Public Act 93-0540
HB0081 Enrolled LRB093 03479 AMC 03507 b
AN ACT concerning health care.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Department of Public Health Powers and
Duties Law of the Civil Administrative Code of Illinois is
amended by adding Section 2310-543 as follows:
(20 ILCS 2310/2310-543 new)
Sec. 2310-543. Information regarding health care
services. With funds made available for this purpose, the
Department may, in conjunction with other programs or
activities related to accessing medical care, develop and
provide to the public and health care patients information
regarding the categories or types of health care services
available and their appropriate use, paying particular
attention to seeking care in hospital emergency departments.
Section 10. The Emergency Medical Treatment Act is
amended by changing Section 2 as follows:
(210 ILCS 70/2 new)
Sec. 2. Findings; prohibited terms.
(a) The Illinois General Assembly makes all of the
following findings:
(1) Hospital emergency services are not always the
most appropriate level of care for patients seeking
unscheduled medical care or for patients who do not have
a regular physician who can treat a significant or acute
medical condition not considered critical, debilitating,
or life-threatening.
(2) Hospital emergency rooms are over-utilized and
too often over-burdened with many injuries or illnesses
that could be managed in a less intensive clinical
setting or physician's office.
(3) Over-utilization of hospital emergency
departments contributes to excess medical and health
insurance costs.
(4) The use of the term "urgent" or "emergi-" or a
similar term in a facility's posted or advertised name
may confuse the public and prospective patients regarding
the type of services offered relative to those provided
by a hospital emergency department. There is significant
risk to the public health and safety if persons requiring
treatment for a critical or life-threatening condition
inappropriately use such facilities.
(5) Many times patients are not clearly aware of
the policies and procedures of their insurer or health
plan that must be followed in the use of emergency rooms
versus non-emergent clinics and what rights they have
under the law in regard to appropriately sought emergency
care.
(6) There is a need to more effectively educate
health care payers and consumers about the most
appropriate use of the various available levels of
medical care and particularly the use of hospital
emergency rooms and walk-in medical clinics that do not
require appointments.
(b) After the effective date of this amendatory Act of
the 93rd General Assembly, no person, facility, or entity
shall hold itself out to the public as an "urgent", "urgi-",
"emergi-", or "emergent" care center or use any similar term,
as defined by rule, that would give the impression that
emergency medical treatment is provided by the person or
entity or at the facility unless the facility is the
emergency room of a facility licensed as a hospital under the
Hospital Licensing Act or a facility licensed as a
freestanding emergency center under the Emergency Medical
Services (EMS) Systems Act.
(c) Violation of this Section constitutes a business
offense with a minimum fine of $5,000 plus $1,000 per day for
a continuing violation, with a maximum of $25,000.
(d) The Director of Public Health in the name of the
people of the State, through the Attorney General, may bring
an action for an injunction or to restrain a violation of
this Section or the rules adopted pursuant to this Section or
to enjoin the future operation or maintenance of any facility
in violation of this Section or the rules adopted pursuant to
this Section.
(e) The Department of Public Health shall adopt rules
necessary for the implementation of this Section.
Section 15. The Managed Care Reform and Patient Rights
Act is amended by adding Section 43 as follows:
(215 ILCS 134/43 new)
Sec. 43. Utilization of health care facilities.
(a) A health care plan must provide its enrollees with a
description of their rights and responsibilities in obtaining
referrals to and making appropriate use of health care
facilities when access to their primary care physician is not
readily available.
(b) Nothing in this Section is intended to affect the
rights of enrollees or relieve a health care plan of its
responsibilities with respect to the provision of and
coverage of emergency services or treatment of an emergency
medical condition, as those terms are defined by this Act,
and as those responsibilities and rights are otherwise
provided under this Act, especially Section 65 of this Act.
Section 99. Effective date. This Act takes effect upon
becoming law.