2017 Legislative Session Wrap-Up

The 2017 Legislative Session began in January. There were over 2200 Senate Bills and 4000 House Bills introduced. Throughout the session, the ICS staff reviewed the legislation to address any concerns or impact on the chiropractic profession.

The legislative session was scheduled to adjourn on May 31. However, neither chamber formally adjourned due to the lack of a state budget. Instead, they went into a continuous session which allows them to be called back at any time. At this time, it is unclear when legislators will return to Springfield. Future session days have not been scheduled yet. There is one committee hearing scheduled in the House of Representatives for Thursday, June 8, 2017, regarding the impact of the budget impasse on human service agencies.

However, several pieces of legislation passed over the course of the legislative session. Below is an update on ICS legislative initiatives, other legislative measures, workers’ compensation reform, and the state budget.

ICS Legislative Initiatives

The following legislative measures were introduced by the ICS on behalf of our members. The ICS introduced these pieces of legislation to provide greater parity for our doctors and to advance the profession.

• Minor Consent Legislation-HB 2700 (Hoffman/Steans): This legislation creates greater parity among health care providers regarding the types of providers who may treat emancipated minors. The ICS began working on this legislation with numerous other health care groups after our doctors were unable to provide needed treatment to certain groups of young people, such as minors living on their own because these young people were not permitted to give their own consent for chiropractic treatment. This legislation provides the protections of the Consent by Minors to Medical Procedures Act to the offices of chiropractic physicians and licensed optometrists. HB 2700 has passed both chambers and currently awaits action by the Governor.  
• Patient Choice & Provider Non-Discrimination-HB 694 (Martwick): This legislation would have codified the non-discrimination provisions from the Affordable Care Act into Illinois law. The legislation was assigned to the committee but faced staunch opposition. We continue to look for ways to advance this legislation in the future.
• Limitation on Co-Payment Fees-HB 693 (Martwick): This legislation would have prohibited an insurance company from charging any fixed co-payment that exceeds 50% of the total billed charges for health care services provided to an insured or enrolled during a visit with a health care provider. The legislation was assigned to the committee but faced staunch opposition. We continue to look for ways to advance this legislation in the future.

Other Legislative Measures

While working to advance our own initiatives, the ICS has monitored, supported, and negotiated several other pieces of legislation. The ICS tracked over 70 pieces of legislation. Below is a sample of some of the pieces of legislation on which we have worked and/or tracked.

Medical Practice Extension

SB 1348 (Martinez/Soto): In the last few weeks of May, legislation was introduced to extend the Medical Practice Act for another two years. This is the first time in the last decade the Medical Practice Act has been granted an extension longer than one year. Under this legislation, the Medical Practice Act will not expire until December 31, 2019.  ICS supported this legislation.  SB 1348 has passed both chambers and awaits action by the Governor.

Acupuncture Sunset Act

HB 2630 (Mah/Martinez): The Acupuncture Practice Act was set to sunset at the end of this year. The Illinois Acupuncture Federation filed legislation that would extend the Act another 10 years and included provisions for scope expansion. The ICS objected to some of the initial scope expansion provisions. The ICS main concern with the legislation was the use of the term “differential diagnosis” in the introduced language.   The ICS argued the term “differential diagnosis” is a technique only for trained physicians.  The terminology was removed at the request of ICS.  Under this legislation, the Acupuncture Practice  Act received a ten-year extension. The legislation expands the definition of acupuncture to include cold laser, vibration, and cupping. The definition was also expanded to include acupuncture evaluation and treatment in accordance with the traditional and modern practice of East Asian medical theory. HB 2630 passed both chambers and awaits action by the Governor.

Telemedicine Legislation

SB 1811 (Althoff/Soto):  Legislation was introduced by a company called “Teladoc” to clarify the ability of doctors outside of the State of Illinois to practice telemedicine in Illinois. Under this legislation, the term telemedicine falls under the term “telehealth” which means the evaluation, diagnosis, or interpretation of electronically transmitted patient-specific data between a remote location and a licensed health care professional that generates interactions or treatment recommendations.

As introduced, the ICS had strong concerns about the language. The language as introduced would have unintentionally prohibited our doctors, as well as other health care providers, from using telemedicine. Along with several stakeholders, the ICS was able to negotiate the drafting concerns with Teladoc. The bill now clarifies the ability of various healthcare providers, including chiropractic physicians, to practice telemedicine in Illinois. The legislation requires the care provided under telemedicine to be consistent with the standard of care for in-person services. SB 1811 has passed both chambers and awaits action by the Governor.

Physical Therapy Dry Needling Scope Expansion

SB 898 (Althoff/Mah): During the legislative session, legislation was filed to allow physical therapists to perform dry needling.  The legislation defines dry needling, outlines educational requirements for physical therapists, and the requirements to demonstrate compliance with the law. The educational requirements include 50 hours of instruction, 30 hours of didactic, and 54 hours of practicum. The legislation also requires that physical therapists complete at least 200 patient treatment sessions under supervision, as determined by rule. The legislation also states insurance does not have cover to dry needling. The legislation was heavily negotiated by various health care providers. SB 898 has passed both chambers and awaits action by the Governor.

Mandated Employee Sick Leave

HB 2771 (Mitchell, C./Hutchinson): This legislation requires employers to provide their employees with up to 40 hours of paid sick time per year.  Also, it allows the employer to have the sick leave used by the employee certified by a healthcare professional. As originally drafted, the legislation did not allow chiropractic physicians to certify employee sick leave for any reason other than a spinal issue. The ICS was able to amend the legislation by clarifying the ability of a chiropractic physician to certify sick leave for any reason under the full scope of chiropractic practice. The legislation has passed the Senate and is now in the House waiting for a concurrence vote. The deadline for this legislation to pass was extended until June 30, 2017.

Network Adequacy and Transparency Act

HB 311 (Harris, G./Holmes): The Illinois State Medical Society introduced legislation that would require insurance companies to be more transparent about the doctors in a network to the patient, provide accurate directories, and ensure pregnant women will not lose their doctor in the 3^rd trimester of pregnancy. The ICS supported this legislation.  The legislation passed the Senate and now is back in the House waiting for a vote on concurrence. The deadline for this legislation to pass was extended until June 30, 2017.

Minimum Wage-SB 81

(Lightford/Guzzardi): During this past session, there was a lot of conversation about increasing the minimum wage. A few different proposals were floated around.  The final product became known as SB 81. The legislation establishes a minimum wage increase that begins in 2018 and ends in 2022. The minimum wage increase is different for individuals who are over 18 and those individuals who are under the age of 18 and have not worked more than 650 hours.  The scheduled increases are as follows for individuals over the age of 18: January 1, 2018: $9 per hour; January 1, 2019: $10 per hour; January 1, 2020: $11.25 per hour; January 1, 2021: $13 per hour; January 1, 2022: $15 per hour.  The scheduled increases are as follows for individuals under the age of 18 and have not worked more than 650 hours during any calendar year: January 1, 2018: $ 8 per hour; January 1, 2019: $8.50 per hour; January 1, 2020: $9.25 per hour; January 1, 2021: $10.50 per hour; January 1, 2022: $12 per hour. The legislation also provides for a tax credit against the withholding tax liability for employers who have 50 or fewer employees. The tax credit is calculated based on the increase in minimum wage. The legislation has passed both chambers and now awaits action from the Governor.

Full Practice Authority for Advanced Practice Nurses

HB 313 (Feigenholtz/Martinez): This legislation grants Advanced Practice Nurses(APRN) independent practice authority.  Under the legislation, the APRN must have 4,000 hours of additional clinical training and 250 hours in additional educational/training components under the supervision of a physician to be able to practice without a written collaborative agreement with a physician. The supervising physician must also provide a written statement that the training was completed. The legislation also has limitations on Schedule II opiate prescriptions. The legislation was an agreement between several healthcare provider groups. The legislation has passed the Senate and is now back in the House to be voted on for concurrence.

Workers’ Compensation Update

In January, a workers’ compensation reform plan was filed in the Senate that would have been very harmful to chiropractic. One of the provisions of the initial reform plan included a limitation on the number of chiropractic, physical therapy, and occupational therapy visits a patient can receive under a workers’ compensation claim.  The ICS strongly opposed this provision. The ICS spoke with legislators, the Governor’s Office, and caucus staff regarding the harmful provision. Due to the efforts of the ICS, this provision has been removed from all subsequent amendments filed.

The amendments that came after the initial filing of the legislation did include a major change to the medical fee schedule. The amendments tied the medical fee schedule to the Medicare fee schedule.

Due to the lack of a final agreement, these amendments were not passed by the Senate. Instead, the Senate Democrats and the House Democrats passed their own workers’ compensation package.

The Democrats’ workers’ compensation bill (HB 2525) would require regulations to be established that set rates insurance companies may charge for workers’ compensation insurance. This legislation has passed the Senate and is in the House waiting on a concurrence vote.

The conversation on workers’ compensation reform is expected to continue as the legislature goes into continuous session.

State Budget Update

Back in January, the Senate began working on several pieces of legislation that would create reforms, along with a budget, with the intent to end the budget impasse. These negotiations took place between Senate President John Cullerton and Senate Minority Leader Christine Radogno. The conversations did not involve Governor Rauner, House Speaker Michael Madigan or House Minority Leader Durkin. Over the course of the session, this overall package hit several stumbling blocks and eventually the two sides were unable to come to an agreement.

In the last two weeks of May, the Senate Democrats passed their own budget plan with their version of the reforms the Governor has been requesting. The Senate Democrats’ budget contained but was not limited to a series of tax increases, funding for the State Employee Group Insurance Program, and funding for several types of social services. The plan also included workers’ compensation reform, a two-year property tax freeze, and changes to the education funding formula. This plan was not agreed to by the Senate Republicans. Therefore, the various pieces of legislation passed strictly on party lines.

The measures were then sent to the House where some things passed, such as workers’ compensation reform, but not the state budget. The House did not vote on the Senate Democrat budget plan or the Senate Democrat revenue increases.

This ultimately leaves the State without a budget again. As of June 1, 2017, the State has gone 701 days without a budget, and the bill backlog is over $14.5 billion. The State fiscal year ends June 30, 2017. Therefore, both chambers are expected to come back into session at various times in the month of June.