HB 2589

Abstract

Amends the Substance Use Disorder Act. Provides that a health care professional or other person acting under the direction of a health care professional may store and, without generating or affixing a patient-specific label, dispense an opioid antagonist to a patient in a hospital, hospital affiliate, or ambulatory treatment center if certain patient information is provided to the patient. Makes changes to provisions concerning the grants awarded under the Drug Overdose Prevention Program. Provides that the Department of Human Services shall (rather than may) develop policy or best practice guidelines for identification of at-risk individuals through SBIRT (Screening, Brief Intervention, and Referral to Treatment) and contract or billing requirements for SBIRT. Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to develop and seek federal approval of a SBIRT benefit for which qualified providers shall be reimbursed under the medical assistance program; and to develop a methodology and bundled reimbursement rate for SBIRT services. Provides that pharmacy fees or hospital fees related to the distribution of opioid antagonists prescribed for the treatment of an opioid overdose shall be covered under the medical assistance program. Amends the Illinois Insurance Code. Provides that an individual or group policy of accident and health insurance amended, delivered, issued, or renewed in this State that provides coverage for prescription drugs must provide coverage for all opioid antagonists approved by the U.S. Food and Drug Administration (FDA). Requires health care plans that provide coverage for hospital expenses to also reimburse a hospital for the hospital's cost of any FDA approved opioid antagonist. Senate Committee Amendment No. 1 Deletes reference to: 215 ILCS 5/356z.23 305 ILCS 5/5-39 Adds reference to: 305 ILCS 5/5-41 new Replaces everything after the enacting clause. Amends the Substance Use Disorder Act. Provides that any hospital licensed under the Hospital Licensing Act or organized under the University of Illinois Hospital Act shall be deemed to have met certain standards and requirements to enroll in the drug overdose prevention program upon completion of the enrollment process except that proof of a standing order and attestation of programmatic requirements shall be waived for enrollment purposes. Provides that reporting mandated by enrollment shall be necessary to carry out or attain eligibility for associated resources for drug overdose prevention projects operated on the licensed premises of the hospital and operated by the hospital or its designated staff. Requires the Department of Human Services to streamline hospital enrollment for drug overdose prevention programs by accepting such deemed status in order to reduce barriers to hospital participation in drug overdose prevention, recognition, or response projects. Provides that a health care professional or other person acting under the direction of a health care professional may, directly or by standing order, obtain, store, and dispense an opioid antagonist to a patient in a facility that includes, but is not limited to, a hospital, a hospital affiliate, or a federally qualified health center if certain patient information is provided to the patient. Makes changes to provisions concerning the grants awarded under the Drug Overdose Prevention Program. Redefines SBIRT (Screening, Brief Intervention, and Referral to Treatment) to mean a comprehensive, integrated, public health approach to the delivery of early intervention and treatment services for persons who are at risk of developing substance use disorders or have substance use disorders including, but not limited to, an addiction to alcohol, opioids, tobacco, or cannabis. Provides that SBIRT services include: (i) a screening to quickly assess the severity of substance use and to identify the appropriate level of treatment; (ii) a brief intervention focused on increasing insight and awareness regarding substance use and motivation toward behavioral change; and (iii) referral to treatment provided to those identified as needing more extensive treatment with access to specialty care. Provides that SBIRT services may include, but are not limited to, the following settings and programs: primary care centers, hospital emergency rooms, hospital in-patient units, trauma centers, community behavioral health programs, and other community settings that provide opportunities for early intervention with at-risk substance users before more severe consequences occur. Amends the Medical Assistance Article of the Illinois Public Aid Code. Defines SBIRT. Requires the Department of Healthcare and Family Services to develop and seek federal approval of a SBIRT benefit for which qualified providers shall be reimbursed under the medical assistance program. Permits the Department of Healthcare and Family Services, in conjunction with the Department of Human Services' Division of Substance Use Prevention and Recovery, to develop a methodology and reimbursement rate for SBIRT services provided by qualified providers in approved settings. Provides that for opioid specific SBIRT services provided in a hospital emergency department, the Department of Healthcare and Family Services shall develop a bundled reimbursement methodology and rate for a package of opioid treatment services. Provides that the package of opioid related services shall be billed on a separate claim and shall be reimbursed outside of the Enhanced Ambulatory Patient Grouping system.