Bill Text: IL HB0424 | 2015-2016 | 99th General Assembly | Introduced

---

Bill Title: Creates the Home Birth Safety Act. Provides for the licensure of midwives by the Department of Financial and Professional Regulation. Creates the Illinois Midwifery Board. Sets forth provisions concerning qualifications, grounds for disciplinary action, and administrative procedures. Amends the Regulatory Sunset Act to set a repeal date for the new Act of January 1, 2026. Also amends the Medical Practice Act of 1987, the Nurse Practice Act, and the Illinois Public Aid Code to make related changes. Effective immediately.

Spectrum: Bipartisan Bill

Status: (Introduced - Dead) 2015-11-16 - Added Chief Co-Sponsor Rep. Dwight Kay [HB0424 Detail]

Download: Illinois-2015-HB0424-Introduced.html

---

99TH GENERAL ASSEMBLY State of Illinois 2015 and 2016 HB0424 Introduced , by Rep. Thomas Morrison SYNOPSIS AS INTRODUCED:
New Act
5 ILCS 80/4.36 new
225 ILCS 60/4 from Ch. 111, par. 4400-4
225 ILCS 65/50-15 was 225 ILCS 65/5-15
305 ILCS 5/5-5 from Ch. 23, par. 5-5
Creates the Home Birth Safety Act. Provides for the licensure of midwives by the Department of Financial and Professional Regulation. Creates the Illinois Midwifery Board. Sets forth provisions concerning qualifications, grounds for disciplinary action, and administrative procedures. Amends the Regulatory Sunset Act to set a repeal date for the new Act of January 1, 2026. Also amends the Medical Practice Act of 1987, the Nurse Practice Act, and the Illinois Public Aid Code to make related changes. Effective immediately.
LRB099 03597 HAF 23605 b
CORRECTIONAL BUDGET AND IMPACT NOTE ACT MAY APPLY FISCAL NOTE ACT MAY APPLY HOME RULE NOTE ACT MAY APPLY
A BILL FOR
HB0424 LRB099 03597 HAF 23605 b
AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 1. Short title. This Act may be cited as the Home
Birth Safety Act.
Section 5. Purpose. The practice of midwifery in
out-of-hospital settings is hereby declared to affect the
public health, safety, and welfare and to be subject to
regulation in the public interest. The purpose of the Act is to
protect and benefit the public by setting standards for the
qualifications, education, training, and experience of those
who seek to obtain licensure and hold the title of licensed
midwife, to promote high standards of professional performance
for those licensed to practice midwifery in out-of-hospital
settings in this State, and to protect the public from
unprofessional conduct by persons licensed to practice
midwifery, as defined in this Act. This Act shall be liberally
construed to best carry out these purposes.
Section 10. Exemptions.
(a) This Act does not prohibit a person licensed under any
other Act in this State from engaging in the practice for which
he or she is licensed or from delegating services as provided

HB0424 - 2 - LRB099 03597 HAF 23605 b
for under that other Act.
(b) Nothing in this Act shall be construed to prohibit or
require licensing under this Act, with regard to:
(1) the gratuitous rendering of services;
(2) the rendering of services by a person, if such
attendance is in accordance with the person's religious
faith and is rendered to persons with a similar religious
faith as an exercise and enjoyment of their religious
freedom; and
(3) a student midwife working under the direction of a
licensed midwife.
Section 15. Definitions. In this Act:
"Board" means the Illinois Midwifery Board.
"Certified professional midwife" means a person who has met
the standards for certification set by the North American
Registry of Midwives or a successor organization and has been
awarded the Certified Professional Midwife (CPM) credential.
"Department" means the Department of Financial and
Professional Regulation.
"Licensed midwife" means a person who has been granted a
license under this Act to engage in the practice of midwifery.
"National Association of Certified Professional Midwives"
or "NACPM" means the professional organization, or its
successor, that promotes the growth and development of the
profession of certified professional midwives.

HB0424 - 3 - LRB099 03597 HAF 23605 b
"North American Registry of Midwives" or "NARM" means the
accredited international agency, or its successor, that has
established and has continued to administer certification for
the credentialing of certified professional midwives.
"Practice of midwifery" means providing the necessary
supervision, care, education, and advice to women during the
antepartum, intrapartum, and postpartum period, conducting
deliveries independently, and caring for the newborn, with such
care including without limitation preventative measures, the
detection of abnormal conditions in the mother and the child,
the procurement of medical assistance, and the execution of
emergency measures in the absence of medical help. "Practice of
midwifery" includes non-prescriptive family planning.
"Secretary" means the Secretary of Financial and
Professional Regulation.
Section 20. Unlicensed practice. Beginning January 1,
2016, no person may practice, attempt to practice, or hold
himself or herself out to practice as a licensed midwife unless
he or she is licensed as a midwife under this Act.
Section 25. Title. A licensed midwife may identify himself
or herself as a "licensed midwife" or a "licensed home birth
midwife" and may use the abbreviation L.M.
Section 30. Informed consent.

HB0424 - 4 - LRB099 03597 HAF 23605 b
(a) A licensed midwife shall, at an initial consultation
with a client, provide a copy of the rules under this Act and
disclose to the client orally and in writing all of the
following:
(1) The licensed midwife's experience and training.
(2) Whether the licensed midwife has malpractice
liability insurance coverage and the policy limits of any
such coverage.
(3) A written protocol for the handling of medical
emergencies, including transportation to a hospital,
particular to each client.
(4) A notice that the client must obtain a physical
examination from a physician licensed to practice medicine
in all its branches, doctor of osteopathy, physician
assistant, or advanced practice nurse.
(b) A copy of the informed consent document, signed and
dated by the client, must be kept in each client's chart.
Section 33. Vicarious liability. No physician licensed to
practice medicine in all its branches or advanced practice
nurse shall be held liable for an injury solely resulting from
an act or omission by a licensed midwife occurring outside of a
hospital, doctor's office or health care facility.
Except as may otherwise be provided by law, nothing in this
Section shall exempt any physician licensed to practice
medicine in all its branches or advanced practice nurse from

HB0424 - 5 - LRB099 03597 HAF 23605 b
liability for his or her own negligent, grossly negligent, or
willful or wanton acts or omissions.
Section 35. Advertising.
(a) Any person licensed under this Act may advertise the
availability of professional midwifery services in the public
media or on premises where professional services are rendered,
if the advertising is truthful and not misleading and is in
conformity with any rules regarding the practice of a licensed
midwife.
(b) A licensee must include in every advertisement for
midwifery services regulated under this Act his or her title as
it appears on the license or the initials authorized under this
Act.
Section 40. Powers and duties of the Department; rules.
(a) The Department shall exercise the powers and duties
prescribed by the Civil Administrative Code of Illinois for the
administration of licensing Acts and shall exercise such other
powers and duties necessary for effectuating the purposes of
this Act.
(b) The Secretary shall adopt rules consistent with the
provisions of this Act for the administration and enforcement
of the Act and for the payment of fees connected to the Act and
may prescribe forms that shall be issued in connection with the
Act. The rules shall include, but not be limited to, the

HB0424 - 6 - LRB099 03597 HAF 23605 b
following:
(1) With regard to testing, care, and screening, a
licensed midwife shall:
(A) offer each client routine prenatal care and
testing in accordance with current American College of
Obstetricians and Gynecologists guidelines;
(B) provide all clients with a plan for 24-hour
on-call availability by a licensed midwife, certified
nurse-midwife, or licensed physician throughout
pregnancy, intrapartum, and 6 weeks postpartum;
(C) provide clients with labor support, fetal
monitoring, and routine assessment of vital signs once
active labor is established;
(D) supervise delivery of infant and placenta,
assess newborn and maternal well-being in immediate
postpartum, and perform Apgar scores;
(E) administer, if necessary, oxytoxin (Pitocin)
solely as an anti-hemorrhagic agent, oxygen and
intravenous fluids for stabilization, and other drugs
or procedures as determined by the Department;
(F) perform routine cord management and inspect
for the appropriate number of vessels;
(G) inspect the placenta and membranes for
completeness;
(H) inspect the perineum and vagina postpartum for
lacerations and stabilize;

HB0424 - 7 - LRB099 03597 HAF 23605 b
(I) observe mother and newborn postpartum until
stable condition is achieved, but in no event for less
than 2 hours;
(J) instruct the mother, father, and other support
persons, both verbally and in writing, of the special
care and precautions for both mother and newborn in the
immediate postpartum period;
(K) reevaluate maternal and newborn well-being
within 36 hours after delivery.
(L) use universal precautions with all biohazard
materials;
(M) ensure that a birth certificate is accurately
completed and filed in accordance with State law;
(N) offer to obtain and submit a blood sample, in
accordance with the recommendations for metabolic
screening of the newborn;
(O) offer an injection of vitamin K for the
newborn, in accordance with the indication, dose, and
administration route set by the Department in rules.
(P) within one week after delivery, offer a newborn
hearing screening to every newborn or refer the parents
to a facility with a newborn hearing screening program;
(Q) within 2 hours after the birth, offer the
administration of anti-biotic ointment into the eyes
of the newborn, in accordance with State law on the
prevention of infant blindness; and

HB0424 - 8 - LRB099 03597 HAF 23605 b
(R) maintain adequate antenatal and perinatal
records of each client and provide records to
consulting licensed physicians and licensed certified
nurse-midwives, in accordance with the federal Health
Insurance Portability and Accountability Act.
(2) With regard to collaboration, a licensed midwife
must form a collaborative relationship with a medical
doctor or doctor of osteopathy licensed under the Illinois
Medical Practice Act of 1987 or a certified nurse-midwife
licensed as an advanced practice nurse under the Nurse
Practice Act. This relationship must:
(A) include documented quarterly review of all
clients under the care of the licensed midwife;
(B) include written protocols and procedures for
assessing risk and appropriateness for home birth;
(C) provide supportive care when care is
transferred to another provider, if possible; and
(D) consider the standards regarding practice of
midwifery established by the National Association of
Certified Professional Midwives, including referral of
mother or baby to appropriate professionals when
either needs care outside the midwife's scope of
practice or expertise.
This relationship shall require the personal presence
of the collaborating care provider at all times at the
place where services are rendered, as long as there is

HB0424 - 9 - LRB099 03597 HAF 23605 b
communication available for consultation by radio,
telephone, Internet, or other telecommunications.
(3) If a licensed midwife makes 10 failed attempts,
documented by certified mail, to arrange a collaborative
relationship, then he or she may practice
unencumbered.
(4) With regard to prohibited practices, a licensed
midwife may not do any of the following:
(A) Administer prescription pharmacological agents
intended to induce or augment labor.
(B) Administer prescription pharmacological agents
to provide pain management.
(C) Use vacuum extractors or forceps.
(D) Prescribe medications.
(E) Perform major surgical procedures including,
but not limited to, abortions, cesarean sections, and
circumcisions.
(5) With regards to Medicaid Reimbursement, no
licensed midwife is required to carry liability insurance
in order to be reimbursed by the State as a Medicaid
provider.
(c) The Department shall consult with the Board in adopting
rules. Notice of proposed rulemaking shall be transmitted to
the Board and the Department shall review the Board's response
and any recommendations made. The Department shall notify the
Board in writing with proper explanation of deviations from the

HB0424 - 10 - LRB099 03597 HAF 23605 b
Board's recommendations and responses.
(d) The Department may at any time seek the advice and the
expert knowledge of the Board on any matter relating to the
administration of this Act.
(e) The Department shall issue quarterly a report to the
Board of the status of all complaints related to the profession
filed with the Department.
(f) Administration by the Department of this Act must be
consistent with standards regarding the practice of midwifery
established by the National Association of Certified
Professional Midwives or a successor organization whose
essential documents include without limitation subject matter
concerning scope of practice, standards of practice, informed
consent, appropriate consultation, collaboration or referral,
and acknowledgement of a woman's right to self determination
concerning her maternity care.
Section 45. Illinois Midwifery Board.
(a) There is created under the authority of the Department
the Illinois Midwifery Board, which shall consist of 7 members
appointed by the Secretary, 4 of whom shall be licensed
midwives who carry the CPM credential, except that initial
appointees must have at least 3 years of experience in the
practice of midwifery in an out-of-hospital setting, be
certified by the North American Registry of Midwives, and meet
the qualifications for licensure set forth in this Act; one of

HB0424 - 11 - LRB099 03597 HAF 23605 b
whom shall be an obstetrician or a family practice physician
licensed under the Medical Practice Act of 1987 who has a
minimum of 2 years of experience providing home birth services
or consulting with home birth providers; one of whom shall be a
certified nurse midwife who has at least 2 years of experience
in providing home birth services; and one of whom shall be a
knowledgeable public member who has given birth with the
assistance of a certified professional midwife in an
out-of-hospital birth setting. Board members shall serve
4-year terms, except that in the case of initial appointments,
terms shall be staggered as follows: 3 members shall serve for
4 years, 2 members shall serve for 3 years, and 2 members shall
serve for 2 years. The Board shall annually elect a chairperson
and vice chairperson.
(b) Any appointment made to fill a vacancy shall be for the
unexpired portion of the term. Appointments to fill vacancies
shall be made in the same manner as original appointments. No
Board member may be reappointed for a term that would cause his
or her continuous service on the Board to exceed 9 years.
(c) Board membership must have reasonable representation
from different geographic areas of this State.
(d) The members of the Board shall be reimbursed for all
legitimate, necessary, and authorized expenses incurred in
attending the meetings of the Board.
(e) The Secretary may remove any member for cause at any
time prior to the expiration of his or her term.

HB0424 - 12 - LRB099 03597 HAF 23605 b
(f) Four Board members shall constitute a quorum. A vacancy
in the membership of the Board shall not impair the right of a
quorum to perform all of the duties of the Board.
(g) The Board shall provide the Department with
recommendations concerning the administration of this Act and
may perform each of the following duties:
(1) Recommend to the Department the prescription and,
from time to time, the revision of any rules that may be
necessary to carry out the provisions of this Act,
including those that are designed to protect the health,
safety, and welfare of the public.
(2) Conduct hearings and disciplinary conferences on
disciplinary charges of licensees.
(3) Report to the Department, upon completion of a
hearing, the disciplinary actions recommended to be taken
against a person found in violation of this Act.
(4) Recommend the approval, denial of approval, and
withdrawal of approval of required education and
continuing educational programs.
(h) The Secretary shall give due consideration to all
recommendations of the Board. If the Secretary takes action
contrary to a recommendation of the Board, the Secretary must
promptly provide a written explanation of that action.
(i) The Board may recommend to the Secretary that one or
more licensed midwives be selected by the Secretary to assist
in any investigation under this Act. Compensation shall be

HB0424 - 13 - LRB099 03597 HAF 23605 b
provided to any licensee who provides assistance under this
subsection (i), in an amount determined by the Secretary.
(j) Members of the Board shall be immune from suit in an
action based upon a disciplinary proceeding or other activity
performed in good faith as a member of the Board, except for
willful or wanton misconduct.
Section 50. Qualifications.
(a) A person is qualified for licensure as a midwife if
that person meets each of the following qualifications:
(1) He or she has earned an associate's degree or
higher, or the equivalent of an associate's degree or
higher, in either nursing or midwifery from an accredited
post-secondary institution or has earned a general
associates degree or its equivalent, including completion
of all of the following coursework from an accredited
post-secondary institution in the following denominations:
(A) Laboratory Science (must include coursework in
Anatomy and Physiology and Microbiology): 12 credit hours.
(B) English or Communications: 6 credit hours.
(C) Social and Behavioral Science (Sociology and
Psychology): 6 credit hours.
(D) Math: 3 credit hours.
(E) Nutrition: 3 credit hours.
(F) Pharmacology: 3 credit hours.
(2) He or she has successfully completed a program of

HB0424 - 14 - LRB099 03597 HAF 23605 b
midwifery education approved by the North American
Registry of Midwives that includes both didactic and
clinical internship experience, the sum of which, on
average, takes 3 to 5 years to complete.
(3) He or she has passed a written and practical skills
examination for the practice of midwifery that has been
developed following the standards set by the National
Commission for Certifying Agencies or a successor
organization and is administered by the North American
Registry of Midwives.
(4) He or she holds a valid CPM credential granted by
the North American Registry of Midwives.
(b) Before January 1, 2017, a person seeking licensure as a
licensed midwife who has not met the educational requirements
set forth in this Section shall be qualified for licensure if
that person does all of the following:
(1) Submits evidence of having successfully passed the
national certification exam described in subsection (a) of
this Section prior to January 1, 2009.
(2) Submits evidence of current certification in adult
CPR and in neonatal resuscitation.
(3) Has continually maintained active, up-to-date
recertification status as a certified professional midwife
with the North American Registry of Midwives.
(4) Submits evidence of practice for at least 5 years
as a midwife delivering in an out-of-hospital setting.

HB0424 - 15 - LRB099 03597 HAF 23605 b
(c) Nothing used in submitting evidence of practice of
midwifery when applying for licensure under this Act shall be
used as evidence or to take legal action against the applicant
regarding the practice of midwifery, nursing, or medicine prior
to the passage of this Act.
Section 55. Social Security Number on application. In
addition to any other information required to be contained in
the application, every application for an original, renewal,
reinstated, or restored license under this Act shall include
the applicant's Social Security Number.
Section 60. Continuing education.
(a) The Department shall require all licensed midwives to
submit proof of the completion of at least 25 hours of
continuing education in classes approved by the North American
Registry of Midwives and 5 hours of peer review per 3-year
license renewal cycle.
(b) Rules adopted under this Act shall require the licensed
midwife to maintain CPM certification by meeting all the
requirements set forth by the North American Registry of
Midwives or its successor.
(c) Each licensee is responsible for maintaining records of
completion of continuing education and shall be prepared to
produce the records when requested by the Department.

HB0424 - 16 - LRB099 03597 HAF 23605 b
Section 65. Inactive status.
(a) A licensed midwife who notifies the Department in
writing on forms prescribed by the Department may elect to
place his or her license on an inactive status and shall be
excused from payment of renewal fees until he or she notifies
the Department in writing of his or her intent to restore the
license.
(b) A licensed midwife whose license is on inactive status
may not practice licensed midwifery in the State of Illinois.
(c) A licensed midwife requesting restoration from
inactive status shall be required to pay the current renewal
fee and to restore his or her license, as provided by the
Department.
(d) Any licensee who engages in the practice of midwifery
while his or her license is lapsed or on inactive status shall
be considered to be practicing without a license, which shall
be grounds for discipline.
Section 70. Renewal, reinstatement, or restoration of
licensure; military service.
(a) The expiration date and renewal period for each license
issued under this Act shall be set by the Department.
(b) All renewal applicants shall provide proof of having
met the requirements of continuing education set forth by the
North American Registry of Midwives or its successor. The
Department shall provide for an orderly process for the

HB0424 - 17 - LRB099 03597 HAF 23605 b
reinstatement of licenses that have not been renewed due to
failure to meet continuing education requirements.
(c) Any licensed midwife who has permitted his or her
license to expire or who has had his or her license on inactive
status may have his or her license restored by making
application to the Department and filing proof acceptable to
the Department of fitness to have the license restored and by
paying the required fees. Proof of fitness may include evidence
attesting to active lawful practice in another jurisdiction.
(d) The Department shall determine, by an evaluation
program, fitness for restoration of a license under this
Section and shall establish procedures and requirements for
restoration.
(e) Any licensed midwife whose license expired while he or
she was (i) in federal service on active duty with the Armed
Forces of the United States or the State Militia and called
into service or training or (ii) or received education under
the supervision of the United States preliminary to induction
into the military service may have his or her license restored
without paying any lapsed renewal fees, if, within 2 years
after honorable termination of service, training, or
education, he or she furnishes the Department with satisfactory
evidence to the effect that he or she has been so engaged.
Section 75. Roster. The Department shall maintain a roster
of the names and addresses of all licensees and of all persons

HB0424 - 18 - LRB099 03597 HAF 23605 b
whose licenses have been suspended or revoked. This roster
shall be available upon written request and payment of the
required fee.
Section 80. Fees.
(a) The Department shall provide for a schedule of fees for
the administration and enforcement of this Act, including
without limitation original licensure, renewal, and
restoration, which fees shall be nonrefundable.
(b) All fees collected under this Act shall be deposited
into the General Professions Dedicated Fund and appropriated to
the Department for the ordinary and contingent expenses of the
Department in the administration of this Act.
Section 85. Returned checks; fines. Any person who delivers
a check or other payment to the Department that is returned to
the Department unpaid by the financial institution upon which
it is drawn shall pay to the Department, in addition to the
amount already owed to the Department, a fine of $50. The fines
imposed by this Section are in addition to any other discipline
provided under this Act for unlicensed practice or practice on
a non-renewed license. The Department shall notify the person
that fees and fines shall be paid to the Department by
certified check or money order within 30 calendar days after
the notification. If, after the expiration of 30 days from the
date of the notification, the person has failed to submit the

HB0424 - 19 - LRB099 03597 HAF 23605 b
necessary remittance, the Department shall automatically
terminate the license or deny the application, without hearing.
If, after termination or denial, the person seeks a license, he
or she shall apply to the Department for restoration or
issuance of the license and pay all fees and fines due to the
Department. The Department may establish a fee for the
processing of an application for restoration of a license to
defray all expenses of processing the application. The
Secretary may waive the fines due under this Section in
individual cases where the Secretary finds that the fines would
be unreasonable or unnecessarily burdensome.
Section 90. Unlicensed practice; civil penalty. Any person
who practices, offers to practice, attempts to practice, or
holds himself or herself out to practice midwifery or as a
midwife without being licensed under this Act shall, in
addition to any other penalty provided by law, pay a civil
penalty to the Department in an amount not to exceed $5,000 for
each offense, as determined by the Department. The civil
penalty shall be assessed by the Department after a hearing is
held in accordance with the provisions set forth in this Act
regarding the provision of a hearing for the discipline of a
licensee. The civil penalty shall be paid within 60 days after
the effective date of the order imposing the civil penalty. The
order shall constitute a judgment and may be filed and
execution had thereon in the same manner as any judgment from

HB0424 - 20 - LRB099 03597 HAF 23605 b
any court of record. The Department may investigate any
unlicensed activity.
Section 95. Grounds for disciplinary action.
(a) The Department may refuse to issue or to renew or may
revoke, suspend, place on probation, reprimand or take other
disciplinary action as the Department may deem proper,
including fines not to exceed $5,000 for each violation, with
regard to any licensee or license for any one or combination of
the following causes:
(1) Violations of this Act or its rules.
(2) Material misstatement in furnishing information to
the Department.
(3) Conviction of any crime under the laws of any U.S.
jurisdiction that is (i) a felony, (ii) a misdemeanor, an
essential element of which is dishonesty, or (iii) directly
related to the practice of the profession.
(4) Making any misrepresentation for the purpose of
obtaining a license.
(5) Professional incompetence or gross negligence.
(6) Gross malpractice.
(7) Aiding or assisting another person in violating any
provision of this Act or its rules.
(8) Failing to provide information within 60 days in
response to a written request made by the Department.
(9) Engaging in dishonorable, unethical, or

HB0424 - 21 - LRB099 03597 HAF 23605 b
unprofessional conduct of a character likely to deceive,
defraud, or harm the public.
(10) Habitual or excessive use or addiction to alcohol,
narcotics, stimulants, or any other chemical agent or drug
that results in the inability to practice with reasonable
judgment, skill, or safety.
(11) Discipline by another U.S. jurisdiction or
foreign nation if at least one of the grounds for the
discipline is the same or substantially equivalent to those
set forth in this Act.
(12) Directly or indirectly giving to or receiving from
any person, firm, corporation, partnership, or association
any fee, commission, rebate, or other form of compensation
for any professional services not actually or personally
rendered. This shall not be deemed to include rent or other
remunerations paid to an individual, partnership, or
corporation by a licensed midwife for the lease, rental, or
use of space, owned or controlled by the individual,
partnership, corporation, or association.
(13) A finding by the Department that the licensee,
after having his or her license placed on probationary
status, has violated the terms of probation.
(14) Abandonment of a patient without cause.
(15) Willfully making or filing false records or
reports relating to a licensee's practice, including, but
not limited to, false records filed with State agencies or

HB0424 - 22 - LRB099 03597 HAF 23605 b
departments.
(16) Physical illness or mental illness, including,
but not limited to, deterioration through the aging process
or loss of motor skill that results in the inability to
practice the profession with reasonable judgment, skill,
or safety.
(17) Failure to provide a patient with a copy of his or
her record upon the written request of the patient.
(18) Conviction by any court of competent
jurisdiction, either within or without this State, of any
violation of any law governing the practice of licensed
midwifery or conviction in this or another state of any
crime that is a felony under the laws of this State or
conviction of a felony in a federal court, if the
Department determines, after investigation, that the
person has not been sufficiently rehabilitated to warrant
the public trust.
(19) A finding that licensure has been applied for or
obtained by fraudulent means.
(20) Being named as a perpetrator in an indicated
report by the Department of Healthcare and Family Services
under the Abused and Neglected Child Reporting Act and upon
proof by clear and convincing evidence that the licensee
has caused a child to be an abused child or a neglected
child, as defined in the Abused and Neglected Child
Reporting Act.

HB0424 - 23 - LRB099 03597 HAF 23605 b
(21) Practicing or attempting to practice under a name
other than the full name shown on a license issued under
this Act.
(22) Immoral conduct in the commission of any act, such
as sexual abuse, sexual misconduct, or sexual
exploitation, related to the licensee's practice.
(23) Maintaining a professional relationship with any
person, firm, or corporation when the licensed midwife
knows or should know that a person, firm, or corporation is
violating this Act.
(24) Failure to provide satisfactory proof of having
participated in approved continuing education programs as
determined by the Board and approved by the Secretary.
Exceptions for extreme hardships are to be defined by the
Department.
(b) The Department may refuse to issue or may suspend the
license of any person who fails to (i) file a tax return or to
pay the tax, penalty, or interest shown in a filed return or
(ii) pay any final assessment of the tax, penalty, or interest,
as required by any tax Act administered by the Illinois
Department of Revenue, until the time that the requirements of
that tax Act are satisfied.
(c) The determination by a circuit court that a licensee is
subject to involuntary admission or judicial admission as
provided in the Mental Health and Developmental Disabilities
Code operates as an automatic suspension. The suspension shall

HB0424 - 24 - LRB099 03597 HAF 23605 b
end only upon a finding by a court that the patient is no
longer subject to involuntary admission or judicial admission,
the issuance of an order so finding and discharging the
patient, and the recommendation of the Board to the Secretary
that the licensee be allowed to resume his or her practice.
(d) In enforcing this Section, the Department, upon a
showing of a possible violation, may compel any person licensed
to practice under this Act or who has applied for licensure or
certification pursuant to this Act to submit to a mental or
physical examination, or both, as required by and at the
expense of the Department. The examining physicians shall be
those specifically designated by the Department. The
Department may order an examining physician to present
testimony concerning the mental or physical examination of the
licensee or applicant. No information shall be excluded by
reason of any common law or statutory privilege relating to
communications between the licensee or applicant and the
examining physician. The person to be examined may have, at his
or her own expense, another physician of his or her choice
present during all aspects of the examination. Failure of any
person to submit to a mental or physical examination when
directed shall be grounds for suspension of a license until the
person submits to the examination if the Department finds,
after notice and hearing, that the refusal to submit to the
examination was without reasonable cause.
If the Department finds an individual unable to practice

HB0424 - 25 - LRB099 03597 HAF 23605 b
because of the reasons set forth in this subsection (d), the
Department may require that individual to submit to care,
counseling, or treatment by physicians approved or designated
by the Department, as a condition, term, or restriction for
continued, reinstated, or renewed licensure to practice or, in
lieu of care, counseling, or treatment, the Department may file
a complaint to immediately suspend, revoke, or otherwise
discipline the license of the individual. Any person whose
license was granted, reinstated, renewed, disciplined, or
supervised subject to such terms, conditions, or restrictions
and who fails to comply with such terms, conditions, or
restrictions shall be referred to the Secretary for a
determination as to whether or not the person shall have his or
her license suspended immediately, pending a hearing by the
Department.
In instances in which the Secretary immediately suspends a
person's license under this Section, a hearing on that person's
license must be convened by the Department within 15 days after
the suspension and completed without appreciable delay. The
Department may review the person's record of treatment and
counseling regarding the impairment, to the extent permitted by
applicable federal statutes and regulations safeguarding the
confidentiality of medical records.
A person licensed under this Act and affected under this
subsection (d) shall be afforded an opportunity to demonstrate
to the Department that he or she can resume practice in

HB0424 - 26 - LRB099 03597 HAF 23605 b
compliance with acceptable and prevailing standards under the
provisions of his or her license.
Section 100. Failure to pay restitution. The Department,
without further process or hearing, shall suspend the license
or other authorization to practice of any person issued under
this Act who has been certified by court order as not having
paid restitution to a person under Section 8A-3.5 of the
Illinois Public Aid Code, under Section 46-1 of the Criminal
Code of 1961, or under Sections 17-8.5 or 17-10.5 of the
Criminal Code of 2012. A person whose license or other
authorization to practice is suspended under this Section is
prohibited from practicing until restitution is made in full.
Section 105. Injunction; cease and desist order.
(a) If a person violates any provision of this Act, the
Secretary may, in the name of the People of the State of
Illinois, through the Attorney General or the State's Attorney
of any county in which the action is brought, petition for an
order enjoining the violation or enforcing compliance with this
Act. Upon the filing of a verified petition in court, the court
may issue a temporary restraining order, without notice or
bond, and may preliminarily and permanently enjoin the
violation. If it is established that the person has violated or
is violating the injunction, the court may punish the offender
for contempt of court. Proceedings under this Section shall be

HB0424 - 27 - LRB099 03597 HAF 23605 b
in addition to, and not in lieu of, all other remedies and
penalties provided by this Act.
(b) If any person practices as a licensed midwife or holds
himself or herself out as a licensed midwife without being
licensed under the provisions of this Act, then any licensed
midwife, any interested party, or any person injured thereby
may, in addition to the Secretary, petition for relief as
provided in subsection (a) of this Section.
(c) Whenever, in the opinion of the Department, any person
violates any provision of this Act, the Department may issue a
rule to show cause why an order to cease and desist should not
be entered against that person. The rule shall clearly set
forth the grounds relied upon by the Department and shall
provide a period of 7 days after the date of the rule to file an
answer to the satisfaction of the Department. Failure to answer
to the satisfaction of the Department shall cause an order to
cease and desist to be issued immediately.
Section 110. Violation; criminal penalty.
(a) Whoever knowingly practices or offers to practice
midwifery in this State without being licensed for that purpose
or exempt under this Act shall be guilty of a Class A
misdemeanor and, for each subsequent conviction, shall be
guilty of a Class 4 felony.
(b) Notwithstanding any other provision of this Act, all
criminal fines, moneys, or other property collected or received

HB0424 - 28 - LRB099 03597 HAF 23605 b
by the Department under this Section or any other State or
federal statute, including, but not limited to, property
forfeited to the Department under Section 505 of the Illinois
Controlled Substances Act or Section 85 of the Methamphetamine
Control and Community Protection Act, shall be deposited into
the Professional Regulation Evidence Fund.
Section 115. Investigation; notice; hearing. The
Department may investigate the actions of any applicant or of
any person or persons holding or claiming to hold a license
under this Act. Before refusing to issue or to renew or taking
any disciplinary action regarding a license, the Department
shall, at least 30 days prior to the date set for the hearing,
notify in writing the applicant or licensee of the nature of
any charges and that a hearing shall be held on a date
designated. The Department shall direct the applicant or
licensee to file a written answer with the Board under oath
within 20 days after the service of the notice and inform the
applicant or licensee that failure to file an answer shall
result in default being taken against the applicant or licensee
and that the license may be suspended, revoked, or placed on
probationary status or that other disciplinary action may be
taken, including limiting the scope, nature, or extent of
practice, as the Secretary may deem proper. Written notice may
be served by personal delivery or certified or registered mail
to the respondent at the address of his or her last

HB0424 - 29 - LRB099 03597 HAF 23605 b
notification to the Department. If the person fails to file an
answer after receiving notice, his or her license may, in the
discretion of the Department, be suspended, revoked, or placed
on probationary status, or the Department may take any
disciplinary action deemed proper, including limiting the
scope, nature, or extent of the person's practice or the
imposition of a fine, without a hearing, if the act or acts
charged constitute sufficient grounds for such action under
this Act. At the time and place fixed in the notice, the Board
shall proceed to hear the charges and the parties or their
counsel shall be accorded ample opportunity to present such
statements, testimony, evidence, and argument as may be
pertinent to the charges or to their defense. The Board may
continue a hearing from time to time.
Section 120. Formal hearing; preservation of record. The
Department, at its expense, shall preserve a record of all
proceedings at the formal hearing of any case. The notice of
hearing, complaint, and all other documents in the nature of
pleadings and written motions filed in the proceedings, the
transcript of testimony, the report of the Board or hearing
officer, and order of the Department shall be the record of the
proceeding. The Department shall furnish a transcript of the
record to any person interested in the hearing upon payment of
the fee required under Section 2105-115 of the Department of
Professional Regulation Law.

HB0424 - 30 - LRB099 03597 HAF 23605 b
Section 125. Witnesses; production of documents; contempt.
Any circuit court may upon application of the Department or its
designee or of the applicant or licensee against whom
proceedings under Section 95 of this Act are pending, enter an
order requiring the attendance of witnesses and their testimony
and the production of documents, papers, files, books, and
records in connection with any hearing or investigation. The
court may compel obedience to its order by proceedings for
contempt.
Section 130. Subpoena; oaths. The Department shall have the
power to subpoena and bring before it any person in this State
and to take testimony either orally or by deposition or both
with the same fees and mileage and in the same manner as
prescribed in civil cases in circuit courts of this State. The
Secretary, the designated hearing officer, and every member of
the Board has the power to administer oaths to witnesses at any
hearing that the Department is authorized to conduct and any
other oaths authorized in any Act administered by the
Department. Any circuit court may, upon application of the
Department or its designee or upon application of the person
against whom proceedings under this Act are pending, enter an
order requiring the attendance of witnesses and their
testimony, and the production of documents, papers, files,
books, and records in connection with any hearing or

HB0424 - 31 - LRB099 03597 HAF 23605 b
investigation. The court may compel obedience to its order by
proceedings for contempt.
Section 135. Findings of fact, conclusions of law, and
recommendations. At the conclusion of the hearing the Board
shall present to the Secretary a written report of its findings
of fact, conclusions of law, and recommendations. The report
shall contain a finding as to whether or not the accused person
violated this Act or failed to comply with the conditions
required under this Act. The Board shall specify the nature of
the violation or failure to comply and shall make its
recommendations to the Secretary.
The report of findings of fact, conclusions of law, and
recommendations of the Board shall be the basis for the
Department's order. If the Secretary disagrees in any regard
with the report of the Board, the Secretary may issue an order
in contravention of the report. The finding is not admissible
in evidence against the person in a criminal prosecution
brought for the violation of this Act, but the hearing and
findings are not a bar to a criminal prosecution brought for
the violation of this Act.
Section 140. Hearing officer. The Secretary may appoint any
attorney duly licensed to practice law in the State of Illinois
to serve as the hearing officer in any action for departmental
refusal to issue, renew, or license an applicant or for

HB0424 - 32 - LRB099 03597 HAF 23605 b
disciplinary action against a licensee. The hearing officer
shall have full authority to conduct the hearing. The hearing
officer shall report his or her findings of fact, conclusions
of law, and recommendations to the Board and the Secretary. The
Board shall have 60 calendar days after receipt of the report
to review the report of the hearing officer and present its
findings of fact, conclusions of law, and recommendations to
the Secretary. If the Board fails to present its report within
the 60-day period, the Secretary may issue an order based on
the report of the hearing officer. If the Secretary disagrees
with the recommendation of the Board or the hearing officer, he
or she may issue an order in contravention of that
recommendation.
Section 145. Service of report; motion for rehearing. In
any case involving the discipline of a license, a copy of the
Board's report shall be served upon the respondent by the
Department, either personally or as provided in this Act for
the service of the notice of hearing. Within 20 days after the
service, the respondent may present to the Department a motion
in writing for a rehearing that shall specify the particular
grounds for rehearing. If no motion for rehearing is filed,
then upon the expiration of the time specified for filing a
motion, or if a motion for rehearing is denied, then upon the
denial, the Secretary may enter an order in accordance with
this Act. If the respondent orders from the reporting service

HB0424 - 33 - LRB099 03597 HAF 23605 b
and pays for a transcript of the record within the time for
filing a motion for rehearing, the 20-day period within which
the motion may be filed shall commence upon the delivery of the
transcript to the respondent.
Section 150. Rehearing. Whenever the Secretary is
satisfied that substantial justice has not been done in the
revocation, suspension, or refusal to issue or renew a license,
the Secretary may order a rehearing by the same or another
hearing officer or by the Board.
Section 155. Prima facie proof. An order or a certified
copy thereof, over the seal of the Department and purporting to
be signed by the Secretary, shall be prima facie proof of the
following:
(1) that the signature is the genuine signature of the
Secretary;
(2) that such Secretary is duly appointed and
qualified; and
(3) that the Board and its members are qualified to
act.
Section 160. Restoration of license. At any time after the
suspension or revocation of any license, the Department may
restore the license to the accused person, unless after an
investigation and a hearing the Department determines that

HB0424 - 34 - LRB099 03597 HAF 23605 b
restoration is not in the public interest.
Section 165. Surrender of license. Upon the revocation or
suspension of any license, the licensee shall immediately
surrender the license to the Department. If the licensee fails
to do so, the Department shall have the right to seize the
license.
Section 170. Summary suspension. The Secretary may
summarily suspend the license of a licensee under this Act
without a hearing, simultaneously with the institution of
proceedings for a hearing provided for in this Act, if the
Secretary finds that evidence in his or her possession
indicates that continuation in practice would constitute an
imminent danger to the public. In the event that the Secretary
summarily suspends a license without a hearing, a hearing by
the Department must be held within 30 days after the suspension
has occurred.
Section 175. Certificate of record. The Department shall
not be required to certify any record to the court or file any
answer in court or otherwise appear in any court in a judicial
review proceeding, unless there is filed in the court, with the
complaint, a receipt from the Department acknowledging payment
of the costs of furnishing and certifying the record. Failure
on the part of the plaintiff to file a receipt in court shall

HB0424 - 35 - LRB099 03597 HAF 23605 b
be grounds for dismissal of the action.
Section 180. Administrative Review Law. All final
administrative decisions of the Department are subject to
judicial review under the Administrative Review Law and its
rules. The term "administrative decision" is defined as in
Section 3-101 of the Code of Civil Procedure.
Section 185. Illinois Administrative Procedure Act. The
Illinois Administrative Procedure Act is hereby expressly
adopted and incorporated in this Act as if all of the
provisions of such Act were included in this Act, except that
the provision of subsection (d) of Section 10-65 of the
Illinois Administrative Procedure Act that provides that at
hearings the licensee has the right to show compliance with all
lawful requirements for retention, continuation, or renewal of
the license is specifically excluded. For purposes of this Act,
the notice required under Section 10-25 of the Illinois
Administrative Procedure Act is deemed sufficient when mailed
to the last known address of a party.
Section 190. Home rule. Pursuant to paragraph (h) of
Section 6 of Article VII of the Illinois Constitution of 1970,
the power to regulate and issue licenses for the practice of
midwifery shall, except as may otherwise be provided within and
pursuant to the provisions of this Act, be exercised by the

HB0424 - 36 - LRB099 03597 HAF 23605 b
State and may not be exercised by any unit of local government,
including home rule units.
Section 195. Severability. The provisions of this Act are
severable under Section 1.31 of the Statute on Statutes.
Section 900. The Regulatory Sunset Act is amended by adding
Section 4.36 as follows:
(5 ILCS 80/4.36 new)
Sec. 4.36. Act repealed on January 1, 2026. The following
Act is repealed on January 1, 2026:
The Home Birth Safety Act.
Section 905. The Medical Practice Act of 1987 is amended by
changing Section 4 as follows:
(225 ILCS 60/4) (from Ch. 111, par. 4400-4)
(Section scheduled to be repealed on December 31, 2015)
Sec. 4. Exemptions. This Act does not apply to the
following:
(1) persons lawfully carrying on their particular
profession or business under any valid existing regulatory
Act of this State, including without limitation persons
engaged in the practice of midwifery who are licensed under
the Home Birth Safety Act;

HB0424 - 37 - LRB099 03597 HAF 23605 b
(2) persons rendering gratuitous services in cases of
emergency; or
(3) persons treating human ailments by prayer or
spiritual means as an exercise or enjoyment of religious
freedom.
(Source: P.A. 96-7, eff. 4-3-09; 97-622, eff. 11-23-11.)
Section 910. The Nurse Practice Act is amended by changing
Section 50-15 as follows:
(225 ILCS 65/50-15) (was 225 ILCS 65/5-15)
(Section scheduled to be repealed on January 1, 2018)
Sec. 50-15. Policy; application of Act.
(a) For the protection of life and the promotion of health,
and the prevention of illness and communicable diseases, any
person practicing or offering to practice advanced,
professional, or practical nursing in Illinois shall submit
evidence that he or she is qualified to practice, and shall be
licensed as provided under this Act. No person shall practice
or offer to practice advanced, professional, or practical
nursing in Illinois or use any title, sign, card or device to
indicate that such a person is practicing professional or
practical nursing unless such person has been licensed under
the provisions of this Act.
(b) This Act does not prohibit the following:
(1) The practice of nursing in Federal employment in

HB0424 - 38 - LRB099 03597 HAF 23605 b
the discharge of the employee's duties by a person who is
employed by the United States government or any bureau,
division or agency thereof and is a legally qualified and
licensed nurse of another state or territory and not in
conflict with Sections 50-50, 55-10, 60-10, and 70-5 of
this Act.
(2) Nursing that is included in the program of study by
students enrolled in programs of nursing or in current
nurse practice update courses approved by the Department.
(3) The furnishing of nursing assistance in an
emergency.
(4) The practice of nursing by a nurse who holds an
active license in another state when providing services to
patients in Illinois during a bonafide emergency or in
immediate preparation for or during interstate transit.
(5) The incidental care of the sick by members of the
family, domestic servants or housekeepers, or care of the
sick where treatment is by prayer or spiritual means.
(6) Persons from being employed as unlicensed
assistive personnel in private homes, long term care
facilities, nurseries, hospitals or other institutions.
(7) The practice of practical nursing by one who is a
licensed practical nurse under the laws of another U.S.
jurisdiction and has applied in writing to the Department,
in form and substance satisfactory to the Department, for a
license as a licensed practical nurse and who is qualified

HB0424 - 39 - LRB099 03597 HAF 23605 b
to receive such license under this Act, until (i) the
expiration of 6 months after the filing of such written
application, (ii) the withdrawal of such application, or
(iii) the denial of such application by the Department.
(8) The practice of advanced practice nursing by one
who is an advanced practice nurse under the laws of another
state, territory of the United States, or country and has
applied in writing to the Department, in form and substance
satisfactory to the Department, for a license as an
advanced practice nurse and who is qualified to receive
such license under this Act, until (i) the expiration of 6
months after the filing of such written application, (ii)
the withdrawal of such application, or (iii) the denial of
such application by the Department.
(9) The practice of professional nursing by one who is
a registered professional nurse under the laws of another
state, territory of the United States or country and has
applied in writing to the Department, in form and substance
satisfactory to the Department, for a license as a
registered professional nurse and who is qualified to
receive such license under Section 55-10, until (1) the
expiration of 6 months after the filing of such written
application, (2) the withdrawal of such application, or (3)
the denial of such application by the Department.
(10) The practice of professional nursing that is
included in a program of study by one who is a registered

HB0424 - 40 - LRB099 03597 HAF 23605 b
professional nurse under the laws of another state or
territory of the United States or foreign country,
territory or province and who is enrolled in a graduate
nursing education program or a program for the completion
of a baccalaureate nursing degree in this State, which
includes clinical supervision by faculty as determined by
the educational institution offering the program and the
health care organization where the practice of nursing
occurs.
(11) Any person licensed in this State under any other
Act from engaging in the practice for which she or he is
licensed, including without limitation any person engaged
in the practice of midwifery who is licensed under the Home
Birth Safety Act.
(12) Delegation to authorized direct care staff
trained under Section 15.4 of the Mental Health and
Developmental Disabilities Administrative Act consistent
with the policies of the Department.
(13) The practice, services, or activities of persons
practicing the specified occupations set forth in
subsection (a) of, and pursuant to a licensing exemption
granted in subsection (b) or (d) of, Section 2105-350 of
the Department of Professional Regulation Law of the Civil
Administrative Code of Illinois, but only for so long as
the 2016 Olympic and Paralympic Games Professional
Licensure Exemption Law is operable.

HB0424 - 41 - LRB099 03597 HAF 23605 b
(14) County correctional personnel from delivering
prepackaged medication for self-administration to an
individual detainee in a correctional facility.
Nothing in this Act shall be construed to limit the
delegation of tasks or duties by a physician, dentist, or
podiatric physician to a licensed practical nurse, a registered
professional nurse, or other persons.
(Source: P.A. 98-214, eff. 8-9-13.)
Section 990. The Illinois Public Aid Code is amended by
changing Section 5-5 as follows:
(305 ILCS 5/5-5) (from Ch. 23, par. 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, including the
services of certified professional midwives licensed pursuant
to the Home Birth Safety Act; (7) home health care services;

HB0424 - 42 - LRB099 03597 HAF 23605 b
(8) private duty nursing service; (9) clinic services; (10)
dental services, including prevention and treatment of
periodontal disease and dental caries disease for pregnant
women, 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 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

HB0424 - 43 - LRB099 03597 HAF 23605 b
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; and (17) any other medical
care, and any other type of remedial care recognized under the
laws of this State, but not including abortions, or induced
miscarriages or premature births, unless, in the opinion of a
physician, such procedures are necessary for the preservation
of the life of the woman seeking such treatment, or except an
induced premature birth intended to produce a live viable child
and such procedure is necessary for the health of the mother or
her unborn child. The Illinois Department, by rule, shall
prohibit any physician from providing medical assistance to
anyone eligible therefor under this Code where such physician
has been found guilty of performing an abortion procedure in a
wilful and wanton manner upon a woman who was not pregnant at
the time such abortion procedure was performed. 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
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

HB0424 - 44 - LRB099 03597 HAF 23605 b
persons who are otherwise eligible for assistance under this
Article.
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
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

HB0424 - 45 - LRB099 03597 HAF 23605 b
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.
Notwithstanding any other provision of this Code and
subject to federal approval, the Department may adopt rules to
allow a dentist who is volunteering his or her service at no
cost to render dental services through an enrolled
not-for-profit health clinic without the dentist personally
enrolling as a participating provider in the medical assistance
program. A not-for-profit health clinic shall include a public
health clinic or Federally Qualified Health Center or other
enrolled provider, as determined by the Department, through
which dental services covered under this Section are performed.
The Department shall establish a process for payment of claims
for reimbursement for covered dental services rendered under
this provision.
The Illinois Department, by rule, may distinguish and

HB0424 - 46 - LRB099 03597 HAF 23605 b
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 women
35 years of age or older who are eligible for medical
assistance under this Article, as follows:
(A) A baseline mammogram for women 35 to 39 years of
age.
(B) An annual mammogram for women 40 years of age or
older.
(C) A mammogram at the age and intervals considered
medically necessary by the woman's health care provider for
women 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 of an entire
breast or breasts if a mammogram demonstrates
heterogeneous or dense breast tissue, when medically

HB0424 - 47 - LRB099 03597 HAF 23605 b
necessary as determined by a physician licensed to practice
medicine in all of its branches.
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, "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.
On and after January 1, 2012, providers participating in a
quality improvement program approved by the Department shall be
reimbursed for screening and diagnostic mammography at the same
rate as the Medicare program's rates, including the increased
reimbursement for digital mammography.
The Department shall convene an expert panel including
representatives of hospitals, free-standing mammography
facilities, and doctors, including radiologists, to establish
quality standards.
Subject to federal approval, the Department shall
establish a rate methodology for mammography at federally
qualified health centers and other encounter-rate clinics.
These clinics or centers may also collaborate with other
hospital-based mammography facilities.

HB0424 - 48 - LRB099 03597 HAF 23605 b
The Department shall establish a methodology to remind
women 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 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 site shall
be outside the metropolitan Chicago area. 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.
Any medical or health care provider shall immediately
recommend, to any pregnant woman who is being provided prenatal
services and is suspected of drug abuse or is addicted as
defined in the Alcoholism and Other Drug Abuse and Dependency
Act, referral to a local substance abuse treatment provider

HB0424 - 49 - LRB099 03597 HAF 23605 b
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 women under this Code shall receive information from
the Department on the availability of services under the Drug
Free Families with a Future or any comparable program providing
case management services for addicted women, including
information on appropriate referrals for other social services
that may be needed by addicted women 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 her substance abuse.

HB0424 - 50 - LRB099 03597 HAF 23605 b
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 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

HB0424 - 51 - LRB099 03597 HAF 23605 b
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
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

HB0424 - 52 - LRB099 03597 HAF 23605 b
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 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

HB0424 - 53 - LRB099 03597 HAF 23605 b
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 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 the effective date of this
amendatory Act of 1984, 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.
The rules and regulations of the Illinois Department shall
require that a written statement including the required opinion
of a physician shall accompany any claim for reimbursement for
abortions, or induced miscarriages or premature births. This

HB0424 - 54 - LRB099 03597 HAF 23605 b
statement shall indicate what procedures were used in providing
such medical services.
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 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.
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) this amendatory Act of the
98th General Assembly, establish procedures to permit ID/DD
facilities licensed under the ID/DD Community Care 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

HB0424 - 55 - LRB099 03597 HAF 23605 b
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
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 category of risk of
the vendor.

HB0424 - 56 - LRB099 03597 HAF 23605 b
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
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

HB0424 - 57 - LRB099 03597 HAF 23605 b
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.
(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.

HB0424 - 58 - LRB099 03597 HAF 23605 b
In the case of long term care facilities, within 5 days of
receipt by the facility of required prescreening information,
data for new admissions shall be entered into the Medical
Electronic Data Interchange (MEDI) or the Recipient
Eligibility Verification (REV) System or successor system, and
within 15 days of receipt by the facility of required
prescreening information, admission documents shall be
submitted through MEDI or REV or shall be submitted directly to
the Department of Human Services using required admission
forms. Effective September 1, 2014, admission documents,
including all prescreening information, must be submitted
through MEDI or REV. Confirmation numbers assigned to an
accepted transaction shall be retained by a facility to verify
timely submittal. Once an admission transaction has been
completed, all resubmitted claims following prior rejection
are subject to receipt no later than 180 days after the
admission transaction has been completed.
Claims that are not submitted and received in compliance
with the foregoing requirements shall not be eligible for
payment under the medical assistance program, and the State
shall have no liability for payment of those claims.
To the extent consistent with applicable information and
privacy, security, and disclosure laws, State and federal
agencies and departments shall provide the Illinois Department
access to confidential and other information and data necessary
to perform eligibility and payment verifications and other

HB0424 - 59 - LRB099 03597 HAF 23605 b
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, 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

HB0424 - 60 - LRB099 03597 HAF 23605 b
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- or
post-adjudicated predictive modeling with an integrated case
management system with link analysis. Such a request for
information shall not be considered as a request for proposal
or as an obligation on the part of the Illinois Department to
take any action or acquire any products or services.
The Illinois Department shall establish policies,
procedures, standards and criteria by rule for the acquisition,
repair and replacement of orthotic and prosthetic devices and
durable medical equipment. Such rules shall provide, but not be
limited to, the following services: (1) immediate repair or
replacement of such devices by recipients; and (2) rental,
lease, purchase or lease-purchase of durable medical equipment
in a cost-effective manner, taking into consideration the
recipient's medical prognosis, the extent of the recipient's
needs, and the requirements and costs for maintaining such
equipment. Subject to prior approval, such rules shall enable a
recipient to temporarily acquire and use alternative or
substitute devices or equipment pending repairs or

HB0424 - 61 - LRB099 03597 HAF 23605 b
replacements of any device or equipment previously authorized
for such recipient by the Department.
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 to select the minimum level
of care eligibility criteria, the Governor shall establish a

HB0424 - 62 - LRB099 03597 HAF 23605 b
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.
The period covered by each report shall be the 3 years
ending on the June 30 prior to the report. The report shall

HB0424 - 63 - LRB099 03597 HAF 23605 b
include suggested legislation for consideration by the General
Assembly. The filing of one copy of the report with the
Speaker, one copy with the Minority Leader and one copy with
the Clerk of the House of Representatives, one copy with the
President, one copy with the Minority Leader and one copy with
the Secretary of the Senate, one copy with the Legislative
Research Unit, and 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 shall be deemed sufficient to comply with this
Section.
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

HB0424 - 64 - LRB099 03597 HAF 23605 b
cover kidney transplantation for noncitizens with end-stage
renal disease who are not eligible for comprehensive medical
benefits, who meet the residency requirements of Section 5-3 of
this Code, and who would otherwise meet the financial
requirements of the appropriate class of eligible persons under
Section 5-2 of this Code. To qualify for coverage of kidney
transplantation, such person must be receiving emergency renal
dialysis services covered by the Department. Providers under
this Section shall be prior approved and certified by the
Department to perform kidney transplantation and the services
under this Section shall be limited to services associated with
kidney transplantation.
(Source: P.A. 97-48, eff. 6-28-11; 97-638, eff. 1-1-12; 97-689,
eff. 6-14-12; 97-1061, eff. 8-24-12; 98-104, Article 9, Section
9-5, eff. 7-22-13; 98-104, Article 12, Section 12-20, eff.
7-22-13; 98-303, eff. 8-9-13; 98-463, eff. 8-16-13; 98-651,
eff. 6-16-14; 98-756, eff. 7-16-14; 98-963, eff. 8-15-14;
revised 10-2-14.)