Advocacy Update: Health Care Violence Prevention, Downcoding, Staffing, & More
HEALTH CARE VIOLENCE
HB 5168 – HEALTH CARE VIOLENCE PREVENT
Sponsor: Rep. Sharon Chung and Ryan Spain
Summary: Amends the Health Care Violence Prevention Act to strengthen workplace safety requirements, prohibit policies that limit reporting violence to law enforcement or IDPH, and expand prevention program standards, including security measures and incident tracking. Establishes new investigation, reporting, and recordkeeping requirements, along with penalties for noncompliance. Also exempts certain workplace violence records from disclosure under the Freedom of Information Act.
SB 2713 – HEALTH CARE VIOLENCE PREVENT
Sponsor: Sen. Julie A. Morrison
Summary: Amends the Health Care Violence Prevention Act to update definitions, prohibit limits on reporting workplace violence, and strengthen prevention program requirements, including security measures and incident tracking. Establishes investigation, reporting, and recordkeeping requirements, with penalties for noncompliance. Also exempts certain workplace violence records from disclosure under FOIA.
STATUS
ICEP has been actively engaged alongside stakeholders, including the Illinois Hospital Association, to negotiate amendments that strike a balance between stronger protections and operational feasibility. We are also working in coordination with ENA and ANA on the workplace violence bill and have submitted our nomination for the commission. These discussions have been productive, and the legislation is expected to advance in the Senate with agreed-upon changes, with strong momentum continuing behind efforts to secure meaningful, enforceable protections for frontline providers.
DOWNCODING
HB 4735 – TRANSPARENCY IN DOWNCODING ACT
Sponsor: Rep. Sharon Chung, Dagmara Avelar, and Ryan Spain
Summary: Creates the Transparency in Downcoding Act. Provides that the Act applies to certain policies of health insurance amended, delivered, issued, or renewed on or after the effective date of the Act, except for employee or employer self-insured health benefit plans under the federal Employee Retirement Income Security Act of 1974 and health care provided pursuant to the Workers’ Compensation Act or the Workers’ Occupational Diseases Act. Prohibits a health insurance issuer from using an automated process, system, or tool to downcode a claim; from downcoding a claim based solely on the reported diagnosis codes; and from using downcoding practices in a targeted or discriminatory manner against physicians who routinely treat patients with complex or chronic conditions. Requires downcoding decisions to be made by a physician licensed to practice medicine in all its branches in any United States jurisdiction and of the same or similar specialty as a physician who typically manages the medical condition or disease. Sets forth provisions concerning notification requirements for downcoded claims; the appeal process for downcoded claims; enforcement by the Department of Insurance; and penalties. Provides that any pattern or practice of discriminatory downcoding identified by the Director of Insurance or another regulatory authority shall be subject to enforcement actions, including fines, restitution, or suspension of the health insurance issuer’s license in this State. Effective immediately.
SB 3114 – TRANSPARENCY IN DOWNCODING ACT
Sponsors: Sen. Dave Koehler, Julie A. Morrison, Cristina Castro
Summary: Creates the Transparency in Downcoding Act to prohibit insurers from using automated or discriminatory downcoding practices and from relying solely on diagnosis codes. Requires downcoding decisions to be made by a licensed physician of a similar specialty and establishes notice and appeal requirements. Provides for enforcement by the Department of Insurance, including penalties for violations.
STATUS
To the credit of the Illinois State Medical Society and a broad coalition of practice groups, what was initially expected to be a multi-year effort has quickly gained traction this session. The bills are moving through the process at a faster pace than anticipated, though negotiations with insurers and other stakeholders are ongoing. While details continue to be refined, there is growing optimism that a meaningful framework could advance this year.
STAFFING
HB 4314 – EMERGENCY PHYSICIAN STAFFING
Sponsor: Rep. William E. Hauter
Summary: Amends the Hospital Emergency Service Act. Provides that every hospital required to be licensed by the Department of Public Health pursuant to the Hospital Licensing Act which provides general medical and surgical hospital services, except for specified long-term acute care hospitals and rehabilitation hospitals, shall have at least one licensed physician who specializes in emergency medicine staffing the emergency department at all times. Effective immediately.
STATUS
The proposal continues to generate discussion among stakeholders, particularly around workforce capacity and hospital flexibility. ICEP remains engaged in conversations to ensure the bill reflects both patient safety priorities and the realities of staffing across different regions of the state. Discussions are ongoing, and the path forward will likely depend on continued stakeholder alignment.
EMS
Sponsor: Rep. Michael J. Kelly
Summary: Amends the EMS Systems Act to require the Department of Public Health to develop a Just Culture Matrix for consistent evaluation and discipline of EMS personnel. Clarifies review board authority in disciplinary cases and updates processes for handling suspensions. Also requires issuance of both physical and digital licenses for EMS personnel.
STATUS
The bill is moving steadily, with general support for its goals of consistency and modernization within EMS systems. Stakeholders continue to work through implementation details, but the proposal is viewed as a positive step toward improving system-wide standards and accountability.
RIFL ACT
Sponsor: Rep. Kevin John Olickal
Summary: Creates the Responsibility in Firearm Legislation (RIFL) Act, establishing a state licensing program for firearm manufacturers through the Department of Financial and Professional Regulation, with fees tied to the public health costs of gun violence. Beginning January 1, 2028, manufacturers must be licensed to operate in Illinois, and retailers may only sell firearms from licensed manufacturers, with significant penalties for violations. The bill also creates a dedicated fund and financial assistance program for victims of firearm violence, administered by the state with oversight and enforcement authority.
Sponsor: Sen. Robert Peters
Summary: Creates the RIFL Act, requiring firearm manufacturers to be licensed in Illinois starting in 2028, with fees tied to the public costs of gun violence and steep penalties for noncompliance. Retailers would be barred from selling firearms from unlicensed manufacturers. The bill also establishes a state fund and program to provide financial assistance to victims of gun violence, with oversight and enforcement by state agencies.
STATUS
ICEP is actively supporting this legislation as part of its broader commitment to reducing preventable injury and violence across Illinois. Emergency physicians see firsthand the devastating impact of firearm-related harm, and this bill represents a meaningful step toward addressing those public health and system-wide costs. ICEP will continue working with stakeholders to advance solutions that support patient safety, provider wellbeing, and community health.
SUMMARY
Overall, ICEP’s priority issues are seeing meaningful movement this session, with several proposals advancing more quickly than anticipated. While negotiations are ongoing across multiple fronts, there is a clear opportunity to make substantive progress on key policy goals.