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Rep. Kelly M. Cassidy
Filed: 5/24/2012
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| 1 | | AMENDMENT TO SENATE BILL 3261
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| 2 | | AMENDMENT NO. ______. Amend Senate Bill 3261, AS AMENDED, |
| 3 | | by replacing everything after the enacting clause with the |
| 4 | | following:
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| 5 | | "Section 5. The Fair Patient Billing Act is amended by |
| 6 | | adding Section 27 as follows: |
| 7 | | (210 ILCS 88/27 new) |
| 8 | | Sec. 27. Application Procedures for Financial Assistance. |
| 9 | | (a) Applications. The Attorney General shall, by rule, |
| 10 | | adopt standard provisions to be included in all applications |
| 11 | | for financial assistance no later than June 30, 2013. On or |
| 12 | | before January 1, 2013, a statewide association representing a |
| 13 | | majority of hospitals may submit to the Attorney General |
| 14 | | recommendations concerning standard provisions to be used in an |
| 15 | | application for financial assistance, and the Attorney General |
| 16 | | shall take those recommendations into account when adopting |
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| 1 | | rules under this subsection. |
| 2 | | (b) Presumptive Eligibility. The Attorney General shall, |
| 3 | | by rule, adopt appropriate methodologies for the determination |
| 4 | | of presumptive eligibility no later than June 30, 2013. On or |
| 5 | | before January 1, 2013, a statewide association representing a |
| 6 | | majority of hospitals may submit to the Attorney General |
| 7 | | recommendations concerning those methodologies, and the |
| 8 | | Attorney General shall take those recommendations into account |
| 9 | | when adopting rules under this subsection. |
| 10 | | Section 10. The Hospital Uninsured Patient Discount Act is |
| 11 | | amended by changing Section 10 as follows: |
| 12 | | (210 ILCS 89/10)
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| 13 | | Sec. 10. Uninsured patient discounts. |
| 14 | | (a) Eligibility. |
| 15 | | (1) A hospital, other than a rural hospital or Critical |
| 16 | | Access Hospital, shall provide a discount from its charges |
| 17 | | to any uninsured patient who applies for a discount and has |
| 18 | | family income of not more than 600% of the federal poverty |
| 19 | | income guidelines for all medically necessary health care |
| 20 | | services exceeding $300 in any one inpatient admission or |
| 21 | | outpatient encounter. |
| 22 | | (2) A hospital, other than a rural hospital or Critical |
| 23 | | Access Hospital, shall provide a charitable discount of |
| 24 | | 100% of its charges for all medically necessary health care |
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| 1 | | services exceeding $300 in any one inpatient admission or |
| 2 | | outpatient encounter to any uninsured patient who applies |
| 3 | | for a discount and has family income of not more than 200% |
| 4 | | of the federal poverty income guidelines. |
| 5 | | (3) (2) A rural hospital or Critical Access Hospital |
| 6 | | shall provide a discount from its charges to any uninsured |
| 7 | | patient who applies for a discount and has annual family |
| 8 | | income of not more than 300% of the federal poverty income |
| 9 | | guidelines for all medically necessary health care |
| 10 | | services exceeding $300 in any one inpatient admission or |
| 11 | | outpatient encounter. |
| 12 | | (4) A rural hospital or Critical Access Hospital shall |
| 13 | | provide a charitable discount of 100% of its charges for |
| 14 | | all medically necessary health care services exceeding |
| 15 | | $300 in any one inpatient admission or outpatient encounter |
| 16 | | to any uninsured patient who applies for a discount and has |
| 17 | | family income of not more than 125% of the federal poverty |
| 18 | | income guidelines. |
| 19 | | (b) Discount. For all health care services exceeding $300 |
| 20 | | in any one inpatient admission or outpatient encounter, a |
| 21 | | hospital shall not collect from an uninsured patient, deemed |
| 22 | | eligible under subsection (a), more than its charges less the |
| 23 | | amount of the uninsured discount. |
| 24 | | (c) Maximum Collectible Amount. |
| 25 | | (1) The maximum amount that may be collected in a 12 |
| 26 | | month period for health care services provided by the |
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| 1 | | hospital from a patient determined by that hospital to be |
| 2 | | eligible under subsection (a) is 25% of the patient's |
| 3 | | family income, and is subject to the patient's continued |
| 4 | | eligibility under this Act. |
| 5 | | (2) The 12 month period to which the maximum amount |
| 6 | | applies shall begin on the first date, after the effective |
| 7 | | date of this Act, an uninsured patient receives health care |
| 8 | | services that are determined to be eligible for the |
| 9 | | uninsured discount at that hospital. |
| 10 | | (3) To be eligible to have this maximum amount applied |
| 11 | | to subsequent charges, the uninsured patient shall inform |
| 12 | | the hospital in subsequent inpatient admissions or |
| 13 | | outpatient encounters that the patient has previously |
| 14 | | received health care services from that hospital and was |
| 15 | | determined to be entitled to the uninsured discount. |
| 16 | | (4) Hospitals may adopt policies to exclude an |
| 17 | | uninsured patient from the application of subdivision |
| 18 | | (c)(1) when the patient owns assets having a value in |
| 19 | | excess of 600% of the federal poverty level for hospitals |
| 20 | | in a metropolitan statistical area or owns assets having a |
| 21 | | value in excess of 300% of the federal poverty level for |
| 22 | | Critical Access Hospitals or hospitals outside a |
| 23 | | metropolitan statistical area, not counting the following |
| 24 | | assets: the uninsured patient's primary residence; |
| 25 | | personal property exempt from judgment under Section |
| 26 | | 12-1001 of the Code of Civil Procedure; or any amounts held |
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| 1 | | in a pension or retirement plan, provided, however, that |
| 2 | | distributions and payments from pension or retirement |
| 3 | | plans may be included as income for the purposes of this |
| 4 | | Act. |
| 5 | | (d) Each hospital bill, invoice, or other summary of |
| 6 | | charges to an uninsured patient shall include with it, or on |
| 7 | | it, a prominent statement that an uninsured patient who meets |
| 8 | | certain income requirements may qualify for an uninsured |
| 9 | | discount and information regarding how an uninsured patient may |
| 10 | | apply for consideration under the hospital's financial |
| 11 | | assistance policy.
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| 12 | | (Source: P.A. 95-965, eff. 12-22-08.)
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| 13 | | Section 99. Effective date. This Act takes effect upon |
| 14 | | becoming law.".
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