Full Text of SB2170 94th General Assembly
SB2170ham001 94TH GENERAL ASSEMBLY
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Rep. Elaine Nekritz
Filed: 4/3/2006
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| AMENDMENT TO SENATE BILL 2170
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| AMENDMENT NO. ______. Amend Senate Bill 2170 by replacing | 3 |
| everything after the enacting clause with the following:
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| "Section 5. The Nursing Home Care Act is amended by adding | 5 |
| Section 2-217 as follows: | 6 |
| (210 ILCS 45/2-217 new) | 7 |
| Sec. 2-217. Order for transportation of resident by | 8 |
| ambulance. If a facility orders transportation of a resident of | 9 |
| the facility by ambulance, the facility must maintain a written | 10 |
| record that shows (i) the name of the person who placed the | 11 |
| order for that transportation and (ii) the medical reason for | 12 |
| that transportation. The facility must maintain the record for | 13 |
| a period of at least 3 years after the date of the order for | 14 |
| transportation by ambulance. | 15 |
| Section 10. The Hospital Licensing Act is amended by adding | 16 |
| Section 6.22 as follows: | 17 |
| (210 ILCS 85/6.22 new) | 18 |
| Sec. 6.22. Arrangement for transportation of patient by | 19 |
| ambulance.
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| (a) In this Section: | 21 |
| "Ambulance service provider" means a Vehicle Service | 22 |
| Provider as defined in the Emergency Medical Services (EMS) |
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| Systems Act who provides non-emergency transportation | 2 |
| services by ambulance. | 3 |
| "Patient" means a person who is transported by an | 4 |
| ambulance service provider.
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| (b) If a hospital arranges for transportation of a patient | 6 |
| of the hospital by ambulance, the hospital must provide the | 7 |
| ambulance service provider, prior to transport, a Physician | 8 |
| Certification Statement formatted and completed in compliance | 9 |
| with federal regulations or an equivalent form developed by the | 10 |
| hospital. The Physician Certification Statement or equivalent | 11 |
| form is not required prior to transport if a delay in transport | 12 |
| can be expected to negatively affect the patient outcome. | 13 |
| (c) If a hospital is unable to provide a Physician | 14 |
| Certification Statement or equivalent form, then the hospital | 15 |
| shall provide to the patient a written notice and a verbal | 16 |
| explanation of the written notice, which notice must meet all | 17 |
| of the following requirements:
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| (1) The following caption must appear at the beginning | 19 |
| of the notice in at least 14-point type: Notice to Patient | 20 |
| Regarding Non-Emergency Ambulance Services. | 21 |
| (2) The notice must contain each of the following | 22 |
| statements in at least 14-point type: | 23 |
| (A) The purpose of this notice is to help you make | 24 |
| an informed choice about whether you want to be | 25 |
| transported by ambulance because your medical | 26 |
| condition does not meet medical necessity for | 27 |
| transportation by an ambulance. | 28 |
| (B) Your insurance may not cover the charges for | 29 |
| ambulance transportation. | 30 |
| (C) You may be responsible for the cost of | 31 |
| ambulance transportation. | 32 |
| (D) The estimated cost of ambulance transportation | 33 |
| is $(amount). | 34 |
| (3) The notice must be signed by the patient or by the |
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| patient's authorized representative. A copy shall be given | 2 |
| to the patient and the hospital shall retain a copy. | 3 |
| (d) The notice set forth in subsection (c) of this Section | 4 |
| shall not be required if a delay in transport can be expected | 5 |
| to negatively affect the patient outcome. | 6 |
| (e) If a patient is physically or mentally unable to sign | 7 |
| the notice described in subsection (c) of this Section and no | 8 |
| authorized representative of the patient is available to sign | 9 |
| the notice on the patient's behalf, the hospital must be able | 10 |
| to provide documentation of the patient's inability to sign the | 11 |
| notice and the unavailability of an authorized representative. | 12 |
| In any case described in this subsection (e), the hospital | 13 |
| shall be considered to have met the requirements of subsection | 14 |
| (c) of this Section.
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| Section 15. The Consumer Fraud and Deceptive Business | 16 |
| Practices Act is amended by adding Section 2XX as follows: | 17 |
| (815 ILCS 505/2XX new) | 18 |
| Sec. 2XX. Notification requirements for non-emergency | 19 |
| ambulance services. | 20 |
| (a) In this Section: | 21 |
| "Ambulance service provider" means a Vehicle Service | 22 |
| Provider, as defined in the Emergency Medical Services (EMS) | 23 |
| Systems Act, who provides non-emergency transportation | 24 |
| services by ambulance. | 25 |
| "Patient" means a person who is transported by an ambulance | 26 |
| service provider. | 27 |
| (b) An ambulance service provider shall provide a written | 28 |
| notice, and a verbal explanation of the written notice, prior | 29 |
| to non-emergency ambulance transports that originate at a | 30 |
| health care facility other than a hospital when no written | 31 |
| documentation of medical necessity is available at the time of | 32 |
| transport. This notice must meet all of the following |
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| requirements: | 2 |
| (1) The following caption must appear at the beginning | 3 |
| of the notice, in at least 14-point type: Notice to Patient | 4 |
| Regarding Non-Emergency Ambulance Services. | 5 |
| (2) The remainder of the notice must be expressed in | 6 |
| clear, simple language and in at least 14-point type. | 7 |
| (3) The notice must contain each of the following | 8 |
| statements: | 9 |
| (A) Notice: Medicare and other insurers may not pay | 10 |
| for any part of the cost of your transport by ambulance | 11 |
| unless certified by your physician or healthcare | 12 |
| provider as allowed under federal rules as being | 13 |
| medically necessary. | 14 |
| (B) The purpose of this notice is to help you make | 15 |
| an informed choice about whether or not you want to be | 16 |
| transported by ambulance, knowing that you might have | 17 |
| to pay for this transport yourself. Before you make any | 18 |
| decision about your options, you should: | 19 |
| (i) Read this entire notice carefully.
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| (ii) Ask a representative of the physician or | 21 |
| facility ordering transport to explain, if you do | 22 |
| not understand or are not sure, the guidelines | 23 |
| regarding medical necessity for transport by | 24 |
| ambulance and to tell you whether or not you meet | 25 |
| these guidelines. | 26 |
| (iii) Ask us how much being transported by | 27 |
| ambulance will cost you, in case you have to pay | 28 |
| for transport by ambulance out of your own pocket | 29 |
| or through other insurance. The estimated cost | 30 |
| will be $(amount).
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| (C) Please choose one option by checking one box | 32 |
| and signing and dating your selection below: | 33 |
| (i) Option 1. Yes. I want to be transported by | 34 |
| ambulance. I understand that Medicare and many |
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| other insurers may not pay for any part of the cost | 2 |
| of my ambulance transport unless certified by my | 3 |
| physician or healthcare provider as allowed under | 4 |
| federal rules as being medically necessary. I | 5 |
| understand that you will file a claim on my behalf | 6 |
| to Medicare or my other insurer. I understand that | 7 |
| you may bill me for items or services and that I | 8 |
| may have to pay the bill while Medicare or my other | 9 |
| insurer is making its decision. If Medicare or my | 10 |
| other insurer does pay on my behalf, I understand | 11 |
| that you will refund to me any payments that I made | 12 |
| to you that are due to me. If Medicare or my other | 13 |
| insurer denies payment, I agree to be personally | 14 |
| and fully responsible for payment. I understand | 15 |
| that I can appeal the decision made by Medicare or | 16 |
| my other insurer. | 17 |
| (ii) Option 2. No. I have decided not to be | 18 |
| transported by ambulance. | 19 |
| (4) The notice must be signed by the patient or by the | 20 |
| patient's authorized
representative. | 21 |
| (5) The notice must contain the patient's full name and | 22 |
| the date of service.
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| (6) The notice must contain the full name and business | 24 |
| address (including the street name and number, city, state, | 25 |
| and zip code) of the ambulance service provider.
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| (c) If a patient is physically or mentally unable to sign | 27 |
| the notice described in subsection (b) at the time of transport | 28 |
| by ambulance and no authorized representative of the patient is | 29 |
| available to sign the notice on the patient's behalf, the | 30 |
| ambulance service provider must be able to provide | 31 |
| documentation of the patient's inability to sign the notice and | 32 |
| the unavailability of an authorized representative. In any case | 33 |
| described in this subsection (c), the ambulance service | 34 |
| provider shall be considered to have met the requirements of |
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| subsection (b).
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| (d) If an ambulance service provider has obtained | 3 |
| documentation of medical necessity prior to transport and the | 4 |
| patient's Medicare or other insurer denies the claim for | 5 |
| transport by ambulance despite this fact, the ambulance service | 6 |
| provider is considered to have met the requirements of | 7 |
| subsection (b). | 8 |
| (e) In addition to any other penalty provided in this Act, | 9 |
| if the court finds that an ambulance service provider has | 10 |
| violated any provision of subsection (b), the court may order | 11 |
| that the ambulance service provider pay to the patient an | 12 |
| amount equal to 3 times the amount claimed due by the ambulance | 13 |
| provider, including any interest, collection costs, and | 14 |
| attorney's fees claimed by the ambulance service provider, and | 15 |
| any attorney's fees incurred by the patient. ".
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