Rep. Michelle Mussman

Filed: 4/1/2015

 

 


 

 


 
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1
AMENDMENT TO HOUSE BILL 3848

2    AMENDMENT NO. ______. Amend House Bill 3848 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The State Finance Act is amended by adding
5Section 5.866 as follows:
 
6    (30 ILCS 105/5.866 new)
7    Sec. 5.866. The Illinois Sexual Assault Emergency
8Treatment Program Fund.
 
9    Section 10. The Sexual Assault Survivors Emergency
10Treatment Act is amended by changing Sections 1a, 5, 7, and 8
11and by adding Section 7.5 as follows:
 
12    (410 ILCS 70/1a)  (from Ch. 111 1/2, par. 87-1a)
13    Sec. 1a. Definitions. In this Act:
14    "Ambulance provider" means an individual or entity that

 

 

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1owns and operates a business or service using ambulances or
2emergency medical services vehicles to transport emergency
3patients.
4    "Areawide sexual assault treatment plan" means a plan,
5developed by the hospitals in the community or area to be
6served, which provides for hospital emergency services to
7sexual assault survivors that shall be made available by each
8of the participating hospitals.
9    "Department" means the Department of Public Health.
10    "Emergency contraception" means medication as approved by
11the federal Food and Drug Administration (FDA) that can
12significantly reduce the risk of pregnancy if taken within 72
13hours after sexual assault.
14    "Follow-up healthcare" means healthcare services related
15to a sexual assault, including laboratory services and pharmacy
16services, rendered within 90 days of the initial visit for
17hospital emergency services.
18    "Forensic services" means the collection of evidence
19pursuant to a statewide sexual assault evidence collection
20program administered by the Department of State Police, using
21the Illinois State Police Sexual Assault Evidence Collection
22Kit.
23    "Health care professional" means a physician, a physician
24assistant, or an advanced practice nurse.
25    "Hospital" has the meaning given to that term in the
26Hospital Licensing Act.

 

 

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1    "Hospital emergency services" means healthcare delivered
2to outpatients within or under the care and supervision of
3personnel working in a designated emergency department of a
4hospital, including, but not limited to, care ordered by such
5personnel for a sexual assault survivor in the emergency
6department.
7    "Illinois State Police Sexual Assault Evidence Collection
8Kit" means a prepackaged set of materials and forms to be used
9for the collection of evidence relating to sexual assault. The
10standardized evidence collection kit for the State of Illinois
11shall be the Illinois State Police Sexual Assault Evidence
12Collection Kit.
13    "Nurse" means a nurse licensed under the Nurse Practice
14Act.
15    "Physician" means a person licensed to practice medicine in
16all its branches.
17    "Sexual assault" means an act of nonconsensual sexual
18conduct or sexual penetration, as defined in Section 11-0.1 of
19the Criminal Code of 2012, including, without limitation, acts
20prohibited under Sections 11-1.20 through 11-1.60 of the
21Criminal Code of 2012.
22    "Sexual assault survivor" means a person who presents for
23hospital emergency services in relation to injuries or trauma
24resulting from a sexual assault.
25    "Sexual assault transfer plan" means a written plan
26developed by a hospital and approved by the Department, which

 

 

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1describes the hospital's procedures for transferring sexual
2assault survivors to another hospital in order to receive
3emergency treatment.
4    "Sexual assault treatment plan" means a written plan
5developed by a hospital that describes the hospital's
6procedures and protocols for providing hospital emergency
7services and forensic services to sexual assault survivors who
8present themselves for such services, either directly or
9through transfer from another hospital.
10    "Transfer services" means the appropriate medical
11screening examination and necessary stabilizing treatment
12prior to the transfer of a sexual assault survivor to a
13hospital that provides hospital emergency services and
14forensic services to sexual assault survivors pursuant to a
15sexual assault treatment plan or areawide sexual assault
16treatment plan.
17    "Voucher" means a document generated by a hospital at the
18time the sexual assault survivor receives hospital emergency
19and forensic services that a sexual assault survivor may
20present to providers for follow-up healthcare.
21(Source: P.A. 96-328, eff. 8-11-09; 96-1551, eff. 7-1-11;
2297-1150, eff. 1-25-13.)
 
23    (410 ILCS 70/5)  (from Ch. 111 1/2, par. 87-5)
24    Sec. 5. Minimum requirements for hospitals providing
25hospital emergency services and forensic services to sexual

 

 

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1assault survivors.
2    (a) Every hospital providing hospital emergency services
3and forensic services to sexual assault survivors under this
4Act shall, as minimum requirements for such services, provide,
5with the consent of the sexual assault survivor, and as ordered
6by the attending physician, an advanced practice nurse who has
7a written collaborative agreement with a collaborating
8physician that authorizes provision of emergency services, or a
9physician assistant who has been delegated authority to provide
10hospital emergency services and forensic services, the
11following:
12        (1) appropriate medical examinations and laboratory
13    tests required to ensure the health, safety, and welfare of
14    a sexual assault survivor or which may be used as evidence
15    in a criminal proceeding against a person accused of the
16    sexual assault, or both; and records of the results of such
17    examinations and tests shall be maintained by the hospital
18    and made available to law enforcement officials upon the
19    request of the sexual assault survivor;
20        (2) appropriate oral and written information
21    concerning the possibility of infection, sexually
22    transmitted disease and pregnancy resulting from sexual
23    assault;
24        (3) appropriate oral and written information
25    concerning accepted medical procedures, medication, and
26    possible contraindications of such medication available

 

 

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1    for the prevention or treatment of infection or disease
2    resulting from sexual assault;
3        (4) an amount of medication for treatment at the
4    hospital and after discharge as is deemed appropriate by
5    the attending physician, an advanced practice nurse, or a
6    physician assistant and consistent with the hospital's
7    current approved protocol for sexual assault survivors;
8        (5) an evaluation of the sexual assault survivor's risk
9    of contracting human immunodeficiency virus (HIV) from the
10    sexual assault;
11        (6) written and oral instructions indicating the need
12    for follow-up examinations and laboratory tests after the
13    sexual assault to determine the presence or absence of
14    sexually transmitted disease;
15        (7) referral by hospital personnel for appropriate
16    counseling; and
17        (8) when HIV prophylaxis is deemed appropriate, an
18    initial dose or doses of HIV prophylaxis, along with
19    written and oral instructions indicating the importance of
20    timely follow-up healthcare.
21    (b) Any person who is a sexual assault survivor who seeks
22emergency hospital services and forensic services or follow-up
23healthcare under this Act shall be provided such services
24without the consent of any parent, guardian, custodian,
25surrogate, or agent.
26    (b-5) Every treating hospital providing hospital emergency

 

 

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1and forensic services to sexual assault survivors shall issue a
2voucher to any sexual assault survivor who is eligible to
3receive one. The hospital shall make a copy of the voucher and
4place it in the medical record of the sexual assault survivor.
5The hospital shall provide a copy of the voucher to the sexual
6assault survivor after discharge upon request.
7    (c) Nothing in this Section creates a physician-patient
8relationship that extends beyond discharge from the hospital
9emergency department.
10(Source: P.A. 95-432, eff. 1-1-08; 96-318, eff. 1-1-10.)
 
11    (410 ILCS 70/7)  (from Ch. 111 1/2, par. 87-7)
12    Sec. 7. Reimbursement.
13    (a) A hospital or health care professional furnishing
14hospital emergency services or forensic services, an ambulance
15provider furnishing transportation to a sexual assault
16survivor, a hospital, health care professional, or laboratory
17providing follow-up healthcare, or a pharmacy dispensing
18prescribed medications to any sexual assault survivor shall
19furnish such services or medications to that person without
20charge and shall seek payment as follows:
21        (1) If a sexual assault survivor is eligible to receive
22    benefits under the medical assistance program under
23    Article V of the Illinois Public Aid Code, the ambulance
24    provider, hospital, health care professional, laboratory,
25    or pharmacy must submit the bill to the Department of

 

 

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1    Healthcare and Family Services and accept the amount paid
2    as full payment.
3        (2) If a sexual assault survivor is covered by one or
4    more policies of health insurance or is a beneficiary under
5    a public or private health coverage program, the ambulance
6    provider, hospital, health care professional, laboratory,
7    or pharmacy shall bill the insurance company or program.
8    With respect to such insured patients, applicable
9    deductible, co-pay, co-insurance, denial of claim, or any
10    other out-of-pocket insurance-related expense may be
11    submitted to the Illinois Sexual Assault Emergency
12    Treatment Program of the Department of Healthcare and
13    Family Services in accordance with 89 Ill. Adm. Code
14    148.510 for payment at the Department of Healthcare and
15    Family Services' allowable rates under the Illinois Public
16    Aid Code. The ambulance provider, hospital, health care
17    professional, laboratory, or pharmacy shall accept the
18    amounts paid by the insurance company or health coverage
19    program and the Illinois Sexual Assault Treatment Program
20    as full payment.
21        (3) If a sexual assault survivor is neither eligible to
22    receive benefits under the medical assistance program
23    under Article V of the Public Aid Code nor covered by a
24    policy of insurance or a public or private health coverage
25    program, the ambulance provider, hospital, health care
26    professional, laboratory, or pharmacy shall submit the

 

 

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1    request for reimbursement to the Illinois Sexual Assault
2    Emergency Treatment Program under the Department of
3    Healthcare and Family Services in accordance with 89 Ill.
4    Adm. Code 148.510 at the Department of Healthcare and
5    Family Services' allowable rates under the Illinois Public
6    Aid Code.
7        (4) If a sexual assault survivor presents a voucher for
8    follow-up healthcare, the healthcare professional or
9    laboratory that provides follow-up healthcare or the
10    pharmacy that dispenses prescribed medications to a sexual
11    assault survivor shall submit the request for
12    reimbursement for follow-up healthcare, laboratory, or
13    pharmacy services to the Illinois Sexual Assault Emergency
14    Treatment Program under the Department of Healthcare and
15    Family Services in accordance with 89 Ill. Adm. Code
16    148.510 at the Department of Healthcare and Family
17    Services' allowable rates under the Illinois Public Aid
18    Code. Nothing in this subsection (a) precludes hospitals
19    from providing follow-up healthcare and receiving
20    reimbursement under this Section.
21When any ambulance provider furnishes transportation, hospital
22provides hospital emergency services and forensic services,
23hospital or health care professional or laboratory provides
24follow-up healthcare, or pharmacy dispenses prescribed
25medications to any sexual assault survivor, as defined by the
26Department of Healthcare and Family Services, who is neither

 

 

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1eligible to receive such services under the Illinois Public Aid
2Code nor covered as to such services by a policy of insurance,
3the ambulance provider, hospital, health care professional,
4pharmacy, or laboratory shall furnish such services to that
5person without charge and shall be entitled to be reimbursed
6for providing such services by the Illinois Sexual Assault
7Emergency Treatment Program under the Department of Healthcare
8and Family Services and at the Department of Healthcare and
9Family Services' allowable rates under the Illinois Public Aid
10Code.
11    (b) Nothing in this Section precludes a hospital, health
12care provider, ambulance provider, laboratory, or pharmacy
13from billing the sexual assault survivor or any applicable
14health insurance or coverage for inpatient services. The
15hospital is responsible for submitting the request for
16reimbursement for ambulance services, hospital emergency
17services, and forensic services to the Illinois Sexual Assault
18Emergency Treatment Program. Nothing in this Section precludes
19hospitals from providing follow-up healthcare and receiving
20reimbursement under this Section.
21    (c) (Blank). The health care professional who provides
22follow-up healthcare and the pharmacy that dispenses
23prescribed medications to a sexual assault survivor are
24responsible for submitting the request for reimbursement for
25follow-up healthcare or pharmacy services to the Illinois
26Sexual Assault Emergency Treatment Program.

 

 

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1    (d) On and after July 1, 2012, the Department shall reduce
2any rate of reimbursement for services or other payments or
3alter any methodologies authorized by this Act or the Illinois
4Public Aid Code to reduce any rate of reimbursement for
5services or other payments in accordance with Section 5-5e of
6the Illinois Public Aid Code.
7    (e) The Department of Healthcare and Family Services shall
8establish standards, rules, and regulations to implement this
9Section.
10(Source: P.A. 97-689, eff. 6-14-12; 98-463, eff. 8-16-13.)
 
11    (410 ILCS 70/7.5 new)
12    Sec. 7.5. Prohibition on billing sexual assault survivors
13directly for certain services; written notice; billing
14protocols.
15    (a) A hospital, health care professional, ambulance
16provider, laboratory, or pharmacy furnishing hospital
17emergency services, forensic services, transportation,
18follow-up healthcare, or medication to a sexual assault
19survivor shall not:
20        (1) charge or submit a bill for any portion of the
21    costs of the services, transportation, or medications to
22    the sexual assault survivor, including any insurance
23    deductible, co-pay, co-insurance, denial of claim by an
24    insurer, spenddown, or any other out-of-pocket expense;
25        (2) communicate with, harass, or intimidate the sexual

 

 

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1    assault survivor for payment of services, including, but
2    not limited to, repeatedly calling or writing to the sexual
3    assault survivor and threatening to refer the matter to a
4    debt collection agency or to an attorney for collection,
5    enforcement, or filing of other process.
6        (3) refer a bill to a collection agency or attorney for
7    collection action against the sexual assault survivor;
8        (4) contact or distribute information to affect the
9    sexual assault survivor's credit rating; or
10        (5) take any other action adverse to the sexual assault
11    survivor or his or her family on account of providing
12    services to the sexual assault survivor.
13    (b) Nothing in this Section precludes a hospital, health
14care provider, ambulance provider, laboratory, or pharmacy
15from billing the sexual assault survivor or any applicable
16health insurance or coverage for inpatient services.
17    (c) Within 60 days after the effective date of this
18amendatory Act of the 99th General Assembly, every hospital
19providing treatment services to sexual assault survivors in
20accordance with a plan approved under Section 2 of this Act
21shall provide a written notice to a sexual assault survivor.
22The written notice must include, but is not limited to, the
23following:
24        (1) a statement that the sexual assault survivor should
25    not be directly billed by any ambulance provider providing
26    transportation services, or by any hospital, health care

 

 

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1    professional, laboratory, or pharmacy for the services the
2    sexual assault survivor received as an outpatient at the
3    hospital;
4        (2) a statement that a sexual assault survivor who is
5    admitted to a hospital may be billed for inpatient services
6    provided by a hospital, health care professional,
7    laboratory, or pharmacy;
8        (3) a statement that prior to leaving the emergency
9    department of the treating facility, the hospital will give
10    the sexual assault survivor a voucher for follow-up
11    healthcare if the sexual assault survivor is eligible to
12    receive a voucher;
13        (4) the definition of "follow-up healthcare" as set
14    forth in Section 1a of this Act;
15        (5) a phone number the sexual assault survivor may call
16    should the sexual assault survivor receive a bill from the
17    hospital for hospital emergency services and forensic
18    services;
19        (6) the toll-free phone number of the Office of the
20    Illinois Attorney General, Crime Victim Services Division,
21    which the sexual assault survivor may call should the
22    sexual assault survivor receive a bill from an ambulance
23    provider, a health care professional, a laboratory, or a
24    pharmacy.
25    This subsection (c) shall not apply to hospitals that
26provide transfer services as defined under Section 1a of this

 

 

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1Act.
2    (d) Within 60 days after the effective date of this
3amendatory Act of the 99th General Assembly, every health care
4professional, except for those employed by a hospital or
5hospital affiliate, as defined in the Hospital Licensing Act,
6or those employed by a hospital operated under the University
7of Illinois Hospital Act who bills separately for hospital
8emergency services or forensic services must develop a billing
9protocol that ensures that no survivor of sexual assault will
10be sent a bill for any hospital emergency services or forensic
11services and submit the billing protocol to the Crime Victim
12Services Division of the Office of the Attorney General for
13approval. Health care professionals who bill as a legal entity
14may submit a single billing protocol for the billing entity.
15The billing protocol must include at a minimum:
16        (1) a description of training for persons who prepare
17    bills for hospital emergency services and forensic
18    services;
19        (2) a written acknowledgement signed by a person who
20    has completed the training sign that the person will not
21    bill survivors of sexual assault;
22        (3) prohibitions on submitting any bill for any portion
23    of hospital emergency services or forensic services
24    provided to a survivor of sexual assault to a collection
25    agency;
26        (4) prohibitions on taking any action that would

 

 

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1    adversely affect the credit of the survivor of sexual
2    assault;
3        (5) the termination of all collection activities if the
4    protocol is violated, and
5        (6) the actions to be taken if a bill is sent to a
6    collection agency or the failure to pay is reported to any
7    credit reporting agency.
8    The Crime Victim Services Division of the Office of the
9Attorney General may provide a sample acceptable billing
10protocol upon request.
11    The Office of the Attorney General shall approve a proposed
12protocol if it finds that the implementation of the protocol
13would result in no survivor of sexual assault being billed or
14sent a bill for hospital emergency services or forensic
15services.
16    If the Office of the Attorney General determines that
17implementation of the protocol could result in the billing of a
18survivor of sexual assault for hospital emergency services or
19forensic services, the Office of the Attorney General shall
20provide the health care professional with a written statement
21of the deficiencies in the protocol. The health care
22professional shall have 30 days to submit a revised billing
23protocol addressing the deficiencies to the Office of the
24Attorney General. The health care professional shall implement
25the protocol upon approval by the Crime Victim Services
26Division of the Office of the Attorney General.

 

 

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1    The health care professional shall submit any proposed
2revision to or modification of an approved billing protocol to
3the Crime Victim Services Division of the Office of the
4Attorney General for approval. The health care professional
5shall implement the revised or modified billing protocol upon
6approval by the Crime Victim Services Division of the Office of
7the Illinois Attorney General.
 
8    (410 ILCS 70/8)  (from Ch. 111 1/2, par. 87-8)
9    Sec. 8. Penalties.
10    (a) Any hospital violating any provisions of this Act other
11than Section 7.5 shall be guilty of a petty offense for each
12violation, and any fine imposed shall be paid into the general
13corporate funds of the city, incorporated town or village in
14which the hospital is located, or of the county, in case such
15hospital is outside the limits of any incorporated
16municipality.
17    (b) The Attorney General may seek the assessment of one or
18more of the following civil monetary penalties in any action
19filed in any action filed under this Act where the hospital,
20health care professional, ambulance provider, laboratory, or
21pharmacy knowingly violates Section 7.5 of the Act:
22        (1) For willful violations of paragraphs (1), (2), (4),
23    or (5) of subsection (a) of Section 7.5 or subsection (c)
24    of Section 7.5, the civil monetary penalty shall not exceed
25    $500 per violation.

 

 

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1        (2) For violations of paragraphs (1), (2), (4), or (5)
2    of subsection (a) of Section 7.5 or subsection (c) of
3    Section 7.5 involving a pattern or practice, the civil
4    monetary penalty shall not exceed $500 per violation.
5        (3) For violations of paragraph (3) of subsection (a)
6    of Section 7.5, the civil monetary penalty shall not exceed
7    $500 for each day the bill is with a collection agency.
8        (4) For violations involving the failure to submit
9    billing protocols within the time period required under
10    subsection (c) of Section 7.5, the civil monetary penalty
11    shall not exceed $100 per day until the health care
12    professional complies with subsection (d) of Section 7.5.
13    All civil monetary penalties shall be deposited in the
14Illinois Sexual Assault Emergency Treatment Program Fund to pay
15for hospital emergency services, forensic services, follow-up
16healthcare, and medications for sexual assault survivors.
17(Source: P.A. 79-564.)".