Illinois General Assembly - Full Text of HB5417
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Full Text of HB5417  103rd General Assembly

HB5417eng 103RD GENERAL ASSEMBLY

 


 
HB5417 EngrossedLRB103 39489 CES 69685 b

1    AN ACT concerning health.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Insurance Code is amended by
5adding Section 356z.71 as follows:
 
6    (215 ILCS 5/356z.71 new)
7    Sec. 356z.71. Coverage for home test kits for sexually
8transmitted infections (STIs).
9    (a) As used in this Section, "home test kit" means a
10product used for a test recommended by the federal Centers for
11Disease Control and Prevention guidelines or the United States
12Preventive Services Task Force that has received a certificate
13of waiver under the Clinical Laboratory Improvement Amendments
14to the federal Public Health Services Act, has been cleared or
15approved by the United States Food and Drug Administration, or
16has been developed by a laboratory in accordance with
17established regulations and quality standards, to allow
18individuals to self-collect specimens for STIs, including HIV,
19remotely at a location outside of a clinical setting.
20    (b) An individual or group policy of accident and health
21insurance amended, delivered, issued, or renewed in this State
22after January 1, 2026 shall provide coverage for home test
23kits for sexually transmitted infections, including any

 

 

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1laboratory costs of processing the kit, that are deemed
2medically necessary or appropriate and ordered directly by a
3clinician for patient use based on clinical guidelines and
4individual patient health needs.
5        (1) A commercial health care plan is required to cover
6    the services outlined in this subsection when ordered for
7    an enrollee by an in-network provider.
8        (2) Except as otherwise provided in this subsection, a
9    policy subject to this subsection shall not impose a
10    deductible, coinsurance, copayment, or any other
11    cost-sharing requirement on the coverage provided. The
12    provisions of this subsection do not apply to coverage of
13    procedures to the extent such coverage would disqualify a
14    high-deductible health plan from eligibility for a health
15    savings account pursuant to the federal Internal Revenue
16    Code, 26 U.S.C. 223.
17        (3) Except as otherwise authorized under this Section,
18    a policy shall not impose any restrictions or delays on
19    the coverage required under this Section.
20        (4) If a plan or issuer uses a network of providers,
21    nothing in this Section shall be construed to require
22    coverage or to prohibit the plan or issuer from imposing
23    cost-sharing for items or services described in this
24    Section that are provided or delivered by an
25    out-of-network provider, unless the plan or issuer does
26    not have in its network a provider who is able to or is

 

 

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1    willing to provide the applicable items or services.
 
2    Section 10. The Illinois Public Aid Code is amended by
3changing Section 5-16.8 as follows:
 
4    (305 ILCS 5/5-16.8)
5    Sec. 5-16.8. Required health benefits. The medical
6assistance program shall (i) provide the post-mastectomy care
7benefits required to be covered by a policy of accident and
8health insurance under Section 356t and the coverage required
9under Sections 356g.5, 356q, 356u, 356w, 356x, 356z.6,
10356z.26, 356z.29, 356z.32, 356z.33, 356z.34, 356z.35, 356z.46,
11356z.47, 356z.51, 356z.53, 356z.56, 356z.59, 356z.60, and
12356z.61, 356z.64, 356z.67, and 356z.71 of the Illinois
13Insurance Code, (ii) be subject to the provisions of Sections
14356z.19, 356z.44, 356z.49, 364.01, 370c, and 370c.1 of the
15Illinois Insurance Code, and (iii) be subject to the
16provisions of subsection (d-5) of Section 10 of the Network
17Adequacy and Transparency Act.
18    The Department, by rule, shall adopt a model similar to
19the requirements of Section 356z.39 of the Illinois Insurance
20Code.
21    On and after July 1, 2012, the Department shall reduce any
22rate of reimbursement for services or other payments or alter
23any methodologies authorized by this Code to reduce any rate
24of reimbursement for services or other payments in accordance

 

 

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1with Section 5-5e.
2    To ensure full access to the benefits set forth in this
3Section, on and after January 1, 2016, the Department shall
4ensure that provider and hospital reimbursement for
5post-mastectomy care benefits required under this Section are
6no lower than the Medicare reimbursement rate.
7(Source: P.A. 102-30, eff. 1-1-22; 102-144, eff. 1-1-22;
8102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-530, eff.
91-1-22; 102-642, eff. 1-1-22; 102-804, eff. 1-1-23; 102-813,
10eff. 5-13-22; 102-816, eff. 1-1-23; 102-1093, eff. 1-1-23;
11102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91, eff.
121-1-24; 103-420, eff. 1-1-24; revised 12-15-23.)
 
13    Section 15. The AIDS Confidentiality Act is amended by
14adding Section 5.6 as follows:
 
15    (410 ILCS 305/5.6 new)
16    Sec. 5.6. Illinois AIDS Drug Assistance Program.
17    (a) The purpose of this Section is to expand and assist
18with implementation of the Rapid Start for HIV treatment
19model. The pilot sites will allow the development of a
20coordinated system of health care services to provide timely
21and quality HIV treatment. This will occur by increasing the
22capacity of the Department of Public Health and build toward
23establishing the Rapid Start model as the standard of care for
24HIV treatment. This program shall be known as the Illinois

 

 

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1AIDS Drug Assistance Program or Illinois ADAP.
2    (b) In this Section:
3    "Conditional approval" means Illinois ADAP approval within
4one business day after submission of documentation of Illinois
5residency, a program agreement form, and an attestation of
6remaining eligibility requirements.
7    "Rapid Start for HIV Treatment" means initiating
8antiretroviral therapy within 7 days after initial diagnosis
9or within 7 days after referral to HIV medical care as defined
10by the Centers for Disease Control and Prevention
11recommendations for HIV treatment.
12    (c) Beginning January 1, 2026, Illinois ADAP shall
13establish a pathway for conditional approval of Illinois ADAP
14enrollment for new applicants seeking to enter or reenter
15medical care. Applicants receiving conditional approval on or
16after January 1, 2026 will have 30 days to submit a complete
17Illinois ADAP application, addressing all remaining
18eligibility requirements.
19    (d) The Department of Public Health shall establish one
20Rapid Start for HIV Treatment pilot site per HIV Care Connect
21Region. The Department may implement processes and adopt rules
22to implement this pilot program in accordance with industry
23standards informed by the most current Centers for Disease
24Control and Prevention and Health Resources and Services
25Administration guidance on HIV care and treatment.
26    (e) The pilot sites shall abide by the following

 

 

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1principles:
2        (1) Nothing About Us Without Us: Pilot site programs
3    and services shall be formulated with transparency,
4    community involvement, and direct ongoing input by people
5    living with and vulnerable to HIV.
6        (2) Equity: Pilot site programs and services shall
7    provide equitable support, services, and resources to all
8    participants and ensure accessibility to the greatest
9    extent possible.
10        (3) Self-Determination: Pilot site programs and
11    services shall prioritize individual dignity and autonomy
12    in decision-making while encouraging people to connect
13    with additional services that promote health and
14    well-being.
15        (4) Reduce Stigma: Pilot site programs and services
16    shall affirm the humanity and dignity of people living
17    with or vulnerable to HIV and shall operate in a way that
18    is welcoming to reduce stigma and build trust.
19        (5) Safe Spaces: Pilot site programs and services
20    shall prioritize relationship-building and trust among
21    partners, staff, and participants to create safe spaces.
22    (f) The Department shall compile reports from each of the
23pilot sites on the operation of the pilot program upon
24completion of the pilot period. The Department shall share a
25comprehensive report summarizing the findings of the pilot
26period with the General Assembly and the Governor's Office and

 

 

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1shall make it publicly available on its Internet website. The
2report may include:
3        (1) the number offers made for enrollment;
4        (2) the number of enrolled participants;
5        (3) the number and reasons of patients declined for
6    service, when available; and
7        (4) the length of time from initial diagnosis or
8    referral to the start of HIV treatment, and, when
9    available, the length of time participants were able to
10    achieve an undetectable viral load.
11    Data shall also include demographic data on the race,
12ethnicity, age, sex, disability status, sexual orientation,
13gender identity, and primary or preferred language of program
14participants in accordance with the Data Governance and
15Organization to Support Equity and Racial Justice Act. The
16reports shall inform the Department's decisions concerning the
17continued operation of the Rapid Start for HIV treatment pilot
18program and its expansion, modification, discontinuation, or
19progress towards becoming the standard of care for HIV
20treatment. The contents of the report shall be in accordance
21with the AIDS Confidentiality Act.
22    Implementation of this Section is subject to
23appropriations made to the Illinois Department of Public
24Health for that purpose.
 
25    Section 20. The County Jail Act is amended by changing

 

 

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1Section 17.10 as follows:
 
2    (730 ILCS 125/17.10)
3    Sec. 17.10. Requirements in connection with HIV/AIDS.
4    (a) In each county other than Cook, during the medical
5admissions exam, the warden of the jail, a correctional
6officer at the jail, or a member of the jail medical staff must
7provide the prisoner with appropriate written information
8concerning human immunodeficiency virus (HIV) and acquired
9immunodeficiency syndrome (AIDS). The Department of Public
10Health and community-based organizations certified to provide
11HIV/AIDS testing must provide these informational materials to
12the warden at no cost to the county. The warden, a correctional
13officer, or a member of the jail medical staff must inform the
14prisoner of the option of being tested for infection with HIV
15by a certified local community-based agency or other available
16medical provider at no charge to the prisoner.
17    (b) In Cook County, during the medical admissions exam, an
18employee of the Cook County Health & Hospitals System must
19provide the prisoner with appropriate information in writing,
20verbally or by video or other electronic means concerning
21human immunodeficiency virus (HIV) and acquired
22immunodeficiency syndrome (AIDS) and must also provide the
23prisoner with option of testing for infection with HIV or any
24other identified causative agent of AIDS, as well as
25counseling in connection with such testing. The Cook County

 

 

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1Health & Hospitals System may provide the inmate with opt-out
2human immunodeficiency virus (HIV) testing, as defined in
3Section 4 of the AIDS Confidentiality Act, unless the inmate
4refuses. If opt-out HIV testing is conducted, the Cook County
5Health & Hospitals System shall place signs in English,
6Spanish, and other languages as needed in multiple, highly
7visible locations in the area where HIV testing is conducted
8informing inmates that they will be tested for HIV unless they
9refuse, and refusal or acceptance of testing shall be
10documented in the inmate's medical record. Pre-test
11information shall be provided to the inmate and informed
12consent obtained from the inmate as required in subsection (q)
13of Section 3 and Section 5 of the AIDS Confidentiality Act. The
14Cook County Health & Hospitals System shall follow procedures
15established by the Department of Public Health to conduct HIV
16testing and testing to confirm positive HIV test results. All
17aspects of HIV testing shall comply with the requirements of
18the AIDS Confidentiality Act, including delivery of test
19results, as determined by the Cook County Health & Hospitals
20System in consultation with the Illinois Department of Public
21Health. Nothing in this Section shall require the Cook County
22Health & Hospitals System to offer HIV testing to inmates who
23are known to be infected with HIV. The Department of Public
24Health and community-based organizations certified to provide
25HIV/AIDS testing may provide these informational materials to
26the Bureau at no cost to the county. The testing provided under

 

 

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1this subsection (b) shall consist of a test approved by the
2Illinois Department of Public Health to determine the presence
3of HIV infection, based upon recommendations of the United
4States Centers for Disease Control and Prevention. If the test
5result is positive, a reliable supplemental test based upon
6recommendations of the United States Centers for Disease
7Control and Prevention shall be administered.
8    (b-5) The Department of Corrections shall include the
9following information in the annual adult correctional
10facility public inspection report for each county:
11        (1) whether the warden of the jail, a correctional
12    officer at the jail, or a member of the jail medical staff
13    provide the prisoner with appropriate written information
14    concerning HIV and AIDS during the medical admissions
15    exam;
16        (2) whether the warden, a correctional officer, or a
17    member of the jail medical staff informs the prisoner of
18    the option of being tested for infection with HIV by a
19    certified local community-based agency or other available
20    medical provider at no charge to the prisoner;
21        (3) whether the warden of the jail makes appropriate
22    written information or visual aids concerning HIV/AIDS
23    available to every visitor to the jail;
24        (4) for Cook County, whether an employee of the Cook
25    County Health and Hospitals System provides the prisoner
26    with appropriate information in writing, verbally, or by

 

 

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1    video or other electronic means concerning HIV and AIDS
2    during the medical admissions exam; and
3        (5) for Cook County, whether an employee of the Cook
4    County Health and Hospitals System provides the prisoner
5    with the option of testing for infection with HIV or any
6    other identified causative agent of AIDS, as well as
7    counseling in connection with such testing.
8    The Department of Public Health and community-based
9organizations certified to provide HIV/AIDS testing shall
10provide these informational materials to the warden at no cost
11to the office of the county sheriff.
12    (c) In each county, the warden of the jail must make
13appropriate written information concerning HIV/AIDS available
14to every visitor to the jail. This information must include
15information concerning persons or entities to contact for
16local counseling and testing. The Department of Public Health
17and community-based organizations certified to provide
18HIV/AIDS testing must provide these informational materials to
19the warden at no cost to the office of the county sheriff.
20    (d) Implementation of this Section is subject to
21appropriation.
22(Source: P.A. 97-244, eff. 8-4-11; 97-323, eff. 8-12-11;
2397-813, eff. 7-13-12; 98-1046, eff. 1-1-15.)