Full Text of HB4087 94th General Assembly
HB4087 94TH GENERAL ASSEMBLY
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94TH GENERAL ASSEMBLY
State of Illinois
2005 and 2006 HB4087
Introduced 7/7/2005, by Rep. Mary E. Flowers SYNOPSIS AS INTRODUCED: |
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New Act |
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110 ILCS 330/5 |
from Ch. 23, par. 1375 |
210 ILCS 85/7 |
from Ch. 111 1/2, par. 148 |
735 ILCS 5/12-701.5 new |
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735 ILCS 5/12-801.5 new |
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Creates the Hospital Billing and Collection Practices Act, which applies only to hospitals that receive public moneys. Provides that a hospital may not give a collection agency or attorney blanket authorization to take legal action against the hospital's patients for the collection of medical debt, including by means of garnishment or wage deduction, and requires a hospital to verify certain information before taking such action. Imposes other limitations in connection with a hospital's debt collection practices, including the referral of patients' accounts to a collection agency. Requires a hospital to train collection agencies and attorneys with whom it contracts for the collection of medical debt concerning the hospital's charity care policy. Requires a hospital to adopt and implement policies and procedures to ensure the timely and accurate submission of claims to third party payors. Requires a hospital to adopt a process for patients to question or dispute bills, and requires implementation of a system to record patient complaints received by a hospital's billing office. Contains provisions concerning billing uninsured patients. Amends the University of Illinois Hospital Act, the Hospital Licensing Act, and the Code of Civil Procedure to make conforming changes. Effective January 1, 2006.
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A BILL FOR
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HB4087 |
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LRB094 12771 DRJ 47615 b |
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| AN ACT concerning regulation.
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| Be it enacted by the People of the State of Illinois,
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| represented in the General Assembly:
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| Article 1. General Provisions | 5 |
| Section 1-1. Short title. This Act may be cited as the | 6 |
| Hospital Billing and Collection Practices Act. | 7 |
| Section 1-5. Legislative findings. The General Assembly | 8 |
| finds as follows: | 9 |
| (1) A hospital bill should never get in the way of a | 10 |
| resident of Illinois receiving essential health services, | 11 |
| and this message should be conveyed to patients and the | 12 |
| communities served by a hospital. | 13 |
| (2) Financial aid policies should be consistent with | 14 |
| the mission and values of the hospital and take into | 15 |
| account each individual's ability to contribute to the cost | 16 |
| of his or her care and the hospital's financial ability to | 17 |
| provide the care. | 18 |
| (3) Financial aid policies should be clear, | 19 |
| understandable, and communicated in a dignified manner. | 20 |
| (4) Debt collection policies, by both hospital staff | 21 |
| and external collection agencies, should reflect
the | 22 |
| mission and values of the hospital. | 23 |
| (5) The General Assembly intends that hospitals employ | 24 |
| high standards when collecting medical debt from their | 25 |
| patients and intends to lead reform efforts in the manner | 26 |
| in which uninsured hospital patients are charged. | 27 |
| Section 1-10. Construction of Act. This Act shall not be | 28 |
| construed to provide an incentive for persons who can afford | 29 |
| health insurance coverage to voluntarily choose to go without | 30 |
| such coverage. |
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| Section 1-15. Definitions. In this Act: | 2 |
| "Charity care" means the provision of free or discounted | 3 |
| care to a patient pursuant to financial assistance policies | 4 |
| approved by the hospital's governing body. | 5 |
| "Collection agency" or "agency" means an individual or | 6 |
| entity that is required to be registered under the Collection | 7 |
| Agency Act. | 8 |
| "Department" means the Department of Public Health. | 9 |
| "Hospital" means a hospital licensed under the Hospital | 10 |
| Licensing Act or subject to the University of Illinois Hospital | 11 |
| Act that receives public moneys. | 12 |
| "Medical debt" means moneys owed by a patient to a hospital | 13 |
| in connection with services provided to the patient by the | 14 |
| hospital. | 15 |
| Article 5. Litigation Practices | 16 |
| Section 5-5. Authority to take legal action against | 17 |
| patient. | 18 |
| (a) A hospital may not give a collection agency or attorney | 19 |
| blanket authorization to take legal action against its patients | 20 |
| for the collection of medical debt. A hospital may not file a | 21 |
| lawsuit against a particular patient to collect medical debt | 22 |
| until a hospital employee with the appropriate level of | 23 |
| authority authorizes the litigation after verifying all of the | 24 |
| following: | 25 |
| (1) There is a reasonable basis to believe that the | 26 |
| patient owes the debt. | 27 |
| (2) All known third party payors have been properly | 28 |
| billed by the hospital,
so that any remaining debt is the | 29 |
| financial responsibility of the patient. The hospital may | 30 |
| not bill a patient for any amount that
an insurance company | 31 |
| is obligated to pay. | 32 |
| (3) If a patient has indicated an inability to pay the | 33 |
| full amount of the
debt in one payment, the hospital has |
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| offered the patient a reasonable
payment plan. The hospital | 2 |
| may require the patient to
provide reasonable verification | 3 |
| of his or her inability to pay the full amount of
the debt | 4 |
| in one payment. | 5 |
| (4) The patient has been given a reasonable opportunity | 6 |
| to submit an application for charity care, if the facts and | 7 |
| circumstances suggest that the patient may be eligible for | 8 |
| charity care, including, for example, if the patient is | 9 |
| uninsured or receives medical assistance under the | 10 |
| Illinois Public Aid Code or other assistance based on need. | 11 |
| (b) The hospital shall set forth in the policy adopted | 12 |
| pursuant to paragraph (2) of Section 30-10 the level of | 13 |
| employee (for example, supervisor, manager, or chief financial | 14 |
| officer) who is authorized to make the determinations required | 15 |
| under subsection (a). The level of employee may vary based on | 16 |
| the amount of the debt. | 17 |
| Section 5-10. Review of debt collection attorney contract | 18 |
| by hospital CEO. On at least an annual basis, a hospital's | 19 |
| chief executive officer shall review and determine whether or | 20 |
| not to issue to or renew any contract with an attorney for the | 21 |
| purpose of collecting medical debt. In determining whether to | 22 |
| issue or renew any such contract, the chief executive officer | 23 |
| shall consider whether the attorney has acted in a manner | 24 |
| consistent with this Act and with the hospital's mission and | 25 |
| policies and applicable laws. | 26 |
| Section 5-15. No subcontracting. A hospital must enter into | 27 |
| a written contract directly with any attorney or law firm | 28 |
| utilized by the hospital to collect medical debt from its | 29 |
| patients and may not subcontract or delegate the selection of | 30 |
| any such attorney or law firm to a collection agency with whom | 31 |
| the hospital has contracted for the collection of medical debt. | 32 |
| Any contract between the hospital and the attorney or law firm | 33 |
| must require the attorney or law firm to act in accordance with | 34 |
| this Act, applicable laws, and the hospital's policies adopted |
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| under Section 30-10. | 2 |
| Section 5-20. No payment of bonus. A hospital may not pay | 3 |
| any debt collection attorney or law firm any performance bonus, | 4 |
| contingency bonus, or other similar payment that is calculated | 5 |
| on the basis of the amount or percentage of debt collected from | 6 |
| 2 or more patients. This Section does
not prohibit a hospital | 7 |
| from paying an attorney a percentage of the debt collected from | 8 |
| a particular patient, provided that the hospital establishes | 9 |
| adequate contractual controls to ensure that the attorney acts | 10 |
| in a manner consistent with this Act and the hospital's | 11 |
| mission.
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| Section 5-25. Oversight. A hospital's general counsel's | 13 |
| office or, if the hospital has no such office, a hospital | 14 |
| employee with suitable experience and authority shall oversee | 15 |
| the conduct of every attorney retained by the hospital to | 16 |
| collect medical debt from its patients and shall oversee all | 17 |
| debt collection litigation. | 18 |
| Section 5-30. Required actions by debt collection | 19 |
| attorney. | 20 |
| (a) A hospital shall require every attorney with whom the | 21 |
| hospital has contracted for the collection of medical debt to | 22 |
| take the following actions with respect to the collection of | 23 |
| medical debt from patients: | 24 |
| (1) File any lawsuits brought against the hospital's | 25 |
| patients for the collection
of medical debt with the | 26 |
| applicable court no later than 7 days after
the summons and | 27 |
| complaint have been served on the patient.
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| (2) Sign and date all pleadings, including, but not | 29 |
| limited to, all complaints and garnishment or wage | 30 |
| deduction pleadings and related documents.
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| (3) Ensure that all affidavits of service that purport | 32 |
| to document the service of any pleading or legal papers | 33 |
| state the following: |
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| (A) If the pleading is served by mail, the | 2 |
| affidavit of service shall state the address to which | 3 |
| it was mailed. | 4 |
| (B) If the pleading is served personally, the | 5 |
| affidavit of service shall state the name of the person | 6 |
| to whom the pleading was delivered. Generalized | 7 |
| statements, such as that the pleading was delivered to
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| "a person of suitable age", shall not suffice for | 9 |
| purposes of this paragraph.
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| (4) Serve, along with any summons and complaint, an | 11 |
| information sheet as set forth in subsection (c) or a | 12 |
| substantially similar information sheet approved in | 13 |
| advance by the Department. | 14 |
| (5) List in the case caption of all pleadings the | 15 |
| county where the lawsuit is or will be filed. | 16 |
| (b) A hospital shall instruct its attorneys not to petition | 17 |
| any court to have any debtor arrested or to have any arrest | 18 |
| warrant or body attachment issued, or to cause such an action, | 19 |
| as a result of the debtor's failure to appear in court, to | 20 |
| complete paperwork, or to otherwise respond to any request or | 21 |
| action by the hospital in connection with its efforts to | 22 |
| collect medical debt from the patient. | 23 |
| (c) The information sheet required to be served under | 24 |
| subdivision (a)(4) shall be in substantially the following | 25 |
| form: | 26 |
| (HOSPITAL NAME) LAWSUIT INFORMATION SHEET | 27 |
| You are receiving this information sheet because you | 28 |
| have been served with a Summons and Complaint (lawsuit) by | 29 |
| (HOSPITAL NAME). (HOSPITAL NAME) cannot give you legal | 30 |
| advice. Therefore, this document provides only basic | 31 |
| information, and you should immediately discuss this | 32 |
| matter with an attorney. | 33 |
| Start of the Lawsuit. To start a lawsuit against you, | 34 |
| (HOSPITAL NAME) has served a Summons and Complaint on you | 35 |
| either: (1) by delivering it to you personally or leaving | 36 |
| it at your home; or (2) by mail, if you agree in writing to |
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| accept "service" of the Summons and Complaint by mail and | 2 |
| sign a form that so indicates. The Summons informs you that | 3 |
| you must provide a formal, written legal "answer" to the | 4 |
| complaint. The Complaint explains why (HOSPITAL NAME) is | 5 |
| suing you and asks a court to make you pay money. The | 6 |
| Summons and Complaint may not include a court file number. | 7 |
| They are, however, the legal documents that begin the | 8 |
| lawsuit. It is very important that you do not ignore the | 9 |
| documents, or you will be in "default." No court hearing is | 10 |
| required for a default judgment to be entered against you | 11 |
| if you do not respond to the Complaint. | 12 |
| Answering a Complaint. The "Answer" is the formal legal | 13 |
| name for your response to the Complaint. The Answer must | 14 |
| meet certain requirements of the Code of Civil Procedure. | 15 |
| Contacting (HOSPITAL NAME) or its attorney by telephone or | 16 |
| written correspondence is not "answering" the Complaint. | 17 |
| While (HOSPITAL NAME) encourages you to call if you have | 18 |
| questions regarding the bill that was sent to collections, | 19 |
| doing so is not a formal "Answer." Some court clerks have | 20 |
| form "Answers" which may be of assistance to you. You must | 21 |
| serve a copy of your Answer on (HOSPITAL NAME)'s attorney | 22 |
| by mail, fax, or hand delivery and complete an Affidavit of | 23 |
| Service that explains who was served, how, and on what | 24 |
| date. The Affidavit of Service form must be signed in | 25 |
| accordance with the Code of Civil Procedure. If you want a | 26 |
| judge to hear the dispute, you should file the original | 27 |
| Answer and Affidavit of Service with the court in the | 28 |
| county in which you are being sued after you have served | 29 |
| your Answer on (HOSPITAL NAME). You will be required to pay | 30 |
| a court filing fee. (If you meet certain financial | 31 |
| guidelines, however, you may not be required to pay the | 32 |
| court filing fee. You may obtain more information regarding | 33 |
| a waiver of the fee by contacting the court clerk.) | 34 |
| Failure to Answer. If you do not "answer" the | 35 |
| Complaint, (HOSPITAL NAME) may get a "default" judgment | 36 |
| entered against you requiring you to pay money. By getting |
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| a default judgment, (HOSPITAL NAME) may be able to initiate | 2 |
| a separate garnishment or wage deduction action against | 3 |
| you. | 4 |
| Section 5-35. Limitation on default judgment. A hospital | 5 |
| may not obtain a default judgment against any particular | 6 |
| patient without the specific, case-by-case approval of its | 7 |
| general counsel's office or, if the hospital has no such | 8 |
| office, a hospital employee with suitable experience and | 9 |
| authority. Before authorizing a default judgment, the general | 10 |
| counsel's office or the hospital employee shall determine: (i) | 11 |
| whether there is a reasonable basis to believe that the patient | 12 |
| may already believe that he or she has adequately answered the | 13 |
| complaint by calling or writing to the hospital, its debt | 14 |
| collection agency, or its attorney; (ii) whether the patient is | 15 |
| sick, disabled, infirm, or elderly so as to potentially render | 16 |
| the patient unable to answer the complaint; or (iii) whether | 17 |
| the patient may not have received service of the complaint. The | 18 |
| hospital shall serve any motion for default judgment on the | 19 |
| patient at the patient's last known address. | 20 |
| Section 5-40. Patient represented by attorney. If a | 21 |
| hospital has knowledge of the identity of an attorney | 22 |
| representing a patient in connection with the hospital's debt | 23 |
| collection efforts, the hospital shall notify every attorney, | 24 |
| law firm, and collection agency with whom it has contracted for | 25 |
| the collection of medical debt of the identity of any attorney | 26 |
| who represents the patient. Neither the hospital nor any | 27 |
| collection agency or attorney retained by the hospital for the | 28 |
| purpose of collecting medical debt may directly contact any | 29 |
| patient known to be represented by an attorney with regard to | 30 |
| the collection of that debt without the permission of the | 31 |
| patient's attorney. | 32 |
| Article 10. Garnishment and Wage Deductions |
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| Section 10-5. Authority to pursue garnishment or wage | 2 |
| deduction. | 3 |
| (a) A hospital may not give a collection agency or attorney | 4 |
| blanket authorization to pursue garnishment or a wage deduction | 5 |
| against its patients for the collection of medical debt. A | 6 |
| hospital may not authorize a collection agency or attorney to | 7 |
| proceed with garnishment or a wage deduction against a | 8 |
| particular patient for the collection of medical debt until a | 9 |
| hospital employee with the appropriate level of authority | 10 |
| authorizes the garnishment or wage deduction for that | 11 |
| particular patient after verifying all of the following: | 12 |
| (1) The hospital has no reasonable basis to believe | 13 |
| that the patient's wages or funds at a financial | 14 |
| institution are likely to be exempt from garnishment. | 15 |
| Factors that my indicate a reasonable basis for such a | 16 |
| belief include the patient's receipt of benefits under the | 17 |
| Social Security Act or receipt of medical assistance under | 18 |
| the Illinois Public Aid Code or other assistance based on | 19 |
| need. | 20 |
| (2) There is a reasonable basis to believe that the | 21 |
| patient owes the debt. | 22 |
| (3) All known third party payors have been properly | 23 |
| billed by the hospital, so that any remaining debt is the | 24 |
| financial responsibility of the patient. The hospital may | 25 |
| not bill a patient for any amount that an insurance company | 26 |
| is obligated to pay. | 27 |
| (4) If the patient has indicated an inability to pay | 28 |
| the full amount of the
debt in one payment, the hospital | 29 |
| has offered the patient a reasonable
payment plan. The | 30 |
| hospital may require the patient to
provide reasonable | 31 |
| verification of his or her inability to pay the full amount | 32 |
| of
the debt in one payment. | 33 |
| (5) The patient has been given a reasonable opportunity | 34 |
| to submit an
application for charity care, if the facts and | 35 |
| circumstances suggest that
the patient may be eligible for | 36 |
| charity care, including, for example, if the
patient is |
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| uninsured or receives medical assistance under the | 2 |
| Illinois Public Aid Code or other
assistance based on need.
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| (b) The hospital shall set forth in the policies adopted | 4 |
| under Section 30-10 the level of employee (for example, | 5 |
| supervisor, manager, or chief financial officer) who is | 6 |
| authorized to make the determinations required under | 7 |
| subsection (a). The level of employee may vary based on the | 8 |
| amount of the debt. | 9 |
| Section 10-10. Limitation on garnishment or wage | 10 |
| deduction. A hospital may not pursue garnishment or a wage | 11 |
| deduction against any patient unless the hospital has first | 12 |
| obtained a judgment against the patient in court for the amount | 13 |
| of the debt. | 14 |
| Section 10-15. Information sheet. | 15 |
| (a) A hospital must include, with the initial notice of a | 16 |
| garnishment or wage deduction that it sends to any patient, an | 17 |
| information sheet as set forth in subsection (b) or a | 18 |
| substantially similar information sheet approved in advance by | 19 |
| the Department. | 20 |
| (b) The information sheet required to be sent under | 21 |
| subsection (a) shall be in substantially the following form: | 22 |
| (HOSPITAL NAME) GARNISHMENT OR WAGE DEDUCTION | 23 |
| INFORMATION SHEET | 24 |
| You are receiving this information sheet because | 25 |
| (HOSPITAL NAME) has started a process to get money from you | 26 |
| by sending a "garnishment summons" to a "garnishee" | 27 |
| (typically your bank) or a "wage deduction summons" to your | 28 |
| employer. These proceedings are called "garnishment" or | 29 |
| "wage deduction" proceedings. (HOSPITAL NAME) cannot | 30 |
| provide you with legal advice. Therefore, this document | 31 |
| provides only basic information. You should immediately | 32 |
| discuss this matter with an attorney. | 33 |
| Taking Money From Your Wages. If (HOSPITAL NAME) is | 34 |
| trying to take money from your wages, you should receive |
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| notice before your wages are taken. Under Illinois law, | 2 |
| (HOSPITAL NAME) cannot take more than 15% of your gross | 3 |
| weekly wages or more than the amount by which your | 4 |
| disposable earnings for a week exceed 45 times the federal | 5 |
| minimum hourly wage, whichever is less. Under federal law, | 6 |
| (HOSPITAL NAME) cannot take more than 25% of your | 7 |
| disposable earnings for a week or more than the amount by | 8 |
| which your disposable earnings for a week exceed 30 times | 9 |
| the federal minimum hourly wage, whichever is less. To find | 10 |
| out how to claim that wages cannot be taken (that is, that | 11 |
| they are "exempt"), you should immediately discuss this | 12 |
| matter with an attorney. Calling (HOSPITAL NAME) is not | 13 |
| sufficient. | 14 |
| Taking Money From Your Bank Accounts. If (HOSPITAL | 15 |
| NAME) is trying to take money from your bank account, the | 16 |
| bank will "freeze" enough money in your account to pay off | 17 |
| your debt to (HOSPITAL NAME). You will not receive notice | 18 |
| of the bank garnishment until after your funds are already | 19 |
| "frozen". You will not have access to your funds while they | 20 |
| are "frozen". Your checks may "bounce," and you may incur | 21 |
| overdraft charges during this time. You may want to contact | 22 |
| your bank or discuss this matter with an attorney | 23 |
| immediately. | 24 |
| Section 10-20. Claim of exemption from garnishment or wage | 25 |
| deduction. If a patient submits a written claim that the | 26 |
| patient's property or wages are exempt from garnishment or wage | 27 |
| deduction, the hospital's debt collection attorney may not | 28 |
| object to the claim of exemption without receiving the | 29 |
| specific, case-by-case approval of the hospital's general | 30 |
| counsel's office or, if the hospital has no such office, a | 31 |
| hospital employee with suitable experience and authority. In | 32 |
| deciding whether to grant such approval in a particular case, | 33 |
| the general counsel's office or hospital employee shall review | 34 |
| all information submitted by the patient in support of the | 35 |
| patient's claim of exemption. |
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| Article 15. Collection Agencies | 2 |
| Section 15-5. Review of collection agency contract by | 3 |
| hospital CEO. On at least an annual basis, a hospital's chief | 4 |
| executive officer shall review and determine whether or not to | 5 |
| issue to or renew a contract with a collection agency for the | 6 |
| purpose of collecting medical debt. In determining whether to | 7 |
| issue or renew any such contract, the chief executive officer | 8 |
| shall consider whether the collection agency has acted in a | 9 |
| manner consistent with this Act and with the hospital's mission | 10 |
| and policies and applicable laws. | 11 |
| Section 15-10. Written contract. A hospital must enter into | 12 |
| a written contract with any collection agency utilized by the | 13 |
| hospital to collect medical debt from its patients. The | 14 |
| contract shall require the collection agency to act in | 15 |
| accordance with this Act, applicable laws, and the hospital's | 16 |
| policies adopted under in Section 30-10. | 17 |
| Section 15-15. Referral of patient's account. | 18 |
| (a) A hospital may not refer any patient's account to a | 19 |
| collection agency for collection of medical debt owed by the | 20 |
| patient unless the hospital has verified all of the following: | 21 |
| (1) There is a reasonable basis to believe that the | 22 |
| patient owes the debt. | 23 |
| (2) All known third party payors have been properly | 24 |
| billed by the hospital,
so that any remaining debt is the | 25 |
| financial responsibility of the patient. The hospital may | 26 |
| not bill a patient for any amount that
an insurance company | 27 |
| is obligated to pay. | 28 |
| (3) If the patient has indicated an inability to pay | 29 |
| the full amount of the
debt in one payment, the hospital | 30 |
| has offered the patient a reasonable
payment plan. The | 31 |
| hospital may require the patient to
provide reasonable | 32 |
| verification of his or her inability to pay the full amount |
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| of the debt in one payment. | 2 |
| (4) The patient has been given a reasonable opportunity | 3 |
| to submit an application for charity care, if the facts and | 4 |
| circumstances suggest that the patient may be eligible for | 5 |
| charity care, including, for example, if the patient is | 6 |
| uninsured or receives medical assistance under the | 7 |
| Illinois Public Aid Code or other assistance based on need. | 8 |
| (b) The hospital shall set forth in the policies adopted | 9 |
| under Section 30-10 the level of employee (for example, | 10 |
| supervisor, manager, or chief financial officer) who is | 11 |
| authorized to make the determinations required under | 12 |
| subsection (a). The level of employee may vary based on the | 13 |
| amount of the debt. | 14 |
| Section 15-20. Patient's previous payment plan. A hospital | 15 |
| may not refer any medical debt to a collection agency or | 16 |
| attorney for the purposes of collection if the patient has made | 17 |
| payments on that debt in accordance with the terms of a payment | 18 |
| plan previously agreed to by the hospital. | 19 |
| Section 15-25. Patient's application for charity care. If a | 20 |
| patient has submitted an application for charity care after the | 21 |
| hospital has referred his or her account for collection | 22 |
| activity, the hospital shall suspend all collection activity | 23 |
| until the patient's charity care application has been processed | 24 |
| by the hospital and the hospital has notified the patient of | 25 |
| its decision concerning the charity care application. | 26 |
| Section 15-30. No payment of bonus. A hospital may not pay | 27 |
| any debt collection agency any performance bonus, contingency | 28 |
| bonus, or other similar payment that is calculated on the basis | 29 |
| of the amount or percentage of debt collected from 2 or more | 30 |
| patients. This Section does not prohibit a hospital from paying | 31 |
| a collection agency a percentage of the debt collected from a | 32 |
| particular
patient, provided that the hospital establishes | 33 |
| adequate contractual controls to ensure that the collection |
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HB4087 |
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LRB094 12771 DRJ 47615 b |
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| 1 |
| agency acts in a manner consistent with this Act and the | 2 |
| hospital's mission.
| 3 |
| Section 15-35. Log of patient complaints. A hospital shall | 4 |
| require every collection agency or attorney utilized by the | 5 |
| hospital for the purpose of collecting medical debt to keep a | 6 |
| log of all oral and written complaints received from any | 7 |
| patient concerning the conduct of the collection agency or | 8 |
| attorney. For purposes of this Section, a "complaint" is any | 9 |
| communication from a patient or a patient's representative in | 10 |
| which the patient or representative expresses concerns about | 11 |
| the conduct of the collection agency or attorney in connection | 12 |
| with the collection of the medical debt owed to the hospital by | 13 |
| the patient. The hospital shall obtain a complete copy of the | 14 |
| log at least 6 times per year. The hospital's contract with the | 15 |
| collection agency or attorney shall state that failure by the | 16 |
| agency or attorney to log and provide all patient complaints in | 17 |
| the manner required by this Section may result in termination | 18 |
| of the hospital's contract with the agency or attorney. | 19 |
| Section 15-40. Record of communications with patients. A | 20 |
| hospital shall require every collection agency and attorney | 21 |
| utilized by the hospital for the purpose of collecting medical | 22 |
| debt to keep a record of the date, time, and purpose of all | 23 |
| communications to or from the hospital's patients in connection | 24 |
| with medical debt collection activities. | 25 |
| Section 15-45. Hospital contact information. If a patient | 26 |
| asks a collection agency or attorney with whom the hospital has | 27 |
| contracted for the collection of medical debt for the contact | 28 |
| information for a hospital, the hospital shall instruct the | 29 |
| agency or attorney to provide the patient with the phone number | 30 |
| and address described in Section 20-10. The hospital shall not | 31 |
| refuse to supply information to or speak with any of its | 32 |
| patients on the basis that a patient's account has been placed | 33 |
| with a collection agency or attorney for collection of medical |
|
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| debt. | 2 |
| Section 15-50. Charity care. A hospital shall train the | 3 |
| employees of the collection agencies with which it contracts | 4 |
| for the collection of medical debt, and the attorneys with whom | 5 |
| it contracts for the collection of medical debt, concerning the | 6 |
| hospital's charity care policy and how a patient may obtain | 7 |
| more information about the hospital's charity care policy or | 8 |
| submit an application for charity care. The hospital shall | 9 |
| require those collection agencies and attorneys to refer | 10 |
| patients who may be eligible for charity care to the hospital. | 11 |
| Section 15-55. Department of Public Health contact | 12 |
| information. A hospital shall include the following statement | 13 |
| (i) in every collection notice sent to a patient by the | 14 |
| hospital or by any collection agency or attorney with whom the | 15 |
| hospital has contracted for the collection of medical debt and | 16 |
| (ii) in every cover letter sent in connection with service of a | 17 |
| summons and complaint and garnishment or wage deduction papers | 18 |
| in connection with the collection of medical debt:
| 19 |
| You have the option to address any concerns with the | 20 |
| Illinois Department of Public Health, which can be reached | 21 |
| at (insert telephone number or numbers). | 22 |
| The hospital shall print this statement with the prominence | 23 |
| required for notices under the federal Fair Debt Collection | 24 |
| Practices Act. | 25 |
| Section 15-60. No report to credit reporting agency. | 26 |
| Neither a hospital nor any collection agency or attorney with | 27 |
| whom it contracts for the collection of medical debt may report | 28 |
| any patient to a credit reporting agency as a result of that | 29 |
| patient's failure to pay a medical bill owed to the hospital. | 30 |
| Article 20. Hospital Central Billing Office | 31 |
| Section 20-5. Billing practices generally. |
|
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| (a) A hospital shall adopt and implement policies and | 2 |
| procedures to ensure the timely and accurate submission of | 3 |
| claims to third party payors. | 4 |
| (b) If a hospital timely receives from a patient | 5 |
| information about the patient's third party payor but does not | 6 |
| timely submit a claim to the third party payor, the hospital | 7 |
| may not bill the patient for any amount in excess of that for | 8 |
| which the patient would have been responsible had the third | 9 |
| party payor paid the claim. | 10 |
| (c) A hospital may not refer any bill to a debt collection | 11 |
| agency or attorney for collection activity while a claim for | 12 |
| payment of the bill is pending with a third party payor with | 13 |
| which the hospital has a contract. A hospital may refer a bill | 14 |
| to a collection agency or attorney following an initial denial | 15 |
| of the claim by the third party payor. A hospital may not refer | 16 |
| a bill to a collection agency or attorney for collection | 17 |
| activity if a claim is denied by a third party payor due to the | 18 |
| hospital's error and that error results in the patient becoming | 19 |
| liable for the debt if the patient would not otherwise be | 20 |
| liable. | 21 |
| (d) The General Assembly recognizes that, in order for a | 22 |
| hospital to properly bill a patient's insurance company, the | 23 |
| hospital may need the patient's cooperation and that the | 24 |
| hospital may not be able to properly bill the patient's
| 25 |
| insurance company without the patient's cooperation. | 26 |
| (e) If a hospital believes that a private third party payor | 27 |
| has improperly delayed or denied payment of a claim, the | 28 |
| hospital may file a complaint with the Department, which may | 29 |
| provide assistance to the hospital or its patient in attempting | 30 |
| to get the claim paid.
| 31 |
| Section 20-10. Questioning or disputing bills. A hospital | 32 |
| shall implement a streamlined process for patients to question | 33 |
| or dispute bills, including a toll-free phone number that | 34 |
| patients may call and an address to which they may write. The | 35 |
| phone number and address shall be listed on all patient bills |
|
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| and collection notices sent by the hospital. The hospital shall | 2 |
| return telephone calls made by patients to this number as | 3 |
| promptly as possible, but in no event later than one business | 4 |
| day after the call is received. For purposes of this Section, | 5 |
| "business day" means a day on which the hospital's billing | 6 |
| office is open for regular business. The hospital shall respond | 7 |
| to correspondence sent to this address by patients within 10 | 8 |
| days after the correspondence is received. | 9 |
| Section 20-15. Documenting claim. If a patient advises a | 10 |
| hospital or a collection agency or attorney with whom the | 11 |
| hospital has contracted for the collection of medical debt that | 12 |
| (i) the patient does not owe all or part of a bill, (ii) a third | 13 |
| party payor should pay the bill, or (iii) the patient needs | 14 |
| documentation concerning the bill, the hospital, the | 15 |
| collection agency, and the attorney must cease further | 16 |
| collection efforts until the hospital or the agency provides | 17 |
| the patient with documentation establishing that, as | 18 |
| applicable, (A) the patient owes the debt or (B) the applicable | 19 |
| third party payor has already paid all amounts for which it is | 20 |
| obligated. The hospital or the collection agency must provide | 21 |
| this documentation in writing within 10 days after it is | 22 |
| requested and may not pursue further collection activity for a | 23 |
| period of 30 days after providing proof that the debt is owed, | 24 |
| so as to give the patient further opportunity to pay the bill | 25 |
| or to challenge the documentation supplied by the hospital. If | 26 |
| the hospital provides the required documentation and the | 27 |
| patient does not respond within 30 days, the hospital may | 28 |
| resume collection activity. | 29 |
| Section 20-20. Log of patient complaints. A hospital shall | 30 |
| develop a system to record and log all patient complaints | 31 |
| received by the hospital's billing office, including at the | 32 |
| addresses identified by the hospital under Section 20-10, | 33 |
| regarding the collection of medical debt by the hospital or by | 34 |
| any collection agency or attorney with whom the hospital has |
|
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| contracted for the collection of medical debt. The hospital may | 2 |
| maintain such records at more than one location. | 3 |
| Article 25. Billing to the Uninsured | 4 |
| Section 25-5. Provision of itemized bill. If a hospital | 5 |
| demands that an uninsured patient pay a medical bill, the | 6 |
| hospital must provide to that patient a detailed, itemized bill | 7 |
| as part of the billing process. | 8 |
| Section 25-10. Limitation on amount charged. | 9 |
| (a) In this Section: | 10 |
| "Most favored insurer" means the nongovernmental third | 11 |
| party payor that provided the most revenue to the hospital | 12 |
| during the previous calendar year. | 13 |
| "Uninsured treatment" means any treatment or services that | 14 |
| are not covered by a plan, contract, or policy that provides | 15 |
| coverage to a patient through or is issued to a patient by
(i) | 16 |
| a self-funded employee benefit plan, (ii) any governmental | 17 |
| program, including, but not limited to, Medicare, medical | 18 |
| assistance under the Illinois Public Aid Code, or the | 19 |
| Children's Health Insurance Program, (iii) any other type of | 20 |
| health insurance, health maintenance, or health plan coverage, | 21 |
| or (iv) any other type of insurance coverage, including but not | 22 |
| limited to no-fault automobile coverage, workers' compensation | 23 |
| coverage, or liability coverage. | 24 |
| (b) A hospital may not charge a patient whose annual | 25 |
| household income is less than $125,000 for any uninsured | 26 |
| treatment in an amount greater than the amount that the | 27 |
| hospital would be reimbursed for that service or treatment from | 28 |
| its most favored insurer. The total charge for uninsured | 29 |
| treatment may not be more than the hospital would be reimbursed | 30 |
| directly from its most favored insurer and from that insurer's | 31 |
| policyholder under any applicable and allowable copayments, | 32 |
| deductibles, or coinsurance. | 33 |
| A hospital shall apply the same percentage discount to its |
|
|
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| charge description master for uninsured treatment that it would | 2 |
| apply to charges incurred by a policyholder of its most favored | 3 |
| insurer. Beginning on the effective date of this Act, each year | 4 |
| a hospital and the Department may agree in advance, by a | 5 |
| confidential letter agreement, on the percentage discount from | 6 |
| the charge description master that the hospital provides to its | 7 |
| most favored insurer and that a hospital shall provide for | 8 |
| uninsured treatment under this Section. A hospital shall | 9 |
| provide to the Department, pursuant to Section 30-25, any | 10 |
| information requested by the Department for purposes of | 11 |
| calculating this discount.
The hospital shall utilize the same | 12 |
| initial charge description master prices for uninsured | 13 |
| treatment that it utilizes for treatment provided to a | 14 |
| policyholder of its most favored insurer.
| 15 |
| (c) If a hospital inadvertently sends a bill to a patient | 16 |
| in an amount that exceeds the amount that is allowed by this | 17 |
| Section because the hospital is not aware that the treatment or | 18 |
| service constitutes uninsured treatment, and if the hospital | 19 |
| thereafter learns that the treatment or service constitutes | 20 |
| uninsured treatment, the hospital shall promptly adjust its | 21 |
| charges so as not to exceed the amount allowable under this | 22 |
| Section and shall promptly notify the patient of the new amount | 23 |
| of the bill. | 24 |
| (d) This Section applies only to medically necessary health | 25 |
| care treatment and does not apply to cosmetic procedures that | 26 |
| are not medically necessary. | 27 |
| Section 25-15. Hospital staff training. In recognition | 28 |
| that some patients express their financial concerns directly to | 29 |
| their treatment providers (for example, doctors or nurses), a | 30 |
| hospital shall train its staff responsible for admissions, | 31 |
| billing, and providing direct patient treatment concerning the | 32 |
| existence of the hospital's charity care policy and how a | 33 |
| patient may obtain more information about the hospital's | 34 |
| charity care policy or submit an application for charity care. |
|
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| 1 |
| Article 30. Miscellaneous Provisions | 2 |
| Section 30-5. No approval of collection by Department or | 3 |
| State. Neither a hospital nor its agents may state or imply, | 4 |
| directly or indirectly, that the State of Illinois or the | 5 |
| Department has approved of, condones, or agrees with any | 6 |
| lawsuit, garnishment, wage deduction, or other attempt by the | 7 |
| hospital to collect medical debt from a patient. | 8 |
| Section 30-10. Required hospital policies. A hospital's | 9 |
| governing body shall adopt all of the following policies, which | 10 |
| shall not be inconsistent with this Act: | 11 |
| (1) A zero tolerance policy for abusive, harassing, | 12 |
| oppressive, false, deceptive, or misleading language or | 13 |
| collections conduct by any collection agency or attorney | 14 |
| with whom the hospital has contracted for the collection of | 15 |
| medical debt, any agent or employee of such a collection | 16 |
| agency or attorney, or any hospital employee who | 17 |
| participates in the collection of medical debt from | 18 |
| patients. | 19 |
| (2) A debt collection litigation policy, which shall | 20 |
| include a policy permitting the garnishment of a patient's | 21 |
| bank accounts or deductions from a patient's wages only | 22 |
| after entry of a judgment. | 23 |
| (3) A policy establishing the procedures to be utilized | 24 |
| by every collection agency with whom the hospital contracts | 25 |
| for the collection of medical debt. | 26 |
| (4) A policy establishing the procedures to be utilized | 27 |
| by the hospital's employees who participate in the | 28 |
| collection of medical debt. | 29 |
| (5) A charity care policy that takes into consideration | 30 |
| the financial ability of the patient to pay a medical bill. | 31 |
| Section 30-15. Required hospital practices. At least once | 32 |
| each year, a hospital's governing body shall review the | 33 |
| hospital's practices in each of the following areas: |
|
|
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| 1 |
| (1) The filing of debt collection litigation against | 2 |
| hospital patients, including the garnishment of a | 3 |
| patient's bank accounts or deductions from a patient's | 4 |
| wages after entry of a default judgment. | 5 |
| (2) The debt collection activities of each collection | 6 |
| agency with which the hospital contracts for the collection | 7 |
| of medical debt. | 8 |
| (3) The debt collection activities of the hospital's | 9 |
| employees who participate in the collection of medical | 10 |
| debt.
| 11 |
| (4) The hospital's compliance with this Act and the | 12 |
| policies adopted under Section 30-10.
| 13 |
| (5) The results of the reviews conducted by the | 14 |
| hospital's chief executive officer under Sections 5-10 and | 15 |
| 15-5.
| 16 |
| (6) The results of the audits required by Section | 17 |
| 30-20.
| 18 |
| (7) The hospital's charity care practices.
| 19 |
| Section 30-20. Audit. At least once each year, a hospital | 20 |
| shall audit (i) the practices of every collection agency and | 21 |
| attorney with whom it has contracted for the collection of | 22 |
| medical debt and (ii) its internal medical debt collection | 23 |
| practices. At a minimum, the audits shall review compliance | 24 |
| with this Act and the hospital's policies. | 25 |
| Section 30-25. Cooperation with Department. A hospital | 26 |
| shall cooperate with, respond to inquires of, and provide | 27 |
| information to the Department in a timely manner as necessary | 28 |
| for the enforcement of this Act. | 29 |
| Section 30-30. Deferral of Department action against | 30 |
| hospital. The Department shall defer enforcement action | 31 |
| against a hospital as it relates to the prices charged by the | 32 |
| hospital to uninsured patients, the hospital's medical debt | 33 |
| collection practices, and the hospital's charity care |
|
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| 1 |
| practices while this Act is in effect, except to enforce the | 2 |
| provisions of this Act. | 3 |
| Article 90. Amendatory Provisions | 4 |
| Section 90-5. The University of Illinois Hospital Act is | 5 |
| amended by changing Section 5 as follows:
| 6 |
| (110 ILCS 330/5) (from Ch. 23, par. 1375)
| 7 |
| Sec. 5. | 8 |
| (a) The University may establish and collect charges for | 9 |
| hospital
services rendered in the University of Illinois | 10 |
| Hospital or in connection
with a University health care | 11 |
| program. However, with
respect to health care professional | 12 |
| services rendered in connection with
a University health care | 13 |
| program at the University
of Illinois Hospital or elsewhere by | 14 |
| the
Doctors of Medicine, the Doctors of Dentistry, or other | 15 |
| health
care
professionals who are members of the University
| 16 |
| faculty,
charges for such professional services shall not be | 17 |
| established or
collected by the University or the University of | 18 |
| Illinois Hospital but may
be by said members of said faculty | 19 |
| who render such services under a
plan or plans organized and | 20 |
| administered by them. All such charges shall be
deposited in a | 21 |
| special fund or funds in the treasury of the University. The
| 22 |
| billing, collecting and disbursing of any such fund shall | 23 |
| remain
exclusively under the supervision and control of such | 24 |
| faculty under a
plan or plans established by them for the | 25 |
| general benefit and support of
University programs and | 26 |
| activities related to the health professions, provided
no | 27 |
| charges may be
made or collected until such plan has been | 28 |
| approved by the University.
However, no person shall make or | 29 |
| collect a personal or professional
charge for his own account | 30 |
| for treating, caring for or nursing a
patient in the University | 31 |
| of Illinois Hospital
(other than health care professional | 32 |
| services provided at the University of
Illinois Hospital by
| 33 |
| non-salaried
adjunct
University faculty who are licensed |
|
|
|
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| 1 |
| dentists or physicians licensed to
practice medicine in all its | 2 |
| branches
members)
or in connection with a
University
health | 3 |
| care program. Nothing herein shall prevent the University from | 4 |
| approving
a plan under which any such fund in the University | 5 |
| treasury may be utilized
in paying the University salaries of | 6 |
| such faculty members, or from assisting
in the billing and | 7 |
| collection of professional charges if all University
costs in | 8 |
| connection therewith are paid from the charges so collected. | 9 |
| (b) The University's collection of charges under this | 10 |
| Section is subject to the Hospital Billing and Collection | 11 |
| Practices Act.
| 12 |
| (Source: P.A. 91-206, eff. 7-20-99; 92-760, eff. 8-2-02.)
| 13 |
| Section 90-10. The Hospital Licensing Act is amended by | 14 |
| changing Section 7 as follows:
| 15 |
| (210 ILCS 85/7) (from Ch. 111 1/2, par. 148)
| 16 |
| Sec. 7. (a) The Director after notice and opportunity for | 17 |
| hearing to the
applicant or licensee may deny, suspend, or | 18 |
| revoke a permit to establish a
hospital or deny, suspend, or | 19 |
| revoke a license to open, conduct, operate,
and maintain a | 20 |
| hospital in any case in which he finds that there has been a
| 21 |
| substantial failure to comply with the provisions of this Act ,
| 22 |
| or the Hospital
Report Card Act , or the Hospital Billing and | 23 |
| Collection Practices Act or the standards, rules, and | 24 |
| regulations established by
virtue of any
either of those Acts.
| 25 |
| (b) Such notice shall be effected by registered mail or by | 26 |
| personal
service setting forth the particular reasons for the | 27 |
| proposed action and
fixing a date, not less than 15 days from | 28 |
| the date of such mailing or
service, at which time the | 29 |
| applicant or licensee shall be given an
opportunity for a | 30 |
| hearing. Such hearing shall be conducted by the Director
or by | 31 |
| an employee of the Department designated in writing by the | 32 |
| Director
as Hearing Officer to conduct the hearing. On the | 33 |
| basis of any such
hearing, or upon default of the applicant or | 34 |
| licensee, the Director shall
make a determination specifying |
|
|
|
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| 1 |
| his findings and conclusions. In case of a
denial to an | 2 |
| applicant of a permit to establish a hospital, such
| 3 |
| determination shall specify the subsection of Section 6 under | 4 |
| which the
permit was denied and shall contain findings of fact | 5 |
| forming the basis of
such denial. A copy of such determination | 6 |
| shall be sent by registered mail
or served personally upon the | 7 |
| applicant or licensee. The decision denying,
suspending, or | 8 |
| revoking a permit or a license shall become final 35 days
after | 9 |
| it is so mailed or served, unless the applicant or licensee, | 10 |
| within
such 35 day period, petitions for review pursuant to | 11 |
| Section 13.
| 12 |
| (c) The procedure governing hearings authorized by this | 13 |
| Section shall be
in accordance with rules promulgated by the | 14 |
| Department and approved by the
Hospital Licensing Board. A full | 15 |
| and complete record shall be kept of all
proceedings, including | 16 |
| the notice of hearing, complaint, and all other
documents in | 17 |
| the nature of pleadings, written motions filed in the
| 18 |
| proceedings, and the report and orders of the Director and | 19 |
| Hearing Officer.
All testimony shall be reported but need not | 20 |
| be transcribed unless the
decision is appealed pursuant to | 21 |
| Section 13. A copy or copies of the
transcript may be obtained | 22 |
| by any interested party on payment of the cost
of preparing | 23 |
| such copy or copies.
| 24 |
| (d) The Director or Hearing Officer shall upon his own | 25 |
| motion, or on the
written request of any party to the | 26 |
| proceeding, issue subpoenas requiring
the attendance and the | 27 |
| giving of testimony by witnesses, and subpoenas
duces tecum | 28 |
| requiring the production of books, papers, records, or
| 29 |
| memoranda. All subpoenas and subpoenas duces tecum issued under | 30 |
| the terms
of this Act may be served by any person of full age. | 31 |
| The fees of witnesses
for attendance and travel shall be the | 32 |
| same as the fees of witnesses before
the Circuit Court of this | 33 |
| State, such fees to be paid when the witness is
excused from | 34 |
| further attendance. When the witness is subpoenaed at the
| 35 |
| instance of the Director, or Hearing Officer, such fees shall | 36 |
| be paid in
the same manner as other expenses of the Department, |
|
|
|
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| 1 |
| and when the witness
is subpoenaed at the instance of any other | 2 |
| party to any such proceeding the
Department may require that | 3 |
| the cost of service of the subpoena or subpoena
duces tecum and | 4 |
| the fee of the witness be borne by the party at whose
instance | 5 |
| the witness is summoned. In such case, the Department in its
| 6 |
| discretion, may require a deposit to cover the cost of such | 7 |
| service and
witness fees. A subpoena or subpoena duces tecum | 8 |
| issued as aforesaid shall
be served in the same manner as a | 9 |
| subpoena issued out of a court.
| 10 |
| (e) Any Circuit Court of this State upon the application of | 11 |
| the
Director, or upon the application of any other party to the | 12 |
| proceeding,
may, in its discretion, compel the attendance of | 13 |
| witnesses, the production
of books, papers, records, or | 14 |
| memoranda and the giving of testimony before
the Director or | 15 |
| Hearing Officer conducting an investigation or holding a
| 16 |
| hearing authorized by this Act, by an attachment for contempt, | 17 |
| or
otherwise, in the same manner as production of evidence may | 18 |
| be compelled
before the court.
| 19 |
| (f) The Director or Hearing Officer, or any party in an | 20 |
| investigation or
hearing before the Department, may cause the | 21 |
| depositions of witnesses
within the State to be taken in the | 22 |
| manner prescribed by law for like
depositions in civil actions | 23 |
| in courts of this State, and to that end
compel the attendance | 24 |
| of witnesses and the production of books, papers,
records, or | 25 |
| memoranda.
| 26 |
| (Source: P.A. 93-563, eff. 1-1-04.)
| 27 |
| Section 90-15. The Code of Civil Procedure is amended by | 28 |
| adding Sections 12-701.5 and 12-801.5 as follows: | 29 |
| (735 ILCS 5/12-701.5 new)
| 30 |
| Sec. 12-701.5. Hospital Billing and Collection Practices | 31 |
| Act. In a garnishment proceeding that is subject to the | 32 |
| Hospital Billing and Collection Practices Act, to the extent | 33 |
| that there is a conflict between a provision of that Act and a | 34 |
| provision of this Part 7, the provision of the Hospital Billing |
|
|
|
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| 1 |
| and Collection Practices Act controls. | 2 |
| (735 ILCS 5/12-801.5 new)
| 3 |
| Sec. 12-801.5. Hospital Billing and Collection Practices | 4 |
| Act. In a wage deduction proceeding that is subject to the | 5 |
| Hospital Billing and Collection Practices Act, to the extent | 6 |
| that there is a conflict between a provision of that Act and a | 7 |
| provision of this Part 8, the provision of the Hospital Billing | 8 |
| and Collection Practices Act controls. | 9 |
| Article 99. Effective Date
| 10 |
| Section 99-99. Effective date. This Act takes effect | 11 |
| January 1, 2006.
|
|