HB4949 EnrolledLRB100 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. This Section does not apply to
15hospitals and hospital affiliates licensed in Illinois.
 
16    Section 5. The Medical Practice Act of 1987 is amended by
17changing Section 22.2 as follows:
 
18    (225 ILCS 60/22.2)
19    (Section scheduled to be repealed on December 31, 2019)
20    Sec. 22.2. Prohibition against fee splitting.
21    (a) A licensee under this Act may not directly or

 

 

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

 

 

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

 

 

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

 

 

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1behalf of the licensee, or (v) including the licensee in a
2program whereby patients or beneficiaries are provided an
3incentive to use the services of the licensee.
4    (g) A violation of any of the provisions of this Section
5constitutes an unlawful practice under the Consumer Fraud and
6Deceptive Business Practices Act. All remedies, penalties, and
7authority granted to the Attorney General by the Consumer Fraud
8and Deceptive Business Practices Act shall be available to him
9or her for the enforcement of this Section. This subsection
10does not apply to hospitals and hospital affiliates licensed in
11Illinois.
12(Source: P.A. 96-608, eff. 8-24-09; 96-1126, eff. 7-20-10.)
 
13    Section 10. The Consumer Fraud and Deceptive Business
14Practices Act is amended by adding Section 2VVV as follows:
 
15    (815 ILCS 505/2VVV new)
16    Sec. 2VVV. Deceptive marketing, advertising, and sale of
17mental health disorder and substance use disorder treatment.
18    (a) As used in this Section:
19    "Facility" has the meaning ascribed to that term in Section
201-10 of the Alcoholism and Other Drug Abuse and Dependency Act.
21    "Hospital affiliate" has the meaning ascribed to that term
22in Section 10.8 of the Hospital Licensing Act.
23    "Mental health disorder" has the same meaning as "mental
24illness" under Section 1-129 of the Mental Health and

 

 

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1Developmental Disabilities Code.
2    "Program" has the meaning ascribed to that term in Section
31-10 of the Alcoholism and Other Drug Abuse and Dependency Act.
4    "Substance use disorder" has the same meaning as "substance
5abuse" under Section 1-10 of the Alcoholism and Other Drug
6Abuse and Dependency Act.
7    "Treatment" has the meaning ascribed to that term in
8Section 1-10 of the Alcoholism and Other Drug Abuse and
9Dependency Act.
10    (b) It is an unlawful practice for any person to engage in
11misleading or false advertising or promotion that
12misrepresents the need to seek mental health disorder or
13substance use disorder treatment outside of the State of
14Illinois.
15    (c) Any marketing, advertising, promotional, or sales
16materials directed to Illinois residents concerning mental
17health disorder or substance use disorder treatment must:
18        (1) prominently display or announce the full physical
19    address of the treatment program or facility;
20        (2) display whether the treatment program or facility
21    is licensed in the State of Illinois;
22        (3) display whether the treatment program or facility
23    has locations in Illinois;
24        (4) display whether the services provided by the
25    treatment program or facility are covered by an insurance
26    policy issued to an Illinois resident;

 

 

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1        (5) display whether the treatment program or facility
2    is an in-network or out-of-network provider;
3        (6) include a link to the Internet website for the
4    Department of Human Services' Division of Mental Health and
5    Division of Alcoholism and Substance Abuse, or any
6    successor State agency that provides information regarding
7    licensed providers of services; and
8        (7) disclose that mental health disorder and substance
9    use disorder treatment may be available at a reduced cost
10    or for free for Illinois residents within the State of
11    Illinois.
12    (d) It is an unlawful practice for any person to enter into
13an arrangement under which a patient seeking mental health
14disorder or substance use disorder treatment is referred to a
15mental health disorder or substance use disorder treatment
16program or facility in exchange for a fee, a percentage of the
17treatment program's or facility's revenues that are related to
18the patient, or any other remuneration that takes into account
19the volume or value of the referrals to the treatment program
20or facility. Such practice shall also be considered a violation
21of the prohibition against fee splitting in Section 22.2 of the
22Medical Practice Act of 1987 and a violation of the Health Care
23Worker Self-Referral Act. This Section does not apply to health
24insurance companies, health maintenance organizations, managed
25care plans, or organizations, including hospitals and hospital
26affiliates licensed in Illinois.