(410 ILCS 225/6)
(from Ch. 111 1/2, par. 7026)
(a) Covered services under the program may
include, but are not necessarily limited to, the following:
(1) Laboratory services related to a recipient's
pregnancy, performed or ordered by a physician, advanced practice registered nurse, or physician assistant.
(2) Screening and treatment for sexually transmitted
(3) Prenatal visits to a physician in the physician's
office, an advanced practice registered nurse in the advanced practice registered nurse's office, a physician assistant in the physician assistant's office, or to a hospital outpatient prenatal clinic, local health department maternity clinic, or community health center.
(4) Radiology services which are directly related to
the pregnancy, are determined to be medically necessary and are ordered by a physician, an advanced practice registered nurse, or a physician assistant.
(5) Pharmacy services related to the pregnancy.
(6) Other medical consultations related to the
(7) Physician, advanced practice registered nurse,
physician assistant, or nurse services associated with delivery.
(8) One postnatal office visit within 60 days after
(9) Two EPSDT-equivalent screenings for the infant
within 90 days after birth.
(10) Social and support services.
(11) Nutrition services.
(12) Case management services.
(b) The following services shall not be covered under the program:
(1) Services determined by the Department not to be
(2) Services not directly related to the pregnancy,
except for the 2 covered EPSDT-equivalent screenings.
(3) Hospital inpatient services.
(4) Anesthesiologist and radiologist services during
a period of hospital inpatient care.
(5) Physician, advanced practice registered nurse,
and physician assistant hospital visits.
(6) Services considered investigational or
(Source: P.A. 100-513, eff. 1-1-18
(410 ILCS 225/8)
Educational information on risks and healthcare needs of premature infants.
(a) It is the purpose of this Section to:
(1) improve healthcare quality and outcomes for
infants born preterm through enhanced hospital discharge, follow-up care, and management processes and reduced rehospitalization from infectious disease and other complications; and
(2) reduce infant morbidity and mortality associated
(b) The General Assembly finds the following:
(1) Infants born premature at less than 37 weeks
gestational age have greater morbidity and mortality than full-term infants.
(2) In 2006, 12.8% of all births in the United States
were premature, accounting for more than 542,000 infants.
(3) In Illinois, 1 in 8 babies were born premature in
2006, or 13.3% of live births, accounting for 23,955 premature births.
(4) Between 1996 and 2006, the rate of infants born
premature in Illinois increased nearly 15%.
(5) The rate of premature birth in Illinois is
highest in African American infants, 19.3%, followed by Native Americans, 15.6%, Hispanics, 12.1%, and Caucasians, 11.9%.
(6) Approximately 70% of premature births occur in
the late preterm period between 34 and 36 weeks of gestation, and late-preterm babies have significant differences in clinical outcomes than full-term infants, including greater risk for temperature instability, hypoglycemia, respiratory distress, and jaundice.
(7) In 2005, preterm birth cost the United States at
least $26.2 billion, or $51,600 for every infant born prematurely.
(8) Medical costs for premature babies are greater
than they are for healthy newborns. In 2007, the average medical costs for a preterm baby were more than 10 times as high as they were for a healthy full-term baby. The costs for a healthy baby from birth to his first birthday were $4,551. For a pre-term baby, the costs were $49,033.
(9) The costs of premature birth in Illinois may be
significant because the State Medicaid Program paid for 40% of all births in 2003.
(10) Premature infant standard of care practices of
clinicians and hospitals may vary across the State, particularly for late preterm births.
(c) The Department of Public Health shall publish on its website information about the possible health complications associated with newborn infants who are born premature at less than 37 weeks gestational age and the proper care and support for these newborn infants. The written information shall, at a minimum, include the following:
(1) The unique health issues affecting infants born
premature, such as increased risk of developmental problems; nutritional challenges; infection; chronic lung disease (bronchopulmonary dysplasia); vision and hearing impairment; breathing problems; feeding; maintaining body temperature; jaundice; hyperactivity; infant mortality as well as long-term complications associated with growth and nutrition; respiratory problems; fine motor skills; reading; and speaking.
(2) The proper care needs of premature infants,
developmental screenings, and monitoring and healthcare services available to premature infants through the Medicaid program or other public or private health programs.
(3) Methods, vaccines, and other preventative
measures to protect premature infants from infectious diseases, including viral respiratory infections.
(4) The emotional and financial burdens and other
challenges that parents and family members of premature infants experience and information about community resources available to support them.
(d) The information shall be easily accessible and written in clear language to educate parents of premature infants across a variety of socioeconomic statuses.
(e) In determining what information is most beneficial to the public, the Department may consult with pediatric healthcare providers, community organizations, or other experts as the Department deems necessary.
(f) The Department shall ensure that the information is accessible to children's health providers, maternal care providers, hospitals, public health departments, and medical organizations. The Department shall encourage those organizations to provide the publications to parents or guardians of premature infants.
(Source: P.A. 96-1117, eff. 7-20-10.)