SB2182 - 104th General Assembly
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| 1 | AN ACT concerning regulation. | |||||||||||||||||||||
| 2 | Be it enacted by the People of the State of Illinois, | |||||||||||||||||||||
| 3 | represented in the General Assembly: | |||||||||||||||||||||
| 4 | Section 1. Short title. This Act may be cited as the | |||||||||||||||||||||
| 5 | Facility Fee Transparency and Prevention Act. | |||||||||||||||||||||
| 6 | Section 5. Definitions. As used in this Act: | |||||||||||||||||||||
| 7 | "Department" means the Department of Public Health. | |||||||||||||||||||||
| 8 | "Facility fee" means any fee charged or billed by a health | |||||||||||||||||||||
| 9 | care facility, clinic, or hospital for operational expenses, | |||||||||||||||||||||
| 10 | separate from the fees charged by a health care provider for | |||||||||||||||||||||
| 11 | professional medical services. | |||||||||||||||||||||
| 12 | "Health care facility" means any hospital, clinic, or | |||||||||||||||||||||
| 13 | other entity providing medical care or health care services | |||||||||||||||||||||
| 14 | within the State. | |||||||||||||||||||||
| 15 | "Health care provider" means any individual licensed or | |||||||||||||||||||||
| 16 | certified to provide health care services in the State. | |||||||||||||||||||||
| 17 | "Hospital" has the meaning given to that term in the | |||||||||||||||||||||
| 18 | Hospital Licensing Act. | |||||||||||||||||||||
| 19 | "Preventive services" means (i) services defined as | |||||||||||||||||||||
| 20 | preventive care under the Affordable Care Act (42 U.S.C. | |||||||||||||||||||||
| 21 | 300gg-13); (ii) evidence-based items or services that have a | |||||||||||||||||||||
| 22 | rating of "A" or "B" in the current recommendations of the | |||||||||||||||||||||
| 23 | United States Preventive Services Task Force; and (iii) | |||||||||||||||||||||
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| 1 | immunizations recommended by the Advisory Committee on | ||||||
| 2 | Immunization Practices of the Centers for Disease Control and | ||||||
| 3 | Prevention. | ||||||
| 4 | Section 10. Prohibition on facility fees for preventive | ||||||
| 5 | services. No health care facility or health care provider | ||||||
| 6 | shall charge or collect a facility fee for preventive services | ||||||
| 7 | provided to a patient. This prohibition applies regardless of | ||||||
| 8 | whether the patient's insurance covers the preventive service. | ||||||
| 9 | Section 15. Restrictions on facility fees for other | ||||||
| 10 | services. | ||||||
| 11 | (a) For any health care service other than preventive | ||||||
| 12 | services, a health care facility may not charge or collect a | ||||||
| 13 | facility fee not covered by the patient's insurance unless the | ||||||
| 14 | patient is provided with written notice of the facility fee 7 | ||||||
| 15 | days prior to the scheduled service, or as soon as possible for | ||||||
| 16 | unscheduled or emergency services. | ||||||
| 17 | (b) The notice must include: | ||||||
| 18 | (1) the specific amount of the facility fee; | ||||||
| 19 | (2) an explanation of the purpose of the facility fee; | ||||||
| 20 | (3) a statement indicating whether the facility fee is | ||||||
| 21 | covered by the patient's insurance; and | ||||||
| 22 | (4) contact information for the facility's billing | ||||||
| 23 | department. | ||||||
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| 1 | Section 20. Notification of new business relationships. | ||||||
| 2 | (a) Health care facilities or health care providers must | ||||||
| 3 | notify patients in writing of any new business relationship | ||||||
| 4 | with, affiliation with, or acquisition by a hospital or health | ||||||
| 5 | system. | ||||||
| 6 | (b) The written notice must: | ||||||
| 7 | (1) be provided at least 30 days before the | ||||||
| 8 | implementation of any facility fees resulting from the new | ||||||
| 9 | business relationship; | ||||||
| 10 | (2) include a clear explanation of the services | ||||||
| 11 | subject to facility fees, the expected amounts of those | ||||||
| 12 | fees, and whether these fees will be covered by insurance; | ||||||
| 13 | and | ||||||
| 14 | (3) provide contact information for questions or | ||||||
| 15 | concerns regarding the new charges. | ||||||
| 16 | (c) The written notice must be delivered by mail, | ||||||
| 17 | electronic communication, or other method reasonably expected | ||||||
| 18 | to reach the patient. | ||||||
| 19 | Section 25. The Facility Fee Reimbursement Fund. | ||||||
| 20 | (a) The Facility Fee Reimbursement Fund is hereby created | ||||||
| 21 | as a special fund in the State treasury to help reimburse | ||||||
| 22 | patients who have been charged facility fees that are not | ||||||
| 23 | consistent with this Act. | ||||||
| 24 | (b) Moneys in the Facility Fee Reimbursement Fund shall be | ||||||
| 25 | used to: | ||||||
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| 1 | (1) reimburse patients who have provided sufficient | ||||||
| 2 | evidence to the Department that they were charged a | ||||||
| 3 | facility fee not in accordance with this Act; and | ||||||
| 4 | (2) to cover any administrative costs related to | ||||||
| 5 | processing reimbursements. | ||||||
| 6 | Section 30. Enforcement and penalties. | ||||||
| 7 | (a) The Department shall enforce this Act. | ||||||
| 8 | (b) Any health care facility or health care provider that | ||||||
| 9 | violates this Act shall be subject to a civil penalty of up to | ||||||
| 10 | $2,500 per violation. All penalties collected under this Act | ||||||
| 11 | shall be deposited into the Facility Fee Reimbursement Fund. | ||||||
| 12 | Section 35. Rulemaking. The Department shall have the | ||||||
| 13 | authority to adopt rules and procedures to implement and | ||||||
| 14 | enforce this Act. | ||||||
| 15 | Section 90. The State Finance Act is amended by adding | ||||||
| 16 | Section 5.1030 as follows: | ||||||
| 17 | (30 ILCS 105/5.1030 new) | ||||||
| 18 | Sec. 5.1030. The Facility Fee Reimbursement Fund. | ||||||
| 19 | Section 99. Effective date. This Act takes effect January | ||||||
| 20 | 1, 2026. | ||||||
