SB2182 104TH GENERAL ASSEMBLY

LRB104 11166 BAB 21248 b

104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
SB2182

Introduced 2/7/2025, by Sen. Steve Stadelman

SYNOPSIS AS INTRODUCED:

New Act
30 ILCS 105/5.1030 new

Creates the Facility Fee Transparency and Prevention Act. Prohibits a health care facility or health care provider from charging or collecting a facility fee for preventive services provided to a patient, regardless of whether the patient's insurance covers the preventive service. Provides that, for any health care service other than preventive services, a health care facility may not charge or collect a facility fee not covered by the patient's insurance unless the patient is provided with written notice, as specified, of the facility fee 7 days prior to the scheduled service, or as soon as possible for unscheduled or emergency services. Requires health care facilities or health care providers to notify patients in writing, as specified, of any new business relationship with, affiliation with, or acquisition by a hospital or health system. Provides that any health care facility or health care provider that violates the Act shall be subject to a civil penalty of up to $2,500 per violation, and all funds collected under the Act shall be deposited into the Facility Fee Reimbursement Fund. Provides that the Facility Fee Reimbursement Fund is created to reimburse patients who have provided sufficient evidence to the Department of Public Health that they were charged a facility fee not in accordance with the Act and to cover any administrative costs related to processing reimbursements. Grants the Department of Public Health authority to adopt rules to implement and enforce the Act. Amends the State Finance Act to make a conforming change. Effective January 1, 2026.

A BILL FOR

AN ACT concerning regulation.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 1. Short title. This Act may be cited as the Facility Fee Transparency and Prevention Act.

Section 5. Definitions. As used in this Act:

"Department" means the Department of Public Health.

"Facility fee" means any fee charged or billed by a health care facility, clinic, or hospital for operational expenses, separate from the fees charged by a health care provider for professional medical services.

"Health care facility" means any hospital, clinic, or other entity providing medical care or health care services within the State.

"Health care provider" means any individual licensed or certified to provide health care services in the State.

"Hospital" has the meaning given to that term in the Hospital Licensing Act.

"Preventive services" means (i) services defined as preventive care under the Affordable Care Act (42 U.S.C. 300gg-13); (ii) evidence-based items or services that have a rating of "A" or "B" in the current recommendations of the United States Preventive Services Task Force; and (iii) immunizations recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention.

Section 10. Prohibition on facility fees for preventive services. No health care facility or health care provider shall charge or collect a facility fee for preventive services provided to a patient. This prohibition applies regardless of whether the patient's insurance covers the preventive service.

Section 15. Restrictions on facility fees for other services.

(a) For any health care service other than preventive services, a health care facility may not charge or collect a facility fee not covered by the patient's insurance unless the patient is provided with written notice of the facility fee 7 days prior to the scheduled service, or as soon as possible for unscheduled or emergency services.

(b) The notice must include:

(1) the specific amount of the facility fee;

(2) an explanation of the purpose of the facility fee;

(3) a statement indicating whether the facility fee is covered by the patient's insurance; and

(4) contact information for the facility's billing department.

Section 20. Notification of new business relationships.

(a) Health care facilities or health care providers must notify patients in writing of any new business relationship with, affiliation with, or acquisition by a hospital or health system.

(b) The written notice must:

(1) be provided at least 30 days before the implementation of any facility fees resulting from the new business relationship;

(2) include a clear explanation of the services subject to facility fees, the expected amounts of those fees, and whether these fees will be covered by insurance; and

(3) provide contact information for questions or concerns regarding the new charges.

(c) The written notice must be delivered by mail, electronic communication, or other method reasonably expected to reach the patient.

Section 25. The Facility Fee Reimbursement Fund.

(a) The Facility Fee Reimbursement Fund is hereby created as a special fund in the State treasury to help reimburse patients who have been charged facility fees that are not consistent with this Act.

(b) Moneys in the Facility Fee Reimbursement Fund shall be used to:

(1) reimburse patients who have provided sufficient evidence to the Department that they were charged a facility fee not in accordance with this Act; and

(2) to cover any administrative costs related to processing reimbursements.

Section 30. Enforcement and penalties.

(a) The Department shall enforce this Act.

(b) Any health care facility or health care provider that violates this Act shall be subject to a civil penalty of up to $2,500 per violation. All penalties collected under this Act shall be deposited into the Facility Fee Reimbursement Fund.

Section 35. Rulemaking. The Department shall have the authority to adopt rules and procedures to implement and enforce this Act.

Section 90. The State Finance Act is amended by adding Section 5.1030 as follows:

(30 ILCS 105/5.1030 new)

Sec. 5.1030. The Facility Fee Reimbursement Fund.

Section 99. Effective date. This Act takes effect January 1, 2026.