HB4949 EngrossedLRB100 16226 KTG 31349 b

1    AN ACT concerning business.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 1. The Health Care Worker Self-Referral Act is
5amended by adding Section 55 as follows:
 
6    (225 ILCS 47/55 new)
7    Sec. 55. Application of the Consumer Fraud and Deceptive
8Business Practices Act. A violation of any of the provisions of
9this Act constitutes an unlawful practice under the Consumer
10Fraud and Deceptive Business Practices Act. All remedies,
11penalties, and authority granted to the Attorney General or
12State's Attorney by the Consumer Fraud and Deceptive Business
13Practices Act shall be available to him or her for the
14enforcement of this Act.
 
15    Section 5. The Medical Practice Act of 1987 is amended by
16changing Section 22.2 as follows:
 
17    (225 ILCS 60/22.2)
18    (Section scheduled to be repealed on December 31, 2019)
19    Sec. 22.2. Prohibition against fee splitting.
20    (a) A licensee under this Act may not directly or
21indirectly divide, share or split any professional fee or other

 

 

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1form of compensation for professional services with anyone in
2exchange for a referral or otherwise, other than as provided in
3this Section 22.2.
4    (b) Nothing contained in this Section abrogates the right
5of 2 or more licensed health care workers as defined in the
6Health Care Worker Self-referral Act to each receive adequate
7compensation for concurrently rendering services to a patient
8and to divide the fee for such service, provided that the
9patient has full knowledge of the division and the division is
10made in proportion to the actual services personally performed
11and responsibility assumed by each licensee consistent with his
12or her license, except as prohibited by law.
13    (c) Nothing contained in this Section prohibits a licensee
14under this Act from practicing medicine through or within any
15form of legal entity authorized to conduct business in this
16State or from pooling, sharing, dividing, or apportioning the
17professional fees and other revenues in accordance with the
18agreements and policies of the entity provided:
19        (1) each owner of the entity is licensed under this
20    Act;
21        (2) the entity is organized under the Medical
22    Corporation Act, the Professional Services Corporation
23    Act, the Professional Association Act, or the Limited
24    Liability Company Act;
25        (3) the entity is allowed by Illinois law to provide
26    physician services or employ physicians such as a licensed

 

 

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1    hospital or hospital affiliate or licensed ambulatory
2    surgical treatment center owned in full or in part by
3    Illinois-licensed physicians;
4        (4) the entity is a combination or joint venture of the
5    entities authorized under this subsection (c); or
6        (5) the entity is an Illinois not for profit
7    corporation that is recognized as exempt from the payment
8    of federal income taxes as an organization described in
9    Section 501(c)(3) of the Internal Revenue Code and all of
10    its members are full-time faculty members of a medical
11    school that offers a M.D. degree program that is accredited
12    by the Liaison Committee on Medical Education and a program
13    of graduate medical education that is accredited by the
14    Accreditation Council for Graduate Medical Education.
15    (d) Nothing contained in this Section prohibits a licensee
16under this Act from paying a fair market value fee to any
17person or entity whose purpose is to perform billing,
18administrative preparation, or collection services based upon
19a percentage of professional service fees billed or collected,
20a flat fee, or any other arrangement that directly or
21indirectly divides professional fees, for the administrative
22preparation of the licensee's claims or the collection of the
23licensee's charges for professional services, provided that:
24        (i) the licensee or the licensee's practice under
25    subsection (c) of this Section at all times controls the
26    amount of fees charged and collected; and

 

 

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1        (ii) all charges collected are paid directly to the
2    licensee or the licensee's practice or are deposited
3    directly into an account in the name of and under the sole
4    control of the licensee or the licensee's practice or
5    deposited into a "Trust Account" by a licensed collection
6    agency in accordance with the requirements of Section 8(c)
7    of the Illinois Collection Agency Act.
8    (e) Nothing contained in this Section prohibits the
9granting of a security interest in the accounts receivable or
10fees of a licensee under this Act or the licensee's practice
11for bona fide advances made to the licensee or licensee's
12practice provided the licensee retains control and
13responsibility for the collection of the accounts receivable
14and fees.
15    (f) Excluding payments that may be made to the owners of or
16licensees in the licensee's practice under subsection (c), a
17licensee under this Act may not divide, share or split a
18professional service fee with, or otherwise directly or
19indirectly pay a percentage of the licensee's professional
20service fees, revenues or profits to anyone for: (i) the
21marketing or management of the licensee's practice, (ii)
22including the licensee or the licensee's practice on any
23preferred provider list, (iii) allowing the licensee to
24participate in any network of health care providers, (iv)
25negotiating fees, charges or terms of service or payment on
26behalf of the licensee, or (v) including the licensee in a

 

 

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1program whereby patients or beneficiaries are provided an
2incentive to use the services of the licensee.
3    (g) A violation of any of the provisions of this Section
4constitutes an unlawful practice under the Consumer Fraud and
5Deceptive Business Practices Act. All remedies, penalties, and
6authority granted to the Attorney General by the Consumer Fraud
7and Deceptive Business Practices Act shall be available to him
8or her for the enforcement of this Section.
9(Source: P.A. 96-608, eff. 8-24-09; 96-1126, eff. 7-20-10.)
 
10    Section 10. The Consumer Fraud and Deceptive Business
11Practices Act is amended by adding Section 2VVV as follows:
 
12    (815 ILCS 505/2VVV new)
13    Sec. 2VVV. Deceptive marketing, advertising, and sale of
14mental health disorder and substance use disorder treatment.
15    (a) As used in this Section:
16    "Facility" has the meaning ascribed to that term in Section
171-10 of the Alcoholism and Other Drug Abuse and Dependency Act.
18    "Mental health disorder" has the same meaning as "mental
19illness" under Section 1-129 of the Mental Health and
20Developmental Disabilities Code.
21    "Program" has the meaning ascribed to that term in Section
221-10 of the Alcoholism and Other Drug Abuse and Dependency Act.
23    "Substance use disorder" has the same meaning as "substance
24abuse" under Section 1-10 of the Alcoholism and Other Drug

 

 

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1Abuse and Dependency Act.
2    "Treatment" has the meaning ascribed to that term in
3Section 1-10 of the Alcoholism and Other Drug Abuse and
4Dependency Act.
5    (b) It is an unlawful practice for any person to engage in
6misleading or false advertising or promotion that
7misrepresents the need to seek mental health disorder or
8substance use disorder treatment outside of the State of
9Illinois.
10    (c) Any marketing, advertising, promotional, or sales
11materials directed to Illinois residents concerning mental
12health disorder or substance use disorder treatment must:
13        (1) prominently display or announce the full physical
14    address of the treatment program or facility;
15        (2) display whether the treatment program or facility
16    is licensed in the State of Illinois;
17        (3) display whether the treatment program or facility
18    has locations in Illinois;
19        (4) display whether the services provided by the
20    treatment program or facility are covered by an insurance
21    policy issued to an Illinois resident;
22        (5) display whether the treatment program or facility
23    is an in-network or out-of-network provider;
24        (6) include a link to the Internet website for the
25    Department of Human Services' Division of Mental Health and
26    Division of Alcoholism and Substance Abuse, or any

 

 

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1    successor State agency that provides information regarding
2    licensed providers of services; and
3        (7) disclose that mental health disorder and substance
4    use disorder treatment may be available at a reduced cost
5    or for free for Illinois residents within the State of
6    Illinois.
7    (d) It is an unlawful practice for any person to enter into
8an arrangement under which a patient seeking mental health
9disorder or substance use disorder treatment is referred to a
10mental health disorder or substance use disorder treatment
11program or facility in exchange for a fee, a percentage of the
12treatment program's or facility's revenues that are related to
13the patient, or any other remuneration that takes into account
14the volume or value of the referrals to the treatment program
15or facility. Such practice shall also be considered a violation
16of the prohibition against fee splitting in Section 22.2 of the
17Medical Practice Act of 1987 and a violation of the Health Care
18Worker Self-Referral Act. This Section does not apply to health
19insurance companies, health maintenance organizations, and
20managed care plans or organizations licensed in Illinois.