(210 ILCS 76/10)
Sec. 10. Definitions. As used in this Act:
"Bad debt" means the current period charge for actual or expected doubtful accounting resulting from the extension of credit. "Charity care" means care provided by a health care provider for which the
provider does not expect to receive payment from the patient or a third party
payer. "Charity care" includes the actual cost of services provided based upon the total cost to charge ratio derived from a nonprofit hospital's most recently filed Medicare cost report Worksheet C and not based upon the charges for the services. "Charity care" does not include bad debt.
"Community benefits" means the unreimbursed cost to a hospital or health
system of providing charity care, language assistant services,
government-sponsored health care, donations, volunteer services,
education, government-sponsored program services, research, and subsidized
health services and collecting bad debts.
"Community benefits" does not include the cost of paying any taxes or other
governmental assessments. "Financial assistance" means a discount provided to a patient under the terms and conditions the hospital offers to qualified patients or as required by law.
"Government-sponsored health care" means the unreimbursed cost to a
hospital or health system of Medicare, providing health care services to
recipients of Medicaid,
and other
federal, State, or local health care programs, eligibility for which
is based on
financial need.
"Health system" means an entity that owns or operates at least one hospital. "Net patient revenue" means gross service revenue less provisions for contractual adjustments with third-party payors, courtesy and policy discounts, or other adjustments and deductions, excluding charity care.
"Nonprofit hospital" means a hospital that is organized as a nonprofit
corporation,
including religious organizations, or a charitable trust under Illinois law or
the laws of
any other state or country.
"Subsidized health services" means those services provided by a hospital in
response to community needs for which the reimbursement is less than the
hospital's cost of providing the services that must be subsidized by other
hospital or nonprofit supporting entity revenue sources. "Subsidized health
services" includes, but is not limited to, emergency and trauma care,
neonatal intensive care, community health clinics, and collaborative efforts
with local government or private agencies to prevent illness and improve
wellness, such as immunization programs.
(Source: P.A. 102-581, eff. 1-1-22.)
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(210 ILCS 76/15)
Sec. 15. Organizational mission statement; community benefits plan. A
nonprofit hospital shall develop:
(1) an organizational mission statement that |
| identifies the hospital's commitment to serving the health care needs of the community; and
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(2) a community benefits plan defined as an
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| operational plan for serving the community's health care needs that:
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(A) sets out goals and objectives for providing
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| community benefits that include charity care and government-sponsored health care;
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(B) identifies the populations and communities
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| served by the hospital; and
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(C) describes activities the hospital is
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| undertaking to address health equity, reduce health disparities, and improve community health. This may include, but is not limited to:
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(i) efforts to recruit and promote a racially
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| and culturally diverse and representative workforce;
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(ii) efforts to procure goods and services
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| locally and from historically underrepresented communities;
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(iii) training that addresses cultural
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| competency and implicit bias; and
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(iv) partnerships and investments to address
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| social needs such as food, housing, and community safety.
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(Source: P.A. 102-581, eff. 1-1-22.)
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(210 ILCS 76/20)
Sec. 20. Annual report for community benefits plan.
(a) Each nonprofit hospital shall prepare an annual report of the community
benefits plan. The report must include, in addition to the community benefits
plan itself,
all of the following background information:
(1) The hospital's mission statement.
(2) A disclosure of the health care needs of the |
| community that were considered in developing the hospital's community benefits plan.
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(3) A disclosure of the amount and types of community
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| benefits actually provided, including charity care, and details about financial assistance applications received and processed by the hospital as specified in paragraph (5) of subsection (a) of Section 22. Charity care must be reported separate from other community benefits. In reporting charity care, the hospital must report the actual cost of services provided, based on the total cost to charge ratio derived from the hospital's Medicare cost report (CMS 2552-96 Worksheet C, Part 1, PPS Inpatient Ratios), not the charges for the services. For a health system that includes more than one hospital, charity care spending and financial assistance application data must be reported separately for each individual hospital within the health system.
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(4) Audited annual financial reports for its most
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| recently completed fiscal year.
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(b) Each nonprofit hospital shall annually file a report of the community
benefits
plan with the Attorney General. The report must be filed not later than the
last day of the sixth month after the close of the hospital's fiscal year,
beginning with the hospital fiscal year that ends in 2004.
(c) Each nonprofit hospital shall prepare a statement that notifies the
public
that
the annual report of the community benefits plan is:
(1) public information;
(2) filed with the Attorney General; and
(3) available to the public on request from the
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This statement shall be made available to the public.
(d) The obligations of a hospital under this Act, except for the filing of
its audited financial report, shall take effect beginning with the hospital's
fiscal year that begins after the effective date of this Act. Within 60 days
of the effective date of this Act, a hospital shall file the audited annual
financial report that has been completed for its most recently completed fiscal
year. Thereafter, a hospital shall include its audited annual financial report
for its most recently completed fiscal year in its annual report of its
community benefits plan.
(Source: P.A. 102-581, eff. 1-1-22.)
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(210 ILCS 76/22) Sec. 22. Public reports. (a) In order to increase transparency and accessibility of charity care and financial assistance data, a hospital shall make the annual hospital community benefits plan report submitted to the Attorney General under Section 20 available to the public by publishing the information on the hospital's website in the same location where annual reports are posted or on a prominent location on the homepage of the hospital's website. A hospital is not required to post its audited financial statements. Information made available to the public shall include, but shall not be limited to, the following: (1) The reporting period. (2) Charity care costs consistent with the reporting |
| requirements in paragraph (3) of subsection (a) of Section 20. Charity care costs associated with services provided in a hospital's emergency department shall be reported as a subset of total charity care costs.
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(3) Total net patient revenue, reported separately by
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| hospital if the reporting health system includes more than one hospital.
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(4) Total community benefits spending. If a hospital
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| is owned or operated by a health system, total community benefits spending may be reported as a health system.
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(5) Data on financial assistance applications
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| consistent with the reporting requirements in paragraph (3) of subsection (a) of Section 20, including:
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(A) the number of applications submitted to the
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| hospital, both complete and incomplete;
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(B) the number of applications approved;
(C) the number of applications denied and the 5
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| most frequent reasons for denial; and
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(D) the number of uninsured patients who have
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| declined or failed to respond to the screening described in subsection (a) of Section 16 of the Fair Patient Billing Act and the 5 most frequent reasons for declining.
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(6) To the extent that race, ethnicity, sex, or
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| preferred language is collected and available for financial assistance applications, the data outlined in paragraph (5) shall be reported by race, ethnicity, sex, and preferred language. If this data is not provided by the patient, the hospital shall indicate this in its reports. Public reporting of this information shall begin with the community benefit report filed on or after July 1, 2022. A hospital that files a report without having a full year of demographic data as required by this Act may indicate this in its report.
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(b) The Attorney General shall provide notice on the Attorney General's website informing the public that, upon request, the Attorney General will provide the annual reports filed with the Attorney General under Section 20. The notice shall include the contact information to submit a request.
(Source: P.A. 102-581, eff. 1-1-22; 103-323, eff. 1-1-24.)
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