Sen. Iris Y. Martinez

Filed: 3/27/2012

 

 


 

 


 
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1
AMENDMENT TO SENATE BILL 1881

2    AMENDMENT NO. ______. Amend Senate Bill 1881, AS AMENDED,
3by replacing everything after the enacting clause with the
4following:
 
5    "Section 1. Short title. This Act may be cited as the
6Hospital Fair Care Act.
 
7    Section 5. Purpose. The purpose of this Act is to improve
8access to basic, affordable health care services for all
9Illinois residents, especially poor and low-income uninsured
10residents, through the regulation of non-profit hospitals,
11which play an important role in the health care safety-net.
12Access to necessary, quality health services is vital to the
13health, safety, and welfare of all individuals living in this
14State and should not be based upon one's ability to pay.
 
15    Section 10. Findings. The General Assembly finds the

 

 

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1following:
2    (1) Rising health care costs have pushed private health
3insurance beyond financial reach for many poor and low-income
4working families, thereby increasing the number of the
5uninsured. Since 1999, average health insurance premiums for
6family coverage have increased 119% according to the 2008
7Kaiser Family Foundation's Employer Health Benefits Survey.
8    (2) According to 2009 Kaiser Family Foundation State Health
9data, 1.74 million individuals living in Illinois are
10uninsured. While the majority of the uninsured are working,
11many do not earn enough to afford private health coverage.
12Fully 35% of the uninsured living in this State earn just
13$25,000 a year or less according to the 2009 Gilead report on
14Illinois' uninsured.
15    (3) Minorities in particular have been disproportionately
16affected by rising health care costs. The Gilead study reports
17that the majority of the uninsured in this State are
18minorities; 27% are Latino, 20% are African-American, 4% are
19"other or multiethnic", and 49% are white.
20    (4) When the uninsured are struck by serious illness or
21injury, financial devastation is common as medical bills mount.
22The Kaiser Family Foundation reports that nearly half (46%) of
23low-income families (those making $30,000 or less a year)
24experience problems paying medical bills. In 2007,
25overwhelming medical bills forced an estimated 20,349 Illinois
26residents to file for bankruptcy. The Hospital Uninsured

 

 

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1Patient Discount Act is a step toward protecting uninsured
2residents from financial devastation, but it does not go far
3enough.
4    (5) The federal Patient Protection and Affordable Care Act,
5along with the federal Health Care and Education Affordability
6Reconciliation Act of 2010, reform the health care system to
7improve coverage through the expansion of Medicaid and
8regulations placed on the health insurance industry. While an
9estimated 32 million residents will gain coverage across the
10country, it is predicted that over 700,000 Illinoisans will
11remain uninsured, and many more will be underinsured, relying
12on the health safety net for care. While federal health reform
13sets forth new requirements for non-profit hospitals,
14including the development and publication of financial
15assistance policies and the regulation of billing and
16collection procedures, it does not set a standard for charity
17care provision.
18    (6) Hospital behavior toward the uninsured plays a direct
19role in access to health care and health outcomes. Many studies
20have found that exorbitant hospital charges combined with
21aggressive billing and collection practices discourage
22low-income, uninsured individuals from seeking medical care
23when it is needed. Accordingly, the uninsured often wait and
24become increasingly ill before seeking medical care, which
25results in more expensive care.
26    (7) The local health care safety-net includes many

 

 

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1different types of health care delivery organizations that
2deliver health care services to State residents with barriers
3to accessing health care. Such barriers include, but are not
4limited to, lack of insurance, no or low income, and ethnic and
5cultural characteristics.
6    (8) This Act focuses on the role of non-profit hospitals in
7providing affordable, necessary medical care to poor and
8low-income uninsured Illinois residents because hospitals are
9typically where people go when they experience a traumatic
10injury or illness.
11    (9) In March 2010, the Illinois Supreme Court ruled in
12Provena Covenant Medical Center v. Department of Revenue that
13non-profit hospitals must provide "charity care", defined as
14free or discounted care, in order to receive State property tax
15exemptions and that the "community benefits" standard is not
16the applicable test. The Court stated that the charitable
17activities of a non-profit hospital must reduce the burdens of
18local government for local property tax purposes. The Court did
19not set a standard for how much charity care a non-profit
20hospital must provide in exchange for local property tax
21exemption. Such standard is evaluated on a case-by-case basis,
22applying the 1968 Methodist Old Peoples Home v. Korzen factors.
23    (10) This Act holds non-profit hospitals accountable for
24the property tax exemptions they receive by ensuring the
25provision of charity care and fairly distributing the burden of
26uninsured patient care among all non-profit hospitals in this

 

 

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1State.
2    (11) While public hospitals are intended to play a far
3greater role than private hospitals in caring for the
4uninsured, private hospitals are expected to play a vital role.
5However, numerous reports have concluded that many private
6hospitals do not do a good job of providing hospital care that
7is affordable to poor and low-income uninsured individuals,
8thereby effectively acting as a barrier to medical treatment
9when it is needed.
10    (12) Access to affordable quality health care, hospital
11care in particular, and ensuring that all State residents,
12rather than just those with the ability to pay, get the
13appropriate medical care when it is necessary are in the public
14interest of this State. This Act seeks to provide a regulatory
15framework to protect access to care for the most vulnerable
16State residents by encouraging private non-profit general
17hospitals to provide affordable health care services to this
18population and discouraging hospital behavior that acts as an
19effective barrier to access to care. In addition, this Act will
20assist the State with its cost of caring for low-income,
21uninsured residents for whom private general hospitals either
22cannot or will not provide care.
 
23    Section 15. Definitions. In this Act:
24    "Bad debt" means an account receivable for services
25furnished to an individual that: (i) is regarded as

 

 

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1uncollectible following reasonable collection action, (ii) is
2charged as a credit loss, and (iii) is not the obligation of
3any federal, State, or local governmental unit. Bad debt does
4not constitute financial assistance, that is, charity care, as
5defined by the Illinois Supreme Court in Provena Covenant
6Medical Center v. Department of Revenue for tax purposes.
7    "Charge" means the price set by a hospital for a specific
8service or supply provided by that hospital.
9    "Charitable benefits" means medical services going
10directly to free or discounted services provided pursuant to a
11hospital's, hospital affiliate's, or hospitals system's
12financial assistance policy, measured at cost and subsidies
13(unreimbursed costs) attributable to the following: providing
14without charge, paying for, or subsidizing goods, activities,
15or services for the purpose of addressing the health of
16low-income individuals by providing financial support to
17community clinics or programs that serve low-income
18individuals; paying or subsidizing health care professionals
19who care for low-income individuals at free or discounted
20rates, including care provided as follow-up to emergency room
21visits; providing or subsidizing outreach services to
22low-income individuals for disease management and prevention;
23providing free or subsidized goods, supplies, or services
24needed by low-income individuals because of their diagnosed
25medical condition; and providing prenatal childbirth outreach
26to at-risk and low-income persons.

 

 

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1    "Collection action" means any activity by which a hospital,
2a designated agent, or an assignee of a hospital or a purchaser
3of a patient account receivable requests payment for services
4from a patient or a patient's family. "Collection action"
5include, without limitation, pre-admission or pre-treatment
6deposits, billing statements, letters, electronic mail,
7telephone, and personal contacts related to hospital bills,
8court summonses and complaints, and any other activity related
9to collecting a hospital bill.
10    "Cost" means the actual expense a hospital incurs to
11provide each service or supply.
12    "Effective date of eligibility" means the later of the date
13on which medical services are rendered or the date of discharge
14from a hospital.
15    "Eligible individual" means an individual (i) who does not
16have public or private health insurance and whose family income
17is at or below 400% of the federal poverty guidelines or (ii)
18who has an insurance plan but the total out-of-pocket hospital
19charges exceed 10% of the patient's family income in a 12-month
20period.
21    "Family" means, for an individual 18 years of age and
22older, the individual's spouse or domestic partner and
23dependent children under age 21, whether living at home or not.
24For an individual under 18 years of age, "family" means parents
25or caretaker relatives.
26    "Federal poverty guidelines" means the poverty guidelines

 

 

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1updated periodically in the Federal Register by the United
2States Department of Health and Human Services under authority
3of 42 U.S.C. 9902(2).
4    "Financial assistance" includes "charity care", as defined
5by the Illinois Supreme Court's decision in Provena Covenant
6Medical Center v. Illinois Department of Revenue and means
7inpatient or outpatient medical services provided
8free-of-charge or at reduced charges to an eligible individual,
9and must be rendered with no expectation of payment from the
10patient or such patient's family. Financial assistance shall be
11measured at the cost of the medical services provided based on
12the total cost-to-charge ratio derived from the hospital's
13Medicare Cost Report (CMS 2552-96 Worksheet C, Part 1 PPS
14Inpatient Ratios). Financial assistance shall not be recorded
15as revenue, an account receivable or bad debt. Financial
16assistance shall include only full financial assistance and
17partial financial assistance as defined in this Act.
18    "General hospital" means any institution required to be
19licensed by this State pursuant to the Hospital Licensing Act
20or the University of Illinois Licensing Act and holds a General
21license pursuant to Title 77, paragraph (1) subsection (g) of
22Section 250.120 of the Illinois Administrative Code. "General
23hospital" does not include hospitals that hold a specialized
24license.
25    "Non-profit hospital" means any general hospital that
26receives a State income, sales, and property tax exemption

 

 

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1through the Illinois Department of Revenue for being
2charitable.
3    "Income" means a family's annual gross earnings and cash
4benefits from all sources before taxes, less payments for child
5support.
6    "Medical services" means services, whether inpatient or
7outpatient services, or supplies that are reasonably expected
8to prevent, diagnose, prevent the worsening of, alleviate,
9correct, or cure a condition that endangers life, causes
10suffering or pain, causes physical deformity or malfunction,
11threatens to cause or aggravate a handicap, or results in
12illness or infirmity. "Medical services" includes any
13inpatient or outpatient hospital services mandated under Title
14XIX of the federal Social Security Act and emergency care
15mandates. "Medical services" also includes plastic surgery
16designed to correct disfigurement caused by injury, illness, or
17congenital defect or deformity. "Medical services" includes
18only services deemed medically necessary.
19    "Non-safety-net hospital" means any freestanding general
20hospital that did not qualify for Medicaid Disproportionate
21Share Hospital (DSH) payment adjustments, pursuant to Title 89,
22Section 148.120(a) of the Illinois Administrative Code, for the
23most recent year that such payments were made.
24    "Operating margin" means the ratio of operating income to
25operating revenues as each are reported in a hospital's audited
26financial statements. The operating margin shall be measured on

 

 

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1a separate hospital basis rather than a system-wide or hospital
2network basis.
3    "Safety-net hospital" means a freestanding general
4hospital that qualified for Medicaid Disproportionate Share
5Hospital (DSH) payment adjustments, pursuant to Title 89,
6Section 148.120(a) of the Illinois Administrative Code, for the
7most recent year that such payments were made.
8    "Subsidies" means unreimbursed costs attributable to the
9following: providing without charge, paying for, or
10subsidizing goods, activities, or services for the purpose of
11addressing the health of low-income individuals by providing
12financial support to community clinics or programs that serve
13low-income individuals; paying or subsidizing health care
14professionals who care for low-income individuals at free or
15discounted rates, including care provided as follow-up to
16emergency room visits; providing or subsidizing outreach
17services to low-income individuals for disease management and
18prevention; providing free or subsidized goods, supplies, or
19services needed by low-income individuals because of their
20diagnosed medical condition; and providing prenatal childbirth
21outreach to at-risk and low-income persons.
 
22    Section 20. Financial assistance requirements.
23    (a) Each general hospital operating in this State must
24provide financial assistance in accordance with Section 25 to
25eligible individuals on a yearly basis in a total amount at

 

 

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1least equal to the thresholds set in this Act.
2    (b) Financial assistance and eligibility are defined as
3follows:
4        (1) For the purpose of this Section, "full financial
5    assistance" means the provision of medical services
6    provided to an eligible individual free-of-charge to the
7    individual. At a minimum, a general hospital must provide
8    full financial assistance to an eligible individual who
9    applies for financial assistance and whose annual income is
10    equal to or less than 200% of the federal poverty
11    guidelines. A general hospital must not take any collection
12    action, including but not limited to, the issuance of a
13    bill or invoice, against any individual or such
14    individual's family who has applied, and qualifies for full
15    financial assistance under this Act with respect to the
16    medical services for which the individual receives
17    financial assistance.
18        (2) for the purpose of this Section, "partial financial
19    assistance" means the provision of medical services
20    provided to an eligible individual at partially discounted
21    charges, which shall not exceed 25% of the individual's
22    income. A general hospital must limit any bill or invoice
23    sent to an eligible individual or the individual's family
24    who applies and qualifies for financial assistance to the
25    following amounts:
26            (A) At a minimum, for an eligible individual whose

 

 

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1        annual income is more than 200% of the federal poverty
2        guidelines but equal to or less than 300% of the
3        federal poverty guidelines, the amount billed to such
4        individual or such individual's family shall not
5        exceed the lesser of 20% of the general hospital's cost
6        of providing the medical services or 25% of the
7        individual's income. At a minimum, for an eligible
8        individual whose annual income is more than 300% of the
9        federal poverty guidelines but equal to or less than
10        400% of the federal poverty guidelines, the amount
11        billed to such individual or such individual's family
12        shall not exceed the lesser of 30% of the general
13        hospital's cost of providing the medical services or
14        25% of the individual's income.
15            (B) If an individual applies and qualifies for
16        partial financial assistance but indicates an
17        inability to pay the full amount of a bill or invoice
18        for such financial assistance in one payment, a general
19        hospital must offer such individual or his or her
20        family a reasonable payment plan without interest. The
21        hospital may require such individual or his or her
22        family to provide reasonable verification of his or her
23        inability to pay the full amount of the bill or invoice
24        in one payment.
25        (3) This Section is not intended to interfere or
26    conflict with any duty established by the Hospital

 

 

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1    Uninsured Patient Discount Act upon hospitals to provide
2    discounts to uninsured patients.
3    (c) Non-profit general hospitals must provide charitable
4benefits, as defined in Section 15 of this Act, for hospital
5fiscal year 2012 and beyond at a threshold level equal to at
6least 6% of the hospital's total revenue. At least 5% must go
7to medical services as defined in Section 15 of this Act and 1%
8may go to subsidies as defined in Section 15 of this Act.
9    Working with representatives of hospitals and of patients
10in need of charitable benefits, the Department of Revenue shall
11develop a standard application for free or discounted medical
12services and a system of presumptive eligibility for use by all
13non-profit hospitals. The Department of Revenue shall adopt the
14standard application and system of presumptive eligibility by
15rule issued no later than 120 days after the effective date of
16this Act.
17    (d) Application procedures for financial assistance are as
18follows:
19        (1) Screening requirements are as follows:
20            (A) General hospitals must screen each individual,
21        on or prior to the effective date of eligibility, to
22        determine whether such individual is uninsured. If an
23        individual is determined to be uninsured, he or she, or
24        the individual's representative, shall be provided an
25        application for financial assistance no later than the
26        effective date of eligibility.

 

 

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1            (B) Individuals who believe they are underinsured
2        will be expected to self-identify to the financial
3        assistance staff at the hospitals to determine
4        eligibility for charity care.
5            (C) General hospitals must refrain from issuing
6        any bill or invoice to an individual who is uninsured,
7        or his or her family, until at least 90 days after the
8        effective date of eligibility and, if the individual
9        files a financial assistance application before the
10        end of the 90-day period, must further refrain from
11        issuing any bill or invoice until the hospital
12        determines the individual's eligibility for financial
13        assistance pursuant to this Act.
14        (2) An individual or individual's representative may
15    submit a financial assistance application to a general
16    hospital within 90 days after the effective date of
17    eligibility.
18        (3) Each general hospital must deliver written notice
19    of a financial assistance determination to an individual or
20    such individual's representative who has applied for
21    financial assistance within 14 days after receipt of a
22    completed financial assistance application. A general
23    hospital must not deny or delay an individual's medical
24    care while his or her application for financial assistance
25    is pending.
26        (4) Until a standard application and presumptive

 

 

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1    eligibility system are adopted by rule by the Department of
2    Revenue, general hospitals may use their own financial
3    assistance application forms to determine eligibility for
4    financial assistance in compliance with this Act. The
5    application form must state eligibility criteria for full
6    and partial financial assistance as set forth in this
7    Section. The application form must be easy to understand
8    and must request only information that is reasonably
9    necessary to determine eligibility.
10        (5) Each general hospital must translate and
11    distribute its financial assistance application form in
12    accordance with the Language Assistance Services Act and
13    must also translate the application form into the
14    non-English languages most frequently used in the service
15    area of the hospital and make those translations of the
16    form readily available.
17    (e) General hospitals must provide notification of the
18availability of financial assistance as follows:
19        (1) Each general hospital must post signs in the
20    inpatient, outpatient, emergency, admissions, and
21    registration areas of the facility and in the business
22    office areas that are customarily used by patients that
23    conspicuously inform patients of the availability of full
24    and partial financial assistance, as defined in this Act,
25    and the location within the hospital at which to apply for
26    financial assistance. Signs must be in English and in the

 

 

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1    languages other than English that are most frequently
2    spoken in the hospital's service area as well as in the
3    languages required under the Language Assistance Services
4    Act.
5        (2) Each general hospital must post a notice in a
6    prominent place on its website that financial assistance is
7    available at the facility. The notice must include a brief
8    description of the financial assistance application
9    process, qualifications for financial assistance, and a
10    copy of the application form. The notice must be in the
11    same language as the signs that are required pursuant to
12    this Section.
13        (3) Each general hospital must provide individual
14    notice, in the appropriate language, of the availability of
15    full or partial financial assistance, as defined in this
16    Act, to any patient who is identified as uninsured.
17        (4) Each general hospital must provide notice, or
18    ensure that notice is provided, of the availability of full
19    or partial financial assistance in any patient bill,
20    invoice, or collection action issued by the hospital or by
21    a collection agent, assignee, or account purchaser the
22    hospital retains or with which the hospital has contracted.
23        (5) Each general hospital must, on a quarterly basis,
24    publish notice in a newspaper of general circulation in the
25    hospital's service area indicating that financial
26    assistance is available at the facility. The notice must

 

 

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1    include a brief description of the financial assistance
2    application process. Each general hospital must provide a
3    similar notice to all community medical centers located in
4    its service area. These notices must be provided in the
5    same languages as the signs that are required in this
6    Section.
7    (f) Patient rights and responsibilities are as follows:
8        (1) General hospitals must distribute to every
9    patient, on or before the effective date of eligibility, a
10    written statement regarding financial assistance. This
11    statement must include the following:
12            (A) the availability of full or partial financial
13        assistance as provided in this Section;
14            (B) a patient's right to apply for financial
15        assistance within 90 days after the effective date of
16        eligibility;
17            (C) a determination of eligibility for full or
18        partial financial assistance must be made, in writing,
19        within 14 days after a completed application is made;
20        and
21            (D) a patient has the right to enter into a payment
22        plan pursuant to this Section if he or she is
23        determined eligible for partial financial assistance.
24        (2) If a patient qualifies for financial assistance
25    pursuant to this Act, then the general hospital shall
26    provide the patient assistance in filling out the

 

 

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1    application and determining what types of documentation
2    are necessary.
3        (3) Individuals applying for or receiving financial
4    assistance from any general hospital must do all of the
5    following:
6            (A) Cooperate with the hospital to provide the
7        information and documentation necessary to apply for
8        other public or private existing programs or resources
9        that may be available to pay for health care,
10        including, without limitation, Medicare, Medicaid, or
11        the Children's Health Insurance Program.
12            (B) Promptly provide the hospital with accurate
13        and complete documentation and information.
14            (C) Promptly notify the hospital of any
15        significant change in financial status that is likely
16        to adversely affect eligibility for financial
17        assistance.
18            (D) Upon qualifying for partial financial
19        assistance, cooperate with the hospital to establish a
20        reasonable payment plan that takes into account
21        available income and assets, the amount of the
22        discounted bill or bills, and any prior payments and
23        must make a good faith effort to comply with this
24        payment plan. The patient is responsible for promptly
25        communicating to the hospital any change in financial
26        situation that may impact his or her ability to pay the

 

 

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1        discounted hospital bills or to honor the provisions of
2        the payment plan.
 
3    Section 25. Fair Care fee. To ensure that low-income,
4uninsured individuals living in the State have access to basic,
5affordable health care and to fairly distribute the cost of
6caring for uninsured patients that other hospitals either
7cannot or will not care for, each hospital that does not meet
8the applicable threshold level of financial assistance set
9forth in Section 20 of this Act shall pay a fee to the State
10Fair Care Trust equal to the difference between the cost of the
11charitable benefits provided for the year and the applicable
12threshold for the year. The fee shall be calculated annually on
13a stand-alone hospital basis as follows:
14        (1) For purposes of calculating the fee, the amount of
15    a general hospital's total revenue shall be determined by
16    the hospital's most recent audited financial statements.
17    If a hospital is part of an affiliated or consolidated
18    group that files audited financial statements on a group
19    basis rather than individually, then the total expenses for
20    the stand-alone hospital shall be determined from the
21    consolidating statements in the affiliated or consolidated
22    audited financial statements.
23        (2) If the financial assistance provided by a hospital
24    for the year in accordance with Section 20 of this Act as
25    reported in the financial assistance statement required in

 

 

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1    Section 20 is less than the threshold set forth in Section
2    20, a fee shall be paid to the State in an amount equal to
3    the difference between the cost of the financial assistance
4    provided and applicable threshold. Any fee due under this
5    Act shall be paid to the State Treasurer within 90 days
6    after receipt of notice of any fee due.
7        (3) Non-profit general hospitals that cannot meet the
8    threshold as defined in Section 20 due to financial
9    hardship may apply for a hardship waiver from the
10    Department of Revenue to determine an exemption from this
11    requirement for a one-year period.
 
12    Section 30. Date of determination of any Fair Care fee. The
13Fair Care fee for a general hospital shall be calculated by the
14Department of Revenue no later than October 1st of each year,
15using the most recent audited financial statements of each
16hospital and the most recently filed hospital financial
17assistance statement, both of which are required to be filed
18with the State pursuant to Section 35 of this Act. The Fair
19Care fee shall be calculated annually for each non-profit
20general hospital located within the State.
 
21    Section 35. Fair Care Trust Fund.
22    (a) There is hereby created the Fair Care Trust Fund as a
23special fund in the State Treasury. All Fair Care Fees and
24penalties paid under this Act shall be deposited into the Fair

 

 

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1Care Trust Fund. Subject to appropriation, money in the Fair
2Care Trust Fund shall be expended exclusively for uncompensated
3indigent care to those non-profit general hospitals that exceed
4the required threshold as set forth in Section 20 of this Act.
5No Fair Care fees or penalties paid pursuant to this Act may be
6transferred to the General Revenue Fund.
7    (b) Fair Care Trust Fund funds shall be distributed
8annually to the Illinois non-profit and public hospitals that
9exceed the 6% standard for charitable benefits, with the funds
10divided among such hospitals in proportion to the dollar amount
11of excess charitable benefits each hospital provided.
 
12    Section 40. Charitable benefits reporting. Not later than
13March 31st of each calendar year, each general non-profit
14hospital operating in this State must submit the following to
15the State Attorney General:
16        (1) Charitable benefits statement. A statement that
17    identifies the dollar amount of charitable benefits,
18    showing an aggregate amount for medical services and an
19    aggregate amount for subsidies, as defined in Section 15 of
20    this Act, furnished by the hospital in its most recently
21    completed fiscal year for which the data is available, in
22    accordance with this Act, to be reported at the actual cost
23    of the services provided based on the total cost-to-charge
24    ratio derived from the hospital's most recently settled
25    Medicare Cost Report. If a hospital is required to file

 

 

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1    Form AG-CBP-1, Annual Non Profit Hospital Community
2    Benefits Plan Report with the Attorney General, then a copy
3    of this form shall be sufficient as long as the financial
4    assistance reported was provided in accordance with
5    Section 20 of this Act. Alternatively, a hospital may also
6    submit a copy of its profile compiled by the Department of
7    Public Health based on that Department's Annual Hospital
8    Questionnaire for purposes of reporting the amount of
9    financial assistance provided for the most recent fiscal
10    year as long as the assistance was provided in accordance
11    with Section 20 of this Act.
12        (2) Most recent annual audited financial statements.
13    The hospital's most recent annual audited financial
14    statements, including consolidating statements if the
15    hospital is part of a group or network that files
16    consolidated or affiliated financial statements.
17        (3) Medicaid Disproportionate Share Hospital
18    Statement. A statement identifying whether the hospital
19    received Medicaid Disproportionate Share Hospital Payments
20    in the most recent year that such payments were made by the
21    State.
22        (4) Other necessary information. Hospitals must report
23    any other information the Attorney General deems necessary
24    to ensure compliance with the provisions of this Act.
 
25    Section 45. Implementation and enforcement.

 

 

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1    (a) The Department of Revenue shall be responsible for
2calculating each general non-profit hospital's Fair Care fee
3due pursuant to Section 25 of this Act. The Department of
4Revenue has the authority to issue any rules necessary to carry
5out this Act.
6    (b) The Director of Revenue shall appoint a Fair Care
7Officer within the Department of Revenue. The Officer shall be
8responsible for ensuring that each general non-profit hospital
9in the State is in compliance with Section 20 of this Act. If
10the Officer determines a general non-profit hospital is not in
11compliance with any of the provisions of this Act, then the
12Officer shall notify the hospital of the assessment of the
13appropriate penalty or penalties provided for in Section 45 of
14this Act. The Fair Care Officer has the authority to adopt any
15rules necessary to carry out this Act.
16    (c) Enforcement of the provisions of this Act shall occur
17as follows:
18        (1) A general non-profit hospital that fails to post
19    any notice or provide any notification required under this
20    Act is subject to a civil penalty of $1,000 per day for
21    each day the required notice is not posted or notification
22    is not provided.
23        (2) A general non-profit hospital that fails to provide
24    information to the public as required under this Act is
25    subject to a civil penalty of $1,000 per violation.
26        (3) A general hospital that violates any provision of

 

 

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1    this Act other than the provisions of subsection (b) of
2    Section 20 and Section 25 is subject to a civil penalty of
3    $1,000 per violation.
4        (4) All fees and penalties provided for in this Act
5    shall constitute a debt to the State. The State's Attorney
6    is authorized to institute a civil suit in the name of the
7    State to recover the amount of any such unpaid fee or
8    penalty.
9        (5) If a general non-profit hospital fails to provide
10    the 6% in charitable benefits and fails to pay a Fair Care
11    fee as required in Section 20, the State Department of
12    Revenue shall revoke that hospital's tax-exempt status,
13    including the State property, sales, and income tax
14    exemptions.
 
15    Section 55. Renewal. This Act shall be reviewed and revised
16by July 1, 2019 after the full implementation of the Affordable
17Care Act.
 
18    Section 90. The State Finance Act is amended by adding
19Section 5.811 as follows:
 
20    (30 ILCS 105/5.811 new)
21    Sec. 5.811. The Fair Care Trust Fund.
 
22    Section 99. Effective date. This Act takes effect January

 

 

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11, 2013.".