| Old | New | Differences | |
|---|---|---|---|
| 1 | - | Public Act 103-0323 | |
| 2 | 1 | HB2719 EnrolledLRB103 27682 AWJ 54059 b HB2719 Enrolled LRB103 27682 AWJ 54059 b | |
| 3 | 2 | HB2719 Enrolled LRB103 27682 AWJ 54059 b | |
| 4 | - | AN ACT concerning regulation. | |
| 5 | - | Be it enacted by the People of the State of Illinois, | |
| 6 | - | represented in the General Assembly: | |
| 7 | - | Section 5. The Community Benefits Act is amended by | |
| 8 | - | changing Section 22 as follows: | |
| 9 | - | (210 ILCS 76/22) | |
| 10 | - | Sec. 22. Public reports. | |
| 11 | - | (a) In order to increase transparency and accessibility of | |
| 12 | - | charity care and financial assistance data, a hospital shall | |
| 13 | - | make the annual hospital community benefits plan report | |
| 14 | - | submitted to the Attorney General under Section 20 available | |
| 15 | - | to the public by publishing the information on the hospital's | |
| 16 | - | website in the same location where annual reports are posted | |
| 17 | - | or on a prominent location on the homepage of the hospital's | |
| 18 | - | website. A hospital is not required to post its audited | |
| 19 | - | financial statements. Information made available to the public | |
| 20 | - | shall include, but shall not be limited to, the following: | |
| 21 | - | (1) The reporting period. | |
| 22 | - | (2) Charity care costs consistent with the reporting | |
| 23 | - | requirements in paragraph (3) of subsection (a) of Section | |
| 24 | - | 20. Charity care costs associated with services provided | |
| 25 | - | in a hospital's emergency department shall be reported as | |
| 26 | - | a subset of total charity care costs. | |
| 3 | + | 1 AN ACT concerning regulation. | |
| 4 | + | 2 Be it enacted by the People of the State of Illinois, | |
| 5 | + | 3 represented in the General Assembly: | |
| 6 | + | 4 Section 5. The Community Benefits Act is amended by | |
| 7 | + | 5 changing Section 22 as follows: | |
| 8 | + | 6 (210 ILCS 76/22) | |
| 9 | + | 7 Sec. 22. Public reports. | |
| 10 | + | 8 (a) In order to increase transparency and accessibility of | |
| 11 | + | 9 charity care and financial assistance data, a hospital shall | |
| 12 | + | 10 make the annual hospital community benefits plan report | |
| 13 | + | 11 submitted to the Attorney General under Section 20 available | |
| 14 | + | 12 to the public by publishing the information on the hospital's | |
| 15 | + | 13 website in the same location where annual reports are posted | |
| 16 | + | 14 or on a prominent location on the homepage of the hospital's | |
| 17 | + | 15 website. A hospital is not required to post its audited | |
| 18 | + | 16 financial statements. Information made available to the public | |
| 19 | + | 17 shall include, but shall not be limited to, the following: | |
| 20 | + | 18 (1) The reporting period. | |
| 21 | + | 19 (2) Charity care costs consistent with the reporting | |
| 22 | + | 20 requirements in paragraph (3) of subsection (a) of Section | |
| 23 | + | 21 20. Charity care costs associated with services provided | |
| 24 | + | 22 in a hospital's emergency department shall be reported as | |
| 25 | + | 23 a subset of total charity care costs. | |
| 27 | 26 | ||
| 28 | 27 | ||
| 29 | 28 | ||
| 30 | 29 | HB2719 Enrolled LRB103 27682 AWJ 54059 b | |
| 31 | 30 | ||
| 32 | 31 | ||
| 33 | - | (3) Total net patient revenue, reported separately by | |
| 34 | - | hospital if the reporting health system includes more than | |
| 35 | - | one hospital. | |
| 36 | - | (4) Total community benefits spending. If a hospital | |
| 37 | - | is owned or operated by a health system, total community | |
| 38 | - | benefits spending may be reported as a health system. | |
| 39 | - | (5) Data on financial assistance applications | |
| 40 | - | consistent with the reporting requirements in paragraph | |
| 41 | - | (3) of subsection (a) of Section 20, including: | |
| 42 | - | (A) the number of applications submitted to the | |
| 43 | - | hospital, both complete and incomplete; | |
| 44 | - | (B) the number of applications approved; and | |
| 45 | - | (C) the number of applications denied and the 5 | |
| 46 | - | most frequent reasons for denial; and . | |
| 47 | - | (D) the number of uninsured patients who have | |
| 48 | - | declined or failed to respond to the screening | |
| 49 | - | described in subsection (a) of Section 16 of the Fair | |
| 50 | - | Patient Billing Act and the 5 most frequent reasons | |
| 51 | - | for declining. | |
| 52 | - | (6) To the extent that race, ethnicity, sex, or | |
| 53 | - | preferred language is collected and available for | |
| 54 | - | financial assistance applications, the data outlined in | |
| 55 | - | paragraph (5) shall be reported by race, ethnicity, sex, | |
| 56 | - | and preferred language. If this data is not provided by | |
| 57 | - | the patient, the hospital shall indicate this in its | |
| 58 | - | reports. Public reporting of this information shall begin | |
| 32 | + | HB2719 Enrolled- 2 -LRB103 27682 AWJ 54059 b HB2719 Enrolled - 2 - LRB103 27682 AWJ 54059 b | |
| 33 | + | HB2719 Enrolled - 2 - LRB103 27682 AWJ 54059 b | |
| 34 | + | 1 (3) Total net patient revenue, reported separately by | |
| 35 | + | 2 hospital if the reporting health system includes more than | |
| 36 | + | 3 one hospital. | |
| 37 | + | 4 (4) Total community benefits spending. If a hospital | |
| 38 | + | 5 is owned or operated by a health system, total community | |
| 39 | + | 6 benefits spending may be reported as a health system. | |
| 40 | + | 7 (5) Data on financial assistance applications | |
| 41 | + | 8 consistent with the reporting requirements in paragraph | |
| 42 | + | 9 (3) of subsection (a) of Section 20, including: | |
| 43 | + | 10 (A) the number of applications submitted to the | |
| 44 | + | 11 hospital, both complete and incomplete; | |
| 45 | + | 12 (B) the number of applications approved; and | |
| 46 | + | 13 (C) the number of applications denied and the 5 | |
| 47 | + | 14 most frequent reasons for denial; and . | |
| 48 | + | 15 (D) the number of uninsured patients who have | |
| 49 | + | 16 declined or failed to respond to the screening | |
| 50 | + | 17 described in subsection (a) of Section 16 of the Fair | |
| 51 | + | 18 Patient Billing Act and the 5 most frequent reasons | |
| 52 | + | 19 for declining. | |
| 53 | + | 20 (6) To the extent that race, ethnicity, sex, or | |
| 54 | + | 21 preferred language is collected and available for | |
| 55 | + | 22 financial assistance applications, the data outlined in | |
| 56 | + | 23 paragraph (5) shall be reported by race, ethnicity, sex, | |
| 57 | + | 24 and preferred language. If this data is not provided by | |
| 58 | + | 25 the patient, the hospital shall indicate this in its | |
| 59 | + | 26 reports. Public reporting of this information shall begin | |
| 59 | 60 | ||
| 60 | 61 | ||
| 61 | - | with the community benefit report filed on or after July | |
| 62 | - | 1, 2022. A hospital that files a report without having a | |
| 63 | - | full year of demographic data as required by this Act may | |
| 64 | - | indicate this in its report. | |
| 65 | - | (b) The Attorney General shall provide notice on the | |
| 66 | - | Attorney General's website informing the public that, upon | |
| 67 | - | request, the Attorney General will provide the annual reports | |
| 68 | - | filed with the Attorney General under Section 20. The notice | |
| 69 | - | shall include the contact information to submit a request. | |
| 70 | - | (Source: P.A. 102-581, eff. 1-1-22.) | |
| 71 | - | Section 10. The Fair Patient Billing Act is amended by | |
| 72 | - | changing Sections 5, 10, 30, 45, and 70 and by adding Section | |
| 73 | - | 16 as follows: | |
| 74 | - | (210 ILCS 88/5) | |
| 75 | - | Sec. 5. Purpose; findings. | |
| 76 | - | (a) The purpose of this Act is to advance the prompt and | |
| 77 | - | accurate payment of health care services through fair and | |
| 78 | - | reasonable billing and collection practices of hospitals. | |
| 79 | - | (b) The General Assembly finds that: | |
| 80 | - | (1) Medical debts are the cause of an increasing | |
| 81 | - | number of bankruptcies in Illinois and are typically | |
| 82 | - | associated with severe financial hardship incurred by | |
| 83 | - | bankrupt persons and their families. | |
| 84 | - | (2) Patients, hospitals, and government bodies alike | |
| 85 | 62 | ||
| 86 | 63 | ||
| 87 | - | will benefit from clearly articulated standards regarding | |
| 88 | - | fair billing and collection practices for all Illinois | |
| 89 | - | hospitals. | |
| 90 | - | (3) Hospitals should employ responsible standards when | |
| 91 | - | collecting debt from their patients. | |
| 92 | - | (4) Patients should be provided sufficient billing | |
| 93 | - | information from hospitals to determine the accuracy of | |
| 94 | - | the bills for which they may be financially responsible. | |
| 95 | - | (5) Patients should be given a fair and reasonable | |
| 96 | - | opportunity to discuss and assess the accuracy of their | |
| 97 | - | bill. | |
| 98 | - | (6) Hospitals should provide patients with timely and | |
| 99 | - | meaningful access to any financial assistance available | |
| 100 | - | through the hospital and any public health insurance | |
| 101 | - | programs for which patients may be eligible to prevent | |
| 102 | - | patients from ending up with avoidable medical debt. | |
| 103 | - | Hospitals should assist patients who need financial | |
| 104 | - | assistance to access it. Patients who are deemed eligible | |
| 105 | - | for hospital financial assistance or public health | |
| 106 | - | insurance programs should not be improperly billed, | |
| 107 | - | steered into payment plans, or sent to collections | |
| 108 | - | Patients should be provided information regarding the | |
| 109 | - | hospital's policies regarding financial assistance options | |
| 110 | - | the hospital may offer to qualified patients. | |
| 111 | - | (7) Hospitals should offer patients the opportunity to | |
| 112 | - | enter into a reasonable payment plan for their hospital | |
| 64 | + | ||
| 65 | + | HB2719 Enrolled - 2 - LRB103 27682 AWJ 54059 b | |
| 113 | 66 | ||
| 114 | 67 | ||
| 115 | - | care. | |
| 116 | - | (8) Patients have an obligation to pay for the | |
| 117 | - | hospital services they receive subject to any discounts or | |
| 118 | - | free care for which they are eligible under Illinois law. | |
| 119 | - | (9) Hospitals have an obligation to screen uninsured | |
| 120 | - | patients before pursuing collection action. To promote the | |
| 121 | - | general welfare and to mitigate the negative impact that | |
| 122 | - | medical debt has on accessing and using needed health | |
| 123 | - | care, hospitals should not attempt to collect a debt from | |
| 124 | - | an uninsured patient without first adequately screening | |
| 125 | - | the patient for public health insurance programs and | |
| 126 | - | financial assistance available to the patient and | |
| 127 | - | assisting the patient in obtaining the hospital financial | |
| 128 | - | assistance for which they are eligible. | |
| 129 | - | (Source: P.A. 94-885, eff. 1-1-07.) | |
| 130 | - | (210 ILCS 88/10) | |
| 131 | - | Sec. 10. Definitions. As used in this Act: | |
| 132 | - | "Collection action" means any referral of a bill to a | |
| 133 | - | collection agency or law firm to collect payment for services | |
| 134 | - | from a patient or a patient's guarantor for hospital services. | |
| 135 | - | "Health care plan" means a health insurance company, | |
| 136 | - | health maintenance organization, preferred provider | |
| 137 | - | arrangement, or third party administrator authorized in this | |
| 138 | - | State to issue policies or subscriber contracts or administer | |
| 139 | - | those policies and contracts that reimburse for inpatient and | |
| 68 | + | HB2719 Enrolled- 3 -LRB103 27682 AWJ 54059 b HB2719 Enrolled - 3 - LRB103 27682 AWJ 54059 b | |
| 69 | + | HB2719 Enrolled - 3 - LRB103 27682 AWJ 54059 b | |
| 70 | + | 1 with the community benefit report filed on or after July | |
| 71 | + | 2 1, 2022. A hospital that files a report without having a | |
| 72 | + | 3 full year of demographic data as required by this Act may | |
| 73 | + | 4 indicate this in its report. | |
| 74 | + | 5 (b) The Attorney General shall provide notice on the | |
| 75 | + | 6 Attorney General's website informing the public that, upon | |
| 76 | + | 7 request, the Attorney General will provide the annual reports | |
| 77 | + | 8 filed with the Attorney General under Section 20. The notice | |
| 78 | + | 9 shall include the contact information to submit a request. | |
| 79 | + | 10 (Source: P.A. 102-581, eff. 1-1-22.) | |
| 80 | + | 11 Section 10. The Fair Patient Billing Act is amended by | |
| 81 | + | 12 changing Sections 5, 10, 30, 45, and 70 and by adding Section | |
| 82 | + | 13 16 as follows: | |
| 83 | + | 14 (210 ILCS 88/5) | |
| 84 | + | 15 Sec. 5. Purpose; findings. | |
| 85 | + | 16 (a) The purpose of this Act is to advance the prompt and | |
| 86 | + | 17 accurate payment of health care services through fair and | |
| 87 | + | 18 reasonable billing and collection practices of hospitals. | |
| 88 | + | 19 (b) The General Assembly finds that: | |
| 89 | + | 20 (1) Medical debts are the cause of an increasing | |
| 90 | + | 21 number of bankruptcies in Illinois and are typically | |
| 91 | + | 22 associated with severe financial hardship incurred by | |
| 92 | + | 23 bankrupt persons and their families. | |
| 93 | + | 24 (2) Patients, hospitals, and government bodies alike | |
| 140 | 94 | ||
| 141 | 95 | ||
| 142 | - | outpatient services provided in a hospital. Health care plan, | |
| 143 | - | however, does not include any government-funded program such | |
| 144 | - | as Medicare or Medicaid, workers' compensation, and accident | |
| 145 | - | liability insurers. | |
| 146 | - | "Insured patient" means a patient who is insured by a | |
| 147 | - | health care plan. | |
| 148 | - | "Medical debt" means a debt arising from the receipt of | |
| 149 | - | health care services, products, or devices. | |
| 150 | - | "Patient" means the individual receiving services from the | |
| 151 | - | hospital and any individual who is the guarantor of the | |
| 152 | - | payment for such services. | |
| 153 | - | "Public health insurance program" means Medicare; | |
| 154 | - | Medicaid; medical assistance under the Non-Citizen Victims of | |
| 155 | - | Trafficking, Torture and Other Serious Crimes program; Health | |
| 156 | - | Benefit for Immigrant Adults; Health Benefit for Immigrant | |
| 157 | - | Seniors; All Kids; or other medical assistance programs | |
| 158 | - | offered by the Department of Healthcare and Family Services. | |
| 159 | - | "Reasonable payment plan" means a plan to pay a hospital | |
| 160 | - | bill that is offered to the patient or the patient's legal | |
| 161 | - | representative and takes into account the patient's available | |
| 162 | - | income and assets, the amount owed, and any prior payments. | |
| 163 | - | "Screen" or "screening" means a process whereby a hospital | |
| 164 | - | engages with a patient to review and assess the patient's | |
| 165 | - | potential eligibility for any financial assistance offered by | |
| 166 | - | the hospital, public health insurance program, or other | |
| 167 | - | discounted care known to the hospital; informs the patient of | |
| 168 | 96 | ||
| 169 | 97 | ||
| 170 | - | the hospital's assessment; documents in the patient's record | |
| 171 | - | the circumstances of the screening; and assists with the | |
| 172 | - | application for hospital financial assistance. | |
| 173 | - | "Uninsured patient" means a patient who is not insured by | |
| 174 | - | a health care plan and is not a beneficiary under a | |
| 175 | - | government-funded program, workers' compensation, or accident | |
| 176 | - | liability insurance. | |
| 177 | - | (Source: P.A. 94-885, eff. 1-1-07.) | |
| 178 | - | (210 ILCS 88/16 new) | |
| 179 | - | Sec. 16. Screening patients for health insurance and | |
| 180 | - | financial assistance. | |
| 181 | - | (a) All hospitals shall screen each uninsured patient, | |
| 182 | - | upon the uninsured patient's agreement, at the earliest | |
| 183 | - | reasonable moment for potential eligibility for both: | |
| 184 | - | (1) public health insurance programs; and | |
| 185 | - | (2) any financial assistance offered by the hospital. | |
| 186 | - | (b) All screening activities, including initial screenings | |
| 187 | - | and all follow-up assistance, must be provided in compliance | |
| 188 | - | with the Language Assistance Services Act. | |
| 189 | - | (c) If a patient declines or fails to respond to the | |
| 190 | - | screening described in subsection (a), the hospital shall | |
| 191 | - | document in the patient's record the patient's decision to | |
| 192 | - | decline or failure to respond to the screening, confirming the | |
| 193 | - | date and method by which the patient declined or failed to | |
| 194 | - | respond. | |
| 98 | + | ||
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| 195 | 100 | ||
| 196 | 101 | ||
| 197 | - | (d) If a patient does not decline the screening described | |
| 198 | - | in subsection (a), a hospital should screen an uninsured | |
| 199 | - | patient during registration unless it would cause a delay of | |
| 200 | - | care to the patient, otherwise a hospital must screen an | |
| 201 | - | uninsured patient at the earliest reasonable moment. | |
| 202 | - | (e) If a patient does not submit screening, financial | |
| 203 | - | assistance application, or reasonable payment plan | |
| 204 | - | documentation within 30 days after a request as required under | |
| 205 | - | Section 45, the hospital shall document the lack of received | |
| 206 | - | documentation, confirming the date that the screening took | |
| 207 | - | place and that the 30-day timeline for responding to the | |
| 208 | - | hospital's request has lapsed, but may be reopened within 90 | |
| 209 | - | days after the date of discharge, date of service, or | |
| 210 | - | completion of the screening. | |
| 211 | - | (f) If the screening indicates that the patient may be | |
| 212 | - | eligible for a public health insurance program, the hospital | |
| 213 | - | shall provide information to the patient about how the patient | |
| 214 | - | can apply for the public health insurance program, including, | |
| 215 | - | but not limited to, referral to health care navigators who | |
| 216 | - | provide free and unbiased eligibility and enrollment | |
| 217 | - | assistance, including health care navigators at federally | |
| 218 | - | qualified health centers; local, State, or federal government | |
| 219 | - | agencies; or any other resources that Illinois recognizes as | |
| 220 | - | designed to assist uninsured individuals in obtaining health | |
| 221 | - | coverage. | |
| 222 | - | (g) If the uninsured patient's application for a public | |
| 102 | + | HB2719 Enrolled- 4 -LRB103 27682 AWJ 54059 b HB2719 Enrolled - 4 - LRB103 27682 AWJ 54059 b | |
| 103 | + | HB2719 Enrolled - 4 - LRB103 27682 AWJ 54059 b | |
| 104 | + | 1 will benefit from clearly articulated standards regarding | |
| 105 | + | 2 fair billing and collection practices for all Illinois | |
| 106 | + | 3 hospitals. | |
| 107 | + | 4 (3) Hospitals should employ responsible standards when | |
| 108 | + | 5 collecting debt from their patients. | |
| 109 | + | 6 (4) Patients should be provided sufficient billing | |
| 110 | + | 7 information from hospitals to determine the accuracy of | |
| 111 | + | 8 the bills for which they may be financially responsible. | |
| 112 | + | 9 (5) Patients should be given a fair and reasonable | |
| 113 | + | 10 opportunity to discuss and assess the accuracy of their | |
| 114 | + | 11 bill. | |
| 115 | + | 12 (6) Hospitals should provide patients with timely and | |
| 116 | + | 13 meaningful access to any financial assistance available | |
| 117 | + | 14 through the hospital and any public health insurance | |
| 118 | + | 15 programs for which patients may be eligible to prevent | |
| 119 | + | 16 patients from ending up with avoidable medical debt. | |
| 120 | + | 17 Hospitals should assist patients who need financial | |
| 121 | + | 18 assistance to access it. Patients who are deemed eligible | |
| 122 | + | 19 for hospital financial assistance or public health | |
| 123 | + | 20 insurance programs should not be improperly billed, | |
| 124 | + | 21 steered into payment plans, or sent to collections | |
| 125 | + | 22 Patients should be provided information regarding the | |
| 126 | + | 23 hospital's policies regarding financial assistance options | |
| 127 | + | 24 the hospital may offer to qualified patients. | |
| 128 | + | 25 (7) Hospitals should offer patients the opportunity to | |
| 129 | + | 26 enter into a reasonable payment plan for their hospital | |
| 223 | 130 | ||
| 224 | 131 | ||
| 225 | - | health insurance program is approved, the hospital shall bill | |
| 226 | - | the insuring entity and shall not pursue the patient for any | |
| 227 | - | aspect of the bill, except for any required copayment, | |
| 228 | - | coinsurance, or other similar payment for which the patient is | |
| 229 | - | responsible under the insurance. If the uninsured patient's | |
| 230 | - | application for public health insurance is denied, the | |
| 231 | - | hospital shall again offer to screen the uninsured patient for | |
| 232 | - | hospital financial assistance and the timeline for applying | |
| 233 | - | for financial assistance under the Hospital Uninsured Patient | |
| 234 | - | Discount Act shall begin again. | |
| 235 | - | (h) A hospital shall offer to screen an insured patient | |
| 236 | - | for hospital financial assistance under this Section if the | |
| 237 | - | patient requests financial assistance screening, if the | |
| 238 | - | hospital is contacted in response to a bill, if the hospital | |
| 239 | - | learns information that suggests an inability to pay, or if | |
| 240 | - | the circumstances otherwise suggest the patient's inability to | |
| 241 | - | pay. | |
| 242 | - | (i) Any hospital that submits an annual hospital community | |
| 243 | - | benefits plan report to the Attorney General shall include in | |
| 244 | - | that report the number of uninsured patients who have declined | |
| 245 | - | or failed to respond to screening under subsection (a) of | |
| 246 | - | Section 16 and the 5 most frequent reasons for declining. | |
| 247 | - | (210 ILCS 88/30) | |
| 248 | - | Sec. 30. Pursuing collection action. | |
| 249 | - | (a) Hospitals and their agents may pursue collection | |
| 250 | 132 | ||
| 251 | 133 | ||
| 252 | - | action against an uninsured patient only if the following | |
| 253 | - | conditions are met: | |
| 254 | - | (1) The hospital has complied with the screening | |
| 255 | - | requirements set forth in Section 16 and applied and | |
| 256 | - | exhausted any discount available to a patient under | |
| 257 | - | Section 10 of the Hospital Uninsured Patient Discount Act. | |
| 258 | - | (2) (1) The hospital has given the uninsured patient | |
| 259 | - | the opportunity to: | |
| 260 | - | (A) assess the accuracy of the bill; | |
| 261 | - | (B) apply for financial assistance under the | |
| 262 | - | hospital's financial assistance policy; and | |
| 263 | - | (C) avail themselves of a reasonable payment plan. | |
| 264 | - | (3) (2) If the uninsured patient has indicated an | |
| 265 | - | inability to pay the full amount of the debt in one | |
| 266 | - | payment, the hospital has offered the patient a reasonable | |
| 267 | - | payment plan. The hospital may require the uninsured | |
| 268 | - | patient to provide reasonable verification of his or her | |
| 269 | - | inability to pay the full amount of the debt in one | |
| 270 | - | payment. | |
| 271 | - | (4) (3) To the extent the hospital provides financial | |
| 272 | - | assistance and the circumstances of the uninsured patient | |
| 273 | - | suggest the potential for eligibility for charity care, | |
| 274 | - | the uninsured patient has been given at least 90 60 days | |
| 275 | - | following the date of discharge or receipt of outpatient | |
| 276 | - | care to submit an application for financial assistance and | |
| 277 | - | shall be provided assistance with the application in | |
| 134 | + | ||
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| 278 | 136 | ||
| 279 | 137 | ||
| 280 | - | compliance with subsection (a) of Section 16 and Section | |
| 281 | - | 27. | |
| 282 | - | (5) (4) If the uninsured patient has agreed to a | |
| 283 | - | reasonable payment plan with the hospital, and the patient | |
| 284 | - | has failed to make payments in accordance with that | |
| 285 | - | reasonable payment plan. | |
| 286 | - | (6) (5) If the uninsured patient informs the hospital | |
| 287 | - | that he or she has applied for health care coverage under a | |
| 288 | - | public health insurance program Medicaid, Kidcare, or | |
| 289 | - | other government-sponsored health care program (and there | |
| 290 | - | is a reasonable basis to believe that the patient will | |
| 291 | - | qualify for such program) but the patient's application is | |
| 292 | - | denied. | |
| 293 | - | (a-5) A hospital shall proactively offer information on | |
| 294 | - | charity care options available to uninsured patients, | |
| 295 | - | regardless of their immigration status or residency. | |
| 296 | - | (b) A hospital may not refer a bill, or portion thereof, to | |
| 297 | - | a collection agency or attorney for collection action against | |
| 298 | - | the insured patient, without first ensuring compliance with | |
| 299 | - | Section 16 and offering the patient the opportunity to request | |
| 300 | - | a reasonable payment plan for the amount personally owed by | |
| 301 | - | the patient. Such an opportunity shall be made available for | |
| 302 | - | the 90 30 days following the date of the initial bill. If the | |
| 303 | - | insured patient requests a reasonable payment plan, but fails | |
| 304 | - | to agree to a plan within 90 30 days of the request, the | |
| 305 | - | hospital may proceed with collection action against the | |
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| 139 | + | HB2719 Enrolled - 5 - LRB103 27682 AWJ 54059 b | |
| 140 | + | 1 care. | |
| 141 | + | 2 (8) Patients have an obligation to pay for the | |
| 142 | + | 3 hospital services they receive subject to any discounts or | |
| 143 | + | 4 free care for which they are eligible under Illinois law. | |
| 144 | + | 5 (9) Hospitals have an obligation to screen uninsured | |
| 145 | + | 6 patients before pursuing collection action. To promote the | |
| 146 | + | 7 general welfare and to mitigate the negative impact that | |
| 147 | + | 8 medical debt has on accessing and using needed health | |
| 148 | + | 9 care, hospitals should not attempt to collect a debt from | |
| 149 | + | 10 an uninsured patient without first adequately screening | |
| 150 | + | 11 the patient for public health insurance programs and | |
| 151 | + | 12 financial assistance available to the patient and | |
| 152 | + | 13 assisting the patient in obtaining the hospital financial | |
| 153 | + | 14 assistance for which they are eligible. | |
| 154 | + | 15 (Source: P.A. 94-885, eff. 1-1-07.) | |
| 155 | + | 16 (210 ILCS 88/10) | |
| 156 | + | 17 Sec. 10. Definitions. As used in this Act: | |
| 157 | + | 18 "Collection action" means any referral of a bill to a | |
| 158 | + | 19 collection agency or law firm to collect payment for services | |
| 159 | + | 20 from a patient or a patient's guarantor for hospital services. | |
| 160 | + | 21 "Health care plan" means a health insurance company, | |
| 161 | + | 22 health maintenance organization, preferred provider | |
| 162 | + | 23 arrangement, or third party administrator authorized in this | |
| 163 | + | 24 State to issue policies or subscriber contracts or administer | |
| 164 | + | 25 those policies and contracts that reimburse for inpatient and | |
| 306 | 165 | ||
| 307 | 166 | ||
| 308 | - | patient. | |
| 309 | - | (c) No collection agency, law firm, or individual may | |
| 310 | - | initiate legal action for non-payment of a hospital bill | |
| 311 | - | against a patient without the written approval of an | |
| 312 | - | authorized hospital employee who reasonably believes that the | |
| 313 | - | conditions for pursuing collection action under this Section | |
| 314 | - | have been met. | |
| 315 | - | (d) Nothing in this Section prohibits a hospital from | |
| 316 | - | engaging an outside third party agency, firm, or individual to | |
| 317 | - | manage the process of implementing the hospital's financial | |
| 318 | - | assistance and reasonable payment plan programs and policies | |
| 319 | - | so long as such agency, firm, or individual is contractually | |
| 320 | - | bound to comply with the terms of this Act. | |
| 321 | - | (Source: P.A. 102-504, eff. 12-1-21.) | |
| 322 | - | (210 ILCS 88/45) | |
| 323 | - | Sec. 45. Patient responsibilities. | |
| 324 | - | (a) To receive the protection and benefits of this Act, a | |
| 325 | - | patient responsible for paying a hospital bill must act | |
| 326 | - | reasonably and cooperate in good faith with the hospital in | |
| 327 | - | the screening process by providing the hospital with all of | |
| 328 | - | the reasonably requested financial and other relevant | |
| 329 | - | information and documentation needed to determine the | |
| 330 | - | patient's potential eligibility for coverage under a public | |
| 331 | - | health insurance program, under the hospital's financial | |
| 332 | - | assistance policy, or for a and reasonable payment plan | |
| 333 | 167 | ||
| 334 | 168 | ||
| 335 | - | options to qualified patients within 30 days of a request for | |
| 336 | - | such information. | |
| 337 | - | (b) To receive the protection and benefits of this Act, a | |
| 338 | - | patient responsible for paying a hospital bill shall | |
| 339 | - | communicate to the hospital any material change in the | |
| 340 | - | patient's financial situation that may affect the patient's | |
| 341 | - | ability to abide by the provisions of an agreed upon | |
| 342 | - | reasonable payment plan or qualification for financial | |
| 343 | - | assistance within 30 days of the change. | |
| 344 | - | (Source: P.A. 94-885, eff. 1-1-07.) | |
| 345 | - | (210 ILCS 88/70) | |
| 346 | - | Sec. 70. Application. | |
| 347 | - | (a) This Act applies to all hospitals licensed under the | |
| 348 | - | Hospital Licensing Act or the University of Illinois Hospital | |
| 349 | - | Act. This Act does not apply to a hospital that does not charge | |
| 350 | - | for its services. | |
| 351 | - | (b) The obligations of hospitals under this Act shall take | |
| 352 | - | effect for services provided on or after the first day of the | |
| 353 | - | month that begins 180 days after the effective date of this | |
| 354 | - | Act. | |
| 355 | - | (c) The obligations of hospitals under this amendatory Act | |
| 356 | - | of the 103rd General Assembly shall apply to services provided | |
| 357 | - | on or after the first day of the month that begins 180 days | |
| 358 | - | after the effective date of this amendatory Act of the 103rd | |
| 359 | - | General Assembly. | |
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| 362 | - | (Source: P.A. 94-885, eff. 1-1-07.) | |
| 363 | - | Section 15. The Hospital Uninsured Patient Discount Act is | |
| 364 | - | amended by changing Section 15 as follows: | |
| 365 | - | (210 ILCS 89/15) | |
| 366 | - | Sec. 15. Patient responsibility. | |
| 367 | - | (a) Hospitals may make the availability of a discount and | |
| 368 | - | the maximum collectible amount under this Act contingent upon | |
| 369 | - | the uninsured patient first applying for coverage under public | |
| 370 | - | health insurance programs, such as Medicare, Medicaid, | |
| 371 | - | AllKids, the State Children's Health Insurance Program, or any | |
| 372 | - | other program, if there is a reasonable basis to believe that | |
| 373 | - | the uninsured patient may be eligible for such program. If the | |
| 374 | - | patient declines to apply for a public health insurance | |
| 375 | - | program on the basis of concern for immigration-related | |
| 376 | - | consequences, the hospital may refer the patient to a free, | |
| 377 | - | unbiased resource such as an Immigrant Family Resource Program | |
| 378 | - | to address the patient's immigration-related concerns and | |
| 379 | - | assist in enrolling the patient in a public health insurance | |
| 380 | - | program. The hospital may still screen the patient for | |
| 381 | - | eligibility under its financial assistance policy. | |
| 382 | - | (b) Hospitals shall permit an uninsured patient to apply | |
| 383 | - | for a discount within 90 days of the date of discharge, or date | |
| 384 | - | of service, completion of the screening under the Fair Patient | |
| 385 | - | Billing Act, or denial of an application for a public health | |
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| 175 | + | 1 outpatient services provided in a hospital. Health care plan, | |
| 176 | + | 2 however, does not include any government-funded program such | |
| 177 | + | 3 as Medicare or Medicaid, workers' compensation, and accident | |
| 178 | + | 4 liability insurers. | |
| 179 | + | 5 "Insured patient" means a patient who is insured by a | |
| 180 | + | 6 health care plan. | |
| 181 | + | 7 "Medical debt" means a debt arising from the receipt of | |
| 182 | + | 8 health care services, products, or devices. | |
| 183 | + | 9 "Patient" means the individual receiving services from the | |
| 184 | + | 10 hospital and any individual who is the guarantor of the | |
| 185 | + | 11 payment for such services. | |
| 186 | + | 12 "Public health insurance program" means Medicare; | |
| 187 | + | 13 Medicaid; medical assistance under the Non-Citizen Victims of | |
| 188 | + | 14 Trafficking, Torture and Other Serious Crimes program; Health | |
| 189 | + | 15 Benefit for Immigrant Adults; Health Benefit for Immigrant | |
| 190 | + | 16 Seniors; All Kids; or other medical assistance programs | |
| 191 | + | 17 offered by the Department of Healthcare and Family Services. | |
| 192 | + | 18 "Reasonable payment plan" means a plan to pay a hospital | |
| 193 | + | 19 bill that is offered to the patient or the patient's legal | |
| 194 | + | 20 representative and takes into account the patient's available | |
| 195 | + | 21 income and assets, the amount owed, and any prior payments. | |
| 196 | + | 22 "Screen" or "screening" means a process whereby a hospital | |
| 197 | + | 23 engages with a patient to review and assess the patient's | |
| 198 | + | 24 potential eligibility for any financial assistance offered by | |
| 199 | + | 25 the hospital, public health insurance program, or other | |
| 200 | + | 26 discounted care known to the hospital; informs the patient of | |
| 386 | 201 | ||
| 387 | 202 | ||
| 388 | - | insurance program. | |
| 389 | - | Hospitals shall offer uninsured patients who receive | |
| 390 | - | community-based primary care provided by a community health | |
| 391 | - | center or a free and charitable clinic, are referred by such an | |
| 392 | - | entity to the hospital, and seek access to nonemergency | |
| 393 | - | hospital-based health care services with an opportunity to be | |
| 394 | - | screened for and assistance with applying for public health | |
| 395 | - | insurance programs if there is a reasonable basis to believe | |
| 396 | - | that the uninsured patient may be eligible for a public health | |
| 397 | - | insurance program. An uninsured patient who receives | |
| 398 | - | community-based primary care provided by a community health | |
| 399 | - | center or free and charitable clinic and is referred by such an | |
| 400 | - | entity to the hospital for whom there is not a reasonable basis | |
| 401 | - | to believe that the uninsured patient may be eligible for a | |
| 402 | - | public health insurance program shall be given the opportunity | |
| 403 | - | to apply for hospital financial assistance when hospital | |
| 404 | - | services are scheduled. | |
| 405 | - | (1) Income verification. Hospitals may require an | |
| 406 | - | uninsured patient who is requesting an uninsured discount | |
| 407 | - | to provide documentation of family income. Acceptable | |
| 408 | - | family income documentation shall include any one of the | |
| 409 | - | following: | |
| 410 | - | (A) a copy of the most recent tax return; | |
| 411 | - | (B) a copy of the most recent W-2 form and 1099 | |
| 412 | - | forms; | |
| 413 | - | (C) copies of the 2 most recent pay stubs; | |
| 414 | 203 | ||
| 415 | 204 | ||
| 416 | - | (D) written income verification from an employer | |
| 417 | - | if paid in cash; or | |
| 418 | - | (E) one other reasonable form of third party | |
| 419 | - | income verification deemed acceptable to the hospital. | |
| 420 | - | (2) Asset verification. Hospitals may require an | |
| 421 | - | uninsured patient who is requesting an uninsured discount | |
| 422 | - | to certify the existence or absence of assets owned by the | |
| 423 | - | patient and to provide documentation of the value of such | |
| 424 | - | assets, except for those assets referenced in paragraph | |
| 425 | - | (4) of subsection (c) of Section 10. Acceptable | |
| 426 | - | documentation may include statements from financial | |
| 427 | - | institutions or some other third party verification of an | |
| 428 | - | asset's value. If no third party verification exists, then | |
| 429 | - | the patient shall certify as to the estimated value of the | |
| 430 | - | asset. | |
| 431 | - | (3) Illinois resident verification. Hospitals may | |
| 432 | - | require an uninsured patient who is requesting an | |
| 433 | - | uninsured discount to verify Illinois residency. | |
| 434 | - | Acceptable verification of Illinois residency shall | |
| 435 | - | include any one of the following: | |
| 436 | - | (A) any of the documents listed in paragraph (1); | |
| 437 | - | (B) a valid state-issued identification card; | |
| 438 | - | (C) a recent residential utility bill; | |
| 439 | - | (D) a lease agreement; | |
| 440 | - | (E) a vehicle registration card; | |
| 441 | - | (F) a voter registration card; | |
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| 444 | - | (G) mail addressed to the uninsured patient at an | |
| 445 | - | Illinois address from a government or other credible | |
| 446 | - | source; | |
| 447 | - | (H) a statement from a family member of the | |
| 448 | - | uninsured patient who resides at the same address and | |
| 449 | - | presents verification of residency; | |
| 450 | - | (I) a letter from a homeless shelter, transitional | |
| 451 | - | house or other similar facility verifying that the | |
| 452 | - | uninsured patient resides at the facility; or | |
| 453 | - | (J) a temporary visitor's drivers license. | |
| 454 | - | (c) Hospital obligations toward an individual uninsured | |
| 455 | - | patient under this Act shall cease if that patient | |
| 456 | - | unreasonably fails or refuses to provide the hospital with | |
| 457 | - | information or documentation requested under subsection (b) or | |
| 458 | - | to apply for coverage under public programs when requested | |
| 459 | - | under subsection (a) within 30 days of the hospital's request. | |
| 460 | - | (d) In order for a hospital to determine the 12 month | |
| 461 | - | maximum amount that can be collected from a patient deemed | |
| 462 | - | eligible under Section 10, an uninsured patient shall inform | |
| 463 | - | the hospital in subsequent inpatient admissions or outpatient | |
| 464 | - | encounters that the patient has previously received health | |
| 465 | - | care services from that hospital and was determined to be | |
| 466 | - | entitled to the uninsured discount. | |
| 467 | - | (e) Hospitals may require patients to certify that all of | |
| 468 | - | the information provided in the application is true. The | |
| 469 | - | application may state that if any of the information is | |
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| 211 | + | 1 the hospital's assessment; documents in the patient's record | |
| 212 | + | 2 the circumstances of the screening; and assists with the | |
| 213 | + | 3 application for hospital financial assistance. | |
| 214 | + | 4 "Uninsured patient" means a patient who is not insured by | |
| 215 | + | 5 a health care plan and is not a beneficiary under a | |
| 216 | + | 6 government-funded program, workers' compensation, or accident | |
| 217 | + | 7 liability insurance. | |
| 218 | + | 8 (Source: P.A. 94-885, eff. 1-1-07.) | |
| 219 | + | 9 (210 ILCS 88/16 new) | |
| 220 | + | 10 Sec. 16. Screening patients for health insurance and | |
| 221 | + | 11 financial assistance. | |
| 222 | + | 12 (a) All hospitals shall screen each uninsured patient, | |
| 223 | + | 13 upon the uninsured patient's agreement, at the earliest | |
| 224 | + | 14 reasonable moment for potential eligibility for both: | |
| 225 | + | 15 (1) public health insurance programs; and | |
| 226 | + | 16 (2) any financial assistance offered by the hospital. | |
| 227 | + | 17 (b) All screening activities, including initial screenings | |
| 228 | + | 18 and all follow-up assistance, must be provided in compliance | |
| 229 | + | 19 with the Language Assistance Services Act. | |
| 230 | + | 20 (c) If a patient declines or fails to respond to the | |
| 231 | + | 21 screening described in subsection (a), the hospital shall | |
| 232 | + | 22 document in the patient's record the patient's decision to | |
| 233 | + | 23 decline or failure to respond to the screening, confirming the | |
| 234 | + | 24 date and method by which the patient declined or failed to | |
| 235 | + | 25 respond. | |
| 470 | 236 | ||
| 471 | 237 | ||
| 472 | - | untrue, any discount granted to the patient is forfeited and | |
| 473 | - | the patient is responsible for payment of the hospital's full | |
| 474 | - | charges. | |
| 475 | - | (f) Hospitals shall ask for an applicant's race, | |
| 476 | - | ethnicity, sex, and preferred language on the financial | |
| 477 | - | assistance application. However, the questions shall be | |
| 478 | - | clearly marked as optional responses for the patient and shall | |
| 479 | - | note that responses or nonresponses by the patient will not | |
| 480 | - | have any impact on the outcome of the application. | |
| 481 | - | (Source: P.A. 102-581, eff. 1-1-22.) | |
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| 246 | + | 1 (d) If a patient does not decline the screening described | |
| 247 | + | 2 in subsection (a), a hospital should screen an uninsured | |
| 248 | + | 3 patient during registration unless it would cause a delay of | |
| 249 | + | 4 care to the patient, otherwise a hospital must screen an | |
| 250 | + | 5 uninsured patient at the earliest reasonable moment. | |
| 251 | + | 6 (e) If a patient does not submit screening, financial | |
| 252 | + | 7 assistance application, or reasonable payment plan | |
| 253 | + | 8 documentation within 30 days after a request as required under | |
| 254 | + | 9 Section 45, the hospital shall document the lack of received | |
| 255 | + | 10 documentation, confirming the date that the screening took | |
| 256 | + | 11 place and that the 30-day timeline for responding to the | |
| 257 | + | 12 hospital's request has lapsed, but may be reopened within 90 | |
| 258 | + | 13 days after the date of discharge, date of service, or | |
| 259 | + | 14 completion of the screening. | |
| 260 | + | 15 (f) If the screening indicates that the patient may be | |
| 261 | + | 16 eligible for a public health insurance program, the hospital | |
| 262 | + | 17 shall provide information to the patient about how the patient | |
| 263 | + | 18 can apply for the public health insurance program, including, | |
| 264 | + | 19 but not limited to, referral to health care navigators who | |
| 265 | + | 20 provide free and unbiased eligibility and enrollment | |
| 266 | + | 21 assistance, including health care navigators at federally | |
| 267 | + | 22 qualified health centers; local, State, or federal government | |
| 268 | + | 23 agencies; or any other resources that Illinois recognizes as | |
| 269 | + | 24 designed to assist uninsured individuals in obtaining health | |
| 270 | + | 25 coverage. | |
| 271 | + | 26 (g) If the uninsured patient's application for a public | |
| 272 | + | ||
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| 282 | + | 1 health insurance program is approved, the hospital shall bill | |
| 283 | + | 2 the insuring entity and shall not pursue the patient for any | |
| 284 | + | 3 aspect of the bill, except for any required copayment, | |
| 285 | + | 4 coinsurance, or other similar payment for which the patient is | |
| 286 | + | 5 responsible under the insurance. If the uninsured patient's | |
| 287 | + | 6 application for public health insurance is denied, the | |
| 288 | + | 7 hospital shall again offer to screen the uninsured patient for | |
| 289 | + | 8 hospital financial assistance and the timeline for applying | |
| 290 | + | 9 for financial assistance under the Hospital Uninsured Patient | |
| 291 | + | 10 Discount Act shall begin again. | |
| 292 | + | 11 (h) A hospital shall offer to screen an insured patient | |
| 293 | + | 12 for hospital financial assistance under this Section if the | |
| 294 | + | 13 patient requests financial assistance screening, if the | |
| 295 | + | 14 hospital is contacted in response to a bill, if the hospital | |
| 296 | + | 15 learns information that suggests an inability to pay, or if | |
| 297 | + | 16 the circumstances otherwise suggest the patient's inability to | |
| 298 | + | 17 pay. | |
| 299 | + | 18 (i) Any hospital that submits an annual hospital community | |
| 300 | + | 19 benefits plan report to the Attorney General shall include in | |
| 301 | + | 20 that report the number of uninsured patients who have declined | |
| 302 | + | 21 or failed to respond to screening under subsection (a) of | |
| 303 | + | 22 Section 16 and the 5 most frequent reasons for declining. | |
| 304 | + | 23 (210 ILCS 88/30) | |
| 305 | + | 24 Sec. 30. Pursuing collection action. | |
| 306 | + | 25 (a) Hospitals and their agents may pursue collection | |
| 307 | + | ||
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| 317 | + | 1 action against an uninsured patient only if the following | |
| 318 | + | 2 conditions are met: | |
| 319 | + | 3 (1) The hospital has complied with the screening | |
| 320 | + | 4 requirements set forth in Section 16 and applied and | |
| 321 | + | 5 exhausted any discount available to a patient under | |
| 322 | + | 6 Section 10 of the Hospital Uninsured Patient Discount Act. | |
| 323 | + | 7 (2) (1) The hospital has given the uninsured patient | |
| 324 | + | 8 the opportunity to: | |
| 325 | + | 9 (A) assess the accuracy of the bill; | |
| 326 | + | 10 (B) apply for financial assistance under the | |
| 327 | + | 11 hospital's financial assistance policy; and | |
| 328 | + | 12 (C) avail themselves of a reasonable payment plan. | |
| 329 | + | 13 (3) (2) If the uninsured patient has indicated an | |
| 330 | + | 14 inability to pay the full amount of the debt in one | |
| 331 | + | 15 payment, the hospital has offered the patient a reasonable | |
| 332 | + | 16 payment plan. The hospital may require the uninsured | |
| 333 | + | 17 patient to provide reasonable verification of his or her | |
| 334 | + | 18 inability to pay the full amount of the debt in one | |
| 335 | + | 19 payment. | |
| 336 | + | 20 (4) (3) To the extent the hospital provides financial | |
| 337 | + | 21 assistance and the circumstances of the uninsured patient | |
| 338 | + | 22 suggest the potential for eligibility for charity care, | |
| 339 | + | 23 the uninsured patient has been given at least 90 60 days | |
| 340 | + | 24 following the date of discharge or receipt of outpatient | |
| 341 | + | 25 care to submit an application for financial assistance and | |
| 342 | + | 26 shall be provided assistance with the application in | |
| 343 | + | ||
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| 353 | + | 1 compliance with subsection (a) of Section 16 and Section | |
| 354 | + | 2 27. | |
| 355 | + | 3 (5) (4) If the uninsured patient has agreed to a | |
| 356 | + | 4 reasonable payment plan with the hospital, and the patient | |
| 357 | + | 5 has failed to make payments in accordance with that | |
| 358 | + | 6 reasonable payment plan. | |
| 359 | + | 7 (6) (5) If the uninsured patient informs the hospital | |
| 360 | + | 8 that he or she has applied for health care coverage under a | |
| 361 | + | 9 public health insurance program Medicaid, Kidcare, or | |
| 362 | + | 10 other government-sponsored health care program (and there | |
| 363 | + | 11 is a reasonable basis to believe that the patient will | |
| 364 | + | 12 qualify for such program) but the patient's application is | |
| 365 | + | 13 denied. | |
| 366 | + | 14 (a-5) A hospital shall proactively offer information on | |
| 367 | + | 15 charity care options available to uninsured patients, | |
| 368 | + | 16 regardless of their immigration status or residency. | |
| 369 | + | 17 (b) A hospital may not refer a bill, or portion thereof, to | |
| 370 | + | 18 a collection agency or attorney for collection action against | |
| 371 | + | 19 the insured patient, without first ensuring compliance with | |
| 372 | + | 20 Section 16 and offering the patient the opportunity to request | |
| 373 | + | 21 a reasonable payment plan for the amount personally owed by | |
| 374 | + | 22 the patient. Such an opportunity shall be made available for | |
| 375 | + | 23 the 90 30 days following the date of the initial bill. If the | |
| 376 | + | 24 insured patient requests a reasonable payment plan, but fails | |
| 377 | + | 25 to agree to a plan within 90 30 days of the request, the | |
| 378 | + | 26 hospital may proceed with collection action against the | |
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| 389 | + | 1 patient. | |
| 390 | + | 2 (c) No collection agency, law firm, or individual may | |
| 391 | + | 3 initiate legal action for non-payment of a hospital bill | |
| 392 | + | 4 against a patient without the written approval of an | |
| 393 | + | 5 authorized hospital employee who reasonably believes that the | |
| 394 | + | 6 conditions for pursuing collection action under this Section | |
| 395 | + | 7 have been met. | |
| 396 | + | 8 (d) Nothing in this Section prohibits a hospital from | |
| 397 | + | 9 engaging an outside third party agency, firm, or individual to | |
| 398 | + | 10 manage the process of implementing the hospital's financial | |
| 399 | + | 11 assistance and reasonable payment plan programs and policies | |
| 400 | + | 12 so long as such agency, firm, or individual is contractually | |
| 401 | + | 13 bound to comply with the terms of this Act. | |
| 402 | + | 14 (Source: P.A. 102-504, eff. 12-1-21.) | |
| 403 | + | 15 (210 ILCS 88/45) | |
| 404 | + | 16 Sec. 45. Patient responsibilities. | |
| 405 | + | 17 (a) To receive the protection and benefits of this Act, a | |
| 406 | + | 18 patient responsible for paying a hospital bill must act | |
| 407 | + | 19 reasonably and cooperate in good faith with the hospital in | |
| 408 | + | 20 the screening process by providing the hospital with all of | |
| 409 | + | 21 the reasonably requested financial and other relevant | |
| 410 | + | 22 information and documentation needed to determine the | |
| 411 | + | 23 patient's potential eligibility for coverage under a public | |
| 412 | + | 24 health insurance program, under the hospital's financial | |
| 413 | + | 25 assistance policy, or for a and reasonable payment plan | |
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| 424 | + | 1 options to qualified patients within 30 days of a request for | |
| 425 | + | 2 such information. | |
| 426 | + | 3 (b) To receive the protection and benefits of this Act, a | |
| 427 | + | 4 patient responsible for paying a hospital bill shall | |
| 428 | + | 5 communicate to the hospital any material change in the | |
| 429 | + | 6 patient's financial situation that may affect the patient's | |
| 430 | + | 7 ability to abide by the provisions of an agreed upon | |
| 431 | + | 8 reasonable payment plan or qualification for financial | |
| 432 | + | 9 assistance within 30 days of the change. | |
| 433 | + | 10 (Source: P.A. 94-885, eff. 1-1-07.) | |
| 434 | + | 11 (210 ILCS 88/70) | |
| 435 | + | 12 Sec. 70. Application. | |
| 436 | + | 13 (a) This Act applies to all hospitals licensed under the | |
| 437 | + | 14 Hospital Licensing Act or the University of Illinois Hospital | |
| 438 | + | 15 Act. This Act does not apply to a hospital that does not charge | |
| 439 | + | 16 for its services. | |
| 440 | + | 17 (b) The obligations of hospitals under this Act shall take | |
| 441 | + | 18 effect for services provided on or after the first day of the | |
| 442 | + | 19 month that begins 180 days after the effective date of this | |
| 443 | + | 20 Act. | |
| 444 | + | 21 (c) The obligations of hospitals under this amendatory Act | |
| 445 | + | 22 of the 103rd General Assembly shall apply to services provided | |
| 446 | + | 23 on or after the first day of the month that begins 180 days | |
| 447 | + | 24 after the effective date of this amendatory Act of the 103rd | |
| 448 | + | 25 General Assembly. | |
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| 459 | + | 1 (Source: P.A. 94-885, eff. 1-1-07.) | |
| 460 | + | 2 Section 15. The Hospital Uninsured Patient Discount Act is | |
| 461 | + | 3 amended by changing Section 15 as follows: | |
| 462 | + | 4 (210 ILCS 89/15) | |
| 463 | + | 5 Sec. 15. Patient responsibility. | |
| 464 | + | 6 (a) Hospitals may make the availability of a discount and | |
| 465 | + | 7 the maximum collectible amount under this Act contingent upon | |
| 466 | + | 8 the uninsured patient first applying for coverage under public | |
| 467 | + | 9 health insurance programs, such as Medicare, Medicaid, | |
| 468 | + | 10 AllKids, the State Children's Health Insurance Program, or any | |
| 469 | + | 11 other program, if there is a reasonable basis to believe that | |
| 470 | + | 12 the uninsured patient may be eligible for such program. If the | |
| 471 | + | 13 patient declines to apply for a public health insurance | |
| 472 | + | 14 program on the basis of concern for immigration-related | |
| 473 | + | 15 consequences, the hospital may refer the patient to a free, | |
| 474 | + | 16 unbiased resource such as an Immigrant Family Resource Program | |
| 475 | + | 17 to address the patient's immigration-related concerns and | |
| 476 | + | 18 assist in enrolling the patient in a public health insurance | |
| 477 | + | 19 program. The hospital may still screen the patient for | |
| 478 | + | 20 eligibility under its financial assistance policy. | |
| 479 | + | 21 (b) Hospitals shall permit an uninsured patient to apply | |
| 480 | + | 22 for a discount within 90 days of the date of discharge, or date | |
| 481 | + | 23 of service, completion of the screening under the Fair Patient | |
| 482 | + | 24 Billing Act, or denial of an application for a public health | |
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| 493 | + | 1 insurance program. | |
| 494 | + | 2 Hospitals shall offer uninsured patients who receive | |
| 495 | + | 3 community-based primary care provided by a community health | |
| 496 | + | 4 center or a free and charitable clinic, are referred by such an | |
| 497 | + | 5 entity to the hospital, and seek access to nonemergency | |
| 498 | + | 6 hospital-based health care services with an opportunity to be | |
| 499 | + | 7 screened for and assistance with applying for public health | |
| 500 | + | 8 insurance programs if there is a reasonable basis to believe | |
| 501 | + | 9 that the uninsured patient may be eligible for a public health | |
| 502 | + | 10 insurance program. An uninsured patient who receives | |
| 503 | + | 11 community-based primary care provided by a community health | |
| 504 | + | 12 center or free and charitable clinic and is referred by such an | |
| 505 | + | 13 entity to the hospital for whom there is not a reasonable basis | |
| 506 | + | 14 to believe that the uninsured patient may be eligible for a | |
| 507 | + | 15 public health insurance program shall be given the opportunity | |
| 508 | + | 16 to apply for hospital financial assistance when hospital | |
| 509 | + | 17 services are scheduled. | |
| 510 | + | 18 (1) Income verification. Hospitals may require an | |
| 511 | + | 19 uninsured patient who is requesting an uninsured discount | |
| 512 | + | 20 to provide documentation of family income. Acceptable | |
| 513 | + | 21 family income documentation shall include any one of the | |
| 514 | + | 22 following: | |
| 515 | + | 23 (A) a copy of the most recent tax return; | |
| 516 | + | 24 (B) a copy of the most recent W-2 form and 1099 | |
| 517 | + | 25 forms; | |
| 518 | + | 26 (C) copies of the 2 most recent pay stubs; | |
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| 529 | + | 1 (D) written income verification from an employer | |
| 530 | + | 2 if paid in cash; or | |
| 531 | + | 3 (E) one other reasonable form of third party | |
| 532 | + | 4 income verification deemed acceptable to the hospital. | |
| 533 | + | 5 (2) Asset verification. Hospitals may require an | |
| 534 | + | 6 uninsured patient who is requesting an uninsured discount | |
| 535 | + | 7 to certify the existence or absence of assets owned by the | |
| 536 | + | 8 patient and to provide documentation of the value of such | |
| 537 | + | 9 assets, except for those assets referenced in paragraph | |
| 538 | + | 10 (4) of subsection (c) of Section 10. Acceptable | |
| 539 | + | 11 documentation may include statements from financial | |
| 540 | + | 12 institutions or some other third party verification of an | |
| 541 | + | 13 asset's value. If no third party verification exists, then | |
| 542 | + | 14 the patient shall certify as to the estimated value of the | |
| 543 | + | 15 asset. | |
| 544 | + | 16 (3) Illinois resident verification. Hospitals may | |
| 545 | + | 17 require an uninsured patient who is requesting an | |
| 546 | + | 18 uninsured discount to verify Illinois residency. | |
| 547 | + | 19 Acceptable verification of Illinois residency shall | |
| 548 | + | 20 include any one of the following: | |
| 549 | + | 21 (A) any of the documents listed in paragraph (1); | |
| 550 | + | 22 (B) a valid state-issued identification card; | |
| 551 | + | 23 (C) a recent residential utility bill; | |
| 552 | + | 24 (D) a lease agreement; | |
| 553 | + | 25 (E) a vehicle registration card; | |
| 554 | + | 26 (F) a voter registration card; | |
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| 565 | + | 1 (G) mail addressed to the uninsured patient at an | |
| 566 | + | 2 Illinois address from a government or other credible | |
| 567 | + | 3 source; | |
| 568 | + | 4 (H) a statement from a family member of the | |
| 569 | + | 5 uninsured patient who resides at the same address and | |
| 570 | + | 6 presents verification of residency; | |
| 571 | + | 7 (I) a letter from a homeless shelter, transitional | |
| 572 | + | 8 house or other similar facility verifying that the | |
| 573 | + | 9 uninsured patient resides at the facility; or | |
| 574 | + | 10 (J) a temporary visitor's drivers license. | |
| 575 | + | 11 (c) Hospital obligations toward an individual uninsured | |
| 576 | + | 12 patient under this Act shall cease if that patient | |
| 577 | + | 13 unreasonably fails or refuses to provide the hospital with | |
| 578 | + | 14 information or documentation requested under subsection (b) or | |
| 579 | + | 15 to apply for coverage under public programs when requested | |
| 580 | + | 16 under subsection (a) within 30 days of the hospital's request. | |
| 581 | + | 17 (d) In order for a hospital to determine the 12 month | |
| 582 | + | 18 maximum amount that can be collected from a patient deemed | |
| 583 | + | 19 eligible under Section 10, an uninsured patient shall inform | |
| 584 | + | 20 the hospital in subsequent inpatient admissions or outpatient | |
| 585 | + | 21 encounters that the patient has previously received health | |
| 586 | + | 22 care services from that hospital and was determined to be | |
| 587 | + | 23 entitled to the uninsured discount. | |
| 588 | + | 24 (e) Hospitals may require patients to certify that all of | |
| 589 | + | 25 the information provided in the application is true. The | |
| 590 | + | 26 application may state that if any of the information is | |
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| 601 | + | 1 untrue, any discount granted to the patient is forfeited and | |
| 602 | + | 2 the patient is responsible for payment of the hospital's full | |
| 603 | + | 3 charges. | |
| 604 | + | 4 (f) Hospitals shall ask for an applicant's race, | |
| 605 | + | 5 ethnicity, sex, and preferred language on the financial | |
| 606 | + | 6 assistance application. However, the questions shall be | |
| 607 | + | 7 clearly marked as optional responses for the patient and shall | |
| 608 | + | 8 note that responses or nonresponses by the patient will not | |
| 609 | + | 9 have any impact on the outcome of the application. | |
| 610 | + | 10 (Source: P.A. 102-581, eff. 1-1-22.) | |
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