Public Act 103-0526
 
HB2222 EnrolledLRB103 30580 LNS 57017 b


  
    AN ACT concerning civil law.
  
 
    Be it enacted by the People of the State of Illinois,
 
represented in the General Assembly:
  






 
 
    Section 5. The Illinois Health Facilities Planning Act is 
amended by changing Section 8.5 as follows:
 
    (20 ILCS 3960/8.5)
    (Section scheduled to be repealed on December 31, 2029)
    Sec. 8.5. Certificate of exemption for change of ownership 
of a health care facility; discontinuation of a category of 
service; public notice and public hearing.
    (a) Upon a finding that an application for a change of 
ownership is complete, the State Board shall publish a legal 
notice on 3 consecutive days in a newspaper of general 
circulation in the area or community to be affected and afford 
the public an opportunity to request a hearing. If the 
application is for a facility located in a Metropolitan 
Statistical Area, an additional legal notice shall be 
published in a newspaper of limited circulation, if one 
exists, in the area in which the facility is located. If the 
newspaper of limited circulation is published on a daily 
basis, the additional legal notice shall be published on 3 
consecutive days. The applicant shall pay the cost incurred by 
the Board in publishing the change of ownership notice in 
newspapers as required under this subsection. The legal notice 
shall also be posted on the Health Facilities and Services 
Review Board's web site and sent to the State Representative 
and State Senator of the district in which the health care 
facility is located and to the Office of the Attorney General. 
An application for change of ownership of a hospital shall not 
be deemed complete without a signed certification that for a 
period of 2 years after the change of ownership transaction is 
effective, the hospital will not adopt a charity care policy 
that is
more restrictive than the policy in effect during the 
year prior to the transaction. An application for a change of 
ownership need not contain signed transaction documents so 
long as it includes the following key terms of the 
transaction:  names and background of the parties; structure of 
the transaction; the person who will be the licensed or 
certified entity after the transaction; the ownership or 
membership interests in such licensed or certified entity both 
prior to and after the transaction; fair market value of 
assets to be transferred; and the purchase price or other form 
of consideration to be provided for those assets. The issuance 
of the certificate of exemption shall be contingent upon the 
applicant submitting a statement to the Board within 90 days 
after the closing date of the transaction, or such longer 
period as provided by the Board, certifying that the change of 
ownership has been completed in accordance with the key terms 
contained in the application.  If such key terms of the 
transaction change, a new application shall be required. 
    Where a change of ownership is among related persons, and 
there are no other changes being proposed at the health care 
facility that would otherwise require a permit or exemption 
under this Act, the applicant shall submit an application 
consisting of a standard notice in a form set forth by the 
Board briefly explaining the reasons for the proposed change 
of ownership. Once such an application is submitted to the 
Board and reviewed by the Board staff, the Board Chair shall 
take action on an application for an exemption for a change of 
ownership among related persons within 45 days after the 
application has been deemed complete, provided the application 
meets the applicable standards under this Section.  If the 
Board Chair has a conflict of interest or for other good cause, 
the Chair may request review by the Board. Notwithstanding  any 
other provision of this Act, for purposes of this Section, a 
change of ownership among related persons means a transaction 
where the parties to the transaction are under common control 
or ownership before and after the transaction is completed.
    Nothing in this Act shall be construed as authorizing the 
Board to impose any conditions, obligations, or limitations, 
other than those required by this Section, with respect to the 
issuance of an exemption for a change of ownership, including, 
but not limited to, the time period before which a subsequent 
change of ownership of the health care facility could be 
sought, or the commitment to continue to offer for a specified 
time period any services currently offered by the health care 
facility.
    The changes made by this amendatory Act of the 103rd 
General Assembly are inoperative on and after January 1, 2027. 
    (a-3) (Blank). 
    (a-5) Upon a finding that an application to discontinue a 
category of service is complete and provides the requested 
information, as specified by the State Board, an exemption 
shall be issued.  No later than 30 days after the issuance of 
the exemption, the health care facility must give written 
notice of the discontinuation of the category of service to 
the State Senator and State Representative serving the 
legislative district in which the health care facility is 
located. No later than 90 days after a discontinuation of a 
category of service, the applicant must submit a statement to 
the State Board certifying that the discontinuation is 
complete. 
    (b) If a public hearing is requested, it shall be held at 
least 15 days but no more than 30 days after the date of 
publication of the legal notice in the community in which the 
facility is located. The hearing shall be held in  the affected 
area or community in a place of reasonable size and 
accessibility and a full and complete written transcript of 
the proceedings shall be made. All interested persons 
attending the hearing shall be given a reasonable opportunity 
to present their positions in writing or orally. The applicant 
shall provide a summary or describe the proposed change of 
ownership at the public hearing.

    (c) For the purposes of this Section "newspaper of limited 
circulation" means a newspaper intended to serve a particular 
or defined population of a specific geographic area within a 
Metropolitan Statistical Area such as a municipality, town, 
village, township, or community area, but does not include 
publications of professional and trade associations. 
    (d) The changes made to this Section by this amendatory  
Act of the 101st General Assembly shall apply to all 
applications submitted after the effective date of this 
amendatory Act of the  101st General Assembly. 
(Source: P.A. 100-201, eff. 8-18-17; 101-83, eff. 7-15-19.)
 
    Section 10. The State Finance Act is amended by adding 
Section 5.990 as follows:
 
    (30 ILCS 105/5.990 new)
    Sec. 5.990. The Antitrust Enforcement Fund. This Section 
is repealed on January 1, 2027.
 
    Section 15. The Illinois Antitrust Act is amended by 
changing Section 7.2 and by adding Sections 7.2a and  13 as 
follows:
 



    (740 ILCS 10/7.2)  (from Ch. 38, par. 60-7.2)



    Sec. 7.2. (1) Whenever it appears to the Attorney General 
that any person has
engaged in, is engaging in, or is about to 
engage in any act or practice
prohibited by this Act, or that 
any person has assisted or participated
in any agreement or 
combination of the nature described herein, he may,
in his 
discretion, conduct an investigation as he deems necessary in

connection with the matter and has the authority prior to the

commencement of any civil or criminal action as provided for 
in the Act
to subpoena witnesses, and pursuant to a subpoena 
(i) compel their
attendance for the purpose of examining them 
under oath, (ii) require the
production of any books, 
documents, records, writings or tangible things
hereafter 
referred to as "documentary material" which
the Attorney 
General deems relevant or material to his investigation,
for 
inspection, reproducing or copying under such terms and 
conditions
as hereafter set forth, (iii) require written 
answers under oath to written
interrogatories, or (iv) require 
compliance with a combination of the
foregoing. Any subpoena 
issued by the Attorney General
shall contain the following 
information:

        (a) The statute and section thereof, the alleged 
    violation of which
is under investigation and the general 
    subject matter of the
investigation.

        (b) The date and place at which time the person is 
    required to
appear or produce documentary material in his 
    possession, custody or
control or submit answers to 
    interrogatories in the office of the Attorney
General 
    located in Springfield or
Chicago. Said date shall not be 
    less than 10 days from date of service
of the subpoena.

        (c) Where documentary material is required to be 
    produced, the same
shall be described by class so as to 
    clearly indicate the material
demanded.

    The Attorney General is hereby authorized, and may so 
elect, to
require the production, pursuant to this section, of 
documentary
material or interrogatory answers prior to the 
taking of any testimony of
the person subpoenaed. Said 
documentary material shall be made available for
inspection 
and copying during normal business hours at the principal

place of business of the person served, or at such other time 
and place,
as may be agreed upon by the person served and the 
Attorney General.
When documentary material is demanded by 
subpoena, said subpoena shall
not:

        (i) contain any requirement which would be 
    unreasonable or improper
if contained in a subpoena duces 
    tecum issued by a court of this State;
or

        (ii) require the disclosure of any documentary 
    material which would
be privileged, or which for any other 
    reason would not be required by a
subpoena duces tecum 
    issued by a court of this State.

    (2) The production of documentary material in response to 
a subpoena served
pursuant to this Section shall be made under 
a sworn certificate, in such
form as the subpoena designates, 
by the person, if a natural person, to
whom the demand is 
directed or, if not a natural person, by a person or
persons 
having knowledge of the facts and circumstances relating to 
such
production, to the effect that all of the documentary 
material required
by the demand and in the possession, 
custody, or control of the person to
whom the demand is 
directed has been produced and made available to the

custodian.  Answers to interrogatories shall be accompanied by 
a statement
under oath attesting to the accuracy of the 
answers.

    While in the possession of the Attorney General and under 
such reasonable
terms and conditions as the Attorney General 
shall prescribe: (A) documentary
material shall be available 
for examination by the person who produced such
material or by 
any duly authorized representative of such person, (B)

transcript of oral testimony shall be available for 
examination by the person
who produced such testimony, or his 
or her counsel and (C) answers to
interrogatories shall be 
available for examination by the person who swore to
their 
accuracy.

    Except as otherwise provided in this Section, no 
documentary material,
transcripts of oral testimony, or 
answers to interrogatories, or copies thereof, in the 
possession of the
Attorney General shall be available for 
examination by any individual other
than an authorized 
employee of the Attorney General or other law enforcement

officials, federal, State, or local, without the consent of 
the person who produced
such material, transcripts, or 
interrogatory answers. Such documentary material, transcripts 
of oral testimony, or answers to interrogatories, or copies 
thereof may be used by the Attorney General in any 
administrative or judicial action or proceeding. 

    For purposes of this Section, all documentary materials, 
transcripts of oral testimony, or answers to interrogatories 
obtained by the Attorney General from other law enforcement 
officials, information voluntarily produced to the Attorney 
General for purposes of any investigation conducted under 
subsection (1), or information provided to the Attorney 
General pursuant to the notice requirement of Section 7.2a 
shall be treated as if produced pursuant to a subpoena served 
pursuant to this Section for purposes of maintaining the 
confidentiality of such information.
    The changes made by this amendatory Act of the 103rd 
General Assembly are inoperative on and after January 1, 2027. 
    (3) No person shall, with intent to avoid, evade, prevent, 
or obstruct
compliance in whole or in part by any person with 
any duly served subpoena
of the Attorney General under this 
Act, knowingly remove from any place,
conceal, withhold, 
destroy, mutilate, alter, or by any other means falsify
any 
documentary material that is the subject of such subpoena.  A 
violation
of this subsection is a Class A misdemeanor.  The 
Attorney General, with
such assistance as he may from time to 
time require of the State's Attorneys
in the several counties, 
shall investigate suspected violations of this
subsection and 
shall commence and try all prosecutions under this subsection.

(Source: P.A. 96-751, eff. 1-1-10; 96-1000, eff. 7-2-10.)

 
    (740 ILCS 10/7.2a new)
    Sec. 7.2a. Notification to the Attorney General.
    (a) As used in this Section:
    "Acquisition" means an agreement, arrangement, or activity

the consummation of which results in a person acquiring

directly or indirectly the control of another person. 
"Acquisition"
includes the acquisition of voting securities 
and noncorporate
interests, such as assets, capital stock, 
membership
interests, or equity interests.
    "Contracting affiliation" means the formation of a 
relationship between 2 or more entities that permits the 
entities to negotiate jointly with health carriers or 
third-party administrators over rates for professional medical 
services, or for one entity to negotiate on behalf of the other 
entity with health carriers or third-party administrators over 
rates for professional medical services. "Contracting 
affiliation" does not include arrangements among entities 
under common ownership.
    "Covered transaction" means any merger, acquisition, or 
contracting affiliation between 2 or more health care 
facilities or provider organizations not previously under 
common ownership or contracting affiliation.
    "Health care facility" means the following facilities, 
organizations, and related persons:
        (1) An ambulatory surgical treatment center required 
    to be licensed under the Ambulatory Surgical Treatment 
    Center Act.
        (2) An institution, place, building, or agency 
    required to be licensed under the Hospital Licensing Act.
        (3) A hospital, ambulatory surgical treatment center, 
    or kidney disease treatment center maintained by the State 
    or any department or agency thereof.
        (4) A kidney disease treatment center, including a 
    free-standing hemodialysis unit required to meet the 
    requirements of 42 CFR 494 in order to be certified for 
    participation in Medicare and Medicaid under Titles XVIII 
    and XIX of the federal Social Security Act of 1935.
        (5) An institution, place, building, or room used for 
    the performance of outpatient surgical procedures that is 
    leased, owned, or operated by or on behalf of an 
    out-of-state facility.
        (6) An institution, place, building, or room used for 
    provision of a health care category of service, as defined 
    under the Illinois Health Facilities Planning Act, 
    including, but not limited to, cardiac catheterization and 
    open heart surgery.
    With the exception of those health care facilities 
specifically included in this Section, nothing in this Section 
shall be intended to include facilities operated as a part of 
the practice of a physician or other licensed health care 
professional, whether practicing in his or her individual 
capacity or within the legal structure of any partnership, 
medical or professional corporation, or unincorporated medical 
or professional group. Further, this Section shall not apply 
to physicians or other licensed health care professional's 
practices where such practices are carried out in a portion of 
a health care facility under contract with such health care 
facility by a physician or by other licensed health care 
professionals, whether practicing in his or her individual 
capacity or within the legal structure of any partnership, 
medical or professional corporation, or unincorporated medical 
or professional groups, unless the entity constructs, 
modifies, or establishes a health care facility as 
specifically defined in this Section.
    "Health care services revenue" means the total revenue 
received for health care services in the previous 12 months.
    "Health carriers" has the meaning given to that term in 
Section 10 of the Health Carrier External Review Act.
    "Illinois health care entity" means a health care facility 
or provider organization that has an office in or is doing 
business in this State.
    "Merger" means the consolidation of 2 or more 
organizations, including 2 or more organizations joining 
through a common parent organization or 2 or more 
organizations forming a new organization, but does not include 
a corporate reorganization.
    "Out-of-state health care entity" means a health care 
facility or provider organization that is not headquartered in 
this State and does not do business in this State.
    "Provider organization" means a corporation, partnership, 
business trust, association, or organized group of persons, 
whether incorporated or not, which is in the business of 
health care delivery or management and that represents 20 or 
more health care providers in contracting with health carriers 
or third-party administrators for the payment of health care 
services. "Provider organization" includes physician 
organizations, physician-hospital organizations, independent 
practice associations, provider networks, and accountable care 
organizations.
    "Third-party administrator" means an entity that 
administers payments for health care services on behalf of a 
client in exchange for an administrative fee.
    (b) Health care facilities or provider organizations that 
are party to a covered transaction shall provide notice of 
such transaction to the Attorney General no later than 30 days 
prior to the transaction closing or effective date of the 
transaction.
    Covered transactions between an Illinois health care 
entity and an out-of-state health care entity must provide 
notice under this subsection where the out-of-state entity 
generates $10,000,000 or more in annual  revenue from patients 
residing in this State.
    (c) The written notice provided by the parties under 
subsection (b) shall be provided as follows:
        (1) For any health care facility or provider 
    organization that is a party to a covered
transaction and 
    files a premerger notification with the
Federal Trade 
    Commission or the United States Department
of Justice, in 
    compliance with the Hart-Scott-Rodino
Antitrust 
    Improvements Act of 1976, 15 U.S.C. 18a, the
notice 
    requirement is satisfied by providing a copy of
such 
    filing to the Attorney General at the same time as it
is 
    provided to the federal government.
        (2) For any  health care facility that is a party to a

    covered transaction that is not described in paragraph

    (1), the notice requirement is satisfied when the 
    healthcare facility files an application for a change of

    ownership with the Health Facilities and Services Review 
    Board, in compliance with the Illinois Health Facilities

    Planning Act. The Health Facilities and Services Review

    Board shall provide a copy of such filing to the Attorney

    General at the same time as it is provided to the

    applicable State legislators under subsection (a) of

    Section 8.5 of the Illinois Health Facilities Planning

    Act.
        (3) For any health care facility or provider 
    organization that is a party to a covered
transaction that 
    is not described in paragraph (1) or (2),
written notice 
    provided by the parties must include:
            (A) the names of the parties and their current 
        business address;
            (B) identification of all locations where health 
        care services are currently provided by each party;
            (C) a brief description of the nature and purpose 
        of the proposed transaction; and
            (D) the anticipated effective date of the proposed 
        transaction.
    Nothing in this subsection prohibits the parties to a 
covered transaction from voluntarily providing additional 
information to the Attorney General.
    (d) The Attorney General may make any requests for 
additional information from the parties that is relevant to 
its investigation of the covered transaction within 30 days of 
the date notice is received under subsections (b) and (c). If 
the Attorney General requests additional information, the 
covered transaction may not proceed until 30 days after the 
parties have substantially complied with the request. Any 
subsequent request for additional information by the Attorney 
General shall not further delay the covered transaction from 
proceeding. Nothing in this Section precludes the Attorney 
General from conducting an investigation or enforcing State or 
federal antitrust laws at a later date.
    (e) Any health care facility or provider organization that 
fails to comply with any provision of this Section is subject 
to a civil penalty of not more than $500 per day for each day 
during which the health care facility or provider organization 
is in violation of this Section.
    Whenever the Attorney General has reason to believe that a 
health care facility or provider organization has engaged in 
or is engaging in a covered transaction without complying with 
the provisions of this Section, the Attorney General may apply 
for and obtain, in an action in the Circuit Court of Sangamon 
or Cook County, a temporary restraining order or injunction, 
or both, prohibiting the health care facility or provider 
organization from continuing its noncompliance or doing any 
act in furtherance thereof. The court may make such further 
orders or judgments, at law or in equity, as may be necessary 
to remedy such noncompliance.
    Before bringing such an action or seeking to recover a 
civil
penalty, the Attorney General shall permit the health 
care
facility or provider organization to come into compliance 
with this Section within 10 days of being notified of its 
alleged noncompliance. The right to cure noncompliance does 
not exist on or after the covered transaction's proposed or 
actual closing date of the covered transaction, whichever is 
sooner.
    (f) This Section is repealed on January 1, 2027.
 
    (740 ILCS 10/13 new)
    Sec. 13. Antitrust Enforcement Fund. Any penalties 
collected from an entity for violations of this Act shall be 
deposited into the Antitrust Enforcement Fund, a special fund 
created in the State treasury that is dedicated to enforcing 
this Act.
    This Section is repealed on January 1, 2027.
 
 
    Section 99. Effective date. This Act takes effect January 
1, 2024. 
  

Effective Date:  1/1/2024