SB2170 94TH GENERAL ASSEMBLY

LRB094 13493 DRJ 50420 b

94TH GENERAL ASSEMBLY
State of Illinois
2005 and 2006
SB2170

Introduced 1/4/2006, by Sen. Susan Garrett

SYNOPSIS AS INTRODUCED:

210 ILCS 45/2-217 new
210 ILCS 50/3.85
210 ILCS 85/6.22 new
815 ILCS 505/2XX new

Amends the Nursing Home Care Act and the Hospital Licensing Act; provides that a nursing home or hospital that orders transportation of a resident or patient by ambulance must maintain a written record showing the name of the person who placed the order for that transportation and the medical reason for that transportation. Amends the Emergency Medical Services (EMS) Systems Act; authorizes the Department of Public Health to suspend, for a period not exceeding 30 days, the license of any vehicle service provider, after an opportunity for a hearing, when findings show that the provider has directly or indirectly given, offered, or promised anything of value to a facility licensed under the Nursing Home Care Act or the Hospital Licensing Act for the purpose of influencing the facility to use the provider's services for the transportation of residents or patients of the facility. Amends the Consumer Fraud and Deceptive Business Practices Act. Sets forth statements that must be included in an agreement for emergency or non-emergency transportation of a patient by an ambulance service provider, and requires that such an agreement contain certain other information and be printed in type of a certain size. Requires that the agreement be signed by the patient or the patient's authorized representative and by the ambulance service provider's authorized agent. Requires that the patient or the patient's authorized representative be provided with an executed copy of the agreement. Provides that it is an unlawful practice under the Act for an ambulance service provider to enter into an agreement with a patient, or a person acting on the patient's behalf, that does not comply with these requirements. Provides that if the court finds that an ambulance service provider has violated any of the requirements concerning an agreement with a patient, the court may order that the ambulance service provider pay to the patient an amount equal to 3 times the maximum amount stated in the agreement that will be due from the patient or, if no such maximum amount is stated in the agreement, 3 times the amount claimed due by the ambulance service provider, including any interest, collection costs, and attorney's fees claimed by the provider.

A BILL FOR

AN ACT concerning business.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Nursing Home Care Act is amended by adding Section 2-217 as follows:

(210 ILCS 45/2-217 new)

Sec. 2-217. Order for transportation of resident by ambulance. If a facility orders transportation of a resident of the facility by ambulance, the facility must maintain a written record that shows (i) the name of the person who placed the order for that transportation and (ii) the medical reason for that transportation.

Section 10. The Emergency Medical Services (EMS) Systems Act is amended by changing Section 3.85 as follows:

(210 ILCS 50/3.85)

Sec. 3.85. Vehicle Service Providers.

(a) "Vehicle Service Provider" means an entity licensed by the Department to provide emergency or non-emergency medical services in compliance with this Act, the rules promulgated by the Department pursuant to this Act, and an operational plan approved by its EMS System(s), utilizing at least ambulances or specialized emergency medical service vehicles (SEMSV).

(1) "Ambulance" means any publicly or privately owned on-road vehicle that is specifically designed, constructed or modified and equipped, and is intended to be used for, and is maintained or operated for the emergency transportation of persons who are sick, injured, wounded or otherwise incapacitated or helpless, or the non-emergency medical transportation of persons who require the presence of medical personnel to monitor the individual's condition or medical apparatus being used on such individuals.

(2) "Specialized Emergency Medical Services Vehicle" or "SEMSV" means a vehicle or conveyance, other than those owned or operated by the federal government, that is primarily intended for use in transporting the sick or injured by means of air, water, or ground transportation, that is not an ambulance as defined in this Act. The term includes watercraft, aircraft and special purpose ground transport vehicles or conveyances not intended for use on public roads.

(3) An ambulance or SEMSV may also be designated as a Limited Operation Vehicle or Special-Use Vehicle:

(A) "Limited Operation Vehicle" means a vehicle which is licensed by the Department to provide basic, intermediate or advanced life support emergency or non-emergency medical services that are exclusively limited to specific events or locales.

(B) "Special-Use Vehicle" means any publicly or privately owned vehicle that is specifically designed, constructed or modified and equipped, and is intended to be used for, and is maintained or operated solely for the emergency or non-emergency transportation of a specific medical class or category of persons who are sick, injured, wounded or otherwise incapacitated or helpless (e.g. high-risk obstetrical patients, neonatal patients).

(b) The Department shall have the authority and responsibility to:

(1) Require all Vehicle Service Providers, both publicly and privately owned, to function within an EMS System;

(2) Require a Vehicle Service Provider utilizing ambulances to have a primary affiliation with an EMS System within the EMS Region in which its Primary Service Area is located, which is the geographic areas in which the provider renders the majority of its emergency responses. This requirement shall not apply to Vehicle Service Providers which exclusively utilize Limited Operation Vehicles;

(3) Establish licensing standards and requirements for Vehicle Service Providers, through rules adopted pursuant to this Act, including but not limited to:

(A) Vehicle design, specification, operation and maintenance standards;

(B) Equipment requirements;

(C) Staffing requirements; and

(D) Annual license renewal.

(4) License all Vehicle Service Providers that have met the Department's requirements for licensure, unless such Provider is owned or licensed by the federal government. All Provider licenses issued by the Department shall specify the level and type of each vehicle covered by the license (BLS, ILS, ALS, ambulance, SEMSV, limited operation vehicle, special use vehicle);

(5) Annually inspect all licensed Vehicle Service Providers, and relicense such Providers that have met the Department's requirements for license renewal;

(6) Suspend, revoke, refuse to issue or refuse to renew the license of any Vehicle Service Provider, or that portion of a license pertaining to a specific vehicle operated by the Provider, after an opportunity for a hearing, when findings show that the Provider or one or more of its vehicles has failed to comply with the standards and requirements of this Act or rules adopted by the Department pursuant to this Act;

(6.5) Suspend, for a period not exceeding 30 days, the license of any Vehicle Service Provider, after an opportunity for a hearing, when findings show that the Provider has directly or indirectly given, offered, or promised anything of value to a facility licensed under the Nursing Home Care Act or the Hospital Licensing Act for the purpose of influencing the facility to use the Provider's services for the transportation of residents or patients of the facility;

(7) Issue an Emergency Suspension Order for any Provider or vehicle licensed under this Act, when the Director or his designee has determined that an immediate and serious danger to the public health, safety and welfare exists. Suspension or revocation proceedings which offer an opportunity for hearing shall be promptly initiated after the Emergency Suspension Order has been issued;

(8) Exempt any licensed vehicle from subsequent vehicle design standards or specifications required by the Department, as long as said vehicle is continuously in compliance with the vehicle design standards and specifications originally applicable to that vehicle, or until said vehicle's title of ownership is transferred;

(9) Exempt any vehicle (except an SEMSV) which was being used as an ambulance on or before December 15, 1980, from vehicle design standards and specifications required by the Department, until said vehicle's title of ownership is transferred. Such vehicles shall not be exempt from all other licensing standards and requirements prescribed by the Department;

(10) Prohibit any Vehicle Service Provider from advertising, identifying its vehicles, or disseminating information in a false or misleading manner concerning the Provider's type and level of vehicles, location, primary service area, response times, level of personnel, licensure status or System participation; and

(11) Charge each Vehicle Service Provider a fee, to be submitted with each application for licensure and license renewal, which shall not exceed $25.00 per vehicle, up to $500.00 per Provider.

(Source: P.A. 89-177, eff. 7-19-95.)

Section 15. The Hospital Licensing Act is amended by adding Section 6.22 as follows:

(210 ILCS 85/6.22 new)

Sec. 6.22. Order for transportation of patient by ambulance. If a hospital orders transportation of a patient of the hospital by ambulance, the hospital must maintain a written record that shows (i) the name of the person who placed the order for that transportation and (ii) the medical reason for that transportation.

Section 20. The Consumer Fraud and Deceptive Business Practices Act is amended by adding Section 2XX as follows:

(815 ILCS 505/2XX new)

Sec. 2XX. Ambulance service contracts.

(a) In this Section:

"Ambulance service provider" means a person who provides emergency or non-emergency transportation services by ambulance.

"Patient" means a person who is transported by ambulance pursuant to an agreement with an ambulance service provider.

(b) An agreement for payment to an ambulance service provider for the provider's emergency or non-emergency transportation of a patient by ambulance must be in writing and must comply with all of the following requirements:

(1) The following caption must appear at the beginning of the agreement, in at least 16-point boldface type: "PATIENT'S RESPONSIBILITY TO PAY FOR AMBULANCE TRANSPORT SERVICE".

(2) The agreement's terms must be expressed in clear, simple language and in at least 14-point boldface type.

(3) The agreement must contain each of the following statements:

(A) "NOTICE: MEDICARE WILL NOT PAY ANY PART OF THE COST OF YOUR TRANSPORT BY AMBULANCE UNLESS CERTIFIED BY YOUR HEALTH CARE PROVIDER AS BEING MEDICALLY NECESSARY."

(B) "(Ambulance service provider) will file a claim for payment for the ambulance transport service provided to you by (ambulance service provider). If Medicare or your other insurer rejects your claim, (ambulance service provider) will give you written notice of that nonpayment, and you will have to pay for the ambulance transport service provided. That total amount will not be more than $(amount)."

(C) "The total interest on any unpaid balance may not exceed 7% per year, and collection costs, including attorney's fees, may not exceed $(amount)."

(D) "If you do not understand any part of this agreement, ask (ambulance service provider) to explain the terms of the agreement to you."

(E) "If Medicare or your other insurer rejects a claim for payment for ambulance transport service provided to you pursuant to this agreement, you have the right to appeal that rejection directly to Medicare or your other insurer."

(F) "(Ambulance service provider) will keep your health information confidential and will not disclose any of that information to anyone else except as necessary to file a claim for payment for the ambulance transport service provided to you."

(4) The agreement must be signed by the patient or by the patient's authorized representative and must contain the following statement immediately preceding the patient's or representative's signature: "I WANT TO BE TRANSPORTED BY AMBULANCE AND AGREE TO THE TERMS OF THIS AGREEMENT, INCLUDING THE TERMS FOR PAYMENT FOR AMBULANCE TRANSPORT SERVICE." The agreement must also be signed by the ambulance service provider's authorized agent.

(5) The agreement must contain (i) the patient's full home address, including the street name and number, city, state, and ZIP code, and (ii) the patient's Medicare identification number and any other insurance identification number.

(6) The agreement must contain the full name and business address (including the street name and number, city, state, and ZIP code) of the ambulance service provider.

An executed copy of the agreement must be provided to the patient or the patient's authorized representative.

(c) It is an unlawful practice within the meaning of this Act for an ambulance service provider to enter into an agreement with a patient, or a person acting on the patient's behalf, that does not comply with subsection (b).

(d) In addition to any other penalty provided in this Act, if the court finds that an ambulance service provider has violated any provision of subsection (b), the court may order that the ambulance service provider pay to the patient an amount equal to 3 times the maximum amount stated in the agreement in compliance with subdivision (b)(3)(B) of this Section or, if no such maximum amount is stated in the agreement, 3 times the amount claimed due by the ambulance service provider, including any interest, collection costs, and attorney's fees claimed by the provider.