093_HB0081

 
                                     LRB093 03479 AMC 03507 b

 1        AN ACT concerning health care.

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

 4        Section 5.  The Department of Public  Health  Powers  and
 5    Duties  Law  of  the Civil Administrative Code of Illinois is
 6    amended by adding Section 2310-543 as follows:

 7        (20 ILCS 2310/2310-543 new)
 8        Sec.   2310-543.  Information   regarding   health   care
 9    services.  With funds made available for  this  purpose,  the
10    Department   may,  in  conjunction  with  other  programs  or
11    activities related to accessing  medical  care,  develop  and
12    provide  to  the  public and health care patients information
13    regarding the categories or types  of  health  care  services
14    available   and  their  appropriate  use,  paying  particular
15    attention to seeking care in hospital emergency departments.

16        Section 10.   The  Emergency  Medical  Treatment  Act  is
17    amended by changing Section 2 as follows:

18        (210 ILCS 70/2 new)
19        Sec. 2.  Findings; prohibited terms.
20        (a)  The  Illinois  General  Assembly  makes  all  of the
21    following findings:
22             (1)  Hospital emergency services are not always  the
23        most  appropriate  level  of  care  for  patients seeking
24        unscheduled medical care or for patients who do not  have
25        a  regular physician who can treat a significant or acute
26        medical condition not considered critical,  debilitating,
27        or life-threatening.
28             (2)  Hospital  emergency rooms are over-utilized and
29        too often over-burdened with many injuries  or  illnesses
 
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 1        that  could  be  managed  in  a  less  intensive clinical
 2        setting or physician's office.
 3             (3)  Over-utilization    of    hospital    emergency
 4        departments contributes  to  excess  medical  and  health
 5        insurance costs.
 6             (4)  The  use of the term "urgent" or "emergi-" or a
 7        similar term in a facility's posted  or  advertised  name
 8        may confuse the public and prospective patients regarding
 9        the  type  of services offered relative to those provided
10        by a hospital emergency department.  There is significant
11        risk to the public health and safety if persons requiring
12        treatment for a critical  or  life-threatening  condition
13        inappropriately use such facilities.
14             (5)  Many  times  patients  are not clearly aware of
15        the policies and procedures of their  insurer  or  health
16        plan  that must be followed in the use of emergency rooms
17        versus non-emergent clinics and  what  rights  they  have
18        under the law in regard to appropriately sought emergency
19        care.
20             (6)  There  is  a  need  to more effectively educate
21        health  care  payers  and  consumers   about   the   most
22        appropriate  use  of  the  various  available  levels  of
23        medical   care  and  particularly  the  use  of  hospital
24        emergency rooms and walk-in medical clinics that  do  not
25        require appointments.
26        (b)  After  the  effective date of this amendatory Act of
27    the 93rd General Assembly, no  person,  facility,  or  entity
28    shall  hold itself out to the public as an "urgent", "urgi-",
29    "emergi-", or "emergent" care center or use  any  other  term
30    that   would  give  the  impression  that  emergency  medical
31    treatment is provided by the  person  or  entity  or  at  the
32    facility  unless  the  facility  is  the  emergency room of a
33    facility licensed as a hospital under the Hospital  Licensing
34    Act or a facility licensed as a freestanding emergency center
 
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 1    under the Emergency Medical Services (EMS) Systems Act.
 2        (c)  Violation  of  this  Section  constitutes a business
 3    offense with a minimum fine of $5,000 plus $1,000 per day for
 4    a continuing violation, with a maximum of $25,000.
 5        (d)  The Director of Public Health in  the  name  of  the
 6    people  of the State, through the Attorney General, may bring
 7    an action for an injunction or to  restrain  a  violation  of
 8    this Section or the rules adopted pursuant to this Section or
 9    to enjoin the future operation or maintenance of any facility
10    in violation of this Section or the rules adopted pursuant to
11    this Section.
12        (e)  The  Department  of  Public Health shall adopt rules
13    necessary for the implementation of this Section.

14        Section 15.  The Managed Care Reform and  Patient  Rights
15    Act is amended by adding Section 43 as follows:

16        (215 ILCS 134/43 new)
17        Sec. 43.  Utilization of health care facilities.
18        (a)  A  health  care plan must provide its enrollees with
19    clear information about their rights and responsibilities  in
20    obtaining  referrals  to and making appropriate use of health
21    care facilities when access to their primary  care  physician
22    is not readily available.
23        (b)  Nothing  in  this  Section is intended to affect the
24    rights of enrollees or relieve a  health  care  plan  of  its
25    responsibilities   with  respect  to  the  provision  of  and
26    coverage of emergency services or treatment of  an  emergency
27    medical  condition,  as  those terms are defined by this Act,
28    and  as  those  responsibilities  and  rights  are  otherwise
29    provided under this Act, especially Section 65 of this Act.

30        Section 99.  Effective date.  This Act takes effect  upon
31    becoming law.