99TH GENERAL ASSEMBLY
State of Illinois
2015 and 2016
HB3848

 

Introduced , by Rep. Michelle Mussman

 

SYNOPSIS AS INTRODUCED:
 
30 ILCS 105/5.866 new
410 ILCS 70/1a  from Ch. 111 1/2, par. 87-1a
410 ILCS 70/5  from Ch. 111 1/2, par. 87-5
410 ILCS 70/7  from Ch. 111 1/2, par. 87-7
410 ILCS 70/7.5 new
410 ILCS 70/8  from Ch. 111 1/2, par. 87-8

    Amends the Sexual Assault Survivors Emergency Treatment Act. Creates the Illinois Sexual Assault Emergency Treatment Program Fund. Prohibits a hospital, health care professional, ambulance provider, laboratory, or pharmacy furnishing hospital emergency services, forensic services, transportation, or medication to a sexual assault survivor from directly billing the survivor. Requires every hospital and health care professional to establish a billing protocol to ensure that no sexual assault survivor is billed for treatment. Contains penalty provisions. Makes other changes. Amends the State Finance Act. Creates the Illinois Sexual Assault Emergency Treatment Program Fund as a special fund in the State treasury.


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

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1    AN ACT concerning public health.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The State Finance Act is amended by adding
5Section 5.866 as follows:
 
6    (30 ILCS 105/5.866 new)
7    Sec. 5.866. The Illinois Sexual Assault Emergency
8Treatment Program Fund.
 
9    Section 10. The Sexual Assault Survivors Emergency
10Treatment Act is amended by changing Sections 1a, 5, 7, and 8
11and by adding Section 7.5 as follows:
 
12    (410 ILCS 70/1a)  (from Ch. 111 1/2, par. 87-1a)
13    Sec. 1a. Definitions. In this Act:
14    "Ambulance provider" means an individual or entity that
15owns and operates a business or service using ambulances or
16emergency medical services vehicles to transport emergency
17patients.
18    "Areawide sexual assault treatment plan" means a plan,
19developed by the hospitals in the community or area to be
20served, which provides for hospital emergency services to
21sexual assault survivors that shall be made available by each

 

 

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1of the participating hospitals.
2    "Department" means the Department of Public Health.
3    "Emergency contraception" means medication as approved by
4the federal Food and Drug Administration (FDA) that can
5significantly reduce the risk of pregnancy if taken within 72
6hours after sexual assault.
7    "Follow-up healthcare" means healthcare services related
8to a sexual assault, including laboratory services and pharmacy
9services, rendered within 90 days of the initial visit for
10hospital emergency services.
11    "Forensic services" means the collection of evidence
12pursuant to a statewide sexual assault evidence collection
13program administered by the Department of State Police, using
14the Illinois State Police Sexual Assault Evidence Collection
15Kit.
16    "Health care professional" means a physician, a physician
17assistant, or an advanced practice nurse.
18    "Hospital" has the meaning given to that term in the
19Hospital Licensing Act.
20    "Hospital emergency services" means healthcare delivered
21to outpatients within or under the care and supervision of
22personnel working in a designated emergency department of a
23hospital, including, but not limited to, care ordered by such
24personnel for a sexual assault survivor in the emergency
25department.
26    "Illinois State Police Sexual Assault Evidence Collection

 

 

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1Kit" means a prepackaged set of materials and forms to be used
2for the collection of evidence relating to sexual assault. The
3standardized evidence collection kit for the State of Illinois
4shall be the Illinois State Police Sexual Assault Evidence
5Collection Kit.
6    "Nurse" means a nurse licensed under the Nurse Practice
7Act.
8    "Physician" means a person licensed to practice medicine in
9all its branches.
10    "Sexual assault" means an act of nonconsensual sexual
11conduct or sexual penetration, as defined in Section 11-0.1 of
12the Criminal Code of 2012, including, without limitation, acts
13prohibited under Sections 11-1.20 through 11-1.60 of the
14Criminal Code of 2012.
15    "Sexual assault survivor" means a person who presents for
16hospital emergency services in relation to injuries or trauma
17resulting from a sexual assault.
18    "Sexual assault transfer plan" means a written plan
19developed by a hospital and approved by the Department, which
20describes the hospital's procedures for transferring sexual
21assault survivors to another hospital in order to receive
22emergency treatment.
23    "Sexual assault treatment plan" means a written plan
24developed by a hospital that describes the hospital's
25procedures and protocols for providing hospital emergency
26services and forensic services to sexual assault survivors who

 

 

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1present themselves for such services, either directly or
2through transfer from another hospital.
3    "Transfer services" means the appropriate medical
4screening examination and necessary stabilizing treatment
5prior to the transfer of a sexual assault survivor to a
6hospital that provides hospital emergency services and
7forensic services to sexual assault survivors pursuant to a
8sexual assault treatment plan or areawide sexual assault
9treatment plan.
10    "Voucher" means a document generated by a hospital at the
11time the sexual assault survivor receives hospital emergency
12and forensic services that a sexual assault survivor may
13present to providers for follow-up healthcare.
14(Source: P.A. 96-328, eff. 8-11-09; 96-1551, eff. 7-1-11;
1597-1150, eff. 1-25-13.)
 
16    (410 ILCS 70/5)  (from Ch. 111 1/2, par. 87-5)
17    Sec. 5. Minimum requirements for hospitals providing
18hospital emergency services and forensic services to sexual
19assault survivors.
20    (a) Every hospital providing hospital emergency services
21and forensic services to sexual assault survivors under this
22Act shall, as minimum requirements for such services, provide,
23with the consent of the sexual assault survivor, and as ordered
24by the attending physician, an advanced practice nurse who has
25a written collaborative agreement with a collaborating

 

 

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1physician that authorizes provision of emergency services, or a
2physician assistant who has been delegated authority to provide
3hospital emergency services and forensic services, the
4following:
5        (1) appropriate medical examinations and laboratory
6    tests required to ensure the health, safety, and welfare of
7    a sexual assault survivor or which may be used as evidence
8    in a criminal proceeding against a person accused of the
9    sexual assault, or both; and records of the results of such
10    examinations and tests shall be maintained by the hospital
11    and made available to law enforcement officials upon the
12    request of the sexual assault survivor;
13        (2) appropriate oral and written information
14    concerning the possibility of infection, sexually
15    transmitted disease and pregnancy resulting from sexual
16    assault;
17        (3) appropriate oral and written information
18    concerning accepted medical procedures, medication, and
19    possible contraindications of such medication available
20    for the prevention or treatment of infection or disease
21    resulting from sexual assault;
22        (4) an amount of medication for treatment at the
23    hospital and after discharge as is deemed appropriate by
24    the attending physician, an advanced practice nurse, or a
25    physician assistant and consistent with the hospital's
26    current approved protocol for sexual assault survivors;

 

 

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1        (5) an evaluation of the sexual assault survivor's risk
2    of contracting human immunodeficiency virus (HIV) from the
3    sexual assault;
4        (6) written and oral instructions indicating the need
5    for follow-up examinations and laboratory tests after the
6    sexual assault to determine the presence or absence of
7    sexually transmitted disease;
8        (7) referral by hospital personnel for appropriate
9    counseling; and
10        (8) when HIV prophylaxis is deemed appropriate, an
11    initial dose or doses of HIV prophylaxis, along with
12    written and oral instructions indicating the importance of
13    timely follow-up healthcare.
14    (b) Any person who is a sexual assault survivor who seeks
15emergency hospital services and forensic services or follow-up
16healthcare under this Act shall be provided such services
17without the consent of any parent, guardian, custodian,
18surrogate, or agent.
19    (b-5) Every hospital providing hospital emergency services
20and forensic services to sexual assault survivors under this
21Act must be registered with the Medical Electronic Data
22Interchange System, administered by the Department of
23Healthcare and Family Services, and shall issue a voucher to
24any sexual assault survivor who is eligible to receive one. The
25hospital shall make a copy of the voucher and place it in the
26medical record of the sexual assault survivor. The hospital

 

 

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1shall provide a copy of the voucher to the sexual assault
2survivor upon request.
3    Within 30 days after the effective date of this amendatory
4Act of the 99th General Assembly, every hospital providing
5services to sexual assault survivors in accordance with a plan
6approved under Section 2 of this Act shall provide proof of
7registration with the Medical Electronic Data Interchange
8System to the Department.
9    (c) Nothing in this Section creates a physician-patient
10relationship that extends beyond discharge from the hospital
11emergency department.
12(Source: P.A. 95-432, eff. 1-1-08; 96-318, eff. 1-1-10.)
 
13    (410 ILCS 70/7)  (from Ch. 111 1/2, par. 87-7)
14    Sec. 7. Reimbursement.
15    (a) A hospital or health care professional furnishing
16hospital emergency services or forensic services, an ambulance
17provider furnishing transportation to a sexual assault
18survivor, a hospital or health care professional or laboratory
19providing follow-up healthcare, or pharmacy dispensing
20prescribed medications to any sexual assault survivor shall
21furnish such services or medications to that person without
22charge and shall seek payment as follows:
23        (1) If a sexual assault survivor is eligible to receive
24    benefits under the medical assistance program under
25    Article V of the Illinois Public Aid Code, the ambulance

 

 

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1    provider, hospital, health care professional, laboratory,
2    or pharmacy must submit the bill to the Department of
3    Healthcare and Family Services and accept the amount paid
4    as full payment.
5        (2) If a sexual assault survivor is covered by one or
6    more policies of insurance, the ambulance provider,
7    hospital, health care professional, laboratory, or
8    pharmacy shall bill the insurance company and accept the
9    amount paid by the insurance company as full payment.
10        (3) If a sexual assault survivor is neither eligible to
11    receive benefits under the medical assistance program
12    under Article V of the Illinois Public Aid Code nor covered
13    by a policy of insurance, the ambulance provider, hospital,
14    health care professional, laboratory, or pharmacy shall
15    submit the request for reimbursement to the Illinois Sexual
16    Assault Emergency Treatment Program and accept the amount
17    paid by the program as full payment. The hospital is
18    responsible for submitting the request for reimbursement
19    for ambulance services, hospital emergency services, and
20    forensic services to the Illinois Sexual Assault Emergency
21    Treatment Program.
22        (4) If a sexual assault survivor presents a voucher for
23    follow-up healthcare, the health care professional and
24    laboratory that provides follow-up healthcare and the
25    pharmacy that dispenses prescribed medications to a sexual
26    assault survivor shall submit the request for

 

 

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1    reimbursement for follow-up healthcare or pharmacy
2    services to the Illinois Sexual Assault Emergency
3    Treatment Program and shall accept the amount paid as full
4    payment. Nothing in this Section precludes hospitals from
5    providing follow-up healthcare and receiving reimbursement
6    under this Section. When any ambulance provider furnishes
7    transportation, hospital provides hospital emergency
8    services and forensic services, hospital or health care
9    professional or laboratory provides follow-up healthcare,
10    or pharmacy dispenses prescribed medications to any sexual
11    assault survivor, as defined by the Department of
12    Healthcare and Family Services, who is neither eligible to
13    receive such services under the Illinois Public Aid Code
14    nor covered as to such services by a policy of insurance,
15    the ambulance provider, hospital, health care
16    professional, pharmacy, or laboratory shall furnish such
17    services to that person without charge and shall be
18    entitled to be reimbursed for providing such services by
19    the Illinois Sexual Assault Emergency Treatment Program
20    under the Department of Healthcare and Family Services and
21    at the Department of Healthcare and Family Services'
22    allowable rates under the Illinois Public Aid Code.
23    (b) (Blank) The hospital is responsible for submitting the
24request for reimbursement for ambulance services, hospital
25emergency services, and forensic services to the Illinois
26Sexual Assault Emergency Treatment Program. Nothing in this

 

 

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1Section precludes hospitals from providing follow-up
2healthcare and receiving reimbursement under this Section.
3    (c) (Blank) The health care professional who provides
4follow-up healthcare and the pharmacy that dispenses
5prescribed medications to a sexual assault survivor are
6responsible for submitting the request for reimbursement for
7follow-up healthcare or pharmacy services to the Illinois
8Sexual Assault Emergency Treatment Program.
9    (d) On and after July 1, 2012, the Department shall reduce
10any rate of reimbursement for services or other payments or
11alter any methodologies authorized by this Act or the Illinois
12Public Aid Code to reduce any rate of reimbursement for
13services or other payments in accordance with Section 5-5e of
14the Illinois Public Aid Code.
15    (e) The Department of Healthcare and Family Services shall
16establish standards, rules, and regulations to implement this
17Section.
18(Source: P.A. 97-689, eff. 6-14-12; 98-463, eff. 8-16-13.)
 
19    (410 ILCS 70/7.5 new)
20    Sec. 7.5. Prohibition of billing sexual assault survivors
21directly; billing protocol.
22    (a) A hospital, health care professional, ambulance
23provider, laboratory, or pharmacy furnishing hospital
24emergency services, forensic services, transportation,
25follow-up healthcare, or medication to a sexual assault

 

 

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1survivor shall not:
2        (1) charge or submit a bill for any portion of the
3    costs of the services, transportation, or medications to
4    the sexual assault survivor, including any insurance
5    deductible , co-pay, co-insurance, denial of claim by an
6    insurer, spenddown, or any other out-of-pocket expense;
7        (2) communicate with, harass, or intimidate the sexual
8    assault survivor for payment of services, including, but
9    not limited to, repeatedly calling or writing to the sexual
10    assault survivor and threatening to refer the matter to a
11    debt collection agency or to an attorney for collection,
12    enforcement, or filing of other process;
13        (3) refer a bill to a collection agency or attorney for
14    collection action against the sexual assault survivor;
15        (4) contact or distribute information to affect the
16    sexual assault survivor's credit rating; or
17        (5) take any other action adverse to the sexual assault
18    survivor or his or her family on account of providing
19    services to the sexual assault survivor.
20    (b) Within 60 days after the effective date of this
21amendatory Act of the 99th General Assembly, every hospital
22providing services to sexual assault survivors in accordance
23with a plan approved under Section 2 of this Act and every
24health care professional who bills separately for hospital
25emergency services or forensic services must develop a billing
26protocol that ensures that no survivor of sexual assault will

 

 

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1be sent a bill for any hospital emergency services or forensic
2services and submit the billing protocol to the Crime Victim
3Services Division of the Office of the Attorney General for
4approval. Health care professionals who bill as a legal entity
5may submit a single billing protocol for the billing entity.
6The billing protocol must include at a minimum:
7        (1) training for persons who prepare bills for hospital
8    emergency services and forensic services;
9        (2) a written acknowledgement signed by a person who
10    has completed the training attesting that he or she will
11    not bill survivors of sexual assault;
12        (3) prohibitions on submitting any bill for any portion
13    of hospital emergency services or forensic services
14    provided to a survivor of sexual assault to a collection
15    agency;
16        (4) prohibitions on taking any action that would
17    adversely affect the credit of the survivor of sexual
18    assault;
19        (5) the termination of all collection activities if the
20    protocol is violated; and
21        (6) the actions to be taken if a bill is sent to a
22    collection agency or information is sent to any agency that
23    generates credit reports to ensure that credit of the
24    survivor of sexual assault is not adversely affected.
25    The Office of the Attorney General shall approve a proposed
26protocol if it finds that the result of the implementation of

 

 

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1the protocol is that a survivor of sexual assault would not be
2billed for hospital emergency services or forensic services.
3    If the Office of the Attorney General determines that
4implementation of the protocol would result in the billing of a
5survivor of sexual assault for hospital emergency services or
6forensic services, the Office of the Attorney General shall
7provide the hospital or health care professional with a written
8statement of the deficiencies in the protocol. The hospital or
9health care professional shall have 10 days to submit a revised
10billing protocol addressing the deficiencies to the Office of
11the Attorney General.
12    (c) The hospital or health care professional shall
13implement the protocol upon approval by the Crime Victim
14Services Division of the Office of the Attorney General. The
15Crime Victim Services Division of the Office of the Attorney
16may provide a sample acceptable billing protocol upon request.
17    (d) The hospital or health care professional shall submit
18any proposed revision to or modification of an approved billing
19protocol to the Crime Victim Services Division of the Office of
20the Attorney General for approval. The hospital or health care
21professional shall implement the revised or modified billing
22protocol upon approval by the Crime Victim Services Division of
23the Office of the Illinois Attorney General.
24    (e) The Office of the Attorney General may provide posters
25or other materials to display in hospital and health care
26billing departments and pharmacies regarding the billing of

 

 

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1sexual assault survivors.
2    (f) A hospital or health care professional who fails to
3submit an acceptable billing protocol within the time frame
4required by subsection (b) of this Section may be fined by the
5Department. The Department, upon the request of the Office of
6the Attorney General, may impose a fine of up to $500 per day
7until a hospital or health care professional complies with the
8requirements of subsections (b) through (d) of this Section.
9Before imposing a fine, the Department shall provide the
10hospital by certified mail with written notice and an
11opportunity for an administrative hearing. Such hearing must be
12requested within 10 working days after receipt of the
13Department's notice. All hearings shall be conducted in
14accordance with the Department's rules on administrative
15hearings. All fines shall be deposited in the Illinois Sexual
16Assault Emergency Treatment Program Fund, a special fund
17created in the State treasury, and, subject to appropriation
18and any grant funds, shall be used by the Department of
19Healthcare and Family Services for reimbursement purposes
20under Section 7 of this Act.
21    (g) A hospital that furnishes emergency services to sexual
22assault survivors shall coordinate with the Illinois Criminal
23Justice Information Authority, the Office of the Attorney
24General, and local rape crisis centers to notify sexual assault
25survivors of the availability of hospital emergency services
26and forensic services at no cost to victims.
 

 

 

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1    (410 ILCS 70/8)  (from Ch. 111 1/2, par. 87-8)
2    Sec. 8. Penalties.
3    (a) Any hospital, health care professional, or ambulance
4provider violating subsection (a) of Section 7.5 of this Act
5shall be subject to a fine by the Department. The Department
6shall impose a fine of $500 for the first violation. For each
7subsequent violation, the Department shall impose a fine of
8$500 multiplied by the total number of past violations. The
9Department may impose a fine of up to $500 per day for each day
10a bill is with a collection agency. Before imposing a fine
11pursuant to this subsection (a), the Department shall provide
12the hospital, health care professional, or ambulance provider
13by certified mail with written notice and an opportunity for an
14administrative hearing. Such a hearing must be requested within
1510 working days after receipt of the Department's notice. All
16hearings shall be conducted in accordance with the Department's
17rules on administrative hearings. All fines shall be deposited
18in the Illinois Sexual Assault Emergency Treatment Program
19Fund.
20    (b) Any hospital violating any provisions of this Act other
21than subsection (a) of Section 7.5 shall be guilty of a petty
22offense for each violation, and any fine imposed shall be paid
23into the general corporate funds of the city, incorporated town
24or village in which the hospital is located, or of the county,
25in case such hospital is outside the limits of any incorporated

 

 

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1municipality.
2(Source: P.A. 79-564.)