Bill Amendment: IL HB4215 | 2025-2026 | 104th General Assembly

NOTE: For additional amemendments please see the Bill Drafting List

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Bill Title: NEWBORN HEARING SCREENING

Status: 2026-05-13 - Added Co-Sponsor Rep. Kevin John Olickal [HB4215 Detail]

Download: Illinois-2025-HB4215-House_Amendment_001.html

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Rep. Diane Blair-Sherlock

Filed: 2/27/2026

 

 

 

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AMENDMENT TO HOUSE BILL 4215
AMENDMENT NO. ______. Amend House Bill 4215 by replacing
everything after the enacting clause with the following:
"Section 5. The Department of Public Health Powers and
Duties Law of the Civil Administrative Code of Illinois is
amended by changing Section 2310-90 as follows:
(20 ILCS 2310/2310-90) (was 20 ILCS 2310/55.09)
Sec. 2310-90. Laboratories; fees; Public Health Laboratory
Services Revolving Fund. To maintain physical, chemical,
bacteriological, and biological laboratories; to make
examinations of milk, water, atmosphere, sewage, wastes, and
other substances, and equipment and processes relating
thereto; to make diagnostic tests for diseases and tests for
the evaluation of health hazards considered necessary for the
protection of the people of the State; and to assess a
reasonable fee for services provided as established by

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regulation, under the Illinois Administrative Procedure Act,
which shall not exceed the Department's actual costs to
provide these services.
Excepting fees collected under the Newborn Metabolic
Screening Act and the Lead Poisoning Prevention Act, all fees
shall be deposited into the Public Health Laboratory Services
Revolving Fund. Other State and federal funds related to
laboratory services may also be deposited into the Fund, and
all interest that accrues on the moneys in the Fund shall be
deposited into the Fund.
Moneys shall be appropriated from the Fund solely for the
purposes of testing specimens submitted in support of
Department programs established for the protection of human
health, welfare, and safety, and for testing specimens
submitted by physicians and other health care providers, to
determine whether chemically hazardous, biologically
infectious substances, or other disease causing conditions are
present.
(Source: P.A. 96-328, eff. 8-11-09.)
Section 10. The Illinois Procurement Code is amended by
changing Section 1-10 as follows:
(30 ILCS 500/1-10)
(Text of Section before amendment by P.A. 104-458)
Sec. 1-10. Application.

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(a) This Code applies only to procurements for which
bidders, offerors, potential contractors, or contractors were
first solicited on or after July 1, 1998. This Code shall not
be construed to affect or impair any contract, or any
provision of a contract, entered into based on a solicitation
prior to the implementation date of this Code as described in
Article 99, including, but not limited to, any covenant
entered into with respect to any revenue bonds or similar
instruments. All procurements for which contracts are
solicited between the effective date of Articles 50 and 99 and
July 1, 1998 shall be substantially in accordance with this
Code and its intent.
(b) This Code shall apply regardless of the source of the
funds with which the contracts are paid, including federal
assistance moneys. This Code shall not apply to:
(1) Contracts between the State and its political
subdivisions or other governments, or between State
governmental bodies, except as specifically provided in
this Code.
(2) Grants, except for the filing requirements of
Section 20-80.
(3) Purchase of care, except as provided in Section
5-30.6 of the Illinois Public Aid Code and this Section.
(4) Hiring of an individual as an employee and not as
an independent contractor, whether pursuant to an
employment code or policy or by contract directly with

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that individual.
(5) Collective bargaining contracts.
(6) Purchase of real estate, except that notice of
this type of contract with a value of more than $25,000
must be published in the Procurement Bulletin within 10
calendar days after the deed is recorded in the county of
jurisdiction. The notice shall identify the real estate
purchased, the names of all parties to the contract, the
value of the contract, and the effective date of the
contract.
(7) Contracts necessary to prepare for anticipated
litigation, enforcement actions, or investigations,
provided that the chief legal counsel to the Governor
shall give his or her prior approval when the procuring
agency is one subject to the jurisdiction of the Governor,
and provided that the chief legal counsel of any other
procuring entity subject to this Code shall give his or
her prior approval when the procuring entity is not one
subject to the jurisdiction of the Governor.
(8) (Blank).
(9) Procurement expenditures by the Illinois
Conservation Foundation when only private funds are used.
(10) (Blank).
(11) Public-private agreements entered into according
to the procurement requirements of Section 20 of the
Public-Private Partnerships for Transportation Act and

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design-build agreements entered into according to the
procurement requirements of Section 25 of the
Public-Private Partnerships for Transportation Act.
(12) (A) Contracts for legal, financial, and other
professional and artistic services entered into by the
Illinois Finance Authority in which the State of Illinois
is not obligated. Such contracts shall be awarded through
a competitive process authorized by the members of the
Illinois Finance Authority and are subject to Sections
5-30, 20-160, 50-13, 50-20, 50-35, and 50-37 of this Code,
as well as the final approval by the members of the
Illinois Finance Authority of the terms of the contract.
(B) Contracts for legal and financial services entered
into by the Illinois Housing Development Authority in
connection with the issuance of bonds in which the State
of Illinois is not obligated. Such contracts shall be
awarded through a competitive process authorized by the
members of the Illinois Housing Development Authority and
are subject to Sections 5-30, 20-160, 50-13, 50-20, 50-35,
and 50-37 of this Code, as well as the final approval by
the members of the Illinois Housing Development Authority
of the terms of the contract.
(13) Contracts for services, commodities, and
equipment to support the delivery of timely forensic
science services in consultation with and subject to the
approval of the Chief Procurement Officer as provided in

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subsection (d) of Section 5-4-3a of the Unified Code of
Corrections, except for the requirements of Sections
20-60, 20-65, 20-70, and 20-160 and Article 50 of this
Code; however, the Chief Procurement Officer may, in
writing with justification, waive any certification
required under Article 50 of this Code. For any contracts
for services which are currently provided by members of a
collective bargaining agreement, the applicable terms of
the collective bargaining agreement concerning
subcontracting shall be followed.
On and after January 1, 2019, this paragraph (13),
except for this sentence, is inoperative.
(14) Contracts for participation expenditures required
by a domestic or international trade show or exhibition of
an exhibitor, member, or sponsor.
(15) Contracts with a railroad or utility that
requires the State to reimburse the railroad or utilities
for the relocation of utilities for construction or other
public purpose. Contracts included within this paragraph
(15) shall include, but not be limited to, those
associated with: relocations, crossings, installations,
and maintenance. For the purposes of this paragraph (15),
"railroad" means any form of non-highway ground
transportation that runs on rails or electromagnetic
guideways and "utility" means: (1) public utilities as
defined in Section 3-105 of the Public Utilities Act, (2)

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telecommunications carriers as defined in Section 13-202
of the Public Utilities Act, (3) electric cooperatives as
defined in Section 3.4 of the Electric Supplier Act, (4)
telephone or telecommunications cooperatives as defined in
Section 13-212 of the Public Utilities Act, (5) rural
water or wastewater waste water systems with 10,000
connections or less, (6) a holder as defined in Section
21-201 of the Public Utilities Act, and (7) municipalities
owning or operating utility systems consisting of public
utilities as that term is defined in Section 11-117-2 of
the Illinois Municipal Code.
(16) Procurement expenditures necessary for the
Department of Public Health to provide the delivery of
timely newborn screening services in accordance with the
Newborn Metabolic Screening Act.
(17) Procurement expenditures necessary for the
Department of Agriculture, the Department of Financial and
Professional Regulation, the Department of Human Services,
and the Department of Public Health to implement the
Compassionate Use of Medical Cannabis Program and Opioid
Alternative Pilot Program requirements and ensure access
to medical cannabis for patients with debilitating medical
conditions in accordance with the Compassionate Use of
Medical Cannabis Program Act.
(18) This Code does not apply to any procurements
necessary for the Department of Agriculture, the

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Department of Financial and Professional Regulation, the
Department of Human Services, the Department of Commerce
and Economic Opportunity, and the Department of Public
Health to implement the Cannabis Regulation and Tax Act if
the applicable agency has made a good faith determination
that it is necessary and appropriate for the expenditure
to fall within this exemption and if the process is
conducted in a manner substantially in accordance with the
requirements of Sections 20-160, 25-60, 30-22, 50-5,
50-10, 50-10.5, 50-12, 50-13, 50-15, 50-20, 50-21, 50-35,
50-36, 50-37, 50-38, and 50-50 of this Code; however, for
Section 50-35, compliance applies only to contracts or
subcontracts over $100,000. Notice of each contract
entered into under this paragraph (18) that is related to
the procurement of goods and services identified in
paragraph (1) through (9) of this subsection shall be
published in the Procurement Bulletin within 14 calendar
days after contract execution. The Chief Procurement
Officer shall prescribe the form and content of the
notice. Each agency shall provide the Chief Procurement
Officer, on a monthly basis, in the form and content
prescribed by the Chief Procurement Officer, a report of
contracts that are related to the procurement of goods and
services identified in this subsection. At a minimum, this
report shall include the name of the contractor, a
description of the supply or service provided, the total

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amount of the contract, the term of the contract, and the
exception to this Code utilized. A copy of any or all of
these contracts shall be made available to the Chief
Procurement Officer immediately upon request. The Chief
Procurement Officer shall submit a report to the Governor
and General Assembly no later than November 1 of each year
that includes, at a minimum, an annual summary of the
monthly information reported to the Chief Procurement
Officer. This exemption becomes inoperative 5 years after
June 25, 2019 (the effective date of Public Act 101-27).
(19) Acquisition of modifications or adjustments,
limited to assistive technology devices and assistive
technology services, adaptive equipment, repairs, and
replacement parts to provide reasonable accommodations (i)
that enable a qualified applicant with a disability to
complete the job application process and be considered for
the position such qualified applicant desires, (ii) that
modify or adjust the work environment to enable a
qualified current employee with a disability to perform
the essential functions of the position held by that
employee, (iii) to enable a qualified current employee
with a disability to enjoy equal benefits and privileges
of employment as are enjoyed by other similarly situated
employees without disabilities, and (iv) that allow a
customer, client, claimant, or member of the public
seeking State services full use and enjoyment of and

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access to its programs, services, or benefits.
For purposes of this paragraph (19):
"Assistive technology devices" means any item, piece
of equipment, or product system, whether acquired
commercially off the shelf, modified, or customized, that
is used to increase, maintain, or improve functional
capabilities of individuals with disabilities.
"Assistive technology services" means any service that
directly assists an individual with a disability in
selection, acquisition, or use of an assistive technology
device.
"Qualified" has the same meaning and use as provided
under the federal Americans with Disabilities Act when
describing an individual with a disability.
(20) Procurement expenditures necessary for the
Illinois Commerce Commission to hire third-party
facilitators pursuant to Sections 16-105.17 and 16-108.18
of the Public Utilities Act or an ombudsman pursuant to
Section 16-107.5 of the Public Utilities Act, a
facilitator pursuant to Section 16-105.17 of the Public
Utilities Act, or a grid auditor pursuant to Section
16-105.10 of the Public Utilities Act.
(21) Procurement expenditures for the purchase,
renewal, and expansion of software, software licenses, or
software maintenance agreements that support the efforts
of the Illinois State Police to enforce, regulate, and

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administer the Firearm Owners Identification Card Act, the
Firearm Concealed Carry Act, the Firearms Restraining
Order Act, the Firearm Dealer License Certification Act,
the Law Enforcement Agencies Data System (LEADS), the
Uniform Crime Reporting Act, the Criminal Identification
Act, the Illinois Uniform Conviction Information Act, and
the Gun Trafficking Information Act, or establish or
maintain record management systems necessary to conduct
human trafficking investigations or gun trafficking or
other stolen firearm investigations. This paragraph (21)
applies to contracts entered into on or after January 10,
2023 (the effective date of Public Act 102-1116) and the
renewal of contracts that are in effect on January 10,
2023 (the effective date of Public Act 102-1116).
(22) Contracts for project management services and
system integration services required for the completion of
the State's enterprise resource planning project. This
exemption becomes inoperative 5 years after June 7, 2023
(the effective date of the changes made to this Section by
Public Act 103-8). This paragraph (22) applies to
contracts entered into on or after June 7, 2023 (the
effective date of the changes made to this Section by
Public Act 103-8) and the renewal of contracts that are in
effect on June 7, 2023 (the effective date of the changes
made to this Section by Public Act 103-8).
(23) Procurements necessary for the Department of

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Insurance to implement the Illinois Health Benefits
Exchange Law if the Department of Insurance has made a
good faith determination that it is necessary and
appropriate for the expenditure to fall within this
exemption. The procurement process shall be conducted in a
manner substantially in accordance with the requirements
of Sections 20-160 and 25-60 and Article 50 of this Code. A
copy of these contracts shall be made available to the
Chief Procurement Officer immediately upon request. This
paragraph is inoperative 5 years after June 27, 2023 (the
effective date of Public Act 103-103).
(24) Contracts for public education programming,
noncommercial sustaining announcements, public service
announcements, and public awareness and education
messaging with the nonprofit trade associations of the
providers of those services that inform the public on
immediate and ongoing health and safety risks and hazards.
(25) Procurements necessary for the Department of
Early Childhood to implement the Department of Early
Childhood Act if the Department has made a good faith
determination that it is necessary and appropriate for the
expenditure to fall within this exemption. This exemption
shall only be used for products and services procured
solely for use by the Department of Early Childhood. The
procurements may include those necessary to design and
build integrated, operational systems of programs and

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services. The procurements may include, but are not
limited to, those necessary to align and update program
standards, integrate funding systems, design and establish
data and reporting systems, align and update models for
technical assistance and professional development, design
systems to manage grants and ensure compliance, design and
implement management and operational structures, and
establish new means of engaging with families, educators,
providers, and stakeholders. The procurement processes
shall be conducted in a manner substantially in accordance
with the requirements of Article 50 (ethics) and Sections
5-5 (Procurement Policy Board), 5-7 (Commission on Equity
and Inclusion), 20-80 (contract files), 20-120
(subcontractors), 20-155 (paperwork), 20-160
(ethics/campaign contribution prohibitions), 25-60
(prevailing wage), and 25-90 (prohibited and authorized
cybersecurity) of this Code. Beginning January 1, 2025,
the Department of Early Childhood shall provide a
quarterly report to the General Assembly detailing a list
of expenditures and contracts for which the Department
uses this exemption. This paragraph is inoperative on and
after July 1, 2027.
(26) Procurements that are necessary for increasing
the recruitment and retention of State employees,
particularly minority candidates for employment,
including:

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(A) procurements related to registration fees for
job fairs and other outreach and recruitment events;
(B) production of recruitment materials; and
(C) other services related to recruitment and
retention of State employees.
The exemption under this paragraph (26) applies only
if the State agency has made a good faith determination
that it is necessary and appropriate for the expenditure
to fall within this paragraph (26). The procurement
process under this paragraph (26) shall be conducted in a
manner substantially in accordance with the requirements
of Sections 20-160 and 25-60 and Article 50 of this Code. A
copy of these contracts shall be made available to the
Chief Procurement Officer immediately upon request.
Nothing in this paragraph (26) authorizes the replacement
or diminishment of State responsibilities in hiring or the
positions that effectuate that hiring. This paragraph (26)
is inoperative on and after June 30, 2029.
(27) Procurements necessary for the Department of
Healthcare and Family Services to implement changes to the
State's Integrated Eligibility System to ensure the
system's compliance with federal implementation mandates
and deadlines, if the Department of Healthcare and Family
Services has made a good faith determination that it is
necessary and appropriate for the procurement to fall
within this exemption.

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Notwithstanding any other provision of law, for contracts
with an annual value of more than $100,000 entered into on or
after October 1, 2017 under an exemption provided in any
paragraph of this subsection (b), except paragraph (1), (2),
or (5), each State agency shall post to the appropriate
procurement bulletin the name of the contractor, a description
of the supply or service provided, the total amount of the
contract, the term of the contract, and the exception to the
Code utilized. The chief procurement officer shall submit a
report to the Governor and General Assembly no later than
November 1 of each year that shall include, at a minimum, an
annual summary of the monthly information reported to the
chief procurement officer.
(c) This Code does not apply to the electric power
procurement process provided for under Section 1-75 of the
Illinois Power Agency Act and Section 16-111.5 of the Public
Utilities Act. This Code does not apply to the procurement of
technical and policy experts pursuant to Section 1-129 of the
Illinois Power Agency Act.
(d) Except for Section 20-160 and Article 50 of this Code,
and as expressly required by Section 9.1 of the Illinois
Lottery Law, the provisions of this Code do not apply to the
procurement process provided for under Section 9.1 of the
Illinois Lottery Law.
(e) This Code does not apply to the process used by the
Capital Development Board to retain a person or entity to

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assist the Capital Development Board with its duties related
to the determination of costs of a clean coal SNG brownfield
facility, as defined by Section 1-10 of the Illinois Power
Agency Act, as required in subsection (h-3) of Section 9-220
of the Public Utilities Act, including calculating the range
of capital costs, the range of operating and maintenance
costs, or the sequestration costs or monitoring the
construction of clean coal SNG brownfield facility for the
full duration of construction.
(f) (Blank).
(g) (Blank).
(h) This Code does not apply to the process to procure or
contracts entered into in accordance with Sections 11-5.2 and
11-5.3 of the Illinois Public Aid Code.
(i) Each chief procurement officer may access records
necessary to review whether a contract, purchase, or other
expenditure is or is not subject to the provisions of this
Code, unless such records would be subject to attorney-client
privilege.
(j) This Code does not apply to the process used by the
Capital Development Board to retain an artist or work or works
of art as required in Section 14 of the Capital Development
Board Act.
(k) This Code does not apply to the process to procure
contracts, or contracts entered into, by the State Board of
Elections or the State Electoral Board for hearing officers

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appointed pursuant to the Election Code.
(l) This Code does not apply to the processes used by the
Illinois Student Assistance Commission to procure supplies and
services paid for from the private funds of the Illinois
Prepaid Tuition Fund. As used in this subsection (l), "private
funds" means funds derived from deposits paid into the
Illinois Prepaid Tuition Trust Fund and the earnings thereon.
(m) This Code shall apply regardless of the source of
funds with which contracts are paid, including federal
assistance moneys. Except as specifically provided in this
Code, this Code shall not apply to procurement expenditures
necessary for the Department of Public Health to conduct the
Healthy Illinois Survey in accordance with Section 2310-431 of
the Department of Public Health Powers and Duties Law of the
Civil Administrative Code of Illinois.
(Source: P.A. 103-8, eff. 6-7-23; 103-103, eff. 6-27-23;
103-570, eff. 1-1-24; 103-580, eff. 12-8-23; 103-594, eff.
6-25-24; 103-605, eff. 7-1-24; 103-865, eff. 1-1-25; 104-2,
eff. 6-16-25; 104-417, eff. 8-15-25)
(Text of Section after amendment by P.A. 104-458)
Sec. 1-10. Application.
(a) This Code applies only to procurements for which
bidders, offerors, potential contractors, or contractors were
first solicited on or after July 1, 1998. This Code shall not
be construed to affect or impair any contract, or any

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provision of a contract, entered into based on a solicitation
prior to the implementation date of this Code as described in
Article 99, including, but not limited to, any covenant
entered into with respect to any revenue bonds or similar
instruments. All procurements for which contracts are
solicited between the effective date of Articles 50 and 99 and
July 1, 1998 shall be substantially in accordance with this
Code and its intent.
(b) This Code shall apply regardless of the source of the
funds with which the contracts are paid, including federal
assistance moneys. This Code shall not apply to:
(1) Contracts between the State and its political
subdivisions or other governments, or between State
governmental bodies, except as specifically provided in
this Code.
(2) Grants, except for the filing requirements of
Section 20-80.
(3) Purchase of care, except as provided in Section
5-30.6 of the Illinois Public Aid Code and this Section.
(4) Hiring of an individual as an employee and not as
an independent contractor, whether pursuant to an
employment code or policy or by contract directly with
that individual.
(5) Collective bargaining contracts.
(6) Purchase of real estate, except that notice of
this type of contract with a value of more than $25,000

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must be published in the Procurement Bulletin within 10
calendar days after the deed is recorded in the county of
jurisdiction. The notice shall identify the real estate
purchased, the names of all parties to the contract, the
value of the contract, and the effective date of the
contract.
(7) Contracts necessary to prepare for anticipated
litigation, enforcement actions, or investigations,
provided that the chief legal counsel to the Governor
shall give his or her prior approval when the procuring
agency is one subject to the jurisdiction of the Governor,
and provided that the chief legal counsel of any other
procuring entity subject to this Code shall give his or
her prior approval when the procuring entity is not one
subject to the jurisdiction of the Governor.
(8) (Blank).
(9) Procurement expenditures by the Illinois
Conservation Foundation when only private funds are used.
(10) (Blank).
(11) Public-private agreements entered into according
to the procurement requirements of Section 20 of the
Public-Private Partnerships for Transportation Act and
design-build agreements entered into according to the
procurement requirements of Section 25 of the
Public-Private Partnerships for Transportation Act.
(12) (A) Contracts for legal, financial, and other

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professional and artistic services entered into by the
Illinois Finance Authority in which the State of Illinois
is not obligated. Such contracts shall be awarded through
a competitive process authorized by the members of the
Illinois Finance Authority and are subject to Sections
5-30, 20-160, 50-13, 50-20, 50-35, and 50-37 of this Code,
as well as the final approval by the members of the
Illinois Finance Authority of the terms of the contract.
(B) Contracts for legal and financial services entered
into by the Illinois Housing Development Authority in
connection with the issuance of bonds in which the State
of Illinois is not obligated. Such contracts shall be
awarded through a competitive process authorized by the
members of the Illinois Housing Development Authority and
are subject to Sections 5-30, 20-160, 50-13, 50-20, 50-35,
and 50-37 of this Code, as well as the final approval by
the members of the Illinois Housing Development Authority
of the terms of the contract.
(13) Contracts for services, commodities, and
equipment to support the delivery of timely forensic
science services in consultation with and subject to the
approval of the Chief Procurement Officer as provided in
subsection (d) of Section 5-4-3a of the Unified Code of
Corrections, except for the requirements of Sections
20-60, 20-65, 20-70, and 20-160 and Article 50 of this
Code; however, the Chief Procurement Officer may, in

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writing with justification, waive any certification
required under Article 50 of this Code. For any contracts
for services which are currently provided by members of a
collective bargaining agreement, the applicable terms of
the collective bargaining agreement concerning
subcontracting shall be followed.
On and after January 1, 2019, this paragraph (13),
except for this sentence, is inoperative.
(14) Contracts for participation expenditures required
by a domestic or international trade show or exhibition of
an exhibitor, member, or sponsor.
(15) Contracts with a railroad or utility that
requires the State to reimburse the railroad or utilities
for the relocation of utilities for construction or other
public purpose. Contracts included within this paragraph
(15) shall include, but not be limited to, those
associated with: relocations, crossings, installations,
and maintenance. For the purposes of this paragraph (15),
"railroad" means any form of non-highway ground
transportation that runs on rails or electromagnetic
guideways and "utility" means: (1) public utilities as
defined in Section 3-105 of the Public Utilities Act, (2)
telecommunications carriers as defined in Section 13-202
of the Public Utilities Act, (3) electric cooperatives as
defined in Section 3.4 of the Electric Supplier Act, (4)
telephone or telecommunications cooperatives as defined in

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Section 13-212 of the Public Utilities Act, (5) rural
water or wastewater waste water systems with 10,000
connections or less, (6) a holder as defined in Section
21-201 of the Public Utilities Act, and (7) municipalities
owning or operating utility systems consisting of public
utilities as that term is defined in Section 11-117-2 of
the Illinois Municipal Code.
(16) Procurement expenditures necessary for the
Department of Public Health to provide the delivery of
timely newborn screening services in accordance with the
Newborn Metabolic Screening Act.
(17) Procurement expenditures necessary for the
Department of Agriculture, the Department of Financial and
Professional Regulation, the Department of Human Services,
and the Department of Public Health to implement the
Compassionate Use of Medical Cannabis Program and Opioid
Alternative Pilot Program requirements and ensure access
to medical cannabis for patients with debilitating medical
conditions in accordance with the Compassionate Use of
Medical Cannabis Program Act.
(18) This Code does not apply to any procurements
necessary for the Department of Agriculture, the
Department of Financial and Professional Regulation, the
Department of Human Services, the Department of Commerce
and Economic Opportunity, and the Department of Public
Health to implement the Cannabis Regulation and Tax Act if

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the applicable agency has made a good faith determination
that it is necessary and appropriate for the expenditure
to fall within this exemption and if the process is
conducted in a manner substantially in accordance with the
requirements of Sections 20-160, 25-60, 30-22, 50-5,
50-10, 50-10.5, 50-12, 50-13, 50-15, 50-20, 50-21, 50-35,
50-36, 50-37, 50-38, and 50-50 of this Code; however, for
Section 50-35, compliance applies only to contracts or
subcontracts over $100,000. Notice of each contract
entered into under this paragraph (18) that is related to
the procurement of goods and services identified in
paragraph (1) through (9) of this subsection shall be
published in the Procurement Bulletin within 14 calendar
days after contract execution. The Chief Procurement
Officer shall prescribe the form and content of the
notice. Each agency shall provide the Chief Procurement
Officer, on a monthly basis, in the form and content
prescribed by the Chief Procurement Officer, a report of
contracts that are related to the procurement of goods and
services identified in this subsection. At a minimum, this
report shall include the name of the contractor, a
description of the supply or service provided, the total
amount of the contract, the term of the contract, and the
exception to this Code utilized. A copy of any or all of
these contracts shall be made available to the Chief
Procurement Officer immediately upon request. The Chief

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Procurement Officer shall submit a report to the Governor
and General Assembly no later than November 1 of each year
that includes, at a minimum, an annual summary of the
monthly information reported to the Chief Procurement
Officer. This exemption becomes inoperative 5 years after
June 25, 2019 (the effective date of Public Act 101-27).
(19) Acquisition of modifications or adjustments,
limited to assistive technology devices and assistive
technology services, adaptive equipment, repairs, and
replacement parts to provide reasonable accommodations (i)
that enable a qualified applicant with a disability to
complete the job application process and be considered for
the position such qualified applicant desires, (ii) that
modify or adjust the work environment to enable a
qualified current employee with a disability to perform
the essential functions of the position held by that
employee, (iii) to enable a qualified current employee
with a disability to enjoy equal benefits and privileges
of employment as are enjoyed by other similarly situated
employees without disabilities, and (iv) that allow a
customer, client, claimant, or member of the public
seeking State services full use and enjoyment of and
access to its programs, services, or benefits.
For purposes of this paragraph (19):
"Assistive technology devices" means any item, piece
of equipment, or product system, whether acquired

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commercially off the shelf, modified, or customized, that
is used to increase, maintain, or improve functional
capabilities of individuals with disabilities.
"Assistive technology services" means any service that
directly assists an individual with a disability in
selection, acquisition, or use of an assistive technology
device.
"Qualified" has the same meaning and use as provided
under the federal Americans with Disabilities Act when
describing an individual with a disability.
(20) Procurement expenditures necessary for the
Illinois Commerce Commission to hire third-party
facilitators pursuant to Sections 16-105.17 and 16-108.18
of the Public Utilities Act or an ombudsman pursuant to
Section 16-107.5 of the Public Utilities Act, a
facilitator pursuant to Section 16-105.17 of the Public
Utilities Act, a grid auditor pursuant to Section
16-105.10 of the Public Utilities Act, a facilitator,
expert, or consultant pursuant to Sections 16-126.2 and
16-202 of the Public Utilities Act, a procurement monitor
pursuant to Section 16-111.5 of the Public Utilities Act,
an ombudsperson pursuant to Section 20-145 of the Public
Utilities Act, or consultants and experts pursuant to
Section 5-15 of the Utility Data Access Act.
(21) Procurement expenditures for the purchase,
renewal, and expansion of software, software licenses, or

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software maintenance agreements that support the efforts
of the Illinois State Police to enforce, regulate, and
administer the Firearm Owners Identification Card Act, the
Firearm Concealed Carry Act, the Firearms Restraining
Order Act, the Firearm Dealer License Certification Act,
the Law Enforcement Agencies Data System (LEADS), the
Uniform Crime Reporting Act, the Criminal Identification
Act, the Illinois Uniform Conviction Information Act, and
the Gun Trafficking Information Act, or establish or
maintain record management systems necessary to conduct
human trafficking investigations or gun trafficking or
other stolen firearm investigations. This paragraph (21)
applies to contracts entered into on or after January 10,
2023 (the effective date of Public Act 102-1116) and the
renewal of contracts that are in effect on January 10,
2023 (the effective date of Public Act 102-1116).
(22) Contracts for project management services and
system integration services required for the completion of
the State's enterprise resource planning project. This
exemption becomes inoperative 5 years after June 7, 2023
(the effective date of the changes made to this Section by
Public Act 103-8). This paragraph (22) applies to
contracts entered into on or after June 7, 2023 (the
effective date of the changes made to this Section by
Public Act 103-8) and the renewal of contracts that are in
effect on June 7, 2023 (the effective date of the changes

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made to this Section by Public Act 103-8).
(23) Procurements necessary for the Department of
Insurance to implement the Illinois Health Benefits
Exchange Law if the Department of Insurance has made a
good faith determination that it is necessary and
appropriate for the expenditure to fall within this
exemption. The procurement process shall be conducted in a
manner substantially in accordance with the requirements
of Sections 20-160 and 25-60 and Article 50 of this Code. A
copy of these contracts shall be made available to the
Chief Procurement Officer immediately upon request. This
paragraph is inoperative 5 years after June 27, 2023 (the
effective date of Public Act 103-103).
(24) Contracts for public education programming,
noncommercial sustaining announcements, public service
announcements, and public awareness and education
messaging with the nonprofit trade associations of the
providers of those services that inform the public on
immediate and ongoing health and safety risks and hazards.
(25) Procurements necessary for the Department of
Early Childhood to implement the Department of Early
Childhood Act if the Department has made a good faith
determination that it is necessary and appropriate for the
expenditure to fall within this exemption. This exemption
shall only be used for products and services procured
solely for use by the Department of Early Childhood. The

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procurements may include those necessary to design and
build integrated, operational systems of programs and
services. The procurements may include, but are not
limited to, those necessary to align and update program
standards, integrate funding systems, design and establish
data and reporting systems, align and update models for
technical assistance and professional development, design
systems to manage grants and ensure compliance, design and
implement management and operational structures, and
establish new means of engaging with families, educators,
providers, and stakeholders. The procurement processes
shall be conducted in a manner substantially in accordance
with the requirements of Article 50 (ethics) and Sections
5-5 (Procurement Policy Board), 5-7 (Commission on Equity
and Inclusion), 20-80 (contract files), 20-120
(subcontractors), 20-155 (paperwork), 20-160
(ethics/campaign contribution prohibitions), 25-60
(prevailing wage), and 25-90 (prohibited and authorized
cybersecurity) of this Code. Beginning January 1, 2025,
the Department of Early Childhood shall provide a
quarterly report to the General Assembly detailing a list
of expenditures and contracts for which the Department
uses this exemption. This paragraph is inoperative on and
after July 1, 2027.
(26) Procurements that are necessary for increasing
the recruitment and retention of State employees,

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particularly minority candidates for employment,
including:
(A) procurements related to registration fees for
job fairs and other outreach and recruitment events;
(B) production of recruitment materials; and
(C) other services related to recruitment and
retention of State employees.
The exemption under this paragraph (26) applies only
if the State agency has made a good faith determination
that it is necessary and appropriate for the expenditure
to fall within this paragraph (26). The procurement
process under this paragraph (26) shall be conducted in a
manner substantially in accordance with the requirements
of Sections 20-160 and 25-60 and Article 50 of this Code. A
copy of these contracts shall be made available to the
Chief Procurement Officer immediately upon request.
Nothing in this paragraph (26) authorizes the replacement
or diminishment of State responsibilities in hiring or the
positions that effectuate that hiring. This paragraph (26)
is inoperative on and after June 30, 2029.
(27) Procurements necessary for the Department of
Healthcare and Family Services to implement changes to the
State's Integrated Eligibility System to ensure the
system's compliance with federal implementation mandates
and deadlines, if the Department of Healthcare and Family
Services has made a good faith determination that it is

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necessary and appropriate for the procurement to fall
within this exemption.
Notwithstanding any other provision of law, for contracts
with an annual value of more than $100,000 entered into on or
after October 1, 2017 under an exemption provided in any
paragraph of this subsection (b), except paragraph (1), (2),
or (5), each State agency shall post to the appropriate
procurement bulletin the name of the contractor, a description
of the supply or service provided, the total amount of the
contract, the term of the contract, and the exception to the
Code utilized. The chief procurement officer shall submit a
report to the Governor and General Assembly no later than
November 1 of each year that shall include, at a minimum, an
annual summary of the monthly information reported to the
chief procurement officer.
(c) This Code does not apply to the electric power
procurement process provided for under Section 1-75 of the
Illinois Power Agency Act and Section 16-111.5 of the Public
Utilities Act. This Code does not apply to the procurement of
technical and policy experts pursuant to Section 1-129 of the
Illinois Power Agency Act.
(d) Except for Section 20-160 and Article 50 of this Code,
and as expressly required by Section 9.1 of the Illinois
Lottery Law, the provisions of this Code do not apply to the
procurement process provided for under Section 9.1 of the
Illinois Lottery Law.

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(e) This Code does not apply to the process used by the
Capital Development Board to retain a person or entity to
assist the Capital Development Board with its duties related
to the determination of costs of a clean coal SNG brownfield
facility, as defined by Section 1-10 of the Illinois Power
Agency Act, as required in subsection (h-3) of Section 9-220
of the Public Utilities Act, including calculating the range
of capital costs, the range of operating and maintenance
costs, or the sequestration costs or monitoring the
construction of clean coal SNG brownfield facility for the
full duration of construction.
(f) (Blank).
(g) (Blank).
(h) This Code does not apply to the process to procure or
contracts entered into in accordance with Sections 11-5.2 and
11-5.3 of the Illinois Public Aid Code.
(i) Each chief procurement officer may access records
necessary to review whether a contract, purchase, or other
expenditure is or is not subject to the provisions of this
Code, unless such records would be subject to attorney-client
privilege.
(j) This Code does not apply to the process used by the
Capital Development Board to retain an artist or work or works
of art as required in Section 14 of the Capital Development
Board Act.
(k) This Code does not apply to the process to procure

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contracts, or contracts entered into, by the State Board of
Elections or the State Electoral Board for hearing officers
appointed pursuant to the Election Code.
(l) This Code does not apply to the processes used by the
Illinois Student Assistance Commission to procure supplies and
services paid for from the private funds of the Illinois
Prepaid Tuition Fund. As used in this subsection (l), "private
funds" means funds derived from deposits paid into the
Illinois Prepaid Tuition Trust Fund and the earnings thereon.
(m) This Code shall apply regardless of the source of
funds with which contracts are paid, including federal
assistance moneys. Except as specifically provided in this
Code, this Code shall not apply to procurement expenditures
necessary for the Department of Public Health to conduct the
Healthy Illinois Survey in accordance with Section 2310-431 of
the Department of Public Health Powers and Duties Law of the
Civil Administrative Code of Illinois.
(Source: P.A. 103-8, eff. 6-7-23; 103-103, eff. 6-27-23;
103-570, eff. 1-1-24; 103-580, eff. 12-8-23; 103-594, eff.
6-25-24; 103-605, eff. 7-1-24; 103-865, eff. 1-1-25; 104-2,
eff. 6-16-25; 104-417, eff. 8-15-25; 104-458, eff. 6-1-26;
revised 1-12-26.)
Section 15. The Illinois Public Aid Code is amended by
changing Section 5-5 as follows:

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(305 ILCS 5/5-5)
Sec. 5-5. Medical services. The Illinois Department, by
rule, shall determine the quantity and quality of and the rate
of reimbursement for the medical assistance for which payment
will be authorized, and the medical services to be provided,
which may include all or part of the following: (1) inpatient
hospital services; (2) outpatient hospital services; (3) other
laboratory and X-ray services; (4) skilled nursing home
services; (5) physicians' services whether furnished in the
office, the patient's home, a hospital, a skilled nursing
home, or elsewhere; (6) medical care, or any other type of
remedial care furnished by licensed practitioners; (7) home
health care services; (8) private duty nursing service; (9)
clinic services; (10) dental services, including prevention
and treatment of periodontal disease and dental caries disease
for pregnant individuals, provided by an individual licensed
to practice dentistry or dental surgery; for purposes of this
item (10), "dental services" means diagnostic, preventive, or
corrective procedures provided by or under the supervision of
a dentist in the practice of his or her profession; (11)
physical therapy and related services; (12) prescribed drugs,
dentures, and prosthetic devices; and eyeglasses prescribed by
a physician skilled in the diseases of the eye, or by an
optometrist, whichever the person may select; (13) other
diagnostic, screening, preventive, and rehabilitative
services, including to ensure that the individual's need for

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intervention or treatment of mental disorders or substance use
disorders or co-occurring mental health and substance use
disorders is determined using a uniform screening, assessment,
and evaluation process inclusive of criteria, for children and
adults; for purposes of this item (13), a uniform screening,
assessment, and evaluation process refers to a process that
includes an appropriate evaluation and, as warranted, a
referral; "uniform" does not mean the use of a singular
instrument, tool, or process that all must utilize; (14)
transportation and such other expenses as may be necessary;
(15) medical treatment of sexual assault survivors, as defined
in Section 1a of the Sexual Assault Survivors Emergency
Treatment Act, for injuries sustained as a result of the
sexual assault, including examinations and laboratory tests to
discover evidence which may be used in criminal proceedings
arising from the sexual assault; (16) the diagnosis and
treatment of sickle cell anemia; (16.5) services performed by
a chiropractic physician licensed under the Medical Practice
Act of 1987 and acting within the scope of his or her license,
including, but not limited to, chiropractic manipulative
treatment; and (17) any other medical care, and any other type
of remedial care recognized under the laws of this State. The
term "any other type of remedial care" shall include nursing
care and nursing home service for persons who rely on
treatment by spiritual means alone through prayer for healing.
Notwithstanding any other provision of this Section, a

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comprehensive tobacco use cessation program that includes
purchasing prescription drugs or prescription medical devices
approved by the Food and Drug Administration shall be covered
under the medical assistance program under this Article for
persons who are otherwise eligible for assistance under this
Article.
Notwithstanding any other provision of this Code,
reproductive health care that is otherwise legal in Illinois
shall be covered under the medical assistance program for
persons who are otherwise eligible for medical assistance
under this Article.
Notwithstanding any other provision of this Section, all
tobacco cessation medications approved by the United States
Food and Drug Administration and all individual and group
tobacco cessation counseling services and telephone-based
counseling services and tobacco cessation medications provided
through the Illinois Tobacco Quitline shall be covered under
the medical assistance program for persons who are otherwise
eligible for assistance under this Article. The Department
shall comply with all federal requirements necessary to obtain
federal financial participation, as specified in 42 CFR
433.15(b)(7), for telephone-based counseling services provided
through the Illinois Tobacco Quitline, including, but not
limited to: (i) entering into a memorandum of understanding or
interagency agreement with the Department of Public Health, as
administrator of the Illinois Tobacco Quitline; and (ii)

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developing a cost allocation plan for Medicaid-allowable
Illinois Tobacco Quitline services in accordance with 45 CFR
95.507. The Department shall submit the memorandum of
understanding or interagency agreement, the cost allocation
plan, and all other necessary documentation to the Centers for
Medicare and Medicaid Services for review and approval.
Coverage under this paragraph shall be contingent upon federal
approval.
Notwithstanding any other provision of this Code, the
Illinois Department may not require, as a condition of payment
for any laboratory test authorized under this Article, that a
physician's handwritten signature appear on the laboratory
test order form. The Illinois Department may, however, impose
other appropriate requirements regarding laboratory test order
documentation.
Upon receipt of federal approval of an amendment to the
Illinois Title XIX State Plan for this purpose, the Department
shall authorize the Chicago Public Schools (CPS) to procure a
vendor or vendors to manufacture eyeglasses for individuals
enrolled in a school within the CPS system. CPS shall ensure
that its vendor or vendors are enrolled as providers in the
medical assistance program and in any capitated Medicaid
managed care entity (MCE) serving individuals enrolled in a
school within the CPS system. Under any contract procured
under this provision, the vendor or vendors must serve only
individuals enrolled in a school within the CPS system. Claims

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for services provided by CPS's vendor or vendors to recipients
of benefits in the medical assistance program under this Code,
the Children's Health Insurance Program, or the Covering ALL
KIDS Health Insurance Program shall be submitted to the
Department or the MCE in which the individual is enrolled for
payment and shall be reimbursed at the Department's or the
MCE's established rates or rate methodologies for eyeglasses.
On and after July 1, 2012, the Department of Healthcare
and Family Services may provide the following services to
persons eligible for assistance under this Article who are
participating in education, training or employment programs
operated by the Department of Human Services as successor to
the Department of Public Aid:
(1) dental services provided by or under the
supervision of a dentist; and
(2) eyeglasses prescribed by a physician skilled in
the diseases of the eye, or by an optometrist, whichever
the person may select.
On and after July 1, 2018, the Department of Healthcare
and Family Services shall provide dental services to any adult
who is otherwise eligible for assistance under the medical
assistance program. As used in this paragraph, "dental
services" means diagnostic, preventative, restorative, or
corrective procedures, including procedures and services for
the prevention and treatment of periodontal disease and dental
caries disease, provided by an individual who is licensed to

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practice dentistry or dental surgery or who is under the
supervision of a dentist in the practice of his or her
profession.
On and after July 1, 2018, targeted dental services, as
set forth in Exhibit D of the Consent Decree entered by the
United States District Court for the Northern District of
Illinois, Eastern Division, in the matter of Memisovski v.
Maram, Case No. 92 C 1982, that are provided to adults under
the medical assistance program shall be established at no less
than the rates set forth in the "New Rate" column in Exhibit D
of the Consent Decree for targeted dental services that are
provided to persons under the age of 18 under the medical
assistance program.
Subject to federal approval, on and after January 1, 2025,
the rates paid for sedation evaluation and the provision of
deep sedation and intravenous sedation for the purpose of
dental services shall be increased by 33% above the rates in
effect on December 31, 2024. The rates paid for nitrous oxide
sedation shall not be impacted by this paragraph and shall
remain the same as the rates in effect on December 31, 2024.
Notwithstanding any other provision of this Code and
subject to federal approval, the Department may adopt rules to
allow a dentist who is volunteering his or her service at no
cost to render dental services through an enrolled
not-for-profit health clinic without the dentist personally
enrolling as a participating provider in the medical

10400HB4215ham001 - 39 - LRB104 15597 BDA 34793 a
assistance program. A not-for-profit health clinic shall
include a public health clinic or Federally Qualified Health
Center or other enrolled provider, as determined by the
Department, through which dental services covered under this
Section are performed. The Department shall establish a
process for payment of claims for reimbursement for covered
dental services rendered under this provision.
Subject to appropriation and to federal approval, the
Department shall file administrative rules updating the
Handicapping Labio-Lingual Deviation orthodontic scoring tool
by January 1, 2025, or as soon as practicable.
On and after January 1, 2022, the Department of Healthcare
and Family Services shall administer and regulate a
school-based dental program that allows for the out-of-office
delivery of preventative dental services in a school setting
to children under 19 years of age. The Department shall
establish, by rule, guidelines for participation by providers
and set requirements for follow-up referral care based on the
requirements established in the Dental Office Reference Manual
published by the Department that establishes the requirements
for dentists participating in the All Kids Dental School
Program. Every effort shall be made by the Department when
developing the program requirements to consider the different
geographic differences of both urban and rural areas of the
State for initial treatment and necessary follow-up care. No
provider shall be charged a fee by any unit of local government

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to participate in the school-based dental program administered
by the Department. Nothing in this paragraph shall be
construed to limit or preempt a home rule unit's or school
district's authority to establish, change, or administer a
school-based dental program in addition to, or independent of,
the school-based dental program administered by the
Department.
The Illinois Department, by rule, may distinguish and
classify the medical services to be provided only in
accordance with the classes of persons designated in Section
5-2.
The Department of Healthcare and Family Services must
provide coverage and reimbursement for amino acid-based
elemental formulas, regardless of delivery method, for the
diagnosis and treatment of (i) eosinophilic disorders and (ii)
short bowel syndrome when the prescribing physician has issued
a written order stating that the amino acid-based elemental
formula is medically necessary.
The Illinois Department shall authorize the provision of,
and shall authorize payment for, screening by low-dose
mammography for the presence of occult breast cancer for
individuals 35 years of age or older who are eligible for
medical assistance under this Article, as follows:
(A) A baseline mammogram for individuals 35 to 39
years of age.
(B) An annual mammogram for individuals 40 years of

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age or older.
(C) A mammogram at the age and intervals considered
medically necessary by the individual's health care
provider for individuals under 40 years of age and having
a family history of breast cancer, prior personal history
of breast cancer, positive genetic testing, or other risk
factors.
(D) A comprehensive ultrasound screening and MRI of an
entire breast or breasts if a mammogram demonstrates
heterogeneous or dense breast tissue or when medically
necessary as determined by a physician licensed to
practice medicine in all of its branches.
(E) A screening MRI when medically necessary, as
determined by a physician licensed to practice medicine in
all of its branches.
(F) A diagnostic mammogram when medically necessary,
as determined by a physician licensed to practice medicine
in all its branches, advanced practice registered nurse,
or physician assistant.
(G) Molecular breast imaging (MBI) and MRI of an
entire breast or breasts if a mammogram demonstrates
heterogeneous or dense breast tissue or when medically
necessary as determined by a physician licensed to
practice medicine in all of its branches, advanced
practice registered nurse, or physician assistant.
The Department shall not impose a deductible, coinsurance,

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copayment, or any other cost-sharing requirement on the
coverage provided under this paragraph; except that this
sentence does not apply to coverage of diagnostic mammograms
to the extent such coverage would disqualify a high-deductible
health plan from eligibility for a health savings account
pursuant to Section 223 of the Internal Revenue Code (26
U.S.C. 223).
All screenings shall include a physical breast exam,
instruction on self-examination and information regarding the
frequency of self-examination and its value as a preventative
tool.
For purposes of this Section:
"Diagnostic mammogram" means a mammogram obtained using
diagnostic mammography.
"Diagnostic mammography" means a method of screening that
is designed to evaluate an abnormality in a breast, including
an abnormality seen or suspected on a screening mammogram or a
subjective or objective abnormality otherwise detected in the
breast.
"Low-dose mammography" means the x-ray examination of the
breast using equipment dedicated specifically for mammography,
including the x-ray tube, filter, compression device, and
image receptor, with an average radiation exposure delivery of
less than one rad per breast for 2 views of an average size
breast. The term also includes digital mammography and
includes breast tomosynthesis.

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"Breast tomosynthesis" means a radiologic procedure that
involves the acquisition of projection images over the
stationary breast to produce cross-sectional digital
three-dimensional images of the breast.
If, at any time, the Secretary of the United States
Department of Health and Human Services, or its successor
agency, promulgates rules or regulations to be published in
the Federal Register or publishes a comment in the Federal
Register or issues an opinion, guidance, or other action that
would require the State, pursuant to any provision of the
Patient Protection and Affordable Care Act (Public Law
111-148), including, but not limited to, 42 U.S.C.
18031(d)(3)(B) or any successor provision, to defray the cost
of any coverage for breast tomosynthesis outlined in this
paragraph, then the requirement that an insurer cover breast
tomosynthesis is inoperative other than any such coverage
authorized under Section 1902 of the Social Security Act, 42
U.S.C. 1396a, and the State shall not assume any obligation
for the cost of coverage for breast tomosynthesis set forth in
this paragraph.
On and after January 1, 2016, the Department shall ensure
that all networks of care for adult clients of the Department
include access to at least one breast imaging Center of
Imaging Excellence as certified by the American College of
Radiology.
On and after January 1, 2012, providers participating in a

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quality improvement program approved by the Department shall
be reimbursed for screening and diagnostic mammography at the
same rate as the Medicare program's rates, including the
increased reimbursement for digital mammography and, after
January 1, 2023 (the effective date of Public Act 102-1018),
breast tomosynthesis.
The Department shall convene an expert panel including
representatives of hospitals, free-standing mammography
facilities, and doctors, including radiologists, to establish
quality standards for mammography.
On and after January 1, 2017, providers participating in a
breast cancer treatment quality improvement program approved
by the Department shall be reimbursed for breast cancer
treatment at a rate that is no lower than 95% of the Medicare
program's rates for the data elements included in the breast
cancer treatment quality program.
The Department shall convene an expert panel, including
representatives of hospitals, free-standing breast cancer
treatment centers, breast cancer quality organizations, and
doctors, including radiologists that are trained in all forms
of FDA-approved breast imaging technologies, breast surgeons,
reconstructive breast surgeons, oncologists, and primary care
providers to establish quality standards for breast cancer
treatment.
Subject to federal approval, the Department shall
establish a rate methodology for mammography at federally

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qualified health centers and other encounter-rate clinics.
These clinics or centers may also collaborate with other
hospital-based mammography facilities. By January 1, 2016, the
Department shall report to the General Assembly on the status
of the provision set forth in this paragraph.
The Department shall establish a methodology to remind
individuals who are age-appropriate for screening mammography,
but who have not received a mammogram within the previous 18
months, of the importance and benefit of screening
mammography. The Department shall work with experts in breast
cancer outreach and patient navigation to optimize these
reminders and shall establish a methodology for evaluating
their effectiveness and modifying the methodology based on the
evaluation.
The Department shall establish a performance goal for
primary care providers with respect to their female patients
over age 40 receiving an annual mammogram. This performance
goal shall be used to provide additional reimbursement in the
form of a quality performance bonus to primary care providers
who meet that goal.
The Department shall devise a means of case-managing or
patient navigation for beneficiaries diagnosed with breast
cancer. This program shall initially operate as a pilot
program in areas of the State with the highest incidence of
mortality related to breast cancer. At least one pilot program
site shall be in the metropolitan Chicago area and at least one

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site shall be outside the metropolitan Chicago area. On or
after July 1, 2016, the pilot program shall be expanded to
include one site in western Illinois, one site in southern
Illinois, one site in central Illinois, and 4 sites within
metropolitan Chicago. An evaluation of the pilot program shall
be carried out measuring health outcomes and cost of care for
those served by the pilot program compared to similarly
situated patients who are not served by the pilot program.
The Department shall require all networks of care to
develop a means either internally or by contract with experts
in navigation and community outreach to navigate cancer
patients to comprehensive care in a timely fashion. The
Department shall require all networks of care to include
access for patients diagnosed with cancer to at least one
academic commission on cancer-accredited cancer program as an
in-network covered benefit.
The Department shall provide coverage and reimbursement
for a human papillomavirus (HPV) vaccine that is approved for
marketing by the federal Food and Drug Administration for all
persons between the ages of 9 and 45. Subject to federal
approval, the Department shall provide coverage and
reimbursement for a human papillomavirus (HPV) vaccine for
persons of the age of 46 and above who have been diagnosed with
cervical dysplasia with a high risk of recurrence or
progression. The Department shall disallow any
preauthorization requirements for the administration of the

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human papillomavirus (HPV) vaccine.
On or after July 1, 2022, individuals who are otherwise
eligible for medical assistance under this Article shall
receive coverage for perinatal depression screenings for the
12-month period beginning on the last day of their pregnancy.
Medical assistance coverage under this paragraph shall be
conditioned on the use of a screening instrument approved by
the Department.
Any medical or health care provider shall immediately
recommend, to any pregnant individual who is being provided
prenatal services and is suspected of having a substance use
disorder as defined in the Substance Use Disorder Act,
referral to a local substance use disorder treatment program
licensed by the Department of Human Services or to a licensed
hospital which provides substance abuse treatment services.
The Department of Healthcare and Family Services shall assure
coverage for the cost of treatment of the drug abuse or
addiction for pregnant recipients in accordance with the
Illinois Medicaid Program in conjunction with the Department
of Human Services.
All medical providers providing medical assistance to
pregnant individuals under this Code shall receive information
from the Department on the availability of services under any
program providing case management services for addicted
individuals, including information on appropriate referrals
for other social services that may be needed by addicted

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individuals in addition to treatment for addiction.
The Illinois Department, in cooperation with the
Departments of Human Services (as successor to the Department
of Alcoholism and Substance Abuse) and Public Health, through
a public awareness campaign, may provide information
concerning treatment for alcoholism and drug abuse and
addiction, prenatal health care, and other pertinent programs
directed at reducing the number of drug-affected infants born
to recipients of medical assistance.
Neither the Department of Healthcare and Family Services
nor the Department of Human Services shall sanction the
recipient solely on the basis of the recipient's substance
abuse.
The Illinois Department shall establish such regulations
governing the dispensing of health services under this Article
as it shall deem appropriate. The Department should seek the
advice of formal professional advisory committees appointed by
the Director of the Illinois Department for the purpose of
providing regular advice on policy and administrative matters,
information dissemination and educational activities for
medical and health care providers, and consistency in
procedures to the Illinois Department.
The Illinois Department may develop and contract with
Partnerships of medical providers to arrange medical services
for persons eligible under Section 5-2 of this Code.
Implementation of this Section may be by demonstration

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projects in certain geographic areas. The Partnership shall be
represented by a sponsor organization. The Department, by
rule, shall develop qualifications for sponsors of
Partnerships. Nothing in this Section shall be construed to
require that the sponsor organization be a medical
organization.
The sponsor must negotiate formal written contracts with
medical providers for physician services, inpatient and
outpatient hospital care, home health services, treatment for
alcoholism and substance abuse, and other services determined
necessary by the Illinois Department by rule for delivery by
Partnerships. Physician services must include prenatal and
obstetrical care. The Illinois Department shall reimburse
medical services delivered by Partnership providers to clients
in target areas according to provisions of this Article and
the Illinois Health Finance Reform Act, except that:
(1) Physicians participating in a Partnership and
providing certain services, which shall be determined by
the Illinois Department, to persons in areas covered by
the Partnership may receive an additional surcharge for
such services.
(2) The Department may elect to consider and negotiate
financial incentives to encourage the development of
Partnerships and the efficient delivery of medical care.
(3) Persons receiving medical services through
Partnerships may receive medical and case management

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services above the level usually offered through the
medical assistance program.
Medical providers shall be required to meet certain
qualifications to participate in Partnerships to ensure the
delivery of high quality medical services. These
qualifications shall be determined by rule of the Illinois
Department and may be higher than qualifications for
participation in the medical assistance program. Partnership
sponsors may prescribe reasonable additional qualifications
for participation by medical providers, only with the prior
written approval of the Illinois Department.
Nothing in this Section shall limit the free choice of
practitioners, hospitals, and other providers of medical
services by clients. In order to ensure patient freedom of
choice, the Illinois Department shall immediately promulgate
all rules and take all other necessary actions so that
provided services may be accessed from therapeutically
certified optometrists to the full extent of the Illinois
Optometric Practice Act of 1987 without discriminating between
service providers.
The Department shall apply for a waiver from the United
States Health Care Financing Administration to allow for the
implementation of Partnerships under this Section.
The Illinois Department shall require health care
providers to maintain records that document the medical care
and services provided to recipients of Medical Assistance

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under this Article. Such records must be retained for a period
of not less than 6 years from the date of service or as
provided by applicable State law, whichever period is longer,
except that if an audit is initiated within the required
retention period then the records must be retained until the
audit is completed and every exception is resolved. The
Illinois Department shall require health care providers to
make available, when authorized by the patient, in writing,
the medical records in a timely fashion to other health care
providers who are treating or serving persons eligible for
Medical Assistance under this Article. All dispensers of
medical services shall be required to maintain and retain
business and professional records sufficient to fully and
accurately document the nature, scope, details and receipt of
the health care provided to persons eligible for medical
assistance under this Code, in accordance with regulations
promulgated by the Illinois Department. The rules and
regulations shall require that proof of the receipt of
prescription drugs, dentures, prosthetic devices and
eyeglasses by eligible persons under this Section accompany
each claim for reimbursement submitted by the dispenser of
such medical services. No such claims for reimbursement shall
be approved for payment by the Illinois Department without
such proof of receipt, unless the Illinois Department shall
have put into effect and shall be operating a system of
post-payment audit and review which shall, on a sampling

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basis, be deemed adequate by the Illinois Department to assure
that such drugs, dentures, prosthetic devices and eyeglasses
for which payment is being made are actually being received by
eligible recipients. Within 90 days after September 16, 1984
(the effective date of Public Act 83-1439), the Illinois
Department shall establish a current list of acquisition costs
for all prosthetic devices and any other items recognized as
medical equipment and supplies reimbursable under this Article
and shall update such list on a quarterly basis, except that
the acquisition costs of all prescription drugs shall be
updated no less frequently than every 30 days as required by
Section 5-5.12.
Notwithstanding any other law to the contrary, the
Illinois Department shall, within 365 days after July 22, 2013
(the effective date of Public Act 98-104), establish
procedures to permit skilled care facilities licensed under
the Nursing Home Care Act to submit monthly billing claims for
reimbursement purposes. Following development of these
procedures, the Department shall, by July 1, 2016, test the
viability of the new system and implement any necessary
operational or structural changes to its information
technology platforms in order to allow for the direct
acceptance and payment of nursing home claims.
Notwithstanding any other law to the contrary, the
Illinois Department shall, within 365 days after August 15,
2014 (the effective date of Public Act 98-963), establish

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procedures to permit ID/DD facilities licensed under the ID/DD
Community Care Act and MC/DD facilities licensed under the
MC/DD Act to submit monthly billing claims for reimbursement
purposes. Following development of these procedures, the
Department shall have an additional 365 days to test the
viability of the new system and to ensure that any necessary
operational or structural changes to its information
technology platforms are implemented.
The Illinois Department shall require all dispensers of
medical services, other than an individual practitioner or
group of practitioners, desiring to participate in the Medical
Assistance program established under this Article to disclose
all financial, beneficial, ownership, equity, surety or other
interests in any and all firms, corporations, partnerships,
associations, business enterprises, joint ventures, agencies,
institutions or other legal entities providing any form of
health care services in this State under this Article.
The Illinois Department may require that all dispensers of
medical services desiring to participate in the medical
assistance program established under this Article disclose,
under such terms and conditions as the Illinois Department may
by rule establish, all inquiries from clients and attorneys
regarding medical bills paid by the Illinois Department, which
inquiries could indicate potential existence of claims or
liens for the Illinois Department.
Enrollment of a vendor shall be subject to a provisional

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period and shall be conditional for one year. During the
period of conditional enrollment, the Department may terminate
the vendor's eligibility to participate in, or may disenroll
the vendor from, the medical assistance program without cause.
Unless otherwise specified, such termination of eligibility or
disenrollment is not subject to the Department's hearing
process. However, a disenrolled vendor may reapply without
penalty.
The Department has the discretion to limit the conditional
enrollment period for vendors based upon the category of risk
of the vendor.
Prior to enrollment and during the conditional enrollment
period in the medical assistance program, all vendors shall be
subject to enhanced oversight, screening, and review based on
the risk of fraud, waste, and abuse that is posed by the
category of risk of the vendor. The Illinois Department shall
establish the procedures for oversight, screening, and review,
which may include, but need not be limited to: criminal and
financial background checks; fingerprinting; license,
certification, and authorization verifications; unscheduled or
unannounced site visits; database checks; prepayment audit
reviews; audits; payment caps; payment suspensions; and other
screening as required by federal or State law.
The Department shall define or specify the following: (i)
by provider notice, the "category of risk of the vendor" for
each type of vendor, which shall take into account the level of

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screening applicable to a particular category of vendor under
federal law and regulations; (ii) by rule or provider notice,
the maximum length of the conditional enrollment period for
each category of risk of the vendor; and (iii) by rule, the
hearing rights, if any, afforded to a vendor in each category
of risk of the vendor that is terminated or disenrolled during
the conditional enrollment period.
To be eligible for payment consideration, a vendor's
payment claim or bill, either as an initial claim or as a
resubmitted claim following prior rejection, must be received
by the Illinois Department, or its fiscal intermediary, no
later than 180 days after the latest date on the claim on which
medical goods or services were provided, with the following
exceptions:
(1) In the case of a provider whose enrollment is in
process by the Illinois Department, the 180-day period
shall not begin until the date on the written notice from
the Illinois Department that the provider enrollment is
complete.
(2) In the case of errors attributable to the Illinois
Department or any of its claims processing intermediaries
which result in an inability to receive, process, or
adjudicate a claim, the 180-day period shall not begin
until the provider has been notified of the error.
(3) In the case of a provider for whom the Illinois
Department initiates the monthly billing process.

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(4) In the case of a provider operated by a unit of
local government with a population exceeding 3,000,000
when local government funds finance federal participation
for claims payments.
For claims for services rendered during a period for which
a recipient received retroactive eligibility, claims must be
filed within 180 days after the Department determines the
applicant is eligible. For claims for which the Illinois
Department is not the primary payer, claims must be submitted
to the Illinois Department within 180 days after the final
adjudication by the primary payer.
In the case of long term care facilities, within 120
calendar days of receipt by the facility of required
prescreening information, new admissions with associated
admission documents shall be submitted through the Medical
Electronic Data Interchange (MEDI) or the Recipient
Eligibility Verification (REV) System or shall be submitted
directly to the Department of Human Services using required
admission forms. Effective September 1, 2014, admission
documents, including all prescreening information, must be
submitted through MEDI or REV. Confirmation numbers assigned
to an accepted transaction shall be retained by a facility to
verify timely submittal. Once an admission transaction has
been completed, all resubmitted claims following prior
rejection are subject to receipt no later than 180 days after
the admission transaction has been completed.

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Claims that are not submitted and received in compliance
with the foregoing requirements shall not be eligible for
payment under the medical assistance program, and the State
shall have no liability for payment of those claims.
To the extent consistent with applicable information and
privacy, security, and disclosure laws, State and federal
agencies and departments shall provide the Illinois Department
access to confidential and other information and data
necessary to perform eligibility and payment verifications and
other Illinois Department functions. This includes, but is not
limited to: information pertaining to licensure;
certification; earnings; immigration status; citizenship; wage
reporting; unearned and earned income; pension income;
employment; supplemental security income; social security
numbers; National Provider Identifier (NPI) numbers; the
National Practitioner Data Bank (NPDB); program and agency
exclusions; taxpayer identification numbers; tax delinquency;
corporate information; and death records.
The Illinois Department shall enter into agreements with
State agencies and departments, and is authorized to enter
into agreements with federal agencies and departments, under
which such agencies and departments shall share data necessary
for medical assistance program integrity functions and
oversight. The Illinois Department shall develop, in
cooperation with other State departments and agencies, and in
compliance with applicable federal laws and regulations,

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appropriate and effective methods to share such data. At a
minimum, and to the extent necessary to provide data sharing,
the Illinois Department shall enter into agreements with State
agencies and departments, and is authorized to enter into
agreements with federal agencies and departments, including,
but not limited to: the Secretary of State; the Department of
Revenue; the Department of Public Health; the Department of
Human Services; and the Department of Financial and
Professional Regulation.
Beginning in fiscal year 2013, the Illinois Department
shall set forth a request for information to identify the
benefits of a pre-payment, post-adjudication, and post-edit
claims system with the goals of streamlining claims processing
and provider reimbursement, reducing the number of pending or
rejected claims, and helping to ensure a more transparent
adjudication process through the utilization of: (i) provider
data verification and provider screening technology; and (ii)
clinical code editing; and (iii) pre-pay, pre-adjudicated, or
post-adjudicated predictive modeling with an integrated case
management system with link analysis. Such a request for
information shall not be considered as a request for proposal
or as an obligation on the part of the Illinois Department to
take any action or acquire any products or services.
The Illinois Department shall establish policies,
procedures, standards and criteria by rule for the
acquisition, repair and replacement of orthotic and prosthetic

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devices and durable medical equipment. Such rules shall
provide, but not be limited to, the following services: (1)
immediate repair or replacement of such devices by recipients;
and (2) rental, lease, purchase or lease-purchase of durable
medical equipment in a cost-effective manner, taking into
consideration the recipient's medical prognosis, the extent of
the recipient's needs, and the requirements and costs for
maintaining such equipment. Subject to prior approval, such
rules shall enable a recipient to temporarily acquire and use
alternative or substitute devices or equipment pending repairs
or replacements of any device or equipment previously
authorized for such recipient by the Department.
Notwithstanding any provision of Section 5-5f to the contrary,
the Department may, by rule, exempt certain replacement
wheelchair parts from prior approval and, for wheelchairs,
wheelchair parts, wheelchair accessories, and related seating
and positioning items, determine the wholesale price by
methods other than actual acquisition costs.
The Department shall require, by rule, all providers of
durable medical equipment to be accredited by an accreditation
organization approved by the federal Centers for Medicare and
Medicaid Services and recognized by the Department in order to
bill the Department for providing durable medical equipment to
recipients. No later than 15 months after the effective date
of the rule adopted pursuant to this paragraph, all providers
must meet the accreditation requirement.

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In order to promote environmental responsibility, meet the
needs of recipients and enrollees, and achieve significant
cost savings, the Department, or a managed care organization
under contract with the Department, may provide recipients or
managed care enrollees who have a prescription or Certificate
of Medical Necessity access to refurbished durable medical
equipment under this Section (excluding prosthetic and
orthotic devices as defined in the Orthotics, Prosthetics, and
Pedorthics Practice Act and complex rehabilitation technology
products and associated services) through the State's
assistive technology program's reutilization program, using
staff with the Assistive Technology Professional (ATP)
Certification if the refurbished durable medical equipment:
(i) is available; (ii) is less expensive, including shipping
costs, than new durable medical equipment of the same type;
(iii) is able to withstand at least 3 years of use; (iv) is
cleaned, disinfected, sterilized, and safe in accordance with
federal Food and Drug Administration regulations and guidance
governing the reprocessing of medical devices in health care
settings; and (v) equally meets the needs of the recipient or
enrollee. The reutilization program shall confirm that the
recipient or enrollee is not already in receipt of the same or
similar equipment from another service provider, and that the
refurbished durable medical equipment equally meets the needs
of the recipient or enrollee. Nothing in this paragraph shall
be construed to limit recipient or enrollee choice to obtain

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new durable medical equipment or place any additional prior
authorization conditions on enrollees of managed care
organizations.
The Department shall execute, relative to the nursing home
prescreening project, written inter-agency agreements with the
Department of Human Services and the Department on Aging, to
effect the following: (i) intake procedures and common
eligibility criteria for those persons who are receiving
non-institutional services; and (ii) the establishment and
development of non-institutional services in areas of the
State where they are not currently available or are
undeveloped; and (iii) notwithstanding any other provision of
law, subject to federal approval, on and after July 1, 2012, an
increase in the determination of need (DON) scores from 29 to
37 for applicants for institutional and home and
community-based long term care; if and only if federal
approval is not granted, the Department may, in conjunction
with other affected agencies, implement utilization controls
or changes in benefit packages to effectuate a similar savings
amount for this population; and (iv) no later than July 1,
2013, minimum level of care eligibility criteria for
institutional and home and community-based long term care; and
(v) no later than October 1, 2013, establish procedures to
permit long term care providers access to eligibility scores
for individuals with an admission date who are seeking or
receiving services from the long term care provider. In order

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to select the minimum level of care eligibility criteria, the
Governor shall establish a workgroup that includes affected
agency representatives and stakeholders representing the
institutional and home and community-based long term care
interests. This Section shall not restrict the Department from
implementing lower level of care eligibility criteria for
community-based services in circumstances where federal
approval has been granted.
The Illinois Department shall develop and operate, in
cooperation with other State Departments and agencies and in
compliance with applicable federal laws and regulations,
appropriate and effective systems of health care evaluation
and programs for monitoring of utilization of health care
services and facilities, as it affects persons eligible for
medical assistance under this Code.
The Illinois Department shall report annually to the
General Assembly, no later than the second Friday in April of
1979 and each year thereafter, in regard to:
(a) actual statistics and trends in utilization of
medical services by public aid recipients;
(b) actual statistics and trends in the provision of
the various medical services by medical vendors;
(c) current rate structures and proposed changes in
those rate structures for the various medical vendors; and
(d) efforts at utilization review and control by the
Illinois Department.

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The period covered by each report shall be the 3 years
ending on the June 30 prior to the report. The report shall
include suggested legislation for consideration by the General
Assembly. The requirement for reporting to the General
Assembly shall be satisfied by filing copies of the report as
required by Section 3.1 of the General Assembly Organization
Act, and filing such additional copies with the State
Government Report Distribution Center for the General Assembly
as is required under paragraph (t) of Section 7 of the State
Library Act.
Rulemaking authority to implement Public Act 95-1045, if
any, is conditioned on the rules being adopted in accordance
with all provisions of the Illinois Administrative Procedure
Act and all rules and procedures of the Joint Committee on
Administrative Rules; any purported rule not so adopted, for
whatever reason, is unauthorized.
On and after July 1, 2012, the Department shall reduce any
rate of reimbursement for services or other payments or alter
any methodologies authorized by this Code to reduce any rate
of reimbursement for services or other payments in accordance
with Section 5-5e.
Because kidney transplantation can be an appropriate,
cost-effective alternative to renal dialysis when medically
necessary and notwithstanding the provisions of Section 1-11
of this Code, beginning October 1, 2014, the Department shall
cover kidney transplantation for noncitizens with end-stage

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renal disease who are not eligible for comprehensive medical
benefits, who meet the residency requirements of Section 5-3
of this Code, and who would otherwise meet the financial
requirements of the appropriate class of eligible persons
under Section 5-2 of this Code. To qualify for coverage of
kidney transplantation, such person must be receiving
emergency renal dialysis services covered by the Department.
Providers under this Section shall be prior approved and
certified by the Department to perform kidney transplantation
and the services under this Section shall be limited to
services associated with kidney transplantation.
Notwithstanding any other provision of this Code to the
contrary, on or after July 1, 2015, all FDA-approved forms of
medication assisted treatment prescribed for the treatment of
alcohol dependence or treatment of opioid dependence shall be
covered under both fee-for-service and managed care medical
assistance programs for persons who are otherwise eligible for
medical assistance under this Article and shall not be subject
to any (1) utilization control, other than those established
under the American Society of Addiction Medicine patient
placement criteria, (2) prior authorization mandate, (3)
lifetime restriction limit mandate, or (4) limitations on
dosage.
On or after July 1, 2015, opioid antagonists prescribed
for the treatment of an opioid overdose, including the
medication product, administration devices, and any pharmacy

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fees or hospital fees related to the dispensing, distribution,
and administration of the opioid antagonist, shall be covered
under the medical assistance program for persons who are
otherwise eligible for medical assistance under this Article.
As used in this Section, "opioid antagonist" means a drug that
binds to opioid receptors and blocks or inhibits the effect of
opioids acting on those receptors, including, but not limited
to, naloxone hydrochloride or any other similarly acting drug
approved by the U.S. Food and Drug Administration. The
Department shall not impose a copayment on the coverage
provided for naloxone hydrochloride under the medical
assistance program.
Upon federal approval, the Department shall provide
coverage and reimbursement for all drugs that are approved for
marketing by the federal Food and Drug Administration and that
are recommended by the federal Public Health Service or the
United States Centers for Disease Control and Prevention for
pre-exposure prophylaxis and related pre-exposure prophylaxis
services, including, but not limited to, HIV and sexually
transmitted infection screening, treatment for sexually
transmitted infections, medical monitoring, assorted labs, and
counseling to reduce the likelihood of HIV infection among
individuals who are not infected with HIV but who are at high
risk of HIV infection.
A federally qualified health center, as defined in Section
1905(l)(2)(B) of the federal Social Security Act, shall be

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reimbursed by the Department in accordance with the federally
qualified health center's encounter rate for services provided
to medical assistance recipients that are performed by a
dental hygienist, as defined under the Illinois Dental
Practice Act, working under the general supervision of a
dentist and employed by a federally qualified health center.
Within 90 days after October 8, 2021 (the effective date
of Public Act 102-665), the Department shall seek federal
approval of a State Plan amendment to expand coverage for
family planning services that includes presumptive eligibility
to individuals whose income is at or below 208% of the federal
poverty level. Coverage under this Section shall be effective
beginning no later than December 1, 2022.
Subject to approval by the federal Centers for Medicare
and Medicaid Services of a Title XIX State Plan amendment
electing the Program of All-Inclusive Care for the Elderly
(PACE) as a State Medicaid option, as provided for by Subtitle
I (commencing with Section 4801) of Title IV of the Balanced
Budget Act of 1997 (Public Law 105-33) and Part 460
(commencing with Section 460.2) of Subchapter E of Title 42 of
the Code of Federal Regulations, PACE program services shall
become a covered benefit of the medical assistance program,
subject to criteria established in accordance with all
applicable laws.
Notwithstanding any other provision of this Code,
community-based pediatric palliative care from a trained

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interdisciplinary team shall be covered under the medical
assistance program as provided in Section 15 of the Pediatric
Palliative Care Act.
Notwithstanding any other provision of this Code, within
12 months after June 2, 2022 (the effective date of Public Act
102-1037) and subject to federal approval, acupuncture
services performed by an acupuncturist licensed under the
Acupuncture Practice Act who is acting within the scope of his
or her license shall be covered under the medical assistance
program. The Department shall apply for any federal waiver or
State Plan amendment, if required, to implement this
paragraph. The Department may adopt any rules, including
standards and criteria, necessary to implement this paragraph.
Notwithstanding any other provision of this Code, the
medical assistance program shall, subject to federal approval,
reimburse hospitals for costs associated with a newborn
screening test for the presence of metachromatic
leukodystrophy, as required under the Newborn Metabolic
Screening Act, at a rate not less than the fee charged by the
Department of Public Health. Notwithstanding any other
provision of this Code, the medical assistance program shall,
subject to appropriation and federal approval, also reimburse
hospitals for costs associated with all newborn screening
tests added on and after August 9, 2024 (the effective date of
Public Act 103-909) to the Newborn Metabolic Screening Act and
required to be performed under that Act at a rate not less than

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the fee charged by the Department of Public Health. The
Department shall seek federal approval before the
implementation of the newborn screening test fees by the
Department of Public Health.
Notwithstanding any other provision of this Code,
beginning on January 1, 2024, subject to federal approval,
cognitive assessment and care planning services provided to a
person who experiences signs or symptoms of cognitive
impairment, as defined by the Diagnostic and Statistical
Manual of Mental Disorders, Fifth Edition, shall be covered
under the medical assistance program for persons who are
otherwise eligible for medical assistance under this Article.
Notwithstanding any other provision of this Code,
medically necessary reconstructive services that are intended
to restore physical appearance shall be covered under the
medical assistance program for persons who are otherwise
eligible for medical assistance under this Article. As used in
this paragraph, "reconstructive services" means treatments
performed on structures of the body damaged by trauma to
restore physical appearance.
Subject to federal approval, for dates of services on and
after January 1, 2026, over-the-counter choline dietary
supplements for pregnant persons shall be covered under the
medical assistance program.
(Source: P.A. 103-102, Article 15, Section 15-5, eff. 1-1-24;
103-102, Article 95, Section 95-15, eff. 1-1-24; 103-123, eff.

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1-1-24; 103-154, eff. 6-30-23; 103-368, eff. 1-1-24; 103-593,
Article 5, Section 5-5, eff. 6-7-24; 103-593, Article 90,
Section 90-5, eff. 6-7-24; 103-605, eff. 7-1-24; 103-808, eff.
1-1-26; 103-909, eff. 8-9-24; 103-1040, eff. 8-9-24; 104-9,
eff. 6-16-25; 104-417, eff. 8-15-25.)
Section 20. The Newborn Screening Act is amended by
changing the title of the Act and Sections 0.01 and 2 as
follows:
(410 ILCS 240/Act title)
An Act concerning health the disease of phenylketonuria
and other metabolic diseases, designating certain powers and
duties in relation thereto, providing penalties for violation
thereof, to repeal an Act therein named and to make an
appropriation in connection therewith.
(410 ILCS 240/0.01) (from Ch. 111 1/2, par. 4902.9)
Sec. 0.01. Short title. This Act may be cited as the
Newborn Metabolic Screening Act.
(Source: P.A. 95-695, eff. 11-5-07.)
(410 ILCS 240/2) (from Ch. 111 1/2, par. 4904)
Sec. 2. General provisions. The Department of Public
Health shall administer the provisions of this Act and shall:
(a) Institute and carry on an intensive educational

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program among physicians, hospitals, public health nurses and
the public concerning disorders included in newborn screening.
This educational program shall include information about the
nature of the diseases and examinations for the detection of
the diseases in early infancy in order that measures may be
taken to prevent the disabilities resulting from the diseases.
(a-5) Require that all newborns be screened for the
presence of certain genetic, metabolic, and congenital
anomalies, including hearing conditions, as determined by the
Department, by rule.
(a-5.1) Require that all blood and biological specimens
collected pursuant to this Act or the rules adopted under this
Act be submitted for testing to the nearest Department
laboratory designated to perform such tests. The following
provisions shall apply concerning testing:
(1) Beginning July 1, 2015, the base fee for newborn
screening services shall be $118. Beginning July 1, 2026,
the Department shall collect an additional newborn
screening fee in an amount determined by the Department by
rule but not less than an additional $45 per newborn for
the Early Hearing Detection and Intervention Program
(EHDI), through which the Department provides
Cytomegalovirus education and parent-to-parent support.
The Department may develop a reasonable fee structure and
may levy additional fees according to such structure to
cover the cost of providing these this testing services

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service and for the follow-up of infants with an abnormal
screening test; however, additional fees may be levied no
sooner than 6 months prior to the beginning of testing for
a new genetic, metabolic, or congenital disorder. All fees
Fees collected from the provision of this testing service
and all additional newborn screening fees collected under
this subsection shall be deposited into placed in the
Metabolic Screening and Treatment Fund. Other State and
federal funds for expenses related to metabolic, hearing,
or congenital condition screening, follow-up, and
treatment programs may also be placed in the Fund. Nothing
in this Section or this Act shall be construed to
override, replace, preempt, or supersede any provision,
requirement, or other duty or prohibition enumerated in
the Early Hearing Detection and Intervention Act.
(2) Moneys shall be appropriated from the Fund to the
Department solely for the purposes of providing newborn
screening, follow-up, and treatment programs, to the Early
Hearing Detection and Intervention Program (EHDI), through
which the Department provides Cytomegalovirus education
and parent-to-parent support. Nothing in this Act shall be
construed to prohibit any licensed medical facility from
collecting additional specimens for testing for metabolic
or neonatal diseases or any other diseases or conditions,
as it deems fit. Any person violating the provisions of
this subsection (a-5.1) is guilty of a petty offense.

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(3) If the Department is unable to provide the
screening using the State Laboratory, it shall temporarily
provide such screening through an accredited laboratory
selected by the Department until the Department has the
capacity to provide screening through the State
Laboratory. If screening is provided on a temporary basis
through an accredited laboratory, the Department shall
substitute the fee charged by the accredited laboratory,
plus a 5% surcharge for documentation and handling, for
the fee authorized in this subsection (a-5.1). This
paragraph (3) does not apply to hearing screenings.
(a-5.2) Maintain a registry of cases, including
information of importance for the purpose of follow-up
services to assess long-term outcomes.
(a-5.3) Supply the necessary metabolic treatment formulas
where practicable for diagnosed cases of amino acid metabolism
disorders, including phenylketonuria, organic acid disorders,
and fatty acid oxidation disorders for as long as medically
indicated, when the product is not available through other
State agencies.
(a-5.4) Arrange for or provide public health nursing,
nutrition, and social services and clinical consultation as
indicated.
(a-5.5) Utilize the Genetic and Metabolic Diseases
Advisory Committee established under the Genetic and Metabolic
Diseases Advisory Committee Act to provide guidance and

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recommendations to the Department's newborn screening program.
The Genetic and Metabolic Diseases Advisory Committee shall
review the feasibility and advisability of including
additional metabolic, genetic, and congenital conditions or
disorders in the newborn screening panel, according to a
review protocol applied to each suggested addition to the
newborn screening panel. The Department shall consider the
recommendations of the Genetic and Metabolic Diseases Advisory
Committee in determining whether to include an additional
disorder in the newborn screening panel prior to proposing an
administrative rule concerning inclusion of an additional
disorder in the newborn screening panel. Notwithstanding any
other provision of law, no new screening may begin prior to the
occurrence of all the following:
(1) the establishment and verification of relevant and
appropriate performance specifications as defined under
the federal Clinical Laboratory Improvement Amendments and
regulations thereunder for U.S. Food and Drug
Administration-cleared or in-house developed methods,
performed under an institutional review board-approved
protocol, if required;
(2) the availability of quality assurance testing
methodology for the processes set forth in item (1) of
this subsection (a-5.5);
(3) the acquisition and installment by the Department
of the equipment necessary to implement the screening

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tests;
(4) the establishment of precise threshold values
ensuring defined disorder identification for each
screening test;
(5) the authentication of pilot testing achieving each
milestone described in items (1) through (4) of this
subsection (a-5.5) for each disorder screening test; and
(6) the authentication of achieving the potential of
high throughput standards for statewide volume of each
disorder screening test concomitant with each milestone
described in items (1) through (4) of this subsection
(a-5.5).
(a-6) (Blank).
(a-7) (Blank).
(a-8) (Blank).
(b) (Blank).
(c) (Blank).
(d) (Blank).
(e) (Blank).
(Source: P.A. 98-440, eff. 8-16-13; 98-756, eff. 7-16-14;
99-403, eff. 8-19-15.)
Section 25. The Genetic Information Privacy Act is amended
by changing Section 30 as follows:
(410 ILCS 513/30)

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Sec. 30. Disclosure of person tested and test results.
(a) No person may disclose or be compelled to disclose the
identity of any person upon whom a genetic test is performed or
the results of a genetic test in a manner that permits
identification of the subject of the test, except to the
following persons:
(1) The subject of the test or the subject's legally
authorized representative. This paragraph does not create
a duty or obligation under which a health care provider
must notify the subject's spouse or legal guardian of the
test results, and no such duty or obligation shall be
implied. No civil liability or criminal sanction under
this Act shall be imposed for any disclosure or
nondisclosure of a test result to a spouse by a physician
acting in good faith under this paragraph. For the purpose
of any proceedings, civil or criminal, the good faith of
any physician acting under this paragraph shall be
presumed.
(2) Any person designated in a specific written
legally effective authorization for release of the test
results executed by the subject of the test or the
subject's legally authorized representative.
(3) An authorized agent or employee of a health
facility or health care provider if the health facility or
health care provider itself is authorized to obtain the
test results, the agent or employee provides patient care,

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and the agent or employee has a need to know the
information in order to conduct the tests or provide care
or treatment.
(4) A health facility, health care provider, or health
care professional that procures, processes, distributes,
or uses:
(A) a human body part from a deceased person with
respect to medical information regarding that person;
or
(B) semen provided prior to the effective date of
this Act for the purpose of artificial insemination.
(5) Health facility staff committees for the purposes
of conducting program monitoring, program evaluation, or
service reviews.
(6) In the case of a minor under 18 years of age, the
health care provider, health care professional, or health
facility who ordered the test shall make a reasonable
effort to notify the minor's parent or legal guardian if,
in the professional judgment of the health care provider,
health care professional, or health facility, notification
would be in the best interest of the minor and the health
care provider, health care professional, or health
facility has first sought unsuccessfully to persuade the
minor to notify the parent or legal guardian or after a
reasonable time after the minor has agreed to notify the
parent or legal guardian, the health care provider, health

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care professional, or health facility has reason to
believe that the minor has not made the notification. This
paragraph shall not create a duty or obligation under
which a health care provider, health care professional, or
health facility must notify the minor's parent or legal
guardian of the test results, nor shall a duty or
obligation be implied. No civil liability or criminal
sanction under this Act shall be imposed for any
notification or non-notification of a minor's test result
by a health care provider, health care professional, or
health facility acting in good faith under this paragraph.
For the purpose of any proceeding, civil or criminal, the
good faith of any health care provider, health care
professional, or health facility acting under this
paragraph shall be presumed.
(b) All information and records held by a State agency,
local health authority, or health oversight agency pertaining
to genetic information shall be strictly confidential and
exempt from copying and inspection under the Freedom of
Information Act. The information and records shall not be
released or made public by the State agency, local health
authority, or health oversight agency and shall not be
admissible as evidence nor discoverable in any action of any
kind in any court or before any tribunal, board, agency, or
person and shall be treated in the same manner as the
information and those records subject to the provisions of

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Part 21 of Article VIII of the Code of Civil Procedure except
under the following circumstances:
(A) when made with the written consent of all
persons to whom the information pertains;
(B) when authorized by Section 5-4-3 of the
Unified Code of Corrections;
(C) when made for the sole purpose of implementing
the Newborn Metabolic Screening Act and rules; or
(D) when made under the authorization of the
Illinois Parentage Act of 2015.
Disclosure shall be limited to those who have a need to
know the information, and no additional disclosures may be
made.
(c) Disclosure by an insurer in accordance with the
requirements of the Article XL of the Illinois Insurance Code
shall be deemed compliance with this Section.
(Source: P.A. 98-1046, eff. 1-1-15; 99-85, eff. 1-1-16.)
Section 95. No acceleration or delay. Where this Act makes
changes in a statute that is represented in this Act by text
that is not yet or no longer in effect (for example, a Section
represented by multiple versions), the use of that text does
not accelerate or delay the taking effect of (i) the changes
made by this Act or (ii) provisions derived from any other
Public Act.

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Section 99. Effective date. This Act takes effect upon
becoming law.".