End of Session Report For the first legislative session in four years, an agreement was reached on a full-year budget by the end of the regular spring session. On May 31, 2018, both the House and Senate chambers completed approval of a package of legislation for fiscal year 2019, which begins July 1, 2018. Although additional unpaid expenses remain for pension and health insurance benefits from prior years, the fiscal year 2019 budget package does reflect this year’s spending and revenue to be balanced at around $38.5 billion. A little over half of this spending and revenue is dedicated to pensions, debt payments, Medicaid, and health insurance for state workers, which are all expenses that in large part are set by federal mandates and prior state laws. Some highlights of the fiscal year 2019 budget include reduced spending throughout state agencies, nearly 40% of which are through cuts to both the Department of Corrections and the Department of Human Services. Pension costs are also estimated to be reduced by up to $445 million, 85% of which is estimated to be the result of voluntary buyouts regarding automatic 3% annual benefit increases. Some spending increases involve the compensation costs of individuals providing social services. Additionally, colleges and universities received a two percent increase in funding along with a new state scholarship program to encourage students to attend school in Illinois with universities being asked to match state funding for the program. Early childhood education and Kindergarten through 12th grade schools received the five percent increase in funding that was envisioned in the education funding formula enacted last year. Since the end of the last legislative session, the legislature introduced over 3,000 pieces of legislation and passed around 600 of them on to the Governor. Enclosed is a report of legislation and regulations that more specifically impacted your group as well as information regarding the legislative process going forward. IAFP End of Session Report Table of Contents IAFP 2018 GA Overview ............................................................................................................... 3 IAFP Rules and Regulations ......................................................................................................... 11 IAFP 2018 Bill Listing.................................................................................................................. 21 Letter to Governor – SB 2332 ....................................................................................................... 35 DHFS Excerpt from FY ’19 Budget HB 109................................................................................ 36 Article 83 - DPH Excerpt from FY ’19 Budget HB 109 .............................................................. 53 DPH – Family Practice Residency citation ................................................................................... 59 Continuation of DPH FY ‘ 19 Budget – HB 109 .......................................................................... 60 Article 156 DPH Excerpt from FY ’19 Budget HB 109 ............................................................... 82 Bill Numbers to date ..................................................................................................................... 83 100th General Assembly Legislative Thresholds .......................................................................... 84 Passed Both Houses ...................................................................................................................... 84 Governor’s Action ........................................................................................................................ 84 General Assembly Action ............................................................................................................. 85 Effective Dates .............................................................................................................................. 85 Veto Session Dates for 2018 ......................................................................................................... 85 2018 Illinois Senate Veto Session Calendar ................................................................................. 86 2018 Illinois House Veto Session Calendar: ................................................................................ 87 To see the text or history of any bill, please go to: www.ilga.gov IAFP 2018 GA Overview HB 4146 Fine/Steans ( Monitor) Passed both Houses & Sent to the Governor 6/29 Amends the Managed Care Reform and Patient Rights Act. During an enrollee's plan year, prohibits a health care plan from removing a drug from its formulary or negatively changing its preferred or cost-tier sharing unless, at l0east 60 days before making the formulary change, the health care plan provides certain notifications to current and prospective enrollees and prescribing providers. Provides that the notification to a prescribing provider shall include a one- page form and may direct the provider to an electronic portal through which the provider may certify that coverage of the drug for the enrollee is medically necessary. Provides that if a provider certifies that a drug is medically necessary, the health care plan shall authorize coverage for the drug based solely on the provider's assertion that coverage is medically necessary and prohibits the health care plan from making certain modifications to the coverage related to the covered drug. Provides that the provisions do not prevent a health care plan from removing a drug from its formulary or denying an enrollee coverage if the U.S. Food and Drug Administration calls into question the clinical safety of the drug, the drug manufacturer notifies the U.S. Food and Drug Administration of a manufacturing discontinuance or potential discontinuance, or the drug manufacturer removes the drug from the market. Provides that the provisions do not prohibit a health care plan from requiring a pharmacist to effect generic substitutions of prescription drugs. Provides that the provisions apply to a policy or contract that is amended, delivered, issued, or renewed on or after January 1, 2019. Provides that the provisions do not apply to a health care plan as defined in the State Employees Group Insurance Act of 1971 or medical assistance under the Illinois Public Aid Code. Provides that the provisions concerning transition of services shall not be construed to prohibit the addition of prescription drugs to a health care plan's list of covered drugs during the coverage year. Effective immediately. HB 4165 Harris/Koehler (Support) Passed both Houses & Sent to the Governor 6/29 Prohibits the State from applying for any federal waiver that would reduce or eliminate any protection or coverage required under the Patient Protection and Affordable Care Act (ACA) that was in effect on January 1, 2017, including, but not limited to, any protection for persons with pre-existing conditions and coverage for services identified as essential health benefits under the ACA. Provides that the State or an agency of the executive branch may apply for such a waiver only if granted authorization by the General Assembly through joint resolution. Amends the Illinois Insurance Code. Prohibits the State from applying for any federal waiver that would permit an individual or group health insurance plan to reduce or eliminate any protection or coverage required under the ACA that was in effect on January 1, 2017, including, but not limited to, any protection for persons with pre-existing conditions and coverage for services identified as essential health benefits under the ACA. Provides that the State or an agency of the executive branch may apply for such a waiver only if granted authorization by the General Assembly through joint resolution. Amends the Illinois Public Aid Code. Prohibits the State or an agency of the executive branch from applying for any federal Medicaid waiver that would result in more restrictive standards, methodologies, procedures, or other requirements than those that were in effect in Illinois as of January 1, 2017 for the Medical Assistance Program, the Children's Health Insurance Program, or any other medical assistance program in Illinois operating under any existing federal waiver authorized by specified provisions of the Social Security Act. Provides that the State or an agency of the executive branch may apply for such a waiver only if granted authorization by the General Assembly through joint resolution. Effective immediately. HB 4515 Swanson/Nybo ( Monitor) Passed Both Houses & Sent to the Governor 6/14 Creates the Lyme Disease Prevention and Protection Act. Provides that the Department of Public Health shall establish the Lyme Disease Prevention, Detection, and Outreach Program to advise the Department on disease prevention and surveillance and provider and public education relating to the disease. Provides that the Department shall continue to support the vector-borne disease epidemiologist coordinator who is responsible for overseeing the program. Provides that the program shall meet specified requirements to raise awareness about and to promote prevention of Lyme disease. Creates the Lyme Disease Task Force. Provides language concerning the duties and membership of the Task Force. Provides that the Department shall prepare a report annually indicating all efforts under the Act, and the report shall be posted on the Department's website and distributed