deviation orthodontic scoring tool by January 1, 2025, or as soon as practicable.

On and after January 1, 2022, the Department of Healthcare and Family Services shall administer and regulate a school-based dental program that allows for the out-of-office delivery of preventative dental services in a school setting SB3365 Enrolled - 8 - LRB104 18483 SSS 31925 b to children under 19 years of age.

The Department shall establish, by rule, guidelines for participation by providers and set requirements for follow-up referral care based on the requirements established in the Dental Office Reference Manual published by the Department that establishes the requirements for dentists participating in the All Kids Dental School Program.

Every effort shall be made by the Department when developing the program requirements to consider the different geographic differences of both urban and rural areas of the State for initial treatment and necessary follow-up care.

No provider shall be charged a fee by any unit of local government to participate in the school-based dental program administered by the Department.

Nothing in this paragraph shall be construed to limit or preempt a home rule unit's or school district's authority to establish, change, or administer a school-based dental program in addition to, or independent of, the school-based dental program administered by the Department.

The Illinois Department, by rule, may distinguish and classify the medical services to be provided only in accordance with the classes of persons designated in Section 5-2.

The Department of Healthcare and Family Services must provide coverage and reimbursement for amino acid-based elemental formulas, regardless of delivery method, for the diagnosis and treatment of (i) eosinophilic disorders and (ii) SB3365 Enrolled - 9 - LRB104 18483 SSS 31925 b short bowel syndrome when the prescribing physician has issued a written order stating that the amino acid-based elemental formula is medically necessary.

The Illinois Department shall authorize the provision of, and shall authorize payment for, screening by low-dose mammography for the presence of occult breast cancer for individuals 35 years of age or older who are eligible for medical assistance under this Article, as follows:

(A) A baseline mammogram for individuals 35 to 39 years of age.

(B) An annual mammogram for individuals 40 years of age or older.

(C) A mammogram at the age and intervals considered medically necessary by the individual's health care provider for individuals under 40 years of age and having a family history of breast cancer, prior personal history of breast cancer, positive genetic testing, or other risk factors.

(D) A comprehensive ultrasound screening and MRI of an entire breast or breasts if a mammogram demonstrates heterogeneous or dense breast tissue or when medically necessary as determined by a physician licensed to practice medicine in all of its branches.

(E) A screening MRI when medically necessary, as determined by a physician licensed to practice medicine in all of its branches.

SB3365 Enrolled - 10 - LRB104 18483 SSS 31925 b (F) A diagnostic mammogram when medically necessary, as determined by a physician licensed to practice medicine in all its branches, advanced practice registered nurse, or physician assistant.

(G) Molecular breast imaging (MBI) and MRI of an entire breast or breasts if a mammogram demonstrates heterogeneous or dense breast tissue or when medically necessary as determined by a physician licensed to practice medicine in all of its branches, advanced practice registered nurse, or physician assistant.

The Department shall not impose a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage provided under this paragraph;

except that this sentence does not apply to coverage of diagnostic mammograms to the extent such coverage would disqualify a high-deductible health plan from eligibility for a health savings account pursuant to Section 223 of the Internal Revenue Code (26 U.S.C.

223).

All screenings shall include a physical breast exam, instruction on self-examination and information regarding the frequency of self-examination and its value as a preventative tool.

For purposes of this Section:

"Diagnostic mammogram" means a mammogram obtained using diagnostic mammography.

"Diagnostic mammography" means a method of screening that SB3365 Enrolled - 11 - LRB104 18483 SSS 31925 b is designed to evaluate an abnormality in a breast, including an abnormality seen or suspected on a screening mammogram or a subjective or objective abnormality otherwise detected in the breast.

"Low-dose mammography" means the x-ray examination of the breast using equipment dedicated specifically for mammography, including the x-ray tube, filter, compression device, and image receptor, with an average radiation exposure delivery of less than one rad per breast for 2 views of an average size breast.

The term also includes digital mammography and includes breast tomosynthesis.

"Breast tomosynthesis" means a radiologic procedure that involves the acquisition of projection images over the stationary breast to produce cross-sectional digital three-dimensional images of the breast.

If, at any time, the Secretary of the United States Department of Health and Human Services, or its successor agency, promulgates rules or regulations to be published in the Federal Register or publishes a comment in the Federal Register or issues an opinion, guidance, or other action that would require the State, pursuant to any provision of the Patient Protection and Affordable Care Act (Public Law 111-148), including, but not limited to, 42 U.S.C.

18031(d)(3)(B) or any successor provision, to defray the cost of any coverage for breast tomosynthesis outlined in this paragraph, then the requirement that an insurer cover breast SB3365 Enrolled - 12 - LRB104 18483 SSS 31925 b tomosynthesis is inoperative other than any such coverage authorized under Section 1902 of the Social Security Act, 42 U.S.C.

1396a, and the State shall not assume any obligation for the cost of coverage for breast tomosynthesis set forth in this paragraph.

On and after January 1, 2016, the Department shall ensure that all networks of care for adult clients of the Department include access to at least one breast imaging Center of Imaging Excellence as certified by the American College of Radiology.

On and after January 1, 2012, providers participating in a quality improvement program approved by the Department shall be reimbursed for screening and diagnostic mammography at the same rate as the Medicare program's rates, including the increased reimbursement for digital mammography and, after January 1, 2023 (the effective date of Public Act 102-1018), breast tomosynthesis.

The Department shall convene an expert panel including representatives of hospitals, free-standing mammography facilities, and doctors, including radiologists, to establish quality standards for mammography.

On and after January 1, 2017, providers participating in a breast cancer treatment quality improvement program approved by the Department shall be reimbursed for breast cancer treatment at a rate that is no lower than 95% of the Medicare program's rates for the data elements included in the breast SB3365 Enrolled - 13 - LRB104 18483 SSS 31925 b cancer treatment quality program.

The Department shall convene an expert panel, including representatives of hospitals, free-standing breast cancer treatment centers, breast cancer quality organizations, and doctors, including radiologists that are trained in all forms of FDA-approved breast imaging technologies, breast surgeons, reconstructive breast surgeons, oncologists, and primary care providers to establish quality standards for breast cancer treatment.

Subject to federal approval, the Department shall establish a rate methodology for mammography at federally qualified health centers and other encounter-rate clinics.

These clinics or centers may also collaborate with other hospital-based mammography facilities.

By January 1, 2016, the Department shall report to the General Assembly on the status of the provision set forth in this paragraph.

The Department shall establish a methodology to remind individuals who are age-appropriate for screening mammography, but who have not received a mammogram within the previous 18 months, of the importance and benefit of screening mammography.

The Department shall work with experts in breast cancer outreach and patient navigation to optimize these reminders and shall establish a methodology for evaluating their effectiveness and modifying the methodology based on the evaluation.

The Department shall establish a performance goal for SB3365 Enrolled - 14 - LRB104 18483 SSS 31925 b primary care providers with respect to their female patients over age 40 receiving an annual mammogram.

This performance goal shall be used to provide additional reimbursement in the form of a quality performance bonus to primary care providers who meet that goal.

The Department shall devise a means of case-managing or patient navigation for beneficiaries diagnosed with breast cancer.

This program shall initially operate as a pilot program in areas of the State with the highest incidence of mortality related to breast cancer.

At least one pilot program site shall be in the metropolitan Chicago area and at least one site shall be outside the metropolitan Chicago area.

On or after July 1, 2016, the pilot program shall be expanded to include one site in western Illinois, one site in southern Illinois, one site in central Illinois, and 4 sites within metropolitan Chicago.

An evaluation of the pilot program shall be carried out measuring health outcomes and cost of care for those served by the pilot program compared to similarly situated patients who are not served by the pilot program.

The Department shall require all networks of care to develop a means either internally or by contract with experts in navigation and community outreach to navigate cancer patients to comprehensive care in a timely fashion.

The Department shall require all networks of care to include access for patients diagnosed with cancer to at least one academic commission on cancer-accredited cancer program as an SB3365 Enrolled - 15 - LRB104 18483 SSS 31925 b in-network covered benefit.

The Department shall provide coverage and reimbursement for a human papillomavirus (HPV) vaccine that is approved for marketing by the federal Food and Drug Administration for all persons between the ages of 9 and 45.

Subject to federal approval, the Department shall provide coverage and reimbursement for a human papillomavirus (HPV) vaccine for persons of the age of 46 and above who have been diagnosed with cervical dysplasia with a high risk of recurrence or progression.

The Department shall disallow any preauthorization requirements for the administration of the human papillomavirus (HPV) vaccine.

On or after July 1, 2022, individuals who are otherwise eligible for medical assistance under this Article shall receive coverage for perinatal depression screenings for the 12-month period beginning on the last day of their pregnancy.

Medical assistance coverage under this paragraph shall be conditioned on the use of a screening instrument approved by the Department.

Any medical or health care provider shall immediately recommend, to any pregnant individual who is being provided prenatal services and is suspected of having a substance use disorder as defined in the Substance Use Disorder Act, referral to a local substance use disorder treatment program licensed by the Department of Human Services or to a licensed hospital which provides substance abuse treatment services.

SB3365 Enrolled - 16 - LRB104 18483 SSS 31925 b The Department of Healthcare and Family Services shall assure coverage for the cost of treatment of the drug abuse or addiction for pregnant recipients in accordance with the Illinois Medicaid Program in conjunction with the Department of Human Services.

All medical providers providing medical assistance to pregnant individuals under this Code shall receive information from the Department on the availability of services under any program providing case management services for addicted individuals, including information on appropriate referrals for other social services that may be needed by addicted individuals in addition to treatment for addiction.

The Illinois Department, in cooperation with the Departments of Human Services (as successor to the Department of Alcoholism and Substance Abuse) and Public Health, through a public awareness campaign, may provide information concerning treatment for alcoholism and drug abuse and addiction, prenatal health care, and other pertinent programs directed at reducing the number of drug-affected infants born to recipients of medical assistance.

Neither the Department of Healthcare and Family Services nor the Department of Human Services shall sanction the recipient solely on the basis of the recipient's substance abuse.

The Illinois Department shall establish such regulations governing the dispensing of health services under this Article SB3365 Enrolled - 17 - LRB104 18483 SSS 31925 b as it shall deem appropriate.

The Department should seek the advice of formal professional advisory committees appointed by the Director of the Illinois Department for the purpose of providing regular advice on policy and administrative matters, information dissemination and educational activities for medical and health care providers, and consistency in procedures to the Illinois Department.

The Illinois Department may develop and contract with Partnerships of medical providers to arrange medical services for persons eligible under Section 5-2 of this Code.

Implementation of this Section may be by demonstration projects in certain geographic areas.

The Partnership shall be represented by a sponsor organization.

The Department, by rule, shall develop qualifications for sponsors of Partnerships.

Nothing in this Section shall be construed to require that the sponsor organization be a medical organization.

The sponsor must negotiate formal written contracts with medical providers for physician services, inpatient and outpatient hospital care, home health services, treatment for alcoholism and substance abuse, and other services determined necessary by the Illinois Department by rule for delivery by Partnerships.

Physician services must include prenatal and obstetrical care.

The Illinois Department shall reimburse medical services delivered by Partnership providers to clients in target areas according to provisions of this Article and SB3365 Enrolled - 18 - LRB104 18483 SSS 31925 b the Illinois Health Finance Reform Act, except that:

(1) Physicians participating in a Partnership and providing certain services, which shall be determined by the Illinois Department, to persons in areas covered by the Partnership may receive an additional surcharge for such services.

(2) The Department may elect to consider and negotiate financial incentives to encourage the development of Partnerships and the efficient delivery of medical care.

(3) Persons receiving medical services through Partnerships may receive medical and case management services above the level usually offered through the medical assistance program.

Medical providers shall be required to meet certain qualifications to participate in Partnerships to ensure the delivery of high quality medical services.

These qualifications shall be determined by rule of the Illinois Department and may be higher than qualifications for participation in the medical assistance program.

Partnership sponsors may prescribe reasonable additional qualifications for participation by medical providers, only with the prior written approval of the Illinois Department.

Nothing in this Section shall limit the free choice of practitioners, hospitals, and other providers of medical services by clients.

In order to ensure patient freedom of choice, the Illinois Department shall immediately promulgate SB3365 Enrolled - 19 - LRB104 18483 SSS 31925 b all rules and take all other necessary actions so that provided services may be accessed from therapeutically certified optometrists to the full extent of the Illinois Optometric Practice Act of 1987 without discriminating between service providers.

The Department shall apply for a waiver from the United States Health Care Financing Administration to allow for the implementation of Partnerships under this Section.

The Illinois Department shall require health care providers to maintain records that document the medical care and services provided to recipients of Medical Assistance under this Article.

Such records must be retained for a period of not less than 6 years from the date of service or as provided by applicable State law, whichever period is longer, except that if an audit is initiated within the required retention period then the records must be retained until the audit is completed and every exception is resolved.

The Illinois Department shall require health care providers to make available, when authorized by the patient, in writing, the medical records in a timely fashion to other health care providers who are treating or serving persons eligible for Medical Assistance under this Article.

All dispensers of medical services shall be required to maintain and retain business and professional records sufficient to fully and accurately document the nature, scope, details and receipt of the health care provided to persons eligible for medical SB3365 Enrolled - 20 - LRB104 18483 SSS 31925 b assistance under this Code, in accordance with regulations promulgated by the Illinois Department.

The rules and regulations shall require that proof of the receipt of prescription drugs, dentures, prosthetic devices and eyeglasses by eligible persons under this Section accompany each claim for reimbursement submitted by the dispenser of such medical services.

No such claims for reimbursement shall be approved for payment by the Illinois Department without such proof of receipt, unless the Illinois Department shall have put into effect and shall be operating a system of post-payment audit and review which shall, on a sampling basis, be deemed adequate by the Illinois Department to assure that such drugs, dentures, prosthetic devices and eyeglasses for which payment is being made are actually being received by eligible recipients.

Within 90 days after September 16, 1984 (the effective date of Public Act 83-1439), the Illinois Department shall establish a current list of acquisition costs for all prosthetic devices and any other items recognized as medical equipment and supplies reimbursable under this Article and shall update such list on a quarterly basis, except that the acquisition costs of all prescription drugs shall be updated no less frequently than every 30 days as required by Section 5-5.12.

Notwithstanding any other law to the contrary, the Illinois Department shall, within 365 days after July 22, 2013 (the effective date of Public Act 98-104), establish SB3365 Enrolled - 21 - LRB104 18483 SSS 31925 b procedures to permit skilled care facilities licensed under the Nursing Home Care Act to submit monthly billing claims for reimbursement purposes.

Following development of these procedures, the Department shall, by July 1, 2016, test the viability of the new system and implement any necessary operational or structural changes to its information technology platforms in order to allow for the direct acceptance and payment of nursing home claims.

Notwithstanding any other law to the contrary, the Illinois Department shall, within 365 days after August 15, 2014 (the effective date of Public Act 98-963), establish procedures to permit ID/DD facilities licensed under the ID/DD Community Care Act and MC/DD facilities licensed under the MC/DD Act to submit monthly billing claims for reimbursement purposes.

Following development of these procedures, the Department shall have an additional 365 days to test the viability of the new system and to ensure that any necessary operational or structural changes to its information technology platforms are implemented.

The Illinois Department shall require all dispensers of medical services, other than an individual practitioner or group of practitioners, desiring to participate in the Medical Assistance program established under this Article to disclose all financial, beneficial, ownership, equity, surety or other interests in any and all firms, corporations, partnerships, associations, business enterprises, joint ventures, agencies, SB3365 Enrolled - 22 - LRB104 18483 SSS 31925 b institutions or other legal entities providing any form of health care services in this State under this Article.

The Illinois Department may require that all dispensers of medical services desiring to participate in the medical assistance program established under this Article disclose, under such terms and conditions as the Illinois Department may by rule establish, all inquiries from clients and attorneys regarding medical bills paid by the Illinois Department, which inquiries could indicate potential existence of claims or liens for the Illinois Department.

Enrollment of a vendor shall be subject to a provisional period and shall be conditional for one year.

During the period of conditional enrollment, the Department may terminate the vendor's eligibility to participate in, or may disenroll the vendor from, the medical assistance program without cause.

Unless otherwise specified, such termination of eligibility or disenrollment is not subject to the Department's hearing process.

However, a disenrolled vendor may reapply without penalty.

The Department has the discretion to limit the conditional enrollment period for vendors based upon the category of risk of the vendor.

Prior to enrollment and during the conditional enrollment period in the medical assistance program, all vendors shall be subject to enhanced oversight, screening, and review based on the risk of fraud, waste, and abuse that is posed by the SB3365 Enrolled - 23 - LRB104 18483 SSS 31925 b category of risk of the vendor.

The Illinois Department shall establish the procedures for oversight, screening, and review, which may include, but need not be limited to:

criminal and financial background checks;

fingerprinting;

license, certification, and authorization verifications;

unscheduled or unannounced site visits;

database checks;

prepayment audit reviews;

audits;

payment caps;

payment suspensions;

and other screening as required by federal or State law.

The Department shall define or specify the following:

(i) by provider notice, the "category of risk of the vendor" for each type of vendor, which shall take into account the level of screening applicable to a particular category of vendor under federal law and regulations;

(ii) by rule or provider notice, the maximum length of the conditional enrollment period for each category of risk of the vendor;

and (iii) by rule, the hearing rights, if any, afforded to a vendor in each category of risk of the vendor that is terminated or disenrolled during the conditional enrollment period.

To be eligible for payment consideration, a vendor's payment claim or bill, either as an initial claim or as a resubmitted claim following prior rejection, must be received by the Illinois Department, or its fiscal intermediary, no later than 180 days after the latest date on the claim on which medical goods or services were provided, with the following exceptions:

(1) In the case of a provider whose enrollment is in SB3365 Enrolled - 24 - LRB104 18483 SSS 31925 b process by the Illinois Department, the 180-day period shall not begin until the date on the written notice from the Illinois Department that the provider enrollment is complete.

(2) In the case of errors attributable to the Illinois Department or any of its claims processing intermediaries which result in an inability to receive, process, or adjudicate a claim, the 180-day period shall not begin until the provider has been notified of the error.

(3) In the case of a provider for whom the Illinois Department initiates the monthly billing process.

(4) In the case of a provider operated by a unit of local government with a population exceeding 3,000,000 when local government funds finance federal participation for claims payments.

For claims for services rendered during a period for which a recipient received retroactive eligibility, claims must be filed within 180 days after the Department determines the applicant is eligible.

For claims for which the Illinois Department is not the primary payer, claims must be submitted to the Illinois Department within 180 days after the final adjudication by the primary payer.

In the case of long term care facilities, within 120 calendar days of receipt by the facility of required prescreening information, new admissions with associated admission documents shall be submitted through the Medical SB3365 Enrolled - 25 - LRB104 18483 SSS 31925 b Electronic Data Interchange (MEDI) or the Recipient Eligibility Verification (REV) System or shall be submitted directly to the Department of Human Services using required admission forms.

Effective September 1, 2014, admission documents, including all prescreening information, must be submitted through MEDI or REV.

Confirmation numbers assigned to an accepted transaction shall be retained by a facility to verify timely submittal.

Once an admission transaction has been completed, all resubmitted claims following prior rejection are subject to receipt no later than 180 days after the admission transaction has been completed.

Claims that are not submitted and received in compliance with the foregoing requirements shall not be eligible for payment under the medical assistance program, and the State shall have no liability for payment of those claims.

To the extent consistent with applicable information and privacy, security, and disclosure laws, State and federal agencies and departments shall provide the Illinois Department access to confidential and other information and data necessary to perform eligibility and payment verifications and other Illinois Department functions.

This includes, but is not limited to:

information pertaining to licensure;

certification;

earnings;

immigration status;

citizenship;

wage reporting;

unearned and earned income;

pension income;

employment;

supplemental security income;

social security numbers;

National Provider Identifier (NPI) numbers;

the SB3365 Enrolled - 26 - LRB104 18483 SSS 31925 b National Practitioner Data Bank (NPDB);

program and agency exclusions;

taxpayer identification numbers;

tax delinquency;

corporate information;

and death records.

The Illinois Department shall enter into agreements with State agencies and departments, and is authorized to enter into agreements with federal agencies and departments, under which such agencies and departments shall share data necessary for medical assistance program integrity functions and oversight.

The Illinois Department shall develop, in cooperation with other State departments and agencies, and in compliance with applicable federal laws and regulations, appropriate and effective methods to share such data.

At a minimum, and to the extent necessary to provide data sharing, the Illinois Department shall enter into agreements with State agencies and departments, and is authorized to enter into agreements with federal agencies and departments, including, but not limited to:

the Secretary of State;

the Department of Revenue;

the Department of Public Health;

the Department of Human Services;

and the Department of Financial and Professional Regulation.

Beginning in fiscal year 2013, the Illinois Department shall set forth a request for information to identify the benefits of a pre-payment, post-adjudication, and post-edit claims system with the goals of streamlining claims processing and provider reimbursement, reducing the number of pending or rejected claims, and helping to ensure a more transparent SB3365 Enrolled - 27 - LRB104 18483 SSS 31925 b adjudication process through the utilization of:

(i) provider data verification and provider screening technology;

and (ii) clinical code editing;

and (iii) pre-pay, pre-adjudicated, or post-adjudicated predictive modeling with an integrated case management system with link analysis.

Such a request for information shall not be considered as a request for proposal or as an obligation on the part of the Illinois Department to take any action or acquire any products or services.

The Illinois Department shall establish policies, procedures, standards and criteria by rule for the acquisition, repair and replacement of orthotic and prosthetic devices and durable medical equipment.

Such rules shall provide, but not be limited to, the following services:

(1) immediate repair or replacement of such devices by recipients;

and (2) rental, lease, purchase or lease-purchase of durable medical equipment in a cost-effective manner, taking into consideration the recipient's medical prognosis, the extent of the recipient's needs, and the requirements and costs for maintaining such equipment.

Subject to prior approval, such rules shall enable a recipient to temporarily acquire and use alternative or substitute devices or equipment pending repairs or replacements of any device or equipment previously authorized for such recipient by the Department.

Notwithstanding any provision of Section 5-5f to the contrary, the Department may, by rule, exempt certain replacement wheelchair parts from prior approval and, for wheelchairs, SB3365 Enrolled - 28 - LRB104 18483 SSS 31925 b wheelchair parts, wheelchair accessories, and related seating and positioning items, determine the wholesale price by methods other than actual acquisition costs.

The Department shall require, by rule, all providers of durable medical equipment to be accredited by an accreditation organization approved by the federal Centers for Medicare and Medicaid Services and recognized by the Department in order to bill the Department for providing durable medical equipment to recipients.

No later than 15 months after the effective date of the rule adopted pursuant to this paragraph, all providers must meet the accreditation requirement.

In order to promote environmental responsibility, meet the needs of recipients and enrollees, and achieve significant cost savings, the Department, or a managed care organization under contract with the Department, may provide recipients or managed care enrollees who have a prescription or Certificate of Medical Necessity access to refurbished durable medical equipment under this Section (excluding prosthetic and orthotic devices as defined in the Orthotics, Prosthetics, and Pedorthics Practice Act and complex rehabilitation technology products and associated services) through the State's assistive technology program's reutilization program, using staff with the Assistive Technology Professional (ATP) Certification if the refurbished durable medical equipment:

(i) is available;

(ii) is less expensive, including shipping costs, than new durable medical equipment of the same type;

SB3365 Enrolled - 29 - LRB104 18483 SSS 31925 b (iii) is able to withstand at least 3 years of use;

(iv) is cleaned, disinfected, sterilized, and safe in accordance with federal Food and Drug Administration regulations and guidance governing the reprocessing of medical devices in health care settings;

and (v) equally meets the needs of the recipient or enrollee.

The reutilization program shall confirm that the recipient or enrollee is not already in receipt of the same or similar equipment from another service provider, and that the refurbished durable medical equipment equally meets the needs of the recipient or enrollee.

Nothing in this paragraph shall be construed to limit recipient or enrollee choice to obtain new durable medical equipment or place any additional prior authorization conditions on enrollees of managed care organizations.

The Department shall execute, relative to the nursing home prescreening project, written inter-agency agreements with the Department of Human Services and the Department on Aging, to effect the following:

(i) intake procedures and common eligibility criteria for those persons who are receiving non-institutional services;

and (ii) the establishment and development of non-institutional services in areas of the State where they are not currently available or are undeveloped;

and (iii) notwithstanding any other provision of law, subject to federal approval, on and after July 1, 2012, an increase in the determination of need (DON) scores from 29 to 37 for applicants for institutional and home and SB3365 Enrolled - 30 - LRB104 18483 SSS 31925 b community-based long term care;

if and only if federal approval is not granted, the Department may, in conjunction with other affected agencies, implement utilization controls or changes in benefit packages to effectuate a similar savings amount for this population;

and (iv) no later than July 1, 2013, minimum level of care eligibility criteria for institutional and home and community-based long term care;

and (v) no later than October 1, 2013, establish procedures to permit long term care providers access to eligibility scores for individuals with an admission date who are seeking or receiving services from the long term care provider.

In order to select the minimum level of care eligibility criteria, the Governor shall establish a workgroup that includes affected agency representatives and stakeholders representing the institutional and home and community-based long term care interests.

This Section shall not restrict the Department from implementing lower level of care eligibility criteria for community-based services in circumstances where federal approval has been granted.

The Illinois Department shall develop and operate, in cooperation with other State Departments and agencies and in compliance with applicable federal laws and regulations, appropriate and effective systems of health care evaluation and programs for monitoring of utilization of health care services and facilities, as it affects persons eligible for medical assistance under this Code.

SB3365 Enrolled - 31 - LRB104 18483 SSS 31925 b The Illinois Department shall report annually to the General Assembly, no later than the second Friday in April of 1979 and each year thereafter, in regard to:

(a) actual statistics and trends in utilization of medical services by public aid recipients;

(b) actual statistics and trends in the provision of the various medical services by medical vendors;

(c) current rate structures and proposed changes in those rate structures for the various medical vendors;

and (d) efforts at utilization review and control by the Illinois Department.

The period covered by each report shall be the 3 years ending on the June 30 prior to the report.

The report shall include suggested legislation for consideration by the General Assembly.

The requirement for reporting to the General Assembly shall be satisfied by filing copies of the report as required by Section 3.1 of the General Assembly Organization Act, and filing such additional copies with the State Government Report Distribution Center for the General Assembly as is required under paragraph (t) of Section 7 of the State Library Act.

Rulemaking authority to implement Public Act 95-1045, if any, is conditioned on the rules being adopted in accordance with all provisions of the Illinois Administrative Procedure Act and all rules and procedures of the Joint Committee on Administrative Rules;

any purported rule not so adopted, for SB3365 Enrolled - 32 - LRB104 18483 SSS 31925 b whatever reason, is unauthorized.

On and after July 1, 2012, the Department shall reduce any rate of reimbursement for services or other payments or alter any methodologies authorized by this Code to reduce any rate of reimbursement for services or other payments in accordance with Section 5-5e.

Because kidney transplantation can be an appropriate, cost-effective alternative to renal dialysis when medically necessary and notwithstanding the provisions of Section 1-11 of this Code, beginning October 1, 2014, the Department shall cover kidney transplantation for noncitizens with end-stage renal disease who are not eligible for comprehensive medical benefits, who meet the residency requirements of Section 5-3 of this Code, and who would otherwise meet the financial requirements of the appropriate class of eligible persons under Section 5-2 of this Code.

To qualify for coverage of kidney transplantation, such person must be receiving emergency renal dialysis services covered by the Department.

Providers under this Section shall be prior approved and certified by the Department to perform kidney transplantation and the services under this Section shall be limited to services associated with kidney transplantation.

Notwithstanding any other provision of this Code to the contrary, on or after July 1, 2015, all FDA-approved forms of medication assisted treatment prescribed for the treatment of alcohol dependence or treatment of opioid dependence shall be SB3365 Enrolled - 33 - LRB104 18483 SSS 31925 b covered under both fee-for-service and managed care medical assistance programs for persons who are otherwise eligible for medical assistance under this Article and shall not be subject to any (1) utilization control, other than those established under the American Society of Addiction Medicine patient placement criteria, (2) prior authorization mandate, (3) lifetime restriction limit mandate, or (4) limitations on dosage.

On or after July 1, 2015, opioid antagonists prescribed for the treatment of an opioid overdose, including the medication product, administration devices, and any pharmacy fees or hospital fees related to the dispensing, distribution, and administration of the opioid antagonist, shall be covered under the medical assistance program for persons who are otherwise eligible for medical assistance under this Article.

As used in this Section, "opioid antagonist" means a drug that binds to opioid receptors and blocks or inhibits the effect of opioids acting on those receptors, including, but not limited to, naloxone hydrochloride or any other similarly acting drug approved by the U.S.

Food and Drug Administration.

The Department shall not impose a copayment on the coverage provided for naloxone hydrochloride under the medical assistance program.

Upon federal approval, the Department shall provide coverage and reimbursement for all drugs that are approved for marketing by the federal Food and Drug Administration and that SB3365 Enrolled - 34 - LRB104 18483 SSS 31925 b are recommended by the federal Public Health Service or the United States Centers for Disease Control and Prevention for pre-exposure prophylaxis and related pre-exposure prophylaxis services, including, but not limited to, HIV and sexually transmitted infection screening, treatment for sexually transmitted infections, medical monitoring, assorted labs, and counseling to reduce the likelihood of HIV infection among individuals who are not infected with HIV but who are at high risk of HIV infection.

A federally qualified health center, as defined in Section 1905(l)(2)(B) of the federal Social Security Act, shall be reimbursed by the Department in accordance with the federally qualified health center's encounter rate for services provided to medical assistance recipients that are performed by a dental hygienist, as defined under the Illinois Dental Practice Act, working under the general supervision of a dentist and employed by a federally qualified health center.

Within 90 days after October 8, 2021 (the effective date of Public Act 102-665), the Department shall seek federal approval of a State Plan amendment to expand coverage for family planning services that includes presumptive eligibility to individuals whose income is at or below 208% of the federal poverty level.

Coverage under this Section shall be effective beginning no later than December 1, 2022.

Subject to approval by the federal Centers for Medicare and Medicaid Services of a Title XIX State Plan amendment SB3365 Enrolled - 35 - LRB104 18483 SSS 31925 b electing the Program of All-Inclusive Care for the Elderly (PACE) as a State Medicaid option, as provided for by Subtitle I (commencing with Section 4801) of Title IV of the Balanced Budget Act of 1997 (Public Law 105-33) and Part 460 (commencing with Section 460.2) of Subchapter E of Title 42 of the Code of Federal Regulations, PACE program services shall become a covered benefit of the medical assistance program, subject to criteria established in accordance with all applicable laws.

Notwithstanding any other provision of this Code, community-based pediatric palliative care from a trained interdisciplinary team shall be covered under the medical assistance program as provided in Section 15 of the Pediatric Palliative Care Act.

Notwithstanding any other provision of this Code, within 12 months after June 2, 2022 (the effective date of Public Act 102-1037) and subject to federal approval, acupuncture services performed by an acupuncturist licensed under the Acupuncture Practice Act who is acting within the scope of his or her license shall be covered under the medical assistance program.

The Department shall apply for any federal waiver or State Plan amendment, if required, to implement this paragraph.

The Department may adopt any rules, including standards and criteria, necessary to implement this paragraph.

Notwithstanding any other provision of this Code, the medical assistance program shall, subject to federal approval, SB3365 Enrolled - 36 - LRB104 18483 SSS 31925 b reimburse hospitals for costs associated with a newborn screening test for the presence of metachromatic leukodystrophy, as required under the Newborn Metabolic Screening Act, at a rate not less than the fee charged by the Department of Public Health.

Notwithstanding any other provision of this Code, the medical assistance program shall, subject to appropriation and federal approval, also reimburse hospitals for costs associated with all newborn screening tests added on and after August 9, 2024 (the effective date of Public Act 103-909) to the Newborn Metabolic Screening Act and required to be performed under that Act at a rate not less than the fee charged by the Department of Public Health.

The Department shall seek federal approval before the implementation of the newborn screening test fees by the Department of Public Health.

Notwithstanding any other provision of this Code, beginning on January 1, 2024, subject to federal approval, cognitive assessment and care planning services provided to a person who experiences signs or symptoms of cognitive impairment, as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, shall be covered under the medical assistance program for persons who are otherwise eligible for medical assistance under this Article.

Notwithstanding any other provision of this Code, medically necessary reconstructive services that are intended to restore physical appearance shall be covered under the SB3365 Enrolled - 37 - LRB104 18483 SSS 31925 b medical assistance program for persons who are otherwise eligible for medical assistance under this Article.

As used in this paragraph, "reconstructive services" means treatments performed on structures of the body damaged by trauma to restore physical appearance.

Subject to federal approval, for dates of services on and after January 1, 2026, over-the-counter choline dietary supplements for pregnant persons shall be covered under the medical assistance program.

(Source:

P.A.

103-102, Article 15, Section 15-5, eff.

1-1-24;

103-102, Article 95, Section 95-15, eff.

1-1-24;

103-123, eff.

1-1-24;

103-154, eff.

6-30-23;

103-368, eff.

1-1-24;

103-593, Article 5, Section 5-5, eff.

6-7-24;

103-593, Article 90, Section 90-5, eff.

6-7-24;

103-605, eff.

7-1-24;

103-808, eff.

1-1-26;

103-909, eff.

8-9-24;

103-1040, eff.

8-9-24;

104-9, eff.

6-16-25;

104-417, eff.

8-15-25.) ARTICLE 6.

Section 6-5.

The Illinois Public Aid Code is amended by adding Article V-J as follows:

(305 ILCS 5/Art.

V-J heading new) ARTICLE V-J.

DISTRESSED HOSPITAL LOAN PROGRAM (305 ILCS 5/5J-1 new) SB3365 Enrolled - 38 - LRB104 18483 SSS 31925 b Sec.

5J-1.

References to Article.

This Article may be referred to as the Distressed Hospital Loan Program Law.

(305 ILCS 5/5J-5 new) Sec.

5J-5.

Distressed Hospital Loan Program.

The Distressed Hospital Loan Program is created.

The purpose of the Program is to provide, subject to appropriation and the availability of funds, interest-free cash flow loans to public, not-for-profit, and for-profit hospitals in significant financial distress to prevent the closure of or to facilitate the reopening of those hospitals.

(305 ILCS 5/5J-10 new) Sec.

5J-10.

Definitions.

As used in this Article:

"Closed hospital" means a hospital that closed after January 1, 2019.

"Department" means the Department of Healthcare and Family Services.

"Program" means the Distressed Hospital Loan Program.

"Public hospital" means a hospital that is licensed by the Hospital Licensing Act and is either owned or operated by a governmental body in Illinois, excluding a State agency, a State university, or a county with a population of 3,000,000 or more.

(305 ILCS 5/5J-15 new) SB3365 Enrolled - 39 - LRB104 18483 SSS 31925 b Sec.

5J-15.

Administration.

The Department shall administer the Distressed Hospital Loan Program in coordination with the Department of Public Health and the Governor's Office of Management and Budget.

The Department shall adopt rules to implement this Program.

(305 ILCS 5/5J-18 new) Sec.

5J-18.

Application requirements.

A hospital applying for aid under this Program shall provide the Department with financial information, in a format determined by the Department, demonstrating the hospital's need for bridge financing due to financial hardship.

(1) Before receiving bridge financing under this Program, an eligible hospital shall submit a plan to the Department, with projections detailing the uses of the proposed loan and a structured plan proposed by the hospital's governing body to regain financial viability and continue operations.

(2) Before issuing a loan under this Program, the Department shall review the plan submitted by an eligible hospital and make a determination both that the plan is viable and that there is a reasonable likelihood that the hospital will be able to regain financial viability, continue to operate as a hospital, and be able to repay the loan.

The Department shall not issue a loan award if the Department is unable to make these determinations.

SB3365 Enrolled - 40 - LRB104 18483 SSS 31925 b (3) All funds loaned in accordance with this Article shall be used as described in the application approved by the Department, which shall be incorporated into any resulting loan agreement.

Any misused funds shall be recouped by the Department subject to the recoupment methods under Section 5J-25.

In addition to any other remedies provided for by law and without sending a notice of liability, the Department may withhold, as payment of any amounts due and owing as repayment of loans issued in accordance with this Article, reimbursements or other amounts otherwise payable by the Department to the loan recipient, including, but not limited to, amounts otherwise payable from a managed care organization performing duties under contract with the Department.

(305 ILCS 5/5J-20 new) Sec.

5J-20.

Application evaluation.

(a) In collaboration with the Governor's Office of Management and Budget and the Department of Public Health, the Department shall develop a methodology to evaluate a hospital's application for a loan through the Program.

(b) The methodology shall consider factors including, but not limited to, whether the hospital is in financial distress as solely determined by the State;

whether the hospital is small, rural, a safety-net hospital, a critical access hospital, a trauma center, an urban hospital providing access SB3365 Enrolled - 41 - LRB104 18483 SSS 31925 b for an underserved area, a hospital that serves a disproportionate share of Medicaid patients, or serving a rural catchment area;

and whether closure of the hospital or service line reduction as a result of the financial distress would significantly impact access to services in the hospital's health service area.

(c) The methodology for determining financial distress may consider such factors as the hospital's prior and projected performance on financial metrics, including the amount of cash on hand, and whether the hospital has experienced, or is projected to experience, negative operating margins.

(d) Subject to appropriation and the availability of funds, any loan to a hospital with an approved loan application shall be issued as soon as reasonably practicable following approval of an application.

Approved applications shall receive funding on a first-come, first-served basis until funding appropriated by the General Assembly for this purpose has been expended.

The Department maintains discretion to determine the amount of a loan approved for a hospital and may approve less than the amount requested by a hospital.

The Department may consider the amount of appropriations available to this Program in the exercise of its discretion.

(e) Hospitals ineligible for State assistance under the Program include:

(1) Hospitals that belong to integrated health care systems with more than 3 separately licensed hospital SB3365 Enrolled - 42 - LRB104 18483 SSS 31925 b facilities.

(2) A hospital that maintains unpaid hospital assessment liability owed to the State and either does not have a negotiated tax repayment agreement with the State or is delinquent under an existing negotiated assessment repayment agreement.

(3) A hospital that is not current on a repayment schedule for a prior advance issued in accordance with 89 Ill.

Adm.

Code 140.71.

(4) A hospital that has not provided required reporting on its finances as mandated by State law or administrative rule.

(5) A hospital that is subject to a stop payment order, as defined by the Grant Accountability and Transparency Act, with the State for any reason.

(6) A hospital that has been under investigation or been issued an immediate jeopardy by the Centers for Medicare and Medicaid Services in the prior 12 months from the time of loan application.

(f) The Department shall give preference to not-for-profit and public hospitals.

Hospitals owned and operated by a for-profit entity shall be subject to a maximum funding limit, expedited repayment time frames, and additional financial and operational transparency requirements as defined in rule.

(g) The Department shall determine the application process, underwriting review, and methodology for approval and SB3365 Enrolled - 43 - LRB104 18483 SSS 31925 b distribution of the loans under the Program.

(h) The Department shall have the authority to determine service provision requirements in approving, and for the duration of, loans to eligible hospitals.

In making its determination, the Department shall consider the impact of any changes to the hospital's service delivery or access to necessary medical care, particularly for beneficiaries of the State's medical assistance Program.

(i) The application process shall allow for at least 30 days for the Department to issue an initial response to any loan application.

(305 ILCS 5/5J-25 new) Sec.

5J-25.

Repayment agreement.

(a) A hospital shall be required to enter into a repayment agreement with the Department to execute the approved loan.

Terms must include, but are not limited to, monthly repayments of the loan beginning no later than 18 months after receipt of the loan and discharge of the loan within 36 months of the date of the loan.

(b) Notwithstanding any other law and to the extent permissible under federal rules, security for the cash flow loans in this Article shall, at a minimum, include reimbursements due to the hospital from the Department, including, but not limited to, any reimbursements under this Code.

The repayment agreement may provide for additional SB3365 Enrolled - 44 - LRB104 18483 SSS 31925 b security for any cash flow loans under this Article.

(c) If the hospital provider fails to comply with the repayment terms of the agreement, the remaining balance of the loan shall be immediately recouped from reimbursements or other amounts otherwise payable by the Department to the loan recipient, including, but not limited to, amounts otherwise payable from a managed care organization performing duties under contract with the Department.

The Department may also recoup amounts otherwise payable by any State agency to the provider, including, but not limited to, State grants and grant appropriations, and apply such amounts as repayment of the unpaid advance.

If such reimbursements or other amounts otherwise payable to the loan recipient are insufficient for complete recovery, the remaining balance shall become immediately due and payable by check to the Department of Healthcare and Family Services.

Failure by the provider to remit such check shall result in the Department pursuing other collection methods.

(d) Any unpaid loan under this Article shall become a lien upon the assets of the hospital that received the loan.

If any hospital provider, outside the usual course of its business, sells or transfers the major part of any one or more of (A) the real property and improvements, (B) the machinery and equipment, or (C) the furniture or fixtures, of any hospital that is subject to the provisions of this Article, the seller or transferor shall pay the Department the amount of any loan, SB3365 Enrolled - 45 - LRB104 18483 SSS 31925 b penalty, and interest (if any) due from it under this Article up to the date of the sale or transfer.

The Department may, in its discretion, foreclose on such a lien, but shall do so in a manner that is consistent with Section 5e of the Retailers' Occupation Tax Act.

If the seller or transferor fails to pay any loan, penalty, and interest (if any) due, the purchaser or transferee of such asset shall be liable for the amount of the loan, penalties, and interest (if any) up to the amount of the reasonable value of the property acquired by the purchaser or transferee.

The purchaser or transferee shall continue to be liable until the purchaser or transferee pays the full amount of the loan, penalties, and interest (if any) up to the amount of the reasonable value of the property acquired by the purchaser or transferee or until the purchaser or transferee receives from the Department a certificate showing that such loan, penalty, and interest have been paid or a certificate from the Department showing that no loan, penalty, or interest is due from the seller or transferor under this Article.

(e) If a hospital provider fails to pay any monthly installment repayments, there shall, unless waived by the Department for reasonable cause, be added to the loan repayment obligation a penalty equal to the lesser of (i) 5% of the amount of the installment not paid on or before the due date plus 5% of the portion thereof remaining unpaid on the last day of each 30-day period thereafter or (ii) 100% of the installment amount not paid on or before the due date.

SB3365 Enrolled - 46 - LRB104 18483 SSS 31925 b (305 ILCS 5/5J-30 new) Sec.

5J-30.

Distressed Hospital Loan Program Fund.

(a) The Distressed Hospital Loan Program Fund is created as a special fund in the State treasury.

(b) Subject to appropriation, the Department may make secured and unsecured loans from amounts in the Distressed Hospital Loan Program Fund to a hospital, or a governmental entity representing a closed hospital, for purposes of preventing the hospital's closure in accordance with the provisions of this Article.

(c) On January 1, 2027, or as soon thereafter as practical, the State Comptroller shall direct and the State Treasurer shall transfer, at the direction of the Director of the Department, an amount not to exceed $85,000,000 from the Healthcare Provider Relief Fund to the Distressed Hospital Loan Program Fund.

(d) All moneys accruing to the Department under this Article from any source, including, but not limited to, all amounts repaid under the terms of any loan agreements, shall be deposited into the Fund.

(e) On June 30, 2033, or as soon thereafter as practical, the State Comptroller shall direct and the State Treasurer shall transfer the remaining balance in the Distressed Hospital Loan Program Fund to the Healthcare Provider Relief Fund.

Upon completion of the transfers, the Distressed SB3365 Enrolled - 47 - LRB104 18483 SSS 31925 b Hospital Loan Program Fund is dissolved and any outstanding obligations or liabilities of the Fund pass to the Healthcare Provider Relief Fund.

The Department shall deposit all subsequent loan repayments or medical assistance program or other reimbursements withheld for due cause in accordance with this Article into the Healthcare Provider Relief Fund.

(f) The Department may require any hospital receiving a loan under this Article to provide the Department with an independent financial audit of the hospital's operations for any fiscal year in which a loan is outstanding.

(305 ILCS 5/5J-35 new) Sec.

5J-35.

Implementation.

The Program described in this Article shall be operative on and after January 1, 2027 and shall be implemented upon administrative rules being in effect.

(305 ILCS 5/5J-40 new) Sec.

5J-40.

Repealer.

This Article is repealed on June 30, 2033.

Section 6-70.

The State Finance Act is amended by adding Section 5.1038 as follows:

(30 ILCS 105/5.1038 new) Sec.

5.1038.

The Distressed Hospital Loan Program Fund.

SB3365 Enrolled - 48 - LRB104 18483 SSS 31925 b This Section is repealed June 30, 2033.

Section 6-72.

The Illinois Administrative Procedure Act is amended by adding Section 5-45.71 as follows:

(5 ILCS 100/5-45.71 new) Sec.

5-45.71.

Emergency rulemaking;

Health Facilities and Services Review Board.

To provide for the expeditious and timely implementation of the changes made by this amendatory Act of the 104th General Assembly to Section 13 of the Illinois Health Facilities Planning Act, emergency rules may be adopted in accordance with Section 5-45 by the Health Facilities and Services Review Board.

The adoption of emergency rules authorized by Section 5-45 and this Section is deemed to be necessary for the public interest, safety, and welfare.

This Section is repealed one year after the effective date of this amendatory Act of the 104th General Assembly.

Section 6-73.

The Freedom of Information Act is amended by changing Section 7.5 as follows:

(5 ILCS 140/7.5) (Text of Section before amendment by P.A.

104-441 and 104-457) Sec.

7.5.

Statutory exemptions.

To the extent provided for by the statutes referenced below, the following shall be SB3365 Enrolled - 49 - LRB104 18483 SSS 31925 b exempt from inspection and copying:

(a) All information determined to be confidential under Section 4002 of the Technology Advancement and Development Act.

(b) Library circulation and order records identifying library users with specific materials under the Library Records Confidentiality Act.

(c) Applications, related documents, and medical records received by the Experimental Organ Transplantation Procedures Board and any and all documents or other records prepared by the Experimental Organ Transplantation Procedures Board or its staff relating to applications it has received.

(d) Information and records held by the Department of Public Health and its authorized representatives relating to known or suspected cases of sexually transmitted infection or any information the disclosure of which is restricted under the Illinois Sexually Transmitted Infection Control Act.

(e) Information the disclosure of which is exempted under Section 30 of the Radon Industry Licensing Act.

(f) Firm performance evaluations under Section 55 of the Architectural, Engineering, and Land Surveying Qualifications Based Selection Act.

(g) Information the disclosure of which is restricted and exempted under Section 50 of the Illinois Prepaid SB3365 Enrolled - 50 - LRB104 18483 SSS 31925 b Tuition Act.

(h) Information the disclosure of which is exempted under the State Officials and Employees Ethics Act, and records of any lawfully created State or local inspector general's office that would be exempt if created or obtained by an Executive Inspector General's office under that Act.

(i) Information contained in a local emergency energy plan submitted to a municipality in accordance with a local emergency energy plan ordinance that is adopted under Section 11-21.5-5 of the Illinois Municipal Code.

(j) Information and data concerning the distribution of surcharge moneys collected and remitted by carriers under the Emergency Telephone System Act.

(k) Law enforcement officer identification information or driver identification information compiled by a law enforcement agency or the Department of Transportation under Section 11-212 of the Illinois Vehicle Code.

(l) Records and information provided to a residential health care facility resident sexual assault and death review team or the Executive Council under the Abuse Prevention Review Team Act.

(m) Information provided to the predatory lending database created pursuant to Article 3 of the Residential Real Property Disclosure Act, except to the extent authorized under that Article.

SB3365 Enrolled - 51 - LRB104 18483 SSS 31925 b (n) Defense budgets and petitions for certification of compensation and expenses for court appointed trial counsel as provided under Sections 10 and 15 of the Capital Crimes Litigation Act (repealed).

This subsection (n) shall apply until the conclusion of the trial of the case, even if the prosecution chooses not to pursue the death penalty prior to trial or sentencing.

(o) Information that is prohibited from being disclosed under Section 4 of the Illinois Health and Hazardous Substances Registry Act.

(p) Security portions of system safety program plans, investigation reports, surveys, schedules, lists, data, or information compiled, collected, or prepared by or for the Department of Transportation under Sections 2705-300 and 2705-616 of the Department of Transportation Law of the Civil Administrative Code of Illinois, the Regional Transportation Authority under Section 2.11 of the Regional Transportation Authority Act, or the St.

Clair County Transit District under the Bi-State Transit Safety Act (repealed).

(q) Information prohibited from being disclosed by the Personnel Record Review Act.

(r) Information prohibited from being disclosed by the Illinois School Student Records Act.

(s) Information the disclosure of which is restricted under Section 5-108 of the Public Utilities Act.

SB3365 Enrolled - 52 - LRB104 18483 SSS 31925 b (t) (Blank).

(u) Records and information provided to an independent team of experts under the Developmental Disability and Mental Health Safety Act (also known as Brian's Law).

(v) Names and information of people who have applied for or received Firearm Owner's Identification Cards under the Firearm Owners Identification Card Act or applied for or received a concealed carry license under the Firearm Concealed Carry Act, unless otherwise authorized by the Firearm Concealed Carry Act;

and databases under the Firearm Concealed Carry Act, records of the Concealed Carry Licensing Review Board under the Firearm Concealed Carry Act, and law enforcement agency objections under the Firearm Concealed Carry Act.

(v-5) Records of the Firearm Owner's Identification Card Review Board that are exempted from disclosure under Section 10 of the Firearm Owners Identification Card Act.

(w) Personally identifiable information which is exempted from disclosure under subsection (g) of Section 19.1 of the Toll Highway Act.

(x) Information which is exempted from disclosure under Section 5-1014.3 of the Counties Code or Section 8-11-21 of the Illinois Municipal Code.

(y) Confidential information under the Adult Protective Services Act and its predecessor enabling statute, the Elder Abuse and Neglect Act, including SB3365 Enrolled - 53 - LRB104 18483 SSS 31925 b information about the identity and administrative finding against any caregiver of a verified and substantiated decision of abuse, neglect, or financial exploitation of an eligible adult maintained in the Registry established under Section 7.5 of the Adult Protective Services Act.

(z) Records and information provided to a fatality review team or the Illinois Fatality Review Team Advisory Council under Section 15 of the Adult Protective Services Act.

(aa) Information which is exempted from disclosure under Section 2.37 of the Wildlife Code.

(bb) Information which is or was prohibited from disclosure by the Juvenile Court Act of 1987.

(cc) Recordings made under the Law Enforcement Officer-Worn Body Camera Act, except to the extent authorized under that Act.

(dd) Information that is prohibited from being disclosed under Section 45 of the Condominium and Common Interest Community Ombudsperson Act.

(ee) Information that is exempted from disclosure under Section 30.1 of the Pharmacy Practice Act.

(ff) Information that is exempted from disclosure under the Revised Uniform Unclaimed Property Act.

(gg) Information that is prohibited from being disclosed under Section 7-603.5 of the Illinois Vehicle Code.

SB3365 Enrolled - 54 - LRB104 18483 SSS 31925 b (hh) Records that are exempt from disclosure under Section 1A-16.7 of the Election Code.

(ii) Information which is exempted from disclosure under Section 2505-800 of the Department of Revenue Law of the Civil Administrative Code of Illinois.

(jj) Information and reports that are required to be submitted to the Department of Labor by registering day and temporary labor service agencies but are exempt from disclosure under subsection (a-1) of Section 45 of the Day and Temporary Labor Services Act.

(kk) Information prohibited from disclosure under the Seizure and Forfeiture Reporting Act.

(ll) Information the disclosure of which is restricted and exempted under Section 5-30.8 of the Illinois Public Aid Code.

(mm) Records that are exempt from disclosure under Section 4.2 of the Crime Victims Compensation Act.

(nn) Information that is exempt from disclosure under Section 70 of the Higher Education Student Assistance Act.

(oo) Communications, notes, records, and reports arising out of a peer support counseling session prohibited from disclosure under the First Responders Suicide Prevention Act.

(pp) Names and all identifying information relating to an employee of an emergency services provider or law enforcement agency under the First Responders Suicide SB3365 Enrolled - 55 - LRB104 18483 SSS 31925 b Prevention Act.

(qq) Information and records held by the Department of Public Health and its authorized representatives collected under the Reproductive Health Act.

(rr) Information that is exempt from disclosure under the Cannabis Regulation and Tax Act.

(ss) Data reported by an employer to the Department of Human Rights pursuant to Section 2-108 of the Illinois Human Rights Act.

(tt) Recordings made under the Children's Advocacy Center Act, except to the extent authorized under that Act.

(uu) Information that is exempt from disclosure under Section 50 of the Sexual Assault Evidence Submission Act.

(vv) Information that is exempt from disclosure under subsections (f) and (j) of Section 5-36 of the Illinois Public Aid Code.

(ww) Information that is exempt from disclosure under Section 16.8 of the State Treasurer Act.

(xx) Information that is exempt from disclosure or information that shall not be made public under the Illinois Insurance Code.

(yy) Information prohibited from being disclosed under the Illinois Educational Labor Relations Act.

(zz) Information prohibited from being disclosed under the Illinois Public Labor Relations Act.

SB3365 Enrolled - 56 - LRB104 18483 SSS 31925 b (aaa) Information prohibited from being disclosed under Section 1-167 of the Illinois Pension Code.

(bbb) Information that is prohibited from disclosure by the Illinois Police Training Act and the Illinois State Police Act.

(ccc) Records exempt from disclosure under Section 2605-304 of the Illinois State Police Law of the Civil Administrative Code of Illinois.

(ddd) Information prohibited from being disclosed under Section 35 of the Address Confidentiality for Victims of Domestic Violence, Sexual Assault, Human Trafficking, or Stalking Act.

(eee) Information prohibited from being disclosed under subsection (b) of Section 75 of the Domestic Violence Fatality Review Act.

(fff) Images from cameras under the Expressway Camera Act and all automated license plate reader (ALPR) information used and collected by the Illinois State Police.

"ALPR information" means information gathered by an ALPR or created from the analysis of data generated by an ALPR.

This subsection (fff) is inoperative on and after July 1, 2028.

(ggg) Information prohibited from disclosure under paragraph (3) of subsection (a) of Section 14 of the Nurse Agency Licensing Act.

(hhh) Information submitted to the Illinois State SB3365 Enrolled - 57 - LRB104 18483 SSS 31925 b Police in an affidavit or application for an assault weapon endorsement, assault weapon attachment endorsement, .50 caliber rifle endorsement, or .50 caliber cartridge endorsement under the Firearm Owners Identification Card Act.

(iii) Data exempt from disclosure under Section 50 of the School Safety Drill Act.

(jjj) Information exempt from disclosure under Section 30 of the Insurance Data Security Law.

(kkk) Confidential business information prohibited from disclosure under Section 45 of the Paint Stewardship Act.

(lll) Data exempt from disclosure under Section 2-3.196 of the School Code.

(mmm) Information prohibited from being disclosed under subsection (e) of Section 1-129 of the Illinois Power Agency Act.

(nnn) Materials received by the Department of Commerce and Economic Opportunity that are confidential under the Music and Musicians Tax Credit and Jobs Act.

(ooo) Data or information provided pursuant to Section 20 of the Statewide Recycling Needs and Assessment Act.

(ppp) Information that is exempt from disclosure under Section 28-11 of the Lawful Health Care Activity Act.

(qqq) Information that is exempt from disclosure under Section 7-101 of the Illinois Human Rights Act.

SB3365 Enrolled - 58 - LRB104 18483 SSS 31925 b (rrr) Information prohibited from being disclosed under Section 4-2 of the Uniform Money Transmission Modernization Act.