Amends the Illinois Insurance Code. Provides that any group or individual policy of accident and health insurance or managed care plan amended, delivered, issued, or renewed on or after January 1, 2027 shall provide coverage for emergency medical services delivered by an out-of-network provider on the same terms as coverage that would be provided for an in-network provider. Provides that this requirement does not apply if the services rendered are not covered for in-network providers. Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code to require coverage under those provisions.

Creates the Procurement Bid Ethics Transparency Act. Provides that no director, employee, investor, or immediate family member of any director, employee, or investor of any corporation, organization, or entity that directly or indirectly operates a procurement bid process for a unit of local government shall simultaneously submit and compete for a procurement bid in that same unit of local government unless they have formally disclosed their involvement to the Executive Ethics Commission. Effective immediately.

Amends the School Code. Requires each school district to include in its student handbook for grades kindergarten through 12 railroad safety messaging. Allows a school district to opt-out of the messaging requirement if the school board of the school district determines that the inclusion of such messaging is unnecessary based on local context or the messaging's alignment with curriculum. Effective July 1, 2026.

Amends the Radiation Protection Act of 1990. Provides that all intrastate and interstate shippers or carriers (rather than intrastate and interstate carriers) of irradiated nuclear reactor fuel are required to notify the Illinois Emergency Management Agency and Office of Homeland Security no less than 7 days (rather than 24 hours) prior to any transportation of irradiated nuclear reactor fuel. Changes the definition of "carrier" and "irradiated reactor fuel". Adds a definition of "shipper". Provides that the Agency may collect, store, and dispose of uncontrolled sources of radiation that have entered the public domain and that the Agency considers to be a threat to public health and safety or the environment. Authorizes the Agency to assess actual costs, as appropriate, for the collection, storage, and disposal of uncontrolled sources of radiation that have entered the public domain and that the Agency considers to be a threat to public health and safety or the environment against any person that owns, owned, possesses, or is responsible for the radioactive material entering the public domain.

Creates the Health Care Funding Act. Establishes the Health Care Funding Association for the primary purpose of equitably determining and collecting assessments for the cost of immunizations and health care information lines in the State that are not covered by other federal or State funding. Requires assessed entities, which include, but are not limited to, writers of individual, group, or stop-loss insurance, health maintenance organizations, third-party administrators, fraternal benefit societies, and certain other entities, to pay a specified quarterly assessment to the Association. Sets forth provisions concerning membership of the Association; powers and duties of the Association; methodology for calculating the assessment amount; reports and audits; immunities; tax-exempt status of the Association; an administrative allowance to the Department of Public Health; and other matters. Amends the State Finance Act to make conforming changes. Effective immediately.

Amends the Harassing and Obscene Communications Article of the Criminal Code of 2012. Provides that in addition to any criminal penalties, a person who is the victim of harassment under the harassment through electronic communications statute may bring a civil action against the perpetrator of the harassment. Provides that in such an action, the victim may be awarded damages not to exceed $10,000,000 for each count of harassment. Provides that these damages may include compensation for any physical injury, emotional distress, reputational harm, or other damages directly resulting from the harassment. Provides that, in addition to compensatory damages, the court may award punitive damages if the defendant's conduct was willfully or maliciously intended to harm the victim. Provides that punitive damages may be awarded in an amount deemed appropriate by the court, not to exceed the statutory limit of $10,000,000 per count. Provides that in any civil action brought under this provision, the prevailing party may be entitled to reasonable attorney's fees, court costs, and other expenses. Provides that the use of an end-to-end encryption messaging system or device to transmit harassing messages or communications is an aggravating factor in sentencing. Provides that a person who violates the harassment through electronic communications statute using an end-to-end encryption messaging system or device to engage in harassment is guilty of a Class 3 felony, regardless of other factors surrounding the offense. Defines "end-to-end encryption messaging system or device". Amends the Unified Code of Corrections to make conforming changes. Effective immediately.

Amends the Property Tax Code. In provisions concerning wooded acreage assessment, provides that the assessed value of property that is subject to assessment under those provisions may not exceed the product of the assessed value of the property for the immediately preceding assessment year multiplied by 104%. Effective immediately.

Creates the Expanded Access to Lung Cancer Screening Act. Provides that the Department of Public Health shall require information and counseling concerning lung cancer screening to be made available to individuals accessing the tobacco quitline. Provides that the Department may enter into contracts and agreements and award grants to persons operating the tobacco quitline. Provides that the Department shall develop signage that discloses referral information for lung cancer screening. Provides that the Department shall develop an educational insert to accompany the sale of tobacco products and nicotine replacement therapies by retailers. Provides that a retailer of tobacco products or nicotine replacement therapies who intentionally violates these provisions is guilty of a petty offense. Provides that the Department shall adopt rules implementing this Act. Defines terms.

Amends the Criminal Code of 2012 concerning the offense of contributing to the criminal delinquency of a minor. Changes the definition of "delinquent minor" to be consistent with the Juvenile Court Act of 1987. Provides that the penalty for contributing to the criminal delinquency of a minor, if the offense committed is vehicular hijacking, is a Class X felony for which the person shall be sentenced to not less than 12 years imprisonment and not more than 60 years imprisonment. Provides that if the offense committed is aggravated vehicular hijacking, the penalty for contributing to the criminal delinquency of a minor is a Class X felony for which the person shall be sentenced to not less than 30 years imprisonment and not more than 60 years imprisonment.

Amends the Ambulatory Surgical Treatment Center Act. Removes a provision which provides that, in ambulatory surgical treatment centers, anesthesia service shall be under the direction of a physician who has had specialized preparation or experience in the area or who has completed a residency in anesthesiology. Specifies that, with respect to anesthesia service in an ambulatory surgical treatment center, a certified registered nurse anesthetist shall seek consultation regarding development of an anesthesia plan and treatment of patients as is appropriate to the certified registered nurse anesthetist's level of expertise and scope of practice and as is warranted by the needs of the patient. Removes a requirement that an anesthesiologist participate through discussion of and agreement with the anesthesia plan and remain physically present and be available on the premises. Provides that a certified registered nurse anesthetist with clinical privileges may perform acts of advanced assessment and diagnosis and may provide such functions for which the certified registered nurse anesthetist is educationally and experientially prepared. Makes conforming changes to the Hospital Licensing Act. Amends the Medical Practice Act of 1987. Provides that a written collaborative agreement shall be adequate with respect to collaboration with certified registered nurse anesthetists if all of the following apply: (1) the agreement is written to promote the exercise of professional judgment by the certified registered nurse anesthetist commensurate with his or her education and experience; (2) the certified registered nurse anesthetist provides service based on a written collaborative agreement with the collaborating physician; and (3) methods of communication are available with the collaborating physician in person or through telecommunications for consultation, collaboration, and referral as needed to address patient care needs. Amends the Nurse Practice Act. Provides that an Illinois-licensed advanced practice registered nurse certified as a certified registered nurse anesthetist shall be deemed by law to possess the ability to practice without a written collaborative agreement. Sets forth requirements for a certified registered nurse anesthetist. Makes conforming changes in the Illinois Dental Practice Act. Effective immediately.

Amends the Video Gaming Act. Prohibits a terminal operator from compensating a sales agent and broker based on a percentage of the after-tax profits from a video gaming terminal, the net terminal income from a video gaming terminal or attributed to licensed establishments, or any other compensation metric based upon the performance of a video gaming terminal in various licensed establishments. Provides that a terminal operator shall not enter into any contract or agreement for the sharing, splitting, or payment of net terminal income with any other person. Prohibits any contract or agreement for the sharing, splitting, or payment of net terminal income with any other person executed before January 1, 2025 from being amended, modified, or extended. Allows a terminal operator to enter into a contract or agreement for the sharing, splitting, or payment of net terminal income with any other person if such contract is approved by the Illinois Gaming Board. Prohibits a sales agent and broker from giving anything of value to a current or potential licensed establishment. Prohibits a sales agent and broker that is not an owner of a terminal operator to solicit or procure a use agreement or any other contract or agreement that purports to control or authorize the placement or operation of a video gaming terminal on behalf of a terminal operator from a current or potential licensed establishment if that person is an immediate family member of a direct or indirect owner, officer, director, manager, employee, or a person who otherwise significantly influences or controls the licensed establishment. Provides that any use agreement currently authorizing the placement and operation of video gaming may continue as a valid and enforceable use agreement through the end of the current use agreement term, but shall not be amended, modified, extended, or renewed after the effective date of the amendatory Act. Prohibits a current or potential licensed establishment from accepting anything of value from a terminal operator or sales agent and broker as any incentive or inducement to locate video gaming terminals in that establishment and licensed establishments. Makes other changes.

Amends the Design-Build Procurement Act. Provides that certain provisions are inoperative for public institutions of higher education on and after January 1, 2026. Removes provisions repealing the Act. Effective immediately.

Amends the Department of Transportation Law of the Civil Administrative Code of Illinois. Provides that if property other than a roadway that is owned by the Department of Transportation has been used as an encampment site for 30 days or more for people who are experiencing homelessness, the property shall be transferred within 30 days to the Department of Natural Resources and treated as a campground under the Campground Licensing and Recreational Area Act.

Amends the Electricity Excise Tax Law. Provides that 100% of the funds received by the Department under the Act as a result of an electric vehicle charging station shall be deposited into the Road Fund. Effective immediately.

Amends the Illinois Vehicle Code. Increases the penalties for operating a motor vehicle while uninsured as follows: a person convicted of 2 or more violations of uninsured driving that causes bodily harm is subject to a fine of $4,500 (currently $2,500); for a first or second offense, a person is subject to a fine in excess of $1,000 (currently $500) but not more than $2,000 (currently $1,000), and having his or her driving privileges suspended for 6 (currently 3) months which may only be reinstated after he or she pays a $500 (currently $100) reinstatement fee; and for a third or subsequent offense, a person is subject to a fine of $2,000 (currently $1,000), and having his or her driving privileges suspended for 12 (currently 6) months which may only be reinstated after he or she pays a $1,000 (currently $100) reinstatement fee. Provides that a person convicted of uninsured driving while driving with suspended license plates is subject to an additional fine of $2,000.