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1 | AN ACT concerning business.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 1. The Health Care Worker Self-Referral Act is | ||||||
5 | amended by adding Section 55 as follows: | ||||||
6 | (225 ILCS 47/55 new) | ||||||
7 | Sec. 55. Application of the Consumer Fraud and Deceptive | ||||||
8 | Business
Practices
Act. A violation of any of the provisions of | ||||||
9 | this Act constitutes an unlawful practice under the Consumer | ||||||
10 | Fraud and Deceptive Business Practices Act. All remedies, | ||||||
11 | penalties, and authority granted to the Attorney General or | ||||||
12 | State's Attorney by the Consumer Fraud and Deceptive Business | ||||||
13 | Practices Act shall be available to him or her for the | ||||||
14 | enforcement of this Act. This Section does not apply to | ||||||
15 | hospitals and hospital affiliates licensed in Illinois. | ||||||
16 | Section 5. The Medical Practice Act of 1987 is amended by | ||||||
17 | changing Section 22.2 as follows: | ||||||
18 | (225 ILCS 60/22.2)
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19 | (Section scheduled to be repealed on December 31, 2019) | ||||||
20 | Sec. 22.2. Prohibition against fee splitting. | ||||||
21 | (a) A licensee under this Act may not directly or |
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1 | indirectly divide, share or split any professional fee or other | ||||||
2 | form of compensation for professional services with anyone in | ||||||
3 | exchange for a referral or otherwise, other than as provided in | ||||||
4 | this Section 22.2. | ||||||
5 | (b) Nothing contained in this Section abrogates the right | ||||||
6 | of 2 or more licensed health care workers as defined in the | ||||||
7 | Health Care Worker Self-referral Act to each receive adequate | ||||||
8 | compensation for concurrently rendering services to a patient | ||||||
9 | and to divide the fee for such service, provided that the | ||||||
10 | patient has full knowledge of the division and the division is | ||||||
11 | made in proportion to the actual services personally performed | ||||||
12 | and responsibility assumed by each licensee consistent with his | ||||||
13 | or her license, except as prohibited by law. | ||||||
14 | (c) Nothing contained in this Section prohibits a licensee | ||||||
15 | under this Act from practicing medicine through or within any | ||||||
16 | form of legal entity authorized to conduct business in this | ||||||
17 | State or from pooling, sharing, dividing, or apportioning the | ||||||
18 | professional fees and other revenues in accordance with the | ||||||
19 | agreements and policies of the entity provided: | ||||||
20 | (1) each owner of the entity is licensed under this | ||||||
21 | Act; | ||||||
22 | (2) the entity is organized under the Medical | ||||||
23 | Corporation Act, the Professional Services Corporation | ||||||
24 | Act, the Professional Association Act, or the Limited | ||||||
25 | Liability Company Act; | ||||||
26 | (3) the entity is allowed by Illinois law to provide |
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1 | physician services or employ physicians such as a licensed | ||||||
2 | hospital or hospital affiliate or licensed ambulatory | ||||||
3 | surgical treatment center owned in full or in part by | ||||||
4 | Illinois-licensed physicians; | ||||||
5 | (4) the entity is a combination or joint venture of the | ||||||
6 | entities authorized under this subsection (c); or | ||||||
7 | (5) the entity is an Illinois not for profit | ||||||
8 | corporation that is recognized as exempt from the payment | ||||||
9 | of federal income taxes as an organization described in | ||||||
10 | Section 501(c)(3) of the Internal Revenue Code and all of | ||||||
11 | its members are full-time faculty members of a medical | ||||||
12 | school that offers a M.D. degree program that is accredited | ||||||
13 | by the Liaison Committee on Medical Education and a program | ||||||
14 | of graduate medical education that is accredited by the | ||||||
15 | Accreditation Council for Graduate Medical Education. | ||||||
16 | (d) Nothing contained in this Section prohibits a licensee | ||||||
17 | under this Act from paying a fair market value fee to any | ||||||
18 | person or entity whose purpose is to perform billing, | ||||||
19 | administrative preparation, or collection services based upon | ||||||
20 | a percentage of professional service fees billed or collected, | ||||||
21 | a flat fee, or any other arrangement that directly or | ||||||
22 | indirectly divides professional fees, for the administrative | ||||||
23 | preparation of the licensee's claims or the collection of the | ||||||
24 | licensee's charges for professional services, provided that: | ||||||
25 | (i) the licensee or the licensee's practice under | ||||||
26 | subsection (c) of this Section at all times controls the |
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1 | amount of fees charged and collected; and | ||||||
2 | (ii) all charges collected are paid directly to the | ||||||
3 | licensee or the licensee's practice or are deposited | ||||||
4 | directly into an account in the name of and under the sole | ||||||
5 | control of the licensee or the licensee's practice or | ||||||
6 | deposited into a "Trust Account" by a licensed collection | ||||||
7 | agency in accordance with the requirements of Section 8(c) | ||||||
8 | of the Illinois Collection Agency Act. | ||||||
9 | (e) Nothing contained in this Section prohibits the | ||||||
10 | granting of a security interest in the accounts receivable or | ||||||
11 | fees of a licensee under this Act or the licensee's practice | ||||||
12 | for bona fide advances made to the licensee or licensee's | ||||||
13 | practice provided the licensee retains control and | ||||||
14 | responsibility for the collection of the accounts receivable | ||||||
15 | and fees. | ||||||
16 | (f) Excluding payments that may be made to the owners of or | ||||||
17 | licensees in the licensee's practice under subsection (c), a | ||||||
18 | licensee under this Act may not divide, share or split a | ||||||
19 | professional service fee with, or otherwise directly or | ||||||
20 | indirectly pay a percentage of the licensee's professional | ||||||
21 | service fees, revenues or profits to anyone for: (i) the | ||||||
22 | marketing or management of the licensee's practice, (ii) | ||||||
23 | including the licensee or the licensee's practice on any | ||||||
24 | preferred provider list, (iii) allowing the licensee to | ||||||
25 | participate in any network of health care providers, (iv) | ||||||
26 | negotiating fees, charges or terms of service or payment on |
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1 | behalf of the licensee, or (v) including the licensee in a | ||||||
2 | program whereby patients or beneficiaries are provided an | ||||||
3 | incentive to use the services of the licensee.
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4 | (g) A violation of any of the provisions of this Section | ||||||
5 | constitutes an unlawful practice under the Consumer Fraud and | ||||||
6 | Deceptive Business Practices Act. All remedies, penalties, and | ||||||
7 | authority granted to the Attorney General by the Consumer Fraud | ||||||
8 | and Deceptive Business Practices Act shall be available to him | ||||||
9 | or her for the enforcement of this Section. This subsection | ||||||
10 | does not apply to hospitals and hospital affiliates licensed in | ||||||
11 | Illinois. | ||||||
12 | (Source: P.A. 96-608, eff. 8-24-09; 96-1126, eff. 7-20-10 .) | ||||||
13 | Section 10. The Consumer Fraud and Deceptive Business | ||||||
14 | Practices Act is amended by adding Section 2VVV as follows: | ||||||
15 | (815 ILCS 505/2VVV new) | ||||||
16 | Sec. 2VVV. Deceptive marketing, advertising, and sale of | ||||||
17 | mental health disorder and substance use disorder treatment. | ||||||
18 | (a) As used in this Section: | ||||||
19 | "Facility" has the meaning ascribed to that term in Section | ||||||
20 | 1-10 of the Alcoholism and Other Drug Abuse and Dependency Act. | ||||||
21 | "Hospital affiliate" has the meaning ascribed to that term | ||||||
22 | in Section 10.8 of the Hospital Licensing Act. | ||||||
23 | "Mental health disorder" has the same meaning as "mental | ||||||
24 | illness" under Section 1-129 of the Mental Health and |
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1 | Developmental Disabilities Code. | ||||||
2 | "Program" has the meaning ascribed to that term in Section | ||||||
3 | 1-10 of the Alcoholism and Other Drug Abuse and Dependency Act. | ||||||
4 | "Substance use disorder" has the same meaning as "substance | ||||||
5 | abuse" under Section 1-10 of the Alcoholism and Other Drug | ||||||
6 | Abuse and Dependency Act. | ||||||
7 | "Treatment" has the meaning ascribed to that term in | ||||||
8 | Section 1-10 of the Alcoholism and Other Drug Abuse and | ||||||
9 | Dependency Act. | ||||||
10 | (b) It is an unlawful practice for any person to engage in | ||||||
11 | misleading or false advertising or promotion that | ||||||
12 | misrepresents the need to seek mental health disorder or | ||||||
13 | substance use disorder treatment outside of the State of | ||||||
14 | Illinois. | ||||||
15 | (c) Any marketing, advertising, promotional, or sales | ||||||
16 | materials directed to Illinois residents concerning mental | ||||||
17 | health disorder or substance use disorder treatment must: | ||||||
18 | (1) prominently display or announce the full physical | ||||||
19 | address of the treatment program or facility; | ||||||
20 | (2) display whether the treatment program or facility | ||||||
21 | is licensed in the State of Illinois; | ||||||
22 | (3) display whether the treatment program or facility | ||||||
23 | has locations in Illinois; | ||||||
24 | (4) display whether the services provided by the | ||||||
25 | treatment program or facility are covered by an insurance | ||||||
26 | policy issued to an Illinois resident; |
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1 | (5) display whether the treatment program or facility | ||||||
2 | is an in-network or out-of-network provider; | ||||||
3 | (6) include a link to the Internet website for the | ||||||
4 | Department of Human Services' Division of Mental Health and | ||||||
5 | Division of Alcoholism and Substance Abuse, or any | ||||||
6 | successor State agency that provides information regarding | ||||||
7 | licensed providers of services; and | ||||||
8 | (7) disclose that mental health disorder and substance | ||||||
9 | use disorder treatment may be available at a reduced cost | ||||||
10 | or for free for Illinois residents within the State of | ||||||
11 | Illinois. | ||||||
12 | (d) It is an unlawful practice for any person to enter into | ||||||
13 | an arrangement under which a patient seeking mental health | ||||||
14 | disorder or substance use disorder treatment is referred to a | ||||||
15 | mental health disorder or substance use disorder treatment | ||||||
16 | program or facility in exchange for a fee, a percentage of the | ||||||
17 | treatment program's or facility's revenues that are related to | ||||||
18 | the patient, or any other remuneration that takes into account | ||||||
19 | the volume or value of the referrals to the treatment program | ||||||
20 | or facility. Such practice shall also be considered a violation | ||||||
21 | of the prohibition against fee splitting in Section 22.2 of the | ||||||
22 | Medical Practice Act of 1987 and a violation of the Health Care | ||||||
23 | Worker Self-Referral Act. This Section does not apply to health | ||||||
24 | insurance companies, health maintenance organizations, managed | ||||||
25 | care plans, or organizations, including hospitals and hospital | ||||||
26 | affiliates licensed in Illinois.
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