99TH GENERAL ASSEMBLY
State of Illinois
2015 and 2016
HB4364

 

Introduced , by Rep. Robyn Gabel

 

SYNOPSIS AS INTRODUCED:
 
New Act
5 ILCS 80/4.37 new
225 ILCS 60/4  from Ch. 111, par. 4400-4
225 ILCS 65/50-15  was 225 ILCS 65/5-15
305 ILCS 5/5-5  from Ch. 23, par. 5-5

    Creates the Home Birth Safety Act. Provides for the licensure of midwives by the Department of Financial and Professional Regulation and for certain limitations on the activities of licensed midwives. Creates the Illinois Midwifery Board. Sets forth provisions concerning qualifications, grounds for disciplinary action, and administrative procedures. Amends the Regulatory Sunset Act to set a repeal date for the new Act of January 1, 2027. Amends the Medical Practice Act of 1987, the Nurse Practice Act, and the Illinois Public Aid Code to make related changes. Effective July 1, 2016.


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CORRECTIONAL BUDGET AND IMPACT NOTE ACT MAY APPLY
FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

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1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 1. Short title. This Act may be cited as the Home
5Birth Safety Act.
 
6    Section 5. Purpose. The practice of midwifery in
7out-of-hospital settings is hereby declared to affect the
8public health, safety, and welfare and to be subject to
9regulation in the public interest. The purpose of this Act is
10to protect and benefit the public by setting standards for the
11qualifications, education, training, and experience of those
12who seek to obtain licensure and hold the title of licensed
13midwife, to promote high standards of professional performance
14for those licensed to practice midwifery in out-of-hospital
15settings in this State, and to protect the public from
16unprofessional conduct by persons licensed to practice
17midwifery, as defined in this Act. This Act shall be liberally
18construed to best carry out these purposes.
 
19    Section 10. Exemptions.
20    (a) This Act does not prohibit a person licensed under any
21other Act in this State from engaging in the practice for which
22he or she is licensed or from delegating services as provided

 

 

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1for under that other Act.
2    (b) Nothing in this Act shall be construed to prohibit or
3require licensing under this Act, with regard to:
4        (1) the gratuitous rendering of services;
5        (2) the rendering of services by a person, if such
6    attendance is in accordance with the person's religious
7    faith and is rendered to persons with a similar religious
8    faith as an exercise and enjoyment of their religious
9    freedom; and
10        (3) a student midwife working under the direction of a
11    licensed midwife.
12    (c) Nothing in this Act abridges, limits, or changes in any
13way the right of parents to deliver their baby where, when,
14how, and with whom they choose, regardless of licensure under
15this Act.
 
16    Section 15. Definitions. In this Act:
17    "Board" means the Illinois Midwifery Board.
18    "Certified professional midwife" or "CPM" means a person
19who has met the standards for certification set by the North
20American Registry of Midwives and has been awarded the
21Certified Professional Midwife credential.
22    "Department" means the Department of Financial and
23Professional Regulation.
24    "International Confederation of Midwives" means the
25organization that sets global standards for the education and

 

 

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1autonomous practice of midwifery.
2    "Licensed midwife" means a person who has been granted a
3license under this Act to engage in the practice of midwifery.
4    "Midwifery Bridge Certificate" means the certificate
5issued by NARM based upon completion of accredited continuing
6education specific to content in emergency skills for
7pregnancy, birth, and newborn care, along with other midwifery
8topics addressing the core competencies of the International
9Confederation of Midwives.
10    "Midwifery Education and Accreditation Council" or "MEAC"
11means the nationally-recognized accrediting agency that
12establishes standards for the education of direct-entry
13midwifery in the United States.
14    "National Association of Certified Professional Midwives"
15means the professional organization, or its successor, that
16promotes the growth and development of the profession of
17certified professional midwives.
18    "North American Registry of Midwives" or "NARM" means the
19accredited international agency, or its successor, that has
20established and has continued to administer certification for
21the credentialing of certified professional midwives.
22    "Practice of midwifery" means providing the necessary
23supervision, care, education, and advice to pregnant people
24during the antepartum, intrapartum, and postpartum period,
25conducting deliveries independently, and caring for the
26newborn, with such care including without limitation

 

 

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1preventative measures, the detection of abnormal conditions in
2the mother and the child, the procurement of medical
3assistance, and the execution of emergency measures in the
4absence of medical help. "Practice of midwifery" includes
5non-prescriptive family planning and basic well-woman care
6limited to Pap tests, sexually transmitted infection
7screenings, and preconception screenings. Preconception
8screenings shall be limited to complete blood count, thyroid,
9Rubella titer, urine culture, blood-typing, and antibody
10screenings and vitamin D level screenings.
11    "Secretary" means the Secretary of Financial and
12Professional Regulation.
 
13    Section 20. Unlicensed practice. Beginning January 1,
142017, no person may practice, attempt to practice, or hold
15himself or herself out to practice as a licensed midwife unless
16he or she is licensed as a midwife under this Act.
 
17    Section 25. Title. A licensed midwife may identify himself
18or herself as a "licensed midwife" and may use the abbreviation
19L.M.
 
20    Section 30. Informed consent.
21    (a) A licensed midwife shall, at an initial consultation
22with a client, provide a copy of the rules under this Act and
23disclose to the client orally and in writing all of the

 

 

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1following:
2        (1) The licensed midwife's experience and training.
3        (2) Whether the licensed midwife has malpractice
4    liability insurance coverage and the policy limits of any
5    such coverage.
6        (3) A written protocol for the handling of medical
7    emergencies, including transportation to a hospital,
8    particular to each client.
9    (b) A copy of the informed consent document, signed and
10dated by the client, must be kept in each client's chart.
 
11    Section 33. Vicarious liability. No physician licensed to
12practice medicine in all its branches or advanced practice
13nurse shall be held liable for an injury solely resulting from
14an act or omission by a licensed midwife.
15    Except as may otherwise be provided by law, nothing in this
16Section shall exempt any physician licensed to practice
17medicine in all its branches or advanced practice nurse from
18liability for his or her own negligent, grossly negligent, or
19willful or wanton acts or omissions.
 
20    Section 35. Advertising.
21    (a) Any person licensed under this Act may advertise the
22availability of professional midwifery services in the public
23media or on premises where professional services are rendered,
24if the advertising is truthful and not misleading and is in

 

 

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1conformity with any rules regarding the practice of a licensed
2midwife.
3    (b) A licensee must include in every advertisement for
4midwifery services regulated under this Act his or her title as
5it appears on the license or the initials authorized under this
6Act.
 
7    Section 40. Powers and duties of the Department; rules.
8    (a) The Department shall exercise the powers and duties
9prescribed by the Civil Administrative Code of Illinois for the
10administration of licensing Acts and shall exercise such other
11powers and duties necessary for effectuating the purposes of
12this Act.
13    (b) The Secretary shall adopt rules consistent with the
14provisions of this Act for the administration and enforcement
15of the Act and for the payment of fees connected to the Act and
16may prescribe forms that shall be issued in connection with the
17Act.
18    (c) Rules adopted by the Department must address the scope
19of practice and services provided and the use of equipment,
20procedures, medications, and other agents which are determined
21by the Department to be necessarily available in order to
22ensure the health and safety of the mother and newborn.
23    (d) The rules adopted by the Department under this Section
24may not:
25        (1) require a licensed midwife to practice midwifery

 

 

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1    under the supervision of another health care provider;
2        (2) require a licensed midwife to enter into a written
3    agreement with another health care provider;
4        (3) limit the location where a licensed midwife may
5    practice midwifery;
6        (4) permit a licensed midwife to do any of the
7    following:
8            (A) administer prescription pharmacological agents
9        intended to induce or augment labor;
10            (B) administer prescription pharmacological agents
11        to provide pain management;
12            (C) use vacuum extractors or forceps;
13            (D) prescribe medications; or
14            (E) perform major surgical procedures, including,
15        but not limited to, abortions, caesarean sections, and
16        circumcisions;
17        (5) administer prescription pharmacological agents
18    intended to induce or augment labor;
19        (6) administer prescription pharmacological agents to
20    provide pain management;
21        (7) use vacuum extractors or forceps;
22        (8) prescribe medications;
23        (9) provide out-of-hospital care to a woman who has had
24    a vertical incision cesarean section;
25        (10) perform surgical procedures, including, but not
26    limited to, cesarean sections and circumcisions; or

 

 

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1        (11) knowingly accept responsibility for prenatal or
2    intrapartum care of a client with any of the following risk
3    factors:
4            (A) chronic significant maternal cardiac,
5        pulmonary, renal, or hepatic disease;
6            (B) malignant disease in an active phase;
7            (C) significant hematological disorders or
8        coagulopathies or pulmonary embolism;
9            (D) insulin requiring diabetes mellitus;
10            (E) known maternal congenital abnormalities
11        affecting childbirth;
12            (F) confirmed isoimmunization, Rh disease with
13        positive titer;
14            (G) active tuberculosis;
15            (H) active syphilis or gonorrhea;
16            (I) active genital herpes infection 2 weeks prior
17        to labor or in labor;
18            (J) pelvic or uterine abnormalities affecting
19        normal vaginal births, including tumors and
20        malformations;
21            (K) alcoholism or abuse;
22            (L) drug addiction or abuse;
23            (M) confirmed AIDS status;
24            (N) uncontrolled current serious psychiatric
25        illness;
26            (O) social or familial conditions unsatisfactory

 

 

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1        for out-of-hospital maternity care services; or
2            (P) fetus with suspected or diagnosed congenital
3        abnormalities that may require immediate medical
4        intervention.
5    (e) With regards to Medicaid reimbursement, no rules
6prescribed by the Department shall require the licensed midwife
7to carry liability insurance in order to be reimbursed by the
8State as a Medicaid provider.
9    (f) The Department shall consult with the Board in adopting
10rules. Notice of proposed rulemaking shall be transmitted to
11the Board and the Department shall review the Board's response
12and any recommendations made. The Department shall notify the
13Board in writing with proper explanation of deviations from the
14Board's recommendations and responses.
15    (g) The Department may at any time seek the advice and the
16expert knowledge of the Board on any matter relating to the
17administration of this Act.
18    (h) The Department shall issue quarterly a report to the
19Board of the status of all complaints related to the profession
20filed with the Department.
21    (i) Administration by the Department of this Act must be
22consistent with standards regarding the practice of midwifery
23established by the National Association of Certified
24Professional Midwives or a successor organization whose
25essential documents include without limitation subject matter
26concerning scope of practice, standards of practice, informed

 

 

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1consent, appropriate consultation, collaboration or referral,
2and acknowledgement of a woman's right to self-determination
3concerning her maternity care.
 
4    Section 41. Midwife requirements. A licensed midwife
5shall:
6        (1) offer each client routine prenatal care and testing
7    in accordance with current American College of
8    Obstetricians and Gynecologists guidelines;
9        (2) provide all clients with a plan for 24-hour,
10    on-call availability by a licensed midwife, certified
11    nurse-midwife, or licensed physician throughout pregnancy,
12    intrapartum, and 6 weeks postpartum;
13        (3) provide clients with labor support, fetal
14    monitoring, and routine assessment of vital signs once
15    active labor is established;
16        (4) supervise delivery of infant and placenta, assess
17    newborn and maternal well-being in immediate postpartum,
18    and perform Apgar scores;
19        (5) perform routine cord management and inspect for
20    appropriate number of vessels;
21        (6) inspect the placenta and membranes for
22    completeness;
23        (7) inspect the perineum and vagina postpartum for
24    lacerations and stabilize;
25        (8) observe mother and newborn postpartum until stable

 

 

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1    condition is achieved, but in no event for less than 2
2    hours;
3        (9) instruct the mother, father, and other support
4    persons, both verbally and in writing, of the special care
5    and precautions for both mother and newborn in the
6    immediate postpartum period;
7        (10) reevaluate maternal and newborn well-being within
8    36 hours of delivery;
9        (11) use universal precautions with all biohazard
10    materials;
11        (12) ensure that a birth certificate is accurately
12    completed and filed in accordance with State law;
13        (13) offer to obtain and submit a blood sample in
14    accordance with the recommendations for metabolic
15    screening of the newborn;
16        (14) offer an injection of vitamin K for the newborn;
17        (15) within one week after delivery, offer a newborn
18    hearing screening to every newborn or refer the parents to
19    a facility with a newborn hearing screening program;
20        (16) within 2 hours after the birth, offer the
21    administration of antibiotic ointment into the eyes of the
22    newborn in accordance with State law on the prevention of
23    infant blindness; and
24        (17) maintain adequate antenatal and perinatal records
25    of each client and provide records to consulting licensed
26    physicians and licensed certified nurse-midwives in

 

 

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1    accordance with federal Health Insurance Portability and
2    Accountability Act regulations.
 
3    Section 42. Administration of drugs. A licensed midwife may
4administer the following agents during the practice of
5midwifery:
6        (1) oxygen for the treatment of fetal distress;
7        (2) eye prophylactics-0.5% Erythromycin ophthalmic
8    ointment or 1% Tetracycline ophthalmic ointment for the
9    prevention of neonatal ophthalmia;
10        (3) Oxytocin or Pitocin as a postpartum
11    antihemorrhagic agent or as prophylaxis for hemorrhage;
12        (4) Methylergonovine or Methergine for the treatment
13    of postpartum hemorrhage;
14        (5) Misoprostol (Cytotec) for the treatment of
15    postpartum hemorrhage;
16        (6) Vitamin K for the prophylaxis of hemorrhagic
17    disease of the newborn;
18        (7) RHo(D) immune globulin for the prevention of RHo(D)
19    sensitization in RHo(D) negative women;
20        (8) intravenous fluids for maternal stabilization,
21    including lactated Ringer's solution, or with 5% dextrose
22    (D5LR), unless unavailable or impractical, in which case
23    0.9% sodium chloride may be administered;
24        (9) Lidocaine injection as a local anesthesia for
25    perineal repair; and

 

 

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1        (10) sterile water subcutaneous injections as a
2    non-pharmacological form of pain relief during the first
3    and second stages of labor.
4    In addition to the drugs, devices, and procedures that are
5identified in this Section, a licensed midwife may administer
6any other prescription drug, use any other device, or perform
7any other procedure as an authorized agent of a licensed
8practitioner with prescriptive authority.
9    The medication indications, dose, route of administration,
10and duration of treatment relating to the administration of
11drugs and procedures identified under this Section shall be
12determined by rule as the Department deems necessary to be in
13keeping with current evidence-based practice standards. The
14Department may approve additional medications, agents, or
15procedures based upon updated evidence-based obstetrical
16guidelines or based upon limited availability of standard
17medications or agents.
 
18    Section 43. Consultation and referral.
19    (a) A licensed midwife shall consult with a physician
20licensed to practice medicine in all of its branches or a
21licensed certified nurse-midwife providing obstetrical care
22whenever there are significant deviations, including abnormal
23laboratory results, relative to a client's pregnancy or to a
24neonate. If a referral to a physician is needed, the licensed
25midwife shall refer the client to a physician and, if possible,

 

 

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1remain in consultation with the physician until resolution of
2the concern. Consultation does not preclude the possibility of
3an out-of-hospital birth. It is appropriate for the licensed
4midwife to maintain care of the client to the greatest degree
5possible, in accordance with the client's wishes, during the
6pregnancy and, if possible, during labor, birth, and the
7postpartum period.
8    (b) A licensed midwife shall consult with a licensed
9physician or certified nurse-midwife with regard to any client
10who presents with or develops the following risk factors or
11presents with or develops other risk factors that, in the
12judgment of the licensed midwife, warrant consultation:
13        (1) Antepartum.
14            (A) Pregnancy-induced hypertension, as evidenced
15        by a blood pressure of 140/90 on 2 occasions greater
16        than 6 hours apart.
17            (B) Persistent, severe headaches, epigastric pain,
18        or visual disturbances.
19            (C) Persistent symptoms of urinary tract
20        infection.
21            (D) Significant vaginal bleeding before the onset
22        of labor not associated with uncomplicated spontaneous
23        abortion.
24            (E) Rupture of membranes prior to the 37th week of
25        gestation.
26            (F) Noted abnormal decrease in or cessation of

 

 

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1        fetal movement.
2            (G) Anemia resistant to supplemental therapy.
3            (H) Fever of 102 degrees Fahrenheit or 39 degrees
4        Celsius or greater for more than 24 hours.
5            (I) Non-vertex presentation after 38 weeks
6        gestation.
7            (J) Hyperemesis or significant dehydration.
8            (K) Isoimmunization, Rh-negative sensitized,
9        positive titers, or any other positive antibody titer,
10        which may have a detrimental effect on mother or fetus.
11            (L) Elevated blood glucose levels unresponsive to
12        dietary management.
13            (M) Positive HIV antibody test.
14            (N) Primary genital herpes infection in pregnancy.
15            (O) Symptoms of malnutrition or anorexia or
16        protracted weight loss or failure to gain weight.
17            (P) Suspected deep vein thrombosis.
18            (Q) Documented placental anomaly or previa.
19            (R) Documented low-lying placenta in woman with
20        history of previous cesarean delivery.
21            (S) Labor prior to the 37th week of gestation.
22            (T) History of prior uterine incision.
23            (U) Lie other than vertex at term.
24            (V) Multiple gestation.
25            (W) Known fetal anomalies that may be affected by
26        the site of birth.

 

 

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1            (X) Marked abnormal fetal heart tones.
2            (Y) Abnormal non-stress test or abnormal
3        biophysical profile.
4            (Z) Marked or severe polyhydramnios or
5        oligohydramnios.
6            (AA) Evidence of intrauterine growth restriction.
7            (BB) Significant abnormal ultrasound findings.
8            (CC) Gestation beyond 42 weeks by reliable
9        confirmed dates.
10        (2) Intrapartum.
11            (A) Rise in blood pressure above baseline, more
12        than 30/15 points or greater than 140/90.
13            (B) Persistent, severe headaches, epigastric pain,
14        or visual disturbances.
15            (C) Significant proteinuria or ketonuria.
16            (D) Fever over 100.6 degrees Fahrenheit or 38
17        degrees Celsius in absence of environmental factors.
18            (E) Ruptured membranes without onset of
19        established labor after 18 hours.
20            (F) Significant bleeding prior to delivery or any
21        abnormal bleeding, with or without abdominal pain, or
22        evidence of placental abruption.
23            (G) Lie not compatible with spontaneous vaginal
24        delivery or unstable fetal lie.
25            (H) Failure to progress after 5 hours of active
26        labor or following 2 hours of active second stage

 

 

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1        labor.
2            (I) Signs or symptoms of maternal infection.
3            (J) Active genital herpes at onset of labor.
4            (K) Fetal heart tones with non-reassuring
5        patterns.
6            (L) Signs or symptoms of fetal distress.
7            (M) Thick meconium or frank bleeding with birth not
8        imminent.
9            (N) Client or licensed midwife desires physician
10        consultation or transfer.
11        (3) Postpartum.
12            (A) Failure to void within 6 hours of birth.
13            (B) Signs or symptoms of maternal shock.
14            (C) Febrile: 102 degrees Fahrenheit or 39 degrees
15        Celsius and unresponsive to therapy for 12 hours.
16            (D) Abnormal lochia or signs or symptoms of uterine
17        sepsis.
18            (E) Suspected deep vein thrombosis.
19            (F) Signs of clinically significant depression.
20    (c) A licensed midwife shall consult with a licensed
21physician or licensed certified nurse-midwife with regard to
22any neonate who is born with or develops the following risk
23factors:
24        (1) Apgar score of 6 or less at 5 minutes without
25    significant improvement by 10 minutes.
26        (2) Persistent grunting respirations or retractions.

 

 

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1        (3) Persistent cardiac irregularities.
2        (4) Persistent central cyanosis or pallor.
3        (5) Persistent lethargy or poor muscle tone.
4        (6) Abnormal cry.
5        (7) Birth weight less than 2,300 grams.
6        (8) Jitteriness or seizures.
7        (9) Jaundice occurring before 24 hours or outside of
8    normal range.
9        (10) Failure to urinate within 24 hours of birth.
10        (11) Failure to pass meconium within 48 hours of birth.
11        (12) Edema.
12        (13) Prolonged temperature instability.
13        (14) Significant signs or symptoms of infection.
14        (15) Significant clinical evidence of glycemic
15    instability.
16        (16) Abnormal, bulging, or depressed fontanel.
17        (17) Significant clinical evidence of prematurity.
18        (18) Medically significant congenital anomalies.
19        (19) Significant or suspected birth injury.
20        (20) Persistent inability to suck.
21        (21) Diminished consciousness.
22        (22) Clinically significant abnormalities in vital
23    signs, muscle tone, or behavior.
24        (23) Clinically significant color abnormality,
25    cyanotic, or pale or abnormal perfusion.
26        (24) Abdominal distension or projectile vomiting.

 

 

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1        (25) Signs of clinically significant dehydration or
2    failure to thrive.
 
3    Section 44. Transfer.
4    (a) Transport via private vehicle is an acceptable method
5of transport if it is the most expedient and safest method for
6accessing medical services. The licensed midwife shall
7initiate immediate transport according to the licensed
8midwife's emergency plan, provide emergency stabilization
9until emergency medical services arrive or transfer is
10completed, accompany the client or follow the client to a
11hospital in a timely fashion, provide pertinent information to
12the receiving facility, and complete an emergency transport
13record. The following conditions shall require immediate
14physician notification and emergency transfer to a hospital:
15        (1) Seizures or unconsciousness.
16        (2) Respiratory distress or arrest.
17        (3) Evidence of shock.
18        (4) Psychosis.
19        (5) Symptomatic chest pain or cardiac arrhythmias.
20        (6) Prolapsed umbilical cord.
21        (7) Shoulder dystocia not resolved by Advanced Life
22    Support in Obstetrics (ALSO) protocol.
23        (8) Symptoms of uterine rupture.
24        (9) Preeclampsia or eclampsia.
25        (10) Severe abdominal pain inconsistent with normal

 

 

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1    labor.
2        (11) Chorioamnionitis.
3        (12) Clinically significant fetal heart rate patterns
4    or other manifestation of fetal distress.
5        (13) Presentation not compatible with spontaneous
6    vaginal delivery.
7        (14) Laceration greater than second degree perineal or
8    any cervical.
9        (15) Hemorrhage non-responsive to therapy.
10        (16) Uterine prolapse or inversion.
11        (17) Persistent uterine atony.
12        (18) Anaphylaxis.
13        (19) Failure to deliver placenta after one hour if
14    there is no bleeding and fundus is firm.
15        (20) Sustained instability or persistent abnormal
16    vital signs.
17        (21) Other conditions or symptoms that could threaten
18    the life of the mother, fetus, or neonate.
19    (b) A licensed midwife may deliver a client's infant with
20any of the complications or conditions set forth in subsection
21(a) of this Section if no physician or other equivalent medical
22services are available and the situation presents immediate
23harm to the health and safety of the client, if the
24complication or condition entails extraordinary and
25unnecessary human suffering, or if delivery occurs during
26transport.
 

 

 

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1    Section 45. Illinois Midwifery Board.
2    (a) There is created under the authority of the Department
3the Illinois Midwifery Board, which shall consist of 5 members
4appointed by the Secretary, 3 of whom shall be licensed
5midwives who carry the CPM credential, except that initial
6appointees must have at least 3 years of experience in the
7practice of midwifery in an out-of-hospital setting, be
8certified by the North American Registry of Midwives, and meet
9the qualifications for licensure set forth in this Act; one of
10whom shall be a licensed obstetrician or a family practice
11physician or certified nurse midwife who has a minimum of 2
12years of experience providing home birth services; and one of
13whom shall be a knowledgeable public member who has given birth
14with the assistance of a certified professional midwife in an
15out-of-hospital birth setting. A physician or certified nurse
16midwife who has a minimum of 2 years' experience consulting or
17collaborating with a home birth provider may stand in
18substitution if the criteria for physician or certified nurse
19midwife Board members cannot be met. Board members shall serve
204-year terms, except that in the case of initial appointments,
21terms shall be staggered as follows: 3 members shall serve for
224 years, and 2 members shall serve for 2 years. The Board shall
23annually elect a chairperson and vice chairperson.
24    (b) Any appointment made to fill a vacancy shall be for the
25unexpired portion of the term. Appointments to fill vacancies

 

 

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1shall be made in the same manner as original appointments. No
2Board member may be reappointed for a term that would cause his
3or her continuous service on the Board to exceed 9 years.
4    (c) Board membership must have reasonable representation
5from different geographic areas of this State.
6    (d) The members of the Board may be reimbursed for all
7legitimate, necessary, and authorized expenses incurred in
8attending the meetings of the Board.
9    (e) The Secretary may remove any member of the Board for
10misconduct, incapacity, or neglect of duty at any time prior to
11the expiration of his or her term.
12    (f) Three Board members shall constitute a quorum. A
13vacancy in the membership of the Board shall not impair the
14right of a quorum to perform all of the duties of the Board.
15    (g) The Board shall provide the Department with
16recommendations concerning the administration of this Act and
17may perform each of the following duties:
18        (1) Recommend to the Department the prescription and,
19    from time to time, the revision of any rules that may be
20    necessary to carry out the provisions of this Act,
21    including those that are designed to protect the health,
22    safety, and welfare of the public.
23        (2) Conduct hearings and disciplinary conferences on
24    disciplinary charges of licensees.
25        (3) Report to the Department, upon completion of a
26    hearing, the disciplinary actions recommended to be taken

 

 

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1    against a person found in violation of this Act.
2        (4) Recommend the approval, denial of approval, and
3    withdrawal of approval of required education and
4    continuing educational programs.
5    (h) The Secretary shall give due consideration to all
6recommendations of the Board. If the Secretary takes action
7contrary to a recommendation of the Board, the Secretary must
8promptly provide a written explanation of that action.
9    (i) The Board may recommend to the Secretary that one or
10more licensed midwives be selected by the Secretary to assist
11in any investigation under this Act. Compensation shall be
12provided to any licensee who provides assistance under this
13subsection (i), in an amount determined by the Secretary.
14    (j) Members of the Board shall be immune from suit in an
15action based upon a disciplinary proceeding or other activity
16performed in good faith as a member of the Board, except for
17willful or wanton misconduct.
18    (k) Members of the Board may participate in and act at any
19meeting of the Illinois Midwifery Board through the use of any
20real-time internet or telephone communication media, by means
21of which all persons participating in the meeting can
22communicate with each other. Participation in such meeting
23shall constitute attendance and presence in person at the
24meeting of the person or persons so participating.
 
25    Section 50. Qualifications.

 

 

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1    (a) A person is qualified for licensure as a midwife if he
2or she has received certification and holds a valid CPM
3credential granted by NARM. In addition to earning his or her
4CPM credential: (1) a CPM certified before January 1, 2020 who
5has obtained certification through an educational pathway not
6accredited by MEAC must earn and submit a Midwifery Bridge
7Certificate issued by NARM or (2) a CPM certified after January
81, 2020 must have completed an educational program or pathway
9accredited by MEAC.
10    (b) A CPM who has maintained licensure in a state that does
11not require an accredited education shall submit a Midwifery
12Bridge Certificate regardless of the date of their
13certification.
 
14    Section 55. Social Security Number on application. In
15addition to any other information required to be contained in
16the application, every application for an original, renewal,
17reinstated, or restored license under this Act shall include
18the applicant's Social Security Number.
 
19    Section 60. Renewal of licensure.
20    (a) Licensed midwives shall renew their license biannually
21at the discretion of the Department.
22    (b) Rules adopted under this Act shall require the licensed
23midwife to maintain CPM certification by meeting all the
24continuing education requirements and other requirements set

 

 

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1forth by the North American Registry of Midwives.
 
2    Section 65. Inactive status.
3    (a) A licensed midwife who notifies the Department in
4writing on forms prescribed by the Department may elect to
5place his or her license on an inactive status and shall be
6excused from payment of renewal fees until he or she notifies
7the Department in writing of his or her intent to restore the
8license.
9    (b) A licensed midwife whose license is on inactive status
10may not practice licensed midwifery in the State of Illinois.
11    (c) A licensed midwife requesting restoration from
12inactive status shall be required to pay the current renewal
13fee and to restore his or her license, as provided by the
14Department.
15    (d) Any licensee who engages in the practice of midwifery
16while his or her license is lapsed or on inactive status shall
17be considered to be practicing without a license, which shall
18be grounds for discipline.
 
19    Section 70. Renewal, reinstatement, or restoration of
20licensure; military service.
21    (a) The expiration date and renewal period for each license
22issued under this Act shall be set by the Department.
23    (b) All renewal applicants shall provide proof of having
24maintained CPM certification by meeting continuing education

 

 

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1requirements and other requirements set forth by the North
2American Registry of Midwives.
3    (c) Any licensed midwife who has permitted his or her
4license to expire or who has had his or her license on inactive
5status may have his or her license restored by making
6application to the Department and filing proof acceptable to
7the Department of fitness to have the license restored and by
8paying the required fees. Proof of fitness may include evidence
9attesting to active lawful practice in another jurisdiction.
10    (d) The Department shall determine, by an evaluation
11program, fitness for restoration of a license under this
12Section and shall establish procedures and requirements for
13restoration.
14    (e) Any licensed midwife whose license expired while he or
15she was (i) in federal service on active duty with the Armed
16Forces of the United States or the State Militia and called
17into service or training or (ii) received education under the
18supervision of the United States preliminary to induction into
19the military service may have his or her license restored
20without paying any lapsed renewal fees, if, within 2 years
21after honorable termination of service, training, or
22education, he or she furnishes the Department with satisfactory
23evidence to the effect that he or she has been so engaged.
 
24    Section 75. Roster. The Department shall maintain a roster
25of the names and addresses of all licensees and of all persons

 

 

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1whose licenses have been suspended or revoked. This roster
2shall be available upon written request and payment of the
3required fee.
 
4    Section 80. Fees.
5    (a) The Department shall provide for a schedule of fees for
6the administration and enforcement of this Act, including
7without limitation original licensure, renewal, and
8restoration, which fees shall be nonrefundable.
9    (b) All fees collected under this Act shall be deposited
10into the General Professions Dedicated Fund and appropriated to
11the Department for the ordinary and contingent expenses of the
12Department in the administration of this Act.
 
13    Section 85. Returned checks; fines. Any person who delivers
14a check or other payment to the Department that is returned to
15the Department unpaid by the financial institution upon which
16it is drawn shall pay to the Department, in addition to the
17amount already owed to the Department, a fine of $50. The fines
18imposed by this Section are in addition to any other discipline
19provided under this Act for unlicensed practice or practice on
20a non-renewed license. The Department shall notify the person
21that fees and fines shall be paid to the Department by
22certified check or money order within 30 calendar days after
23the notification. If, after the expiration of 30 days from the
24date of the notification, the person has failed to submit the

 

 

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1necessary remittance, the Department shall automatically
2terminate the license or deny the application, without hearing.
3If, after termination or denial, the person seeks a license, he
4or she shall apply to the Department for restoration or
5issuance of the license and pay all fees and fines due to the
6Department. The Department may establish a fee for the
7processing of an application for restoration of a license to
8defray all expenses of processing the application. The
9Secretary may waive the fines due under this Section in
10individual cases where the Secretary finds that the fines would
11be unreasonable or unnecessarily burdensome.
 
12    Section 90. Unlicensed practice; civil penalty. Any person
13who practices, offers to practice, attempts to practice, or
14holds himself or herself out to practice midwifery or as a
15midwife without being licensed under this Act shall, in
16addition to any other penalty provided by law, pay a civil
17penalty to the Department in an amount not to exceed $5,000 for
18each offense, as determined by the Department. The civil
19penalty shall be assessed by the Department after a hearing is
20held in accordance with the provisions set forth in this Act
21regarding the provision of a hearing for the discipline of a
22licensee. The civil penalty shall be paid within 60 days after
23the effective date of the order imposing the civil penalty. The
24order shall constitute a judgment and may be filed and
25execution had thereon in the same manner as any judgment from

 

 

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1any court of record. The Department may investigate any
2unlicensed activity.
 
3    Section 95. Grounds for disciplinary action.
4    (a) The Department may refuse to issue or to renew or may
5revoke, suspend, place on probation, reprimand or take other
6disciplinary action as the Department may deem proper,
7including fines not to exceed $5,000 for each violation, with
8regard to any licensee or license for any one or combination of
9the following causes:
10        (1) Violations of this Act or its rules.
11        (2) Material misstatement in furnishing information to
12    the Department.
13        (3) Conviction of any crime under the laws of any U.S.
14    jurisdiction that is (i) a felony, (ii) a misdemeanor, an
15    essential element of which is dishonesty, or (iii) directly
16    related to the practice of the profession.
17        (4) Making any misrepresentation for the purpose of
18    obtaining a license.
19        (5) Professional incompetence or gross negligence.
20        (6) Gross malpractice.
21        (7) Aiding or assisting another person in violating any
22    provision of this Act or its rules.
23        (8) Failing to provide information within 60 days in
24    response to a written request made by the Department.
25        (9) Engaging in dishonorable, unethical, or

 

 

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1    unprofessional conduct of a character likely to deceive,
2    defraud, or harm the public.
3        (10) Habitual or excessive use or addiction to alcohol,
4    narcotics, stimulants, or any other chemical agent or drug
5    that results in the inability to practice with reasonable
6    judgment, skill, or safety.
7        (11) Discipline by another U.S. jurisdiction or
8    foreign nation if at least one of the grounds for the
9    discipline is the same or substantially equivalent to those
10    set forth in this Act.
11        (12) Directly or indirectly giving to or receiving from
12    any person, firm, corporation, partnership, or association
13    any fee, commission, rebate, or other form of compensation
14    for any professional services not actually or personally
15    rendered. This shall not be deemed to include rent or other
16    remunerations paid to an individual, partnership, or
17    corporation by a licensed midwife for the lease, rental, or
18    use of space, owned or controlled by the individual,
19    partnership, corporation, or association.
20        (13) A finding by the Department that the licensee,
21    after having his or her license placed on probationary
22    status, has violated the terms of probation.
23        (14) Abandonment of a patient without cause.
24        (15) Willfully making or filing false records or
25    reports relating to a licensee's practice, including, but
26    not limited to, false records filed with State agencies or

 

 

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1    departments.
2        (16) Physical illness or mental illness, including,
3    but not limited to, deterioration through the aging process
4    or loss of motor skill that results in the inability to
5    practice the profession with reasonable judgment, skill,
6    or safety.
7        (17) Failure to provide a patient with a copy of his or
8    her record upon the written request of the patient.
9        (18) Conviction by any court of competent
10    jurisdiction, either within or without this State, of any
11    violation of any law governing the practice of licensed
12    midwifery or conviction in this or another state of any
13    crime that is a felony under the laws of this State or
14    conviction of a felony in a federal court, if the
15    Department determines, after investigation, that the
16    person has not been sufficiently rehabilitated to warrant
17    the public trust.
18        (19) A finding that licensure has been applied for or
19    obtained by fraudulent means.
20        (20) Being named as a perpetrator in an indicated
21    report by the Department of Healthcare and Family Services
22    under the Abused and Neglected Child Reporting Act and upon
23    proof by clear and convincing evidence that the licensee
24    has caused a child to be an abused child or a neglected
25    child, as defined in the Abused and Neglected Child
26    Reporting Act.

 

 

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1        (21) Practicing or attempting to practice under a name
2    other than the full name shown on a license issued under
3    this Act.
4        (22) Immoral conduct in the commission of any act, such
5    as sexual abuse, sexual misconduct, or sexual
6    exploitation, related to the licensee's practice.
7        (23) Maintaining a professional relationship with any
8    person, firm, or corporation when the licensed midwife
9    knows or should know that a person, firm, or corporation is
10    violating this Act.
11        (24) Failure to provide satisfactory proof of having
12    participated in approved continuing education programs as
13    determined by the Board and approved by the Secretary.
14    Exceptions for extreme hardships are to be defined by the
15    Department.
16    (b) The Department may refuse to issue or may suspend the
17license of any person who fails to (i) file a tax return or to
18pay the tax, penalty, or interest shown in a filed return or
19(ii) pay any final assessment of the tax, penalty, or interest,
20as required by any tax Act administered by the Illinois
21Department of Revenue, until the time that the requirements of
22that tax Act are satisfied.
23    (c) The determination by a circuit court that a licensee is
24subject to involuntary admission or judicial admission as
25provided in the Mental Health and Developmental Disabilities
26Code operates as an automatic suspension. The suspension shall

 

 

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1end only upon a finding by a court that the patient is no
2longer subject to involuntary admission or judicial admission,
3the issuance of an order so finding and discharging the
4patient, and the recommendation of the Board to the Secretary
5that the licensee be allowed to resume his or her practice.
6    (d) In enforcing this Section, the Department, upon a
7showing of a possible violation, may compel any person licensed
8to practice under this Act or who has applied for licensure or
9certification pursuant to this Act to submit to a mental or
10physical examination, or both, as required by and at the
11expense of the Department. The examining physicians shall be
12those specifically designated by the Department. The
13Department may order an examining physician to present
14testimony concerning the mental or physical examination of the
15licensee or applicant. No information shall be excluded by
16reason of any common law or statutory privilege relating to
17communications between the licensee or applicant and the
18examining physician. The person to be examined may have, at his
19or her own expense, another physician of his or her choice
20present during all aspects of the examination. Failure of any
21person to submit to a mental or physical examination when
22directed shall be grounds for suspension of a license until the
23person submits to the examination if the Department finds,
24after notice and hearing, that the refusal to submit to the
25examination was without reasonable cause.
26    If the Department finds an individual unable to practice

 

 

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1because of the reasons set forth in this subsection (d), the
2Department may require that individual to submit to care,
3counseling, or treatment by physicians approved or designated
4by the Department, as a condition, term, or restriction for
5continued, reinstated, or renewed licensure to practice or, in
6lieu of care, counseling, or treatment, the Department may file
7a complaint to immediately suspend, revoke, or otherwise
8discipline the license of the individual. Any person whose
9license was granted, reinstated, renewed, disciplined, or
10supervised subject to such terms, conditions, or restrictions
11and who fails to comply with such terms, conditions, or
12restrictions shall be referred to the Secretary for a
13determination as to whether or not the person shall have his or
14her license suspended immediately, pending a hearing by the
15Department.
16    In instances in which the Secretary immediately suspends a
17person's license under this Section, a hearing on that person's
18license must be convened by the Department within 15 days after
19the suspension and completed without appreciable delay. The
20Department may review the person's record of treatment and
21counseling regarding the impairment, to the extent permitted by
22applicable federal statutes and regulations safeguarding the
23confidentiality of medical records.
24    A person licensed under this Act and affected under this
25subsection (d) shall be afforded an opportunity to demonstrate
26to the Department that he or she can resume practice in

 

 

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1compliance with acceptable and prevailing standards under the
2provisions of his or her license.
 
3    Section 100. Failure to pay restitution. The Department,
4without further process or hearing, shall suspend the license
5or other authorization to practice of any person issued under
6this Act who has been certified by court order as not having
7paid restitution to a person under Section 8A-3.5 of the
8Illinois Public Aid Code, under Section 46-1 of the Criminal
9Code of 1961, or under Sections 17-8.5 or 17-10.5 of the
10Criminal Code of 2012. A person whose license or other
11authorization to practice is suspended under this Section is
12prohibited from practicing until restitution is made in full.
 
13    Section 105. Injunction; cease and desist order.
14    (a) If a person violates any provision of this Act, the
15Secretary may, in the name of the People of the State of
16Illinois, through the Attorney General or the State's Attorney
17of any county in which the action is brought, petition for an
18order enjoining the violation or enforcing compliance with this
19Act. Upon the filing of a verified petition in court, the court
20may issue a temporary restraining order, without notice or
21bond, and may preliminarily and permanently enjoin the
22violation. If it is established that the person has violated or
23is violating the injunction, the court may punish the offender
24for contempt of court. Proceedings under this Section shall be

 

 

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1in addition to, and not in lieu of, all other remedies and
2penalties provided by this Act.
3    (b) If any person practices as a licensed midwife or holds
4himself or herself out as a licensed midwife without being
5licensed under the provisions of this Act, then any licensed
6midwife, any interested party, or any person injured thereby
7may, in addition to the Secretary, petition for relief as
8provided in subsection (a) of this Section.
9    (c) Whenever, in the opinion of the Department, any person
10violates any provision of this Act, the Department may issue a
11rule to show cause why an order to cease and desist should not
12be entered against that person. The rule shall clearly set
13forth the grounds relied upon by the Department and shall
14provide a period of 7 days after the date of the rule to file an
15answer to the satisfaction of the Department. Failure to answer
16to the satisfaction of the Department shall cause an order to
17cease and desist to be issued immediately.
 
18    Section 110. Violation; criminal penalty.
19    (a) Whoever knowingly practices or offers to practice
20midwifery in this State without being licensed for that purpose
21or exempt under this Act shall be guilty of a Class A
22misdemeanor and, for each subsequent conviction, shall be
23guilty of a Class 4 felony.
24    (b) Notwithstanding any other provision of this Act, all
25criminal fines, moneys, or other property collected or received

 

 

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1by the Department under this Section or any other State or
2federal statute, including, but not limited to, property
3forfeited to the Department under Section 505 of the Illinois
4Controlled Substances Act or Section 85 of the Methamphetamine
5Control and Community Protection Act, shall be deposited into
6the Professional Regulation Evidence Fund.
 
7    Section 115. Investigation; notice; hearing. The
8Department may investigate the actions of any applicant or of
9any person or persons holding or claiming to hold a license
10under this Act. Before refusing to issue or to renew or taking
11any disciplinary action regarding a license, the Department
12shall, at least 30 days prior to the date set for the hearing,
13notify in writing the applicant or licensee of the nature of
14any charges and that a hearing shall be held on a date
15designated. The Department shall direct the applicant or
16licensee to file a written answer with the Board under oath
17within 20 days after the service of the notice and inform the
18applicant or licensee that failure to file an answer shall
19result in default being taken against the applicant or licensee
20and that the license may be suspended, revoked, or placed on
21probationary status or that other disciplinary action may be
22taken, including limiting the scope, nature, or extent of
23practice, as the Secretary may deem proper. Written notice may
24be served by personal delivery or certified or registered mail
25to the respondent at the address of his or her last

 

 

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1notification to the Department. If the person fails to file an
2answer after receiving notice, his or her license may, in the
3discretion of the Department, be suspended, revoked, or placed
4on probationary status, or the Department may take any
5disciplinary action deemed proper, including limiting the
6scope, nature, or extent of the person's practice or the
7imposition of a fine, without a hearing, if the act or acts
8charged constitute sufficient grounds for such action under
9this Act. At the time and place fixed in the notice, the Board
10shall proceed to hear the charges and the parties or their
11counsel shall be accorded ample opportunity to present such
12statements, testimony, evidence, and argument as may be
13pertinent to the charges or to their defense. The Board may
14continue a hearing from time to time.
 
15    Section 120. Formal hearing; preservation of record. The
16Department, at its expense, shall preserve a record of all
17proceedings at the formal hearing of any case. The notice of
18hearing, complaint, and all other documents in the nature of
19pleadings and written motions filed in the proceedings, the
20transcript of testimony, the report of the Board or hearing
21officer, and order of the Department shall be the record of the
22proceeding. The Department shall furnish a transcript of the
23record to any person interested in the hearing upon payment of
24the fee required under Section 2105-115 of the Department of
25Professional Regulation Law.
 

 

 

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1    Section 125. Witnesses; production of documents; contempt.
2Any circuit court may upon application of the Department or its
3designee or of the applicant or licensee against whom
4proceedings under Section 95 of this Act are pending, enter an
5order requiring the attendance of witnesses and their testimony
6and the production of documents, papers, files, books, and
7records in connection with any hearing or investigation. The
8court may compel obedience to its order by proceedings for
9contempt.
 
10    Section 130. Subpoena; oaths. The Department shall have the
11power to subpoena and bring before it any person in this State
12and to take testimony either orally or by deposition or both
13with the same fees and mileage and in the same manner as
14prescribed in civil cases in circuit courts of this State. The
15Secretary, the designated hearing officer, and every member of
16the Board has the power to administer oaths to witnesses at any
17hearing that the Department is authorized to conduct and any
18other oaths authorized in any Act administered by the
19Department. Any circuit court may, upon application of the
20Department or its designee or upon application of the person
21against whom proceedings under this Act are pending, enter an
22order requiring the attendance of witnesses and their
23testimony, and the production of documents, papers, files,
24books, and records in connection with any hearing or

 

 

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1investigation. The court may compel obedience to its order by
2proceedings for contempt.
 
3    Section 135. Findings of fact, conclusions of law, and
4recommendations. At the conclusion of the hearing the Board
5shall present to the Secretary a written report of its findings
6of fact, conclusions of law, and recommendations. The report
7shall contain a finding as to whether or not the accused person
8violated this Act or failed to comply with the conditions
9required under this Act. The Board shall specify the nature of
10the violation or failure to comply and shall make its
11recommendations to the Secretary.
12    The report of findings of fact, conclusions of law, and
13recommendations of the Board shall be the basis for the
14Department's order. If the Secretary disagrees in any regard
15with the report of the Board, the Secretary may issue an order
16in contravention of the report. The finding is not admissible
17in evidence against the person in a criminal prosecution
18brought for the violation of this Act, but the hearing and
19findings are not a bar to a criminal prosecution brought for
20the violation of this Act.
 
21    Section 140. Hearing officer. The Secretary may appoint any
22attorney duly licensed to practice law in the State of Illinois
23to serve as the hearing officer in any action for departmental
24refusal to issue, renew, or license an applicant or for

 

 

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1disciplinary action against a licensee. The hearing officer
2shall have full authority to conduct the hearing. The hearing
3officer shall report his or her findings of fact, conclusions
4of law, and recommendations to the Board and the Secretary. The
5Board shall have 60 calendar days after receipt of the report
6to review the report of the hearing officer and present its
7findings of fact, conclusions of law, and recommendations to
8the Secretary. If the Board fails to present its report within
9the 60-day period, the Secretary may issue an order based on
10the report of the hearing officer. If the Secretary disagrees
11with the recommendation of the Board or the hearing officer, he
12or she may issue an order in contravention of that
13recommendation.
 
14    Section 145. Service of report; motion for rehearing. In
15any case involving the discipline of a license, a copy of the
16Board's report shall be served upon the respondent by the
17Department, either personally or as provided in this Act for
18the service of the notice of hearing. Within 20 days after the
19service, the respondent may present to the Department a motion
20in writing for a rehearing that shall specify the particular
21grounds for rehearing. If no motion for rehearing is filed,
22then upon the expiration of the time specified for filing a
23motion, or if a motion for rehearing is denied, then upon the
24denial, the Secretary may enter an order in accordance with
25this Act. If the respondent orders from the reporting service

 

 

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1and pays for a transcript of the record within the time for
2filing a motion for rehearing, the 20-day period within which
3the motion may be filed shall commence upon the delivery of the
4transcript to the respondent.
 
5    Section 150. Rehearing. Whenever the Secretary is
6satisfied that substantial justice has not been done in the
7revocation, suspension, or refusal to issue or renew a license,
8the Secretary may order a rehearing by the same or another
9hearing officer or by the Board.
 
10    Section 155. Prima facie proof. An order or a certified
11copy thereof, over the seal of the Department and purporting to
12be signed by the Secretary, shall be prima facie proof of the
13following:
14        (1) that the signature is the genuine signature of the
15    Secretary;
16        (2) that such Secretary is duly appointed and
17    qualified; and
18        (3) that the Board and its members are qualified to
19    act.
 
20    Section 160. Restoration of license. At any time after the
21suspension or revocation of any license, the Department may
22restore the license to the accused person, unless after an
23investigation and a hearing the Department determines that

 

 

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1restoration is not in the public interest.
 
2    Section 165. Surrender of license. Upon the revocation or
3suspension of any license, the licensee shall immediately
4surrender the license to the Department. If the licensee fails
5to do so, the Department shall have the right to seize the
6license.
 
7    Section 170. Summary suspension. The Secretary may
8summarily suspend the license of a licensee under this Act
9without a hearing, simultaneously with the institution of
10proceedings for a hearing provided for in this Act, if the
11Secretary finds that evidence in his or her possession
12indicates that continuation in practice would constitute an
13imminent danger to the public. In the event that the Secretary
14summarily suspends a license without a hearing, a hearing by
15the Department must be held within 30 days after the suspension
16has occurred.
 
17    Section 175. Certificate of record. The Department shall
18not be required to certify any record to the court or file any
19answer in court or otherwise appear in any court in a judicial
20review proceeding, unless there is filed in the court, with the
21complaint, a receipt from the Department acknowledging payment
22of the costs of furnishing and certifying the record. Failure
23on the part of the plaintiff to file a receipt in court shall

 

 

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1be grounds for dismissal of the action.
 
2    Section 180. Administrative Review Law. All final
3administrative decisions of the Department are subject to
4judicial review under the Administrative Review Law and its
5rules. The term "administrative decision" is defined as in
6Section 3-101 of the Code of Civil Procedure.
 
7    Section 185. Illinois Administrative Procedure Act. The
8Illinois Administrative Procedure Act is hereby expressly
9adopted and incorporated in this Act as if all of the
10provisions of such Act were included in this Act, except that
11the provision of subsection (d) of Section 10-65 of the
12Illinois Administrative Procedure Act that provides that at
13hearings the licensee has the right to show compliance with all
14lawful requirements for retention, continuation, or renewal of
15the license is specifically excluded. For purposes of this Act,
16the notice required under Section 10-25 of the Illinois
17Administrative Procedure Act is deemed sufficient when mailed
18to the last known address of a party.
 
19    Section 190. Home rule. Pursuant to paragraph (h) of
20Section 6 of Article VII of the Illinois Constitution of 1970,
21the power to regulate and issue licenses for the practice of
22midwifery shall, except as may otherwise be provided within and
23pursuant to the provisions of this Act, be exercised by the

 

 

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1State and may not be exercised by any unit of local government,
2including home rule units.
 
3    Section 195. Severability. The provisions of this Act are
4severable under Section 1.31 of the Statute on Statutes.
 
5    Section 900. The Regulatory Sunset Act is amended by adding
6Section 4.37 as follows:
 
7    (5 ILCS 80/4.37 new)
8    Sec. 4.37. Act repealed on January 1, 2027. The following
9Act is repealed on January 1, 2027:
10    The Home Birth Safety Act.
 
11    Section 905. The Medical Practice Act of 1987 is amended by
12changing Section 4 as follows:
 
13    (225 ILCS 60/4)  (from Ch. 111, par. 4400-4)
14    (Section scheduled to be repealed on December 31, 2016)
15    Sec. 4. Exemptions. This Act does not apply to the
16following:
17        (1) persons lawfully carrying on their particular
18    profession or business under any valid existing regulatory
19    Act of this State, including without limitation persons
20    engaged in the practice of midwifery who are licensed under
21    the Home Birth Safety Act;

 

 

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1        (2) persons rendering gratuitous services in cases of
2    emergency; or
3        (3) persons treating human ailments by prayer or
4    spiritual means as an exercise or enjoyment of religious
5    freedom.
6(Source: P.A. 96-7, eff. 4-3-09; 97-622, eff. 11-23-11.)
 
7    Section 910. The Nurse Practice Act is amended by changing
8Section 50-15 as follows:
 
9    (225 ILCS 65/50-15)   (was 225 ILCS 65/5-15)
10    (Section scheduled to be repealed on January 1, 2018)
11    Sec. 50-15. Policy; application of Act.
12    (a) For the protection of life and the promotion of health,
13and the prevention of illness and communicable diseases, any
14person practicing or offering to practice advanced,
15professional, or practical nursing in Illinois shall submit
16evidence that he or she is qualified to practice, and shall be
17licensed as provided under this Act. No person shall practice
18or offer to practice advanced, professional, or practical
19nursing in Illinois or use any title, sign, card or device to
20indicate that such a person is practicing professional or
21practical nursing unless such person has been licensed under
22the provisions of this Act.
23    (b) This Act does not prohibit the following:
24        (1) The practice of nursing in Federal employment in

 

 

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1    the discharge of the employee's duties by a person who is
2    employed by the United States government or any bureau,
3    division or agency thereof and is a legally qualified and
4    licensed nurse of another state or territory and not in
5    conflict with Sections 50-50, 55-10, 60-10, and 70-5 of
6    this Act.
7        (2) Nursing that is included in the program of study by
8    students enrolled in programs of nursing or in current
9    nurse practice update courses approved by the Department.
10        (3) The furnishing of nursing assistance in an
11    emergency.
12        (4) The practice of nursing by a nurse who holds an
13    active license in another state when providing services to
14    patients in Illinois during a bonafide emergency or in
15    immediate preparation for or during interstate transit.
16        (5) The incidental care of the sick by members of the
17    family, domestic servants or housekeepers, or care of the
18    sick where treatment is by prayer or spiritual means.
19        (6) Persons from being employed as unlicensed
20    assistive personnel in private homes, long term care
21    facilities, nurseries, hospitals or other institutions.
22        (7) The practice of practical nursing by one who is a
23    licensed practical nurse under the laws of another U.S.
24    jurisdiction and has applied in writing to the Department,
25    in form and substance satisfactory to the Department, for a
26    license as a licensed practical nurse and who is qualified

 

 

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1    to receive such license under this Act, until (i) the
2    expiration of 6 months after the filing of such written
3    application, (ii) the withdrawal of such application, or
4    (iii) the denial of such application by the Department.
5        (8) The practice of advanced practice nursing by one
6    who is an advanced practice nurse under the laws of another
7    state, territory of the United States, or country and has
8    applied in writing to the Department, in form and substance
9    satisfactory to the Department, for a license as an
10    advanced practice nurse and who is qualified to receive
11    such license under this Act, until (i) the expiration of 6
12    months after the filing of such written application, (ii)
13    the withdrawal of such application, or (iii) the denial of
14    such application by the Department.
15        (9) The practice of professional nursing by one who is
16    a registered professional nurse under the laws of another
17    state, territory of the United States or country and has
18    applied in writing to the Department, in form and substance
19    satisfactory to the Department, for a license as a
20    registered professional nurse and who is qualified to
21    receive such license under Section 55-10, until (1) the
22    expiration of 6 months after the filing of such written
23    application, (2) the withdrawal of such application, or (3)
24    the denial of such application by the Department.
25        (10) The practice of professional nursing that is
26    included in a program of study by one who is a registered

 

 

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1    professional nurse under the laws of another state or
2    territory of the United States or foreign country,
3    territory or province and who is enrolled in a graduate
4    nursing education program or a program for the completion
5    of a baccalaureate nursing degree in this State, which
6    includes clinical supervision by faculty as determined by
7    the educational institution offering the program and the
8    health care organization where the practice of nursing
9    occurs.
10        (11) Any person licensed in this State under any other
11    Act from engaging in the practice for which she or he is
12    licensed, including without limitation any person engaged
13    in the practice of midwifery who is licensed under the Home
14    Birth Safety Act.
15        (12) Delegation to authorized direct care staff
16    trained under Section 15.4 of the Mental Health and
17    Developmental Disabilities Administrative Act consistent
18    with the policies of the Department.
19        (13) The practice, services, or activities of persons
20    practicing the specified occupations set forth in
21    subsection (a) of, and pursuant to a licensing exemption
22    granted in subsection (b) or (d) of, Section 2105-350 of
23    the Department of Professional Regulation Law of the Civil
24    Administrative Code of Illinois, but only for so long as
25    the 2016 Olympic and Paralympic Games Professional
26    Licensure Exemption Law is operable.

 

 

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1        (14) County correctional personnel from delivering
2    prepackaged medication for self-administration to an
3    individual detainee in a correctional facility.
4    Nothing in this Act shall be construed to limit the
5delegation of tasks or duties by a physician, dentist, or
6podiatric physician to a licensed practical nurse, a registered
7professional nurse, or other persons.
8(Source: P.A. 98-214, eff. 8-9-13.)
 
9    Section 990. The Illinois Public Aid Code is amended by
10changing Section 5-5 as follows:
 
11    (305 ILCS 5/5-5)  (from Ch. 23, par. 5-5)
12    (Text of Section before amendment by P.A. 99-407)
13    Sec. 5-5. Medical services. The Illinois Department, by
14rule, shall determine the quantity and quality of and the rate
15of reimbursement for the medical assistance for which payment
16will be authorized, and the medical services to be provided,
17which may include all or part of the following: (1) inpatient
18hospital services; (2) outpatient hospital services; (3) other
19laboratory and X-ray services; (4) skilled nursing home
20services; (5) physicians' services whether furnished in the
21office, the patient's home, a hospital, a skilled nursing home,
22or elsewhere; (6) medical care, or any other type of remedial
23care furnished by licensed practitioners, including the
24services of certified professional midwives licensed pursuant

 

 

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1to the Home Birth Safety Act; (7) home health care services;
2(8) private duty nursing service; (9) clinic services; (10)
3dental services, including prevention and treatment of
4periodontal disease and dental caries disease for pregnant
5women, provided by an individual licensed to practice dentistry
6or dental surgery; for purposes of this item (10), "dental
7services" means diagnostic, preventive, or corrective
8procedures provided by or under the supervision of a dentist in
9the practice of his or her profession; (11) physical therapy
10and related services; (12) prescribed drugs, dentures, and
11prosthetic devices; and eyeglasses prescribed by a physician
12skilled in the diseases of the eye, or by an optometrist,
13whichever the person may select; (13) other diagnostic,
14screening, preventive, and rehabilitative services, including
15to ensure that the individual's need for intervention or
16treatment of mental disorders or substance use disorders or
17co-occurring mental health and substance use disorders is
18determined using a uniform screening, assessment, and
19evaluation process inclusive of criteria, for children and
20adults; for purposes of this item (13), a uniform screening,
21assessment, and evaluation process refers to a process that
22includes an appropriate evaluation and, as warranted, a
23referral; "uniform" does not mean the use of a singular
24instrument, tool, or process that all must utilize; (14)
25transportation and such other expenses as may be necessary;
26(15) medical treatment of sexual assault survivors, as defined

 

 

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1in Section 1a of the Sexual Assault Survivors Emergency
2Treatment Act, for injuries sustained as a result of the sexual
3assault, including examinations and laboratory tests to
4discover evidence which may be used in criminal proceedings
5arising from the sexual assault; (16) the diagnosis and
6treatment of sickle cell anemia; and (17) any other medical
7care, and any other type of remedial care recognized under the
8laws of this State, but not including abortions, or induced
9miscarriages or premature births, unless, in the opinion of a
10physician, such procedures are necessary for the preservation
11of the life of the woman seeking such treatment, or except an
12induced premature birth intended to produce a live viable child
13and such procedure is necessary for the health of the mother or
14her unborn child. The Illinois Department, by rule, shall
15prohibit any physician from providing medical assistance to
16anyone eligible therefor under this Code where such physician
17has been found guilty of performing an abortion procedure in a
18wilful and wanton manner upon a woman who was not pregnant at
19the time such abortion procedure was performed. The term "any
20other type of remedial care" shall include nursing care and
21nursing home service for persons who rely on treatment by
22spiritual means alone through prayer for healing.
23    Notwithstanding any other provision of this Section, a
24comprehensive tobacco use cessation program that includes
25purchasing prescription drugs or prescription medical devices
26approved by the Food and Drug Administration shall be covered

 

 

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1under the medical assistance program under this Article for
2persons who are otherwise eligible for assistance under this
3Article.
4    Notwithstanding any other provision of this Code, the
5Illinois Department may not require, as a condition of payment
6for any laboratory test authorized under this Article, that a
7physician's handwritten signature appear on the laboratory
8test order form. The Illinois Department may, however, impose
9other appropriate requirements regarding laboratory test order
10documentation.
11    Upon receipt of federal approval of an amendment to the
12Illinois Title XIX State Plan for this purpose, the Department
13shall authorize the Chicago Public Schools (CPS) to procure a
14vendor or vendors to manufacture eyeglasses for individuals
15enrolled in a school within the CPS system. CPS shall ensure
16that its vendor or vendors are enrolled as providers in the
17medical assistance program and in any capitated Medicaid
18managed care entity (MCE) serving individuals enrolled in a
19school within the CPS system. Under any contract procured under
20this provision, the vendor or vendors must serve only
21individuals enrolled in a school within the CPS system. Claims
22for services provided by CPS's vendor or vendors to recipients
23of benefits in the medical assistance program under this Code,
24the Children's Health Insurance Program, or the Covering ALL
25KIDS Health Insurance Program shall be submitted to the
26Department or the MCE in which the individual is enrolled for

 

 

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1payment and shall be reimbursed at the Department's or the
2MCE's established rates or rate methodologies for eyeglasses.
3    On and after July 1, 2012, the Department of Healthcare and
4Family Services may provide the following services to persons
5eligible for assistance under this Article who are
6participating in education, training or employment programs
7operated by the Department of Human Services as successor to
8the Department of Public Aid:
9        (1) dental services provided by or under the
10    supervision of a dentist; and
11        (2) eyeglasses prescribed by a physician skilled in the
12    diseases of the eye, or by an optometrist, whichever the
13    person may select.
14    Notwithstanding any other provision of this Code and
15subject to federal approval, the Department may adopt rules to
16allow a dentist who is volunteering his or her service at no
17cost to render dental services through an enrolled
18not-for-profit health clinic without the dentist personally
19enrolling as a participating provider in the medical assistance
20program. A not-for-profit health clinic shall include a public
21health clinic or Federally Qualified Health Center or other
22enrolled provider, as determined by the Department, through
23which dental services covered under this Section are performed.
24The Department shall establish a process for payment of claims
25for reimbursement for covered dental services rendered under
26this provision.

 

 

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1    The Illinois Department, by rule, may distinguish and
2classify the medical services to be provided only in accordance
3with the classes of persons designated in Section 5-2.
4    The Department of Healthcare and Family Services must
5provide coverage and reimbursement for amino acid-based
6elemental formulas, regardless of delivery method, for the
7diagnosis and treatment of (i) eosinophilic disorders and (ii)
8short bowel syndrome when the prescribing physician has issued
9a written order stating that the amino acid-based elemental
10formula is medically necessary.
11    The Illinois Department shall authorize the provision of,
12and shall authorize payment for, screening by low-dose
13mammography for the presence of occult breast cancer for women
1435 years of age or older who are eligible for medical
15assistance under this Article, as follows:
16        (A) A baseline mammogram for women 35 to 39 years of
17    age.
18        (B) An annual mammogram for women 40 years of age or
19    older.
20        (C) A mammogram at the age and intervals considered
21    medically necessary by the woman's health care provider for
22    women under 40 years of age and having a family history of
23    breast cancer, prior personal history of breast cancer,
24    positive genetic testing, or other risk factors.
25        (D) A comprehensive ultrasound screening of an entire
26    breast or breasts if a mammogram demonstrates

 

 

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1    heterogeneous or dense breast tissue, when medically
2    necessary as determined by a physician licensed to practice
3    medicine in all of its branches.
4        (E) A screening MRI when medically necessary, as
5    determined by a physician licensed to practice medicine in
6    all of its branches.
7    All screenings shall include a physical breast exam,
8instruction on self-examination and information regarding the
9frequency of self-examination and its value as a preventative
10tool. For purposes of this Section, "low-dose mammography"
11means the x-ray examination of the breast using equipment
12dedicated specifically for mammography, including the x-ray
13tube, filter, compression device, and image receptor, with an
14average radiation exposure delivery of less than one rad per
15breast for 2 views of an average size breast. The term also
16includes digital mammography.
17    On and after January 1, 2016, the Department shall ensure
18that all networks of care for adult clients of the Department
19include access to at least one breast imaging Center of Imaging
20Excellence as certified by the American College of Radiology.
21    On and after January 1, 2012, providers participating in a
22quality improvement program approved by the Department shall be
23reimbursed for screening and diagnostic mammography at the same
24rate as the Medicare program's rates, including the increased
25reimbursement for digital mammography.
26    The Department shall convene an expert panel including

 

 

HB4364- 57 -LRB099 15854 MLM 40164 b

1representatives of hospitals, free-standing mammography
2facilities, and doctors, including radiologists, to establish
3quality standards for mammography.
4    On and after January 1, 2017, providers participating in a
5breast cancer treatment quality improvement program approved
6by the Department shall be reimbursed for breast cancer
7treatment at a rate that is no lower than 95% of the Medicare
8program's rates for the data elements included in the breast
9cancer treatment quality program.
10    The Department shall convene an expert panel, including
11representatives of hospitals, free standing breast cancer
12treatment centers, breast cancer quality organizations, and
13doctors, including breast surgeons, reconstructive breast
14surgeons, oncologists, and primary care providers to establish
15quality standards for breast cancer treatment.
16    Subject to federal approval, the Department shall
17establish a rate methodology for mammography at federally
18qualified health centers and other encounter-rate clinics.
19These clinics or centers may also collaborate with other
20hospital-based mammography facilities. By January 1, 2016, the
21Department shall report to the General Assembly on the status
22of the provision set forth in this paragraph.
23    The Department shall establish a methodology to remind
24women who are age-appropriate for screening mammography, but
25who have not received a mammogram within the previous 18
26months, of the importance and benefit of screening mammography.

 

 

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1The Department shall work with experts in breast cancer
2outreach and patient navigation to optimize these reminders and
3shall establish a methodology for evaluating their
4effectiveness and modifying the methodology based on the
5evaluation.
6    The Department shall establish a performance goal for
7primary care providers with respect to their female patients
8over age 40 receiving an annual mammogram. This performance
9goal shall be used to provide additional reimbursement in the
10form of a quality performance bonus to primary care providers
11who meet that goal.
12    The Department shall devise a means of case-managing or
13patient navigation for beneficiaries diagnosed with breast
14cancer. This program shall initially operate as a pilot program
15in areas of the State with the highest incidence of mortality
16related to breast cancer. At least one pilot program site shall
17be in the metropolitan Chicago area and at least one site shall
18be outside the metropolitan Chicago area. On or after July 1,
192016, the pilot program shall be expanded to include one site
20in western Illinois, one site in southern Illinois, one site in
21central Illinois, and 4 sites within metropolitan Chicago. An
22evaluation of the pilot program shall be carried out measuring
23health outcomes and cost of care for those served by the pilot
24program compared to similarly situated patients who are not
25served by the pilot program.
26    The Department shall require all networks of care to

 

 

HB4364- 59 -LRB099 15854 MLM 40164 b

1develop a means either internally or by contract with experts
2in navigation and community outreach to navigate cancer
3patients to comprehensive care in a timely fashion. The
4Department shall require all networks of care to include access
5for patients diagnosed with cancer to at least one academic
6commission on cancer-accredited cancer program as an
7in-network covered benefit.
8    Any medical or health care provider shall immediately
9recommend, to any pregnant woman who is being provided prenatal
10services and is suspected of drug abuse or is addicted as
11defined in the Alcoholism and Other Drug Abuse and Dependency
12Act, referral to a local substance abuse treatment provider
13licensed by the Department of Human Services or to a licensed
14hospital which provides substance abuse treatment services.
15The Department of Healthcare and Family Services shall assure
16coverage for the cost of treatment of the drug abuse or
17addiction for pregnant recipients in accordance with the
18Illinois Medicaid Program in conjunction with the Department of
19Human Services.
20    All medical providers providing medical assistance to
21pregnant women under this Code shall receive information from
22the Department on the availability of services under the Drug
23Free Families with a Future or any comparable program providing
24case management services for addicted women, including
25information on appropriate referrals for other social services
26that may be needed by addicted women in addition to treatment

 

 

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1for addiction.
2    The Illinois Department, in cooperation with the
3Departments of Human Services (as successor to the Department
4of Alcoholism and Substance Abuse) and Public Health, through a
5public awareness campaign, may provide information concerning
6treatment for alcoholism and drug abuse and addiction, prenatal
7health care, and other pertinent programs directed at reducing
8the number of drug-affected infants born to recipients of
9medical assistance.
10    Neither the Department of Healthcare and Family Services
11nor the Department of Human Services shall sanction the
12recipient solely on the basis of her substance abuse.
13    The Illinois Department shall establish such regulations
14governing the dispensing of health services under this Article
15as it shall deem appropriate. The Department should seek the
16advice of formal professional advisory committees appointed by
17the Director of the Illinois Department for the purpose of
18providing regular advice on policy and administrative matters,
19information dissemination and educational activities for
20medical and health care providers, and consistency in
21procedures to the Illinois Department.
22    The Illinois Department may develop and contract with
23Partnerships of medical providers to arrange medical services
24for persons eligible under Section 5-2 of this Code.
25Implementation of this Section may be by demonstration projects
26in certain geographic areas. The Partnership shall be

 

 

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1represented by a sponsor organization. The Department, by rule,
2shall develop qualifications for sponsors of Partnerships.
3Nothing in this Section shall be construed to require that the
4sponsor organization be a medical organization.
5    The sponsor must negotiate formal written contracts with
6medical providers for physician services, inpatient and
7outpatient hospital care, home health services, treatment for
8alcoholism and substance abuse, and other services determined
9necessary by the Illinois Department by rule for delivery by
10Partnerships. Physician services must include prenatal and
11obstetrical care. The Illinois Department shall reimburse
12medical services delivered by Partnership providers to clients
13in target areas according to provisions of this Article and the
14Illinois Health Finance Reform Act, except that:
15        (1) Physicians participating in a Partnership and
16    providing certain services, which shall be determined by
17    the Illinois Department, to persons in areas covered by the
18    Partnership may receive an additional surcharge for such
19    services.
20        (2) The Department may elect to consider and negotiate
21    financial incentives to encourage the development of
22    Partnerships and the efficient delivery of medical care.
23        (3) Persons receiving medical services through
24    Partnerships may receive medical and case management
25    services above the level usually offered through the
26    medical assistance program.

 

 

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1    Medical providers shall be required to meet certain
2qualifications to participate in Partnerships to ensure the
3delivery of high quality medical services. These
4qualifications shall be determined by rule of the Illinois
5Department and may be higher than qualifications for
6participation in the medical assistance program. Partnership
7sponsors may prescribe reasonable additional qualifications
8for participation by medical providers, only with the prior
9written approval of the Illinois Department.
10    Nothing in this Section shall limit the free choice of
11practitioners, hospitals, and other providers of medical
12services by clients. In order to ensure patient freedom of
13choice, the Illinois Department shall immediately promulgate
14all rules and take all other necessary actions so that provided
15services may be accessed from therapeutically certified
16optometrists to the full extent of the Illinois Optometric
17Practice Act of 1987 without discriminating between service
18providers.
19    The Department shall apply for a waiver from the United
20States Health Care Financing Administration to allow for the
21implementation of Partnerships under this Section.
22    The Illinois Department shall require health care
23providers to maintain records that document the medical care
24and services provided to recipients of Medical Assistance under
25this Article. Such records must be retained for a period of not
26less than 6 years from the date of service or as provided by

 

 

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1applicable State law, whichever period is longer, except that
2if an audit is initiated within the required retention period
3then the records must be retained until the audit is completed
4and every exception is resolved. The Illinois Department shall
5require health care providers to make available, when
6authorized by the patient, in writing, the medical records in a
7timely fashion to other health care providers who are treating
8or serving persons eligible for Medical Assistance under this
9Article. All dispensers of medical services shall be required
10to maintain and retain business and professional records
11sufficient to fully and accurately document the nature, scope,
12details and receipt of the health care provided to persons
13eligible for medical assistance under this Code, in accordance
14with regulations promulgated by the Illinois Department. The
15rules and regulations shall require that proof of the receipt
16of prescription drugs, dentures, prosthetic devices and
17eyeglasses by eligible persons under this Section accompany
18each claim for reimbursement submitted by the dispenser of such
19medical services. No such claims for reimbursement shall be
20approved for payment by the Illinois Department without such
21proof of receipt, unless the Illinois Department shall have put
22into effect and shall be operating a system of post-payment
23audit and review which shall, on a sampling basis, be deemed
24adequate by the Illinois Department to assure that such drugs,
25dentures, prosthetic devices and eyeglasses for which payment
26is being made are actually being received by eligible

 

 

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1recipients. Within 90 days after September 16, 1984 (the
2effective date of Public Act 83-1439) this amendatory Act of
31984, the Illinois Department shall establish a current list of
4acquisition costs for all prosthetic devices and any other
5items recognized as medical equipment and supplies
6reimbursable under this Article and shall update such list on a
7quarterly basis, except that the acquisition costs of all
8prescription drugs shall be updated no less frequently than
9every 30 days as required by Section 5-5.12.
10    The rules and regulations of the Illinois Department shall
11require that a written statement including the required opinion
12of a physician shall accompany any claim for reimbursement for
13abortions, or induced miscarriages or premature births. This
14statement shall indicate what procedures were used in providing
15such medical services.
16    Notwithstanding any other law to the contrary, the Illinois
17Department shall, within 365 days after July 22, 2013 (the
18effective date of Public Act 98-104), establish procedures to
19permit skilled care facilities licensed under the Nursing Home
20Care Act to submit monthly billing claims for reimbursement
21purposes. Following development of these procedures, the
22Department shall, by July 1, 2016, test the viability of the
23new system and implement any necessary operational or
24structural changes to its information technology platforms in
25order to allow for the direct acceptance and payment of nursing
26home claims.

 

 

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1    Notwithstanding any other law to the contrary, the Illinois
2Department shall, within 365 days after August 15, 2014 (the
3effective date of Public Act 98-963), establish procedures to
4permit ID/DD facilities licensed under the ID/DD Community Care
5Act and MC/DD facilities licensed under the MC/DD Act to submit
6monthly billing claims for reimbursement purposes. Following
7development of these procedures, the Department shall have an
8additional 365 days to test the viability of the new system and
9to ensure that any necessary operational or structural changes
10to its information technology platforms are implemented.
11    The Illinois Department shall require all dispensers of
12medical services, other than an individual practitioner or
13group of practitioners, desiring to participate in the Medical
14Assistance program established under this Article to disclose
15all financial, beneficial, ownership, equity, surety or other
16interests in any and all firms, corporations, partnerships,
17associations, business enterprises, joint ventures, agencies,
18institutions or other legal entities providing any form of
19health care services in this State under this Article.
20    The Illinois Department may require that all dispensers of
21medical services desiring to participate in the medical
22assistance program established under this Article disclose,
23under such terms and conditions as the Illinois Department may
24by rule establish, all inquiries from clients and attorneys
25regarding medical bills paid by the Illinois Department, which
26inquiries could indicate potential existence of claims or liens

 

 

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1for the Illinois Department.
2    Enrollment of a vendor shall be subject to a provisional
3period and shall be conditional for one year. During the period
4of conditional enrollment, the Department may terminate the
5vendor's eligibility to participate in, or may disenroll the
6vendor from, the medical assistance program without cause.
7Unless otherwise specified, such termination of eligibility or
8disenrollment is not subject to the Department's hearing
9process. However, a disenrolled vendor may reapply without
10penalty.
11    The Department has the discretion to limit the conditional
12enrollment period for vendors based upon category of risk of
13the vendor.
14    Prior to enrollment and during the conditional enrollment
15period in the medical assistance program, all vendors shall be
16subject to enhanced oversight, screening, and review based on
17the risk of fraud, waste, and abuse that is posed by the
18category of risk of the vendor. The Illinois Department shall
19establish the procedures for oversight, screening, and review,
20which may include, but need not be limited to: criminal and
21financial background checks; fingerprinting; license,
22certification, and authorization verifications; unscheduled or
23unannounced site visits; database checks; prepayment audit
24reviews; audits; payment caps; payment suspensions; and other
25screening as required by federal or State law.
26    The Department shall define or specify the following: (i)

 

 

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1by provider notice, the "category of risk of the vendor" for
2each type of vendor, which shall take into account the level of
3screening applicable to a particular category of vendor under
4federal law and regulations; (ii) by rule or provider notice,
5the maximum length of the conditional enrollment period for
6each category of risk of the vendor; and (iii) by rule, the
7hearing rights, if any, afforded to a vendor in each category
8of risk of the vendor that is terminated or disenrolled during
9the conditional enrollment period.
10    To be eligible for payment consideration, a vendor's
11payment claim or bill, either as an initial claim or as a
12resubmitted claim following prior rejection, must be received
13by the Illinois Department, or its fiscal intermediary, no
14later than 180 days after the latest date on the claim on which
15medical goods or services were provided, with the following
16exceptions:
17        (1) In the case of a provider whose enrollment is in
18    process by the Illinois Department, the 180-day period
19    shall not begin until the date on the written notice from
20    the Illinois Department that the provider enrollment is
21    complete.
22        (2) In the case of errors attributable to the Illinois
23    Department or any of its claims processing intermediaries
24    which result in an inability to receive, process, or
25    adjudicate a claim, the 180-day period shall not begin
26    until the provider has been notified of the error.

 

 

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1        (3) In the case of a provider for whom the Illinois
2    Department initiates the monthly billing process.
3        (4) In the case of a provider operated by a unit of
4    local government with a population exceeding 3,000,000
5    when local government funds finance federal participation
6    for claims payments.
7    For claims for services rendered during a period for which
8a recipient received retroactive eligibility, claims must be
9filed within 180 days after the Department determines the
10applicant is eligible. For claims for which the Illinois
11Department is not the primary payer, claims must be submitted
12to the Illinois Department within 180 days after the final
13adjudication by the primary payer.
14    In the case of long term care facilities, within 5 days of
15receipt by the facility of required prescreening information,
16data for new admissions shall be entered into the Medical
17Electronic Data Interchange (MEDI) or the Recipient
18Eligibility Verification (REV) System or successor system, and
19within 15 days of receipt by the facility of required
20prescreening information, admission documents shall be
21submitted through MEDI or REV or shall be submitted directly to
22the Department of Human Services using required admission
23forms. Effective September 1, 2014, admission documents,
24including all prescreening information, must be submitted
25through MEDI or REV. Confirmation numbers assigned to an
26accepted transaction shall be retained by a facility to verify

 

 

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1timely submittal. Once an admission transaction has been
2completed, all resubmitted claims following prior rejection
3are subject to receipt no later than 180 days after the
4admission transaction has been completed.
5    Claims that are not submitted and received in compliance
6with the foregoing requirements shall not be eligible for
7payment under the medical assistance program, and the State
8shall have no liability for payment of those claims.
9    To the extent consistent with applicable information and
10privacy, security, and disclosure laws, State and federal
11agencies and departments shall provide the Illinois Department
12access to confidential and other information and data necessary
13to perform eligibility and payment verifications and other
14Illinois Department functions. This includes, but is not
15limited to: information pertaining to licensure;
16certification; earnings; immigration status; citizenship; wage
17reporting; unearned and earned income; pension income;
18employment; supplemental security income; social security
19numbers; National Provider Identifier (NPI) numbers; the
20National Practitioner Data Bank (NPDB); program and agency
21exclusions; taxpayer identification numbers; tax delinquency;
22corporate information; and death records.
23    The Illinois Department shall enter into agreements with
24State agencies and departments, and is authorized to enter into
25agreements with federal agencies and departments, under which
26such agencies and departments shall share data necessary for

 

 

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1medical assistance program integrity functions and oversight.
2The Illinois Department shall develop, in cooperation with
3other State departments and agencies, and in compliance with
4applicable federal laws and regulations, appropriate and
5effective methods to share such data. At a minimum, and to the
6extent necessary to provide data sharing, the Illinois
7Department shall enter into agreements with State agencies and
8departments, and is authorized to enter into agreements with
9federal agencies and departments, including but not limited to:
10the Secretary of State; the Department of Revenue; the
11Department of Public Health; the Department of Human Services;
12and the Department of Financial and Professional Regulation.
13    Beginning in fiscal year 2013, the Illinois Department
14shall set forth a request for information to identify the
15benefits of a pre-payment, post-adjudication, and post-edit
16claims system with the goals of streamlining claims processing
17and provider reimbursement, reducing the number of pending or
18rejected claims, and helping to ensure a more transparent
19adjudication process through the utilization of: (i) provider
20data verification and provider screening technology; and (ii)
21clinical code editing; and (iii) pre-pay, pre- or
22post-adjudicated predictive modeling with an integrated case
23management system with link analysis. Such a request for
24information shall not be considered as a request for proposal
25or as an obligation on the part of the Illinois Department to
26take any action or acquire any products or services.

 

 

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1    The Illinois Department shall establish policies,
2procedures, standards and criteria by rule for the acquisition,
3repair and replacement of orthotic and prosthetic devices and
4durable medical equipment. Such rules shall provide, but not be
5limited to, the following services: (1) immediate repair or
6replacement of such devices by recipients; and (2) rental,
7lease, purchase or lease-purchase of durable medical equipment
8in a cost-effective manner, taking into consideration the
9recipient's medical prognosis, the extent of the recipient's
10needs, and the requirements and costs for maintaining such
11equipment. Subject to prior approval, such rules shall enable a
12recipient to temporarily acquire and use alternative or
13substitute devices or equipment pending repairs or
14replacements of any device or equipment previously authorized
15for such recipient by the Department.
16    The Department shall execute, relative to the nursing home
17prescreening project, written inter-agency agreements with the
18Department of Human Services and the Department on Aging, to
19effect the following: (i) intake procedures and common
20eligibility criteria for those persons who are receiving
21non-institutional services; and (ii) the establishment and
22development of non-institutional services in areas of the State
23where they are not currently available or are undeveloped; and
24(iii) notwithstanding any other provision of law, subject to
25federal approval, on and after July 1, 2012, an increase in the
26determination of need (DON) scores from 29 to 37 for applicants

 

 

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1for institutional and home and community-based long term care;
2if and only if federal approval is not granted, the Department
3may, in conjunction with other affected agencies, implement
4utilization controls or changes in benefit packages to
5effectuate a similar savings amount for this population; and
6(iv) no later than July 1, 2013, minimum level of care
7eligibility criteria for institutional and home and
8community-based long term care; and (v) no later than October
91, 2013, establish procedures to permit long term care
10providers access to eligibility scores for individuals with an
11admission date who are seeking or receiving services from the
12long term care provider. In order to select the minimum level
13of care eligibility criteria, the Governor shall establish a
14workgroup that includes affected agency representatives and
15stakeholders representing the institutional and home and
16community-based long term care interests. This Section shall
17not restrict the Department from implementing lower level of
18care eligibility criteria for community-based services in
19circumstances where federal approval has been granted.
20    The Illinois Department shall develop and operate, in
21cooperation with other State Departments and agencies and in
22compliance with applicable federal laws and regulations,
23appropriate and effective systems of health care evaluation and
24programs for monitoring of utilization of health care services
25and facilities, as it affects persons eligible for medical
26assistance under this Code.

 

 

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1    The Illinois Department shall report annually to the
2General Assembly, no later than the second Friday in April of
31979 and each year thereafter, in regard to:
4        (a) actual statistics and trends in utilization of
5    medical services by public aid recipients;
6        (b) actual statistics and trends in the provision of
7    the various medical services by medical vendors;
8        (c) current rate structures and proposed changes in
9    those rate structures for the various medical vendors; and
10        (d) efforts at utilization review and control by the
11    Illinois Department.
12    The period covered by each report shall be the 3 years
13ending on the June 30 prior to the report. The report shall
14include suggested legislation for consideration by the General
15Assembly. The filing of one copy of the report with the
16Speaker, one copy with the Minority Leader and one copy with
17the Clerk of the House of Representatives, one copy with the
18President, one copy with the Minority Leader and one copy with
19the Secretary of the Senate, one copy with the Legislative
20Research Unit, and such additional copies with the State
21Government Report Distribution Center for the General Assembly
22as is required under paragraph (t) of Section 7 of the State
23Library Act shall be deemed sufficient to comply with this
24Section.
25    Rulemaking authority to implement Public Act 95-1045, if
26any, is conditioned on the rules being adopted in accordance

 

 

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1with all provisions of the Illinois Administrative Procedure
2Act and all rules and procedures of the Joint Committee on
3Administrative Rules; any purported rule not so adopted, for
4whatever reason, is unauthorized.
5    On and after July 1, 2012, the Department shall reduce any
6rate of reimbursement for services or other payments or alter
7any methodologies authorized by this Code to reduce any rate of
8reimbursement for services or other payments in accordance with
9Section 5-5e.
10    Because kidney transplantation can be an appropriate, cost
11effective alternative to renal dialysis when medically
12necessary and notwithstanding the provisions of Section 1-11 of
13this Code, beginning October 1, 2014, the Department shall
14cover kidney transplantation for noncitizens with end-stage
15renal disease who are not eligible for comprehensive medical
16benefits, who meet the residency requirements of Section 5-3 of
17this Code, and who would otherwise meet the financial
18requirements of the appropriate class of eligible persons under
19Section 5-2 of this Code. To qualify for coverage of kidney
20transplantation, such person must be receiving emergency renal
21dialysis services covered by the Department. Providers under
22this Section shall be prior approved and certified by the
23Department to perform kidney transplantation and the services
24under this Section shall be limited to services associated with
25kidney transplantation.
26    Notwithstanding any other provision of this Code to the

 

 

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1contrary, on or after July 1, 2015, all FDA approved forms of
2medication assisted treatment prescribed for the treatment of
3alcohol dependence or treatment of opioid dependence shall be
4covered under both fee for service and managed care medical
5assistance programs for persons who are otherwise eligible for
6medical assistance under this Article and shall not be subject
7to any (1) utilization control, other than those established
8under the American Society of Addiction Medicine patient
9placement criteria, (2) prior authorization mandate, or (3)
10lifetime restriction limit mandate.
11    On or after July 1, 2015, opioid antagonists prescribed for
12the treatment of an opioid overdose, including the medication
13product, administration devices, and any pharmacy fees related
14to the dispensing and administration of the opioid antagonist,
15shall be covered under the medical assistance program for
16persons who are otherwise eligible for medical assistance under
17this Article. As used in this Section, "opioid antagonist"
18means a drug that binds to opioid receptors and blocks or
19inhibits the effect of opioids acting on those receptors,
20including, but not limited to, naloxone hydrochloride or any
21other similarly acting drug approved by the U.S. Food and Drug
22Administration.
23(Source: P.A. 98-104, Article 9, Section 9-5, eff. 7-22-13;
2498-104, Article 12, Section 12-20, eff. 7-22-13; 98-303, eff.
258-9-13; 98-463, eff. 8-16-13; 98-651, eff. 6-16-14; 98-756,
26eff. 7-16-14; 98-963, eff. 8-15-14; 99-78, eff. 7-20-15;

 

 

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199-180, eff. 7-29-15; 99-236, eff. 8-3-15; 99-433, eff.
28-21-15; 99-480, eff. 9-9-15; revised 10-13-15.)
 
3    (Text of Section after amendment by P.A. 99-407)
4    Sec. 5-5. Medical services. The Illinois Department, by
5rule, shall determine the quantity and quality of and the rate
6of reimbursement for the medical assistance for which payment
7will be authorized, and the medical services to be provided,
8which may include all or part of the following: (1) inpatient
9hospital services; (2) outpatient hospital services; (3) other
10laboratory and X-ray services; (4) skilled nursing home
11services; (5) physicians' services whether furnished in the
12office, the patient's home, a hospital, a skilled nursing home,
13or elsewhere; (6) medical care, or any other type of remedial
14care furnished by licensed practitioners, including the
15services of certified professional midwives licensed pursuant
16to the Home Birth Safety Act; (7) home health care services;
17(8) private duty nursing service; (9) clinic services; (10)
18dental services, including prevention and treatment of
19periodontal disease and dental caries disease for pregnant
20women, provided by an individual licensed to practice dentistry
21or dental surgery; for purposes of this item (10), "dental
22services" means diagnostic, preventive, or corrective
23procedures provided by or under the supervision of a dentist in
24the practice of his or her profession; (11) physical therapy
25and related services; (12) prescribed drugs, dentures, and

 

 

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1prosthetic devices; and eyeglasses prescribed by a physician
2skilled in the diseases of the eye, or by an optometrist,
3whichever the person may select; (13) other diagnostic,
4screening, preventive, and rehabilitative services, including
5to ensure that the individual's need for intervention or
6treatment of mental disorders or substance use disorders or
7co-occurring mental health and substance use disorders is
8determined using a uniform screening, assessment, and
9evaluation process inclusive of criteria, for children and
10adults; for purposes of this item (13), a uniform screening,
11assessment, and evaluation process refers to a process that
12includes an appropriate evaluation and, as warranted, a
13referral; "uniform" does not mean the use of a singular
14instrument, tool, or process that all must utilize; (14)
15transportation and such other expenses as may be necessary;
16(15) medical treatment of sexual assault survivors, as defined
17in Section 1a of the Sexual Assault Survivors Emergency
18Treatment Act, for injuries sustained as a result of the sexual
19assault, including examinations and laboratory tests to
20discover evidence which may be used in criminal proceedings
21arising from the sexual assault; (16) the diagnosis and
22treatment of sickle cell anemia; and (17) any other medical
23care, and any other type of remedial care recognized under the
24laws of this State, but not including abortions, or induced
25miscarriages or premature births, unless, in the opinion of a
26physician, such procedures are necessary for the preservation

 

 

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1of the life of the woman seeking such treatment, or except an
2induced premature birth intended to produce a live viable child
3and such procedure is necessary for the health of the mother or
4her unborn child. The Illinois Department, by rule, shall
5prohibit any physician from providing medical assistance to
6anyone eligible therefor under this Code where such physician
7has been found guilty of performing an abortion procedure in a
8wilful and wanton manner upon a woman who was not pregnant at
9the time such abortion procedure was performed. The term "any
10other type of remedial care" shall include nursing care and
11nursing home service for persons who rely on treatment by
12spiritual means alone through prayer for healing.
13    Notwithstanding any other provision of this Section, a
14comprehensive tobacco use cessation program that includes
15purchasing prescription drugs or prescription medical devices
16approved by the Food and Drug Administration shall be covered
17under the medical assistance program under this Article for
18persons who are otherwise eligible for assistance under this
19Article.
20    Notwithstanding any other provision of this Code, the
21Illinois Department may not require, as a condition of payment
22for any laboratory test authorized under this Article, that a
23physician's handwritten signature appear on the laboratory
24test order form. The Illinois Department may, however, impose
25other appropriate requirements regarding laboratory test order
26documentation.

 

 

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1    Upon receipt of federal approval of an amendment to the
2Illinois Title XIX State Plan for this purpose, the Department
3shall authorize the Chicago Public Schools (CPS) to procure a
4vendor or vendors to manufacture eyeglasses for individuals
5enrolled in a school within the CPS system. CPS shall ensure
6that its vendor or vendors are enrolled as providers in the
7medical assistance program and in any capitated Medicaid
8managed care entity (MCE) serving individuals enrolled in a
9school within the CPS system. Under any contract procured under
10this provision, the vendor or vendors must serve only
11individuals enrolled in a school within the CPS system. Claims
12for services provided by CPS's vendor or vendors to recipients
13of benefits in the medical assistance program under this Code,
14the Children's Health Insurance Program, or the Covering ALL
15KIDS Health Insurance Program shall be submitted to the
16Department or the MCE in which the individual is enrolled for
17payment and shall be reimbursed at the Department's or the
18MCE's established rates or rate methodologies for eyeglasses.
19    On and after July 1, 2012, the Department of Healthcare and
20Family Services may provide the following services to persons
21eligible for assistance under this Article who are
22participating in education, training or employment programs
23operated by the Department of Human Services as successor to
24the Department of Public Aid:
25        (1) dental services provided by or under the
26    supervision of a dentist; and

 

 

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1        (2) eyeglasses prescribed by a physician skilled in the
2    diseases of the eye, or by an optometrist, whichever the
3    person may select.
4    Notwithstanding any other provision of this Code and
5subject to federal approval, the Department may adopt rules to
6allow a dentist who is volunteering his or her service at no
7cost to render dental services through an enrolled
8not-for-profit health clinic without the dentist personally
9enrolling as a participating provider in the medical assistance
10program. A not-for-profit health clinic shall include a public
11health clinic or Federally Qualified Health Center or other
12enrolled provider, as determined by the Department, through
13which dental services covered under this Section are performed.
14The Department shall establish a process for payment of claims
15for reimbursement for covered dental services rendered under
16this provision.
17    The Illinois Department, by rule, may distinguish and
18classify the medical services to be provided only in accordance
19with the classes of persons designated in Section 5-2.
20    The Department of Healthcare and Family Services must
21provide coverage and reimbursement for amino acid-based
22elemental formulas, regardless of delivery method, for the
23diagnosis and treatment of (i) eosinophilic disorders and (ii)
24short bowel syndrome when the prescribing physician has issued
25a written order stating that the amino acid-based elemental
26formula is medically necessary.

 

 

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1    The Illinois Department shall authorize the provision of,
2and shall authorize payment for, screening by low-dose
3mammography for the presence of occult breast cancer for women
435 years of age or older who are eligible for medical
5assistance under this Article, as follows:
6        (A) A baseline mammogram for women 35 to 39 years of
7    age.
8        (B) An annual mammogram for women 40 years of age or
9    older.
10        (C) A mammogram at the age and intervals considered
11    medically necessary by the woman's health care provider for
12    women under 40 years of age and having a family history of
13    breast cancer, prior personal history of breast cancer,
14    positive genetic testing, or other risk factors.
15        (D) A comprehensive ultrasound screening of an entire
16    breast or breasts if a mammogram demonstrates
17    heterogeneous or dense breast tissue, when medically
18    necessary as determined by a physician licensed to practice
19    medicine in all of its branches.
20        (E) A screening MRI when medically necessary, as
21    determined by a physician licensed to practice medicine in
22    all of its branches.
23    All screenings shall include a physical breast exam,
24instruction on self-examination and information regarding the
25frequency of self-examination and its value as a preventative
26tool. For purposes of this Section, "low-dose mammography"

 

 

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1means the x-ray examination of the breast using equipment
2dedicated specifically for mammography, including the x-ray
3tube, filter, compression device, and image receptor, with an
4average radiation exposure delivery of less than one rad per
5breast for 2 views of an average size breast. The term also
6includes digital mammography and includes breast
7tomosynthesis. As used in this Section, the term "breast
8tomosynthesis" means a radiologic procedure that involves the
9acquisition of projection images over the stationary breast to
10produce cross-sectional digital three-dimensional images of
11the breast.
12    On and after January 1, 2016, the Department shall ensure
13that all networks of care for adult clients of the Department
14include access to at least one breast imaging Center of Imaging
15Excellence as certified by the American College of Radiology.
16    On and after January 1, 2012, providers participating in a
17quality improvement program approved by the Department shall be
18reimbursed for screening and diagnostic mammography at the same
19rate as the Medicare program's rates, including the increased
20reimbursement for digital mammography.
21    The Department shall convene an expert panel including
22representatives of hospitals, free-standing mammography
23facilities, and doctors, including radiologists, to establish
24quality standards for mammography.
25    On and after January 1, 2017, providers participating in a
26breast cancer treatment quality improvement program approved

 

 

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1by the Department shall be reimbursed for breast cancer
2treatment at a rate that is no lower than 95% of the Medicare
3program's rates for the data elements included in the breast
4cancer treatment quality program.
5    The Department shall convene an expert panel, including
6representatives of hospitals, free standing breast cancer
7treatment centers, breast cancer quality organizations, and
8doctors, including breast surgeons, reconstructive breast
9surgeons, oncologists, and primary care providers to establish
10quality standards for breast cancer treatment.
11    Subject to federal approval, the Department shall
12establish a rate methodology for mammography at federally
13qualified health centers and other encounter-rate clinics.
14These clinics or centers may also collaborate with other
15hospital-based mammography facilities. By January 1, 2016, the
16Department shall report to the General Assembly on the status
17of the provision set forth in this paragraph.
18    The Department shall establish a methodology to remind
19women who are age-appropriate for screening mammography, but
20who have not received a mammogram within the previous 18
21months, of the importance and benefit of screening mammography.
22The Department shall work with experts in breast cancer
23outreach and patient navigation to optimize these reminders and
24shall establish a methodology for evaluating their
25effectiveness and modifying the methodology based on the
26evaluation.

 

 

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1    The Department shall establish a performance goal for
2primary care providers with respect to their female patients
3over age 40 receiving an annual mammogram. This performance
4goal shall be used to provide additional reimbursement in the
5form of a quality performance bonus to primary care providers
6who meet that goal.
7    The Department shall devise a means of case-managing or
8patient navigation for beneficiaries diagnosed with breast
9cancer. This program shall initially operate as a pilot program
10in areas of the State with the highest incidence of mortality
11related to breast cancer. At least one pilot program site shall
12be in the metropolitan Chicago area and at least one site shall
13be outside the metropolitan Chicago area. On or after July 1,
142016, the pilot program shall be expanded to include one site
15in western Illinois, one site in southern Illinois, one site in
16central Illinois, and 4 sites within metropolitan Chicago. An
17evaluation of the pilot program shall be carried out measuring
18health outcomes and cost of care for those served by the pilot
19program compared to similarly situated patients who are not
20served by the pilot program.
21    The Department shall require all networks of care to
22develop a means either internally or by contract with experts
23in navigation and community outreach to navigate cancer
24patients to comprehensive care in a timely fashion. The
25Department shall require all networks of care to include access
26for patients diagnosed with cancer to at least one academic

 

 

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1commission on cancer-accredited cancer program as an
2in-network covered benefit.
3    Any medical or health care provider shall immediately
4recommend, to any pregnant woman who is being provided prenatal
5services and is suspected of drug abuse or is addicted as
6defined in the Alcoholism and Other Drug Abuse and Dependency
7Act, referral to a local substance abuse treatment provider
8licensed by the Department of Human Services or to a licensed
9hospital which provides substance abuse treatment services.
10The Department of Healthcare and Family Services shall assure
11coverage for the cost of treatment of the drug abuse or
12addiction for pregnant recipients in accordance with the
13Illinois Medicaid Program in conjunction with the Department of
14Human Services.
15    All medical providers providing medical assistance to
16pregnant women under this Code shall receive information from
17the Department on the availability of services under the Drug
18Free Families with a Future or any comparable program providing
19case management services for addicted women, including
20information on appropriate referrals for other social services
21that may be needed by addicted women in addition to treatment
22for addiction.
23    The Illinois Department, in cooperation with the
24Departments of Human Services (as successor to the Department
25of Alcoholism and Substance Abuse) and Public Health, through a
26public awareness campaign, may provide information concerning

 

 

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1treatment for alcoholism and drug abuse and addiction, prenatal
2health care, and other pertinent programs directed at reducing
3the number of drug-affected infants born to recipients of
4medical assistance.
5    Neither the Department of Healthcare and Family Services
6nor the Department of Human Services shall sanction the
7recipient solely on the basis of her substance abuse.
8    The Illinois Department shall establish such regulations
9governing the dispensing of health services under this Article
10as it shall deem appropriate. The Department should seek the
11advice of formal professional advisory committees appointed by
12the Director of the Illinois Department for the purpose of
13providing regular advice on policy and administrative matters,
14information dissemination and educational activities for
15medical and health care providers, and consistency in
16procedures to the Illinois Department.
17    The Illinois Department may develop and contract with
18Partnerships of medical providers to arrange medical services
19for persons eligible under Section 5-2 of this Code.
20Implementation of this Section may be by demonstration projects
21in certain geographic areas. The Partnership shall be
22represented by a sponsor organization. The Department, by rule,
23shall develop qualifications for sponsors of Partnerships.
24Nothing in this Section shall be construed to require that the
25sponsor organization be a medical organization.
26    The sponsor must negotiate formal written contracts with

 

 

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1medical providers for physician services, inpatient and
2outpatient hospital care, home health services, treatment for
3alcoholism and substance abuse, and other services determined
4necessary by the Illinois Department by rule for delivery by
5Partnerships. Physician services must include prenatal and
6obstetrical care. The Illinois Department shall reimburse
7medical services delivered by Partnership providers to clients
8in target areas according to provisions of this Article and the
9Illinois Health Finance Reform Act, except that:
10        (1) Physicians participating in a Partnership and
11    providing certain services, which shall be determined by
12    the Illinois Department, to persons in areas covered by the
13    Partnership may receive an additional surcharge for such
14    services.
15        (2) The Department may elect to consider and negotiate
16    financial incentives to encourage the development of
17    Partnerships and the efficient delivery of medical care.
18        (3) Persons receiving medical services through
19    Partnerships may receive medical and case management
20    services above the level usually offered through the
21    medical assistance program.
22    Medical providers shall be required to meet certain
23qualifications to participate in Partnerships to ensure the
24delivery of high quality medical services. These
25qualifications shall be determined by rule of the Illinois
26Department and may be higher than qualifications for

 

 

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1participation in the medical assistance program. Partnership
2sponsors may prescribe reasonable additional qualifications
3for participation by medical providers, only with the prior
4written approval of the Illinois Department.
5    Nothing in this Section shall limit the free choice of
6practitioners, hospitals, and other providers of medical
7services by clients. In order to ensure patient freedom of
8choice, the Illinois Department shall immediately promulgate
9all rules and take all other necessary actions so that provided
10services may be accessed from therapeutically certified
11optometrists to the full extent of the Illinois Optometric
12Practice Act of 1987 without discriminating between service
13providers.
14    The Department shall apply for a waiver from the United
15States Health Care Financing Administration to allow for the
16implementation of Partnerships under this Section.
17    The Illinois Department shall require health care
18providers to maintain records that document the medical care
19and services provided to recipients of Medical Assistance under
20this Article. Such records must be retained for a period of not
21less than 6 years from the date of service or as provided by
22applicable State law, whichever period is longer, except that
23if an audit is initiated within the required retention period
24then the records must be retained until the audit is completed
25and every exception is resolved. The Illinois Department shall
26require health care providers to make available, when

 

 

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1authorized by the patient, in writing, the medical records in a
2timely fashion to other health care providers who are treating
3or serving persons eligible for Medical Assistance under this
4Article. All dispensers of medical services shall be required
5to maintain and retain business and professional records
6sufficient to fully and accurately document the nature, scope,
7details and receipt of the health care provided to persons
8eligible for medical assistance under this Code, in accordance
9with regulations promulgated by the Illinois Department. The
10rules and regulations shall require that proof of the receipt
11of prescription drugs, dentures, prosthetic devices and
12eyeglasses by eligible persons under this Section accompany
13each claim for reimbursement submitted by the dispenser of such
14medical services. No such claims for reimbursement shall be
15approved for payment by the Illinois Department without such
16proof of receipt, unless the Illinois Department shall have put
17into effect and shall be operating a system of post-payment
18audit and review which shall, on a sampling basis, be deemed
19adequate by the Illinois Department to assure that such drugs,
20dentures, prosthetic devices and eyeglasses for which payment
21is being made are actually being received by eligible
22recipients. Within 90 days after September 16, 1984 (the
23effective date of Public Act 83-1439) this amendatory Act of
241984, the Illinois Department shall establish a current list of
25acquisition costs for all prosthetic devices and any other
26items recognized as medical equipment and supplies

 

 

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1reimbursable under this Article and shall update such list on a
2quarterly basis, except that the acquisition costs of all
3prescription drugs shall be updated no less frequently than
4every 30 days as required by Section 5-5.12.
5    The rules and regulations of the Illinois Department shall
6require that a written statement including the required opinion
7of a physician shall accompany any claim for reimbursement for
8abortions, or induced miscarriages or premature births. This
9statement shall indicate what procedures were used in providing
10such medical services.
11    Notwithstanding any other law to the contrary, the Illinois
12Department shall, within 365 days after July 22, 2013 (the
13effective date of Public Act 98-104), establish procedures to
14permit skilled care facilities licensed under the Nursing Home
15Care Act to submit monthly billing claims for reimbursement
16purposes. Following development of these procedures, the
17Department shall, by July 1, 2016, test the viability of the
18new system and implement any necessary operational or
19structural changes to its information technology platforms in
20order to allow for the direct acceptance and payment of nursing
21home claims.
22    Notwithstanding any other law to the contrary, the Illinois
23Department shall, within 365 days after August 15, 2014 (the
24effective date of Public Act 98-963), establish procedures to
25permit ID/DD facilities licensed under the ID/DD Community Care
26Act and MC/DD facilities licensed under the MC/DD Act to submit

 

 

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1monthly billing claims for reimbursement purposes. Following
2development of these procedures, the Department shall have an
3additional 365 days to test the viability of the new system and
4to ensure that any necessary operational or structural changes
5to its information technology platforms are implemented.
6    The Illinois Department shall require all dispensers of
7medical services, other than an individual practitioner or
8group of practitioners, desiring to participate in the Medical
9Assistance program established under this Article to disclose
10all financial, beneficial, ownership, equity, surety or other
11interests in any and all firms, corporations, partnerships,
12associations, business enterprises, joint ventures, agencies,
13institutions or other legal entities providing any form of
14health care services in this State under this Article.
15    The Illinois Department may require that all dispensers of
16medical services desiring to participate in the medical
17assistance program established under this Article disclose,
18under such terms and conditions as the Illinois Department may
19by rule establish, all inquiries from clients and attorneys
20regarding medical bills paid by the Illinois Department, which
21inquiries could indicate potential existence of claims or liens
22for the Illinois Department.
23    Enrollment of a vendor shall be subject to a provisional
24period and shall be conditional for one year. During the period
25of conditional enrollment, the Department may terminate the
26vendor's eligibility to participate in, or may disenroll the

 

 

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1vendor from, the medical assistance program without cause.
2Unless otherwise specified, such termination of eligibility or
3disenrollment is not subject to the Department's hearing
4process. However, a disenrolled vendor may reapply without
5penalty.
6    The Department has the discretion to limit the conditional
7enrollment period for vendors based upon category of risk of
8the vendor.
9    Prior to enrollment and during the conditional enrollment
10period in the medical assistance program, all vendors shall be
11subject to enhanced oversight, screening, and review based on
12the risk of fraud, waste, and abuse that is posed by the
13category of risk of the vendor. The Illinois Department shall
14establish the procedures for oversight, screening, and review,
15which may include, but need not be limited to: criminal and
16financial background checks; fingerprinting; license,
17certification, and authorization verifications; unscheduled or
18unannounced site visits; database checks; prepayment audit
19reviews; audits; payment caps; payment suspensions; and other
20screening as required by federal or State law.
21    The Department shall define or specify the following: (i)
22by provider notice, the "category of risk of the vendor" for
23each type of vendor, which shall take into account the level of
24screening applicable to a particular category of vendor under
25federal law and regulations; (ii) by rule or provider notice,
26the maximum length of the conditional enrollment period for

 

 

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1each category of risk of the vendor; and (iii) by rule, the
2hearing rights, if any, afforded to a vendor in each category
3of risk of the vendor that is terminated or disenrolled during
4the conditional enrollment period.
5    To be eligible for payment consideration, a vendor's
6payment claim or bill, either as an initial claim or as a
7resubmitted claim following prior rejection, must be received
8by the Illinois Department, or its fiscal intermediary, no
9later than 180 days after the latest date on the claim on which
10medical goods or services were provided, with the following
11exceptions:
12        (1) In the case of a provider whose enrollment is in
13    process by the Illinois Department, the 180-day period
14    shall not begin until the date on the written notice from
15    the Illinois Department that the provider enrollment is
16    complete.
17        (2) In the case of errors attributable to the Illinois
18    Department or any of its claims processing intermediaries
19    which result in an inability to receive, process, or
20    adjudicate a claim, the 180-day period shall not begin
21    until the provider has been notified of the error.
22        (3) In the case of a provider for whom the Illinois
23    Department initiates the monthly billing process.
24        (4) In the case of a provider operated by a unit of
25    local government with a population exceeding 3,000,000
26    when local government funds finance federal participation

 

 

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1    for claims payments.
2    For claims for services rendered during a period for which
3a recipient received retroactive eligibility, claims must be
4filed within 180 days after the Department determines the
5applicant is eligible. For claims for which the Illinois
6Department is not the primary payer, claims must be submitted
7to the Illinois Department within 180 days after the final
8adjudication by the primary payer.
9    In the case of long term care facilities, within 5 days of
10receipt by the facility of required prescreening information,
11data for new admissions shall be entered into the Medical
12Electronic Data Interchange (MEDI) or the Recipient
13Eligibility Verification (REV) System or successor system, and
14within 15 days of receipt by the facility of required
15prescreening information, admission documents shall be
16submitted through MEDI or REV or shall be submitted directly to
17the Department of Human Services using required admission
18forms. Effective September 1, 2014, admission documents,
19including all prescreening information, must be submitted
20through MEDI or REV. Confirmation numbers assigned to an
21accepted transaction shall be retained by a facility to verify
22timely submittal. Once an admission transaction has been
23completed, all resubmitted claims following prior rejection
24are subject to receipt no later than 180 days after the
25admission transaction has been completed.
26    Claims that are not submitted and received in compliance

 

 

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1with the foregoing requirements shall not be eligible for
2payment under the medical assistance program, and the State
3shall have no liability for payment of those claims.
4    To the extent consistent with applicable information and
5privacy, security, and disclosure laws, State and federal
6agencies and departments shall provide the Illinois Department
7access to confidential and other information and data necessary
8to perform eligibility and payment verifications and other
9Illinois Department functions. This includes, but is not
10limited to: information pertaining to licensure;
11certification; earnings; immigration status; citizenship; wage
12reporting; unearned and earned income; pension income;
13employment; supplemental security income; social security
14numbers; National Provider Identifier (NPI) numbers; the
15National Practitioner Data Bank (NPDB); program and agency
16exclusions; taxpayer identification numbers; tax delinquency;
17corporate information; and death records.
18    The Illinois Department shall enter into agreements with
19State agencies and departments, and is authorized to enter into
20agreements with federal agencies and departments, under which
21such agencies and departments shall share data necessary for
22medical assistance program integrity functions and oversight.
23The Illinois Department shall develop, in cooperation with
24other State departments and agencies, and in compliance with
25applicable federal laws and regulations, appropriate and
26effective methods to share such data. At a minimum, and to the

 

 

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1extent necessary to provide data sharing, the Illinois
2Department shall enter into agreements with State agencies and
3departments, and is authorized to enter into agreements with
4federal agencies and departments, including but not limited to:
5the Secretary of State; the Department of Revenue; the
6Department of Public Health; the Department of Human Services;
7and the Department of Financial and Professional Regulation.
8    Beginning in fiscal year 2013, the Illinois Department
9shall set forth a request for information to identify the
10benefits of a pre-payment, post-adjudication, and post-edit
11claims system with the goals of streamlining claims processing
12and provider reimbursement, reducing the number of pending or
13rejected claims, and helping to ensure a more transparent
14adjudication process through the utilization of: (i) provider
15data verification and provider screening technology; and (ii)
16clinical code editing; and (iii) pre-pay, pre- or
17post-adjudicated predictive modeling with an integrated case
18management system with link analysis. Such a request for
19information shall not be considered as a request for proposal
20or as an obligation on the part of the Illinois Department to
21take any action or acquire any products or services.
22    The Illinois Department shall establish policies,
23procedures, standards and criteria by rule for the acquisition,
24repair and replacement of orthotic and prosthetic devices and
25durable medical equipment. Such rules shall provide, but not be
26limited to, the following services: (1) immediate repair or

 

 

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1replacement of such devices by recipients; and (2) rental,
2lease, purchase or lease-purchase of durable medical equipment
3in a cost-effective manner, taking into consideration the
4recipient's medical prognosis, the extent of the recipient's
5needs, and the requirements and costs for maintaining such
6equipment. Subject to prior approval, such rules shall enable a
7recipient to temporarily acquire and use alternative or
8substitute devices or equipment pending repairs or
9replacements of any device or equipment previously authorized
10for such recipient by the Department.
11    The Department shall execute, relative to the nursing home
12prescreening project, written inter-agency agreements with the
13Department of Human Services and the Department on Aging, to
14effect the following: (i) intake procedures and common
15eligibility criteria for those persons who are receiving
16non-institutional services; and (ii) the establishment and
17development of non-institutional services in areas of the State
18where they are not currently available or are undeveloped; and
19(iii) notwithstanding any other provision of law, subject to
20federal approval, on and after July 1, 2012, an increase in the
21determination of need (DON) scores from 29 to 37 for applicants
22for institutional and home and community-based long term care;
23if and only if federal approval is not granted, the Department
24may, in conjunction with other affected agencies, implement
25utilization controls or changes in benefit packages to
26effectuate a similar savings amount for this population; and

 

 

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1(iv) no later than July 1, 2013, minimum level of care
2eligibility criteria for institutional and home and
3community-based long term care; and (v) no later than October
41, 2013, establish procedures to permit long term care
5providers access to eligibility scores for individuals with an
6admission date who are seeking or receiving services from the
7long term care provider. In order to select the minimum level
8of care eligibility criteria, the Governor shall establish a
9workgroup that includes affected agency representatives and
10stakeholders representing the institutional and home and
11community-based long term care interests. This Section shall
12not restrict the Department from implementing lower level of
13care eligibility criteria for community-based services in
14circumstances where federal approval has been granted.
15    The Illinois Department shall develop and operate, in
16cooperation with other State Departments and agencies and in
17compliance with applicable federal laws and regulations,
18appropriate and effective systems of health care evaluation and
19programs for monitoring of utilization of health care services
20and facilities, as it affects persons eligible for medical
21assistance under this Code.
22    The Illinois Department shall report annually to the
23General Assembly, no later than the second Friday in April of
241979 and each year thereafter, in regard to:
25        (a) actual statistics and trends in utilization of
26    medical services by public aid recipients;

 

 

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1        (b) actual statistics and trends in the provision of
2    the various medical services by medical vendors;
3        (c) current rate structures and proposed changes in
4    those rate structures for the various medical vendors; and
5        (d) efforts at utilization review and control by the
6    Illinois Department.
7    The period covered by each report shall be the 3 years
8ending on the June 30 prior to the report. The report shall
9include suggested legislation for consideration by the General
10Assembly. The filing of one copy of the report with the
11Speaker, one copy with the Minority Leader and one copy with
12the Clerk of the House of Representatives, one copy with the
13President, one copy with the Minority Leader and one copy with
14the Secretary of the Senate, one copy with the Legislative
15Research Unit, and such additional copies with the State
16Government Report Distribution Center for the General Assembly
17as is required under paragraph (t) of Section 7 of the State
18Library Act shall be deemed sufficient to comply with this
19Section.
20    Rulemaking authority to implement Public Act 95-1045, if
21any, is conditioned on the rules being adopted in accordance
22with all provisions of the Illinois Administrative Procedure
23Act and all rules and procedures of the Joint Committee on
24Administrative Rules; any purported rule not so adopted, for
25whatever reason, is unauthorized.
26    On and after July 1, 2012, the Department shall reduce any

 

 

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1rate of reimbursement for services or other payments or alter
2any methodologies authorized by this Code to reduce any rate of
3reimbursement for services or other payments in accordance with
4Section 5-5e.
5    Because kidney transplantation can be an appropriate, cost
6effective alternative to renal dialysis when medically
7necessary and notwithstanding the provisions of Section 1-11 of
8this Code, beginning October 1, 2014, the Department shall
9cover kidney transplantation for noncitizens with end-stage
10renal disease who are not eligible for comprehensive medical
11benefits, who meet the residency requirements of Section 5-3 of
12this Code, and who would otherwise meet the financial
13requirements of the appropriate class of eligible persons under
14Section 5-2 of this Code. To qualify for coverage of kidney
15transplantation, such person must be receiving emergency renal
16dialysis services covered by the Department. Providers under
17this Section shall be prior approved and certified by the
18Department to perform kidney transplantation and the services
19under this Section shall be limited to services associated with
20kidney transplantation.
21    Notwithstanding any other provision of this Code to the
22contrary, on or after July 1, 2015, all FDA approved forms of
23medication assisted treatment prescribed for the treatment of
24alcohol dependence or treatment of opioid dependence shall be
25covered under both fee for service and managed care medical
26assistance programs for persons who are otherwise eligible for

 

 

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1medical assistance under this Article and shall not be subject
2to any (1) utilization control, other than those established
3under the American Society of Addiction Medicine patient
4placement criteria, (2) prior authorization mandate, or (3)
5lifetime restriction limit mandate.
6    On or after July 1, 2015, opioid antagonists prescribed for
7the treatment of an opioid overdose, including the medication
8product, administration devices, and any pharmacy fees related
9to the dispensing and administration of the opioid antagonist,
10shall be covered under the medical assistance program for
11persons who are otherwise eligible for medical assistance under
12this Article. As used in this Section, "opioid antagonist"
13means a drug that binds to opioid receptors and blocks or
14inhibits the effect of opioids acting on those receptors,
15including, but not limited to, naloxone hydrochloride or any
16other similarly acting drug approved by the U.S. Food and Drug
17Administration.
18(Source: P.A. 98-104, Article 9, Section 9-5, eff. 7-22-13;
1998-104, Article 12, Section 12-20, eff. 7-22-13; 98-303, eff.
208-9-13; 98-463, eff. 8-16-13; 98-651, eff. 6-16-14; 98-756,
21eff. 7-16-14; 98-963, eff. 8-15-14; 99-78, eff. 7-20-15;
2299-180, eff. 7-29-15; 99-236, eff. 8-3-15; 99-407 (see Section
2399 of P.A. 99-407 for its effective date); 99-433, eff.
248-21-15; 99-480, eff. 9-9-15; revised 10-13-15.)
 
25    Section 995. No acceleration or delay. Where this Act makes

 

 

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1changes in a statute that is represented in this Act by text
2that is not yet or no longer in effect (for example, a Section
3represented by multiple versions), the use of that text does
4not accelerate or delay the taking effect of (i) the changes
5made by this Act or (ii) provisions derived from any other
6Public Act.
 
7    Section 999. Effective date. This Act takes effect July 1,
82016.