093_SB0460sam001

 










                                     LRB093 03659 AMC 12257 a

 1                    AMENDMENT TO SENATE BILL 460

 2        AMENDMENT NO.     .  Amend Senate Bill 460  by  replacing
 3    everything after the enacting clause with the following:

 4        "Section  5.   The Department of Public Health Powers and
 5    Duties Law of the Civil Administrative Code  of  Illinois  is
 6    amended by adding Section 2310-543 as follows:

 7        (20 ILCS 2310/2310-543 new)
 8        Sec.   2310-543.  Information   regarding   health   care
 9    services.   With  funds  made available for this purpose, the
10    Department  may,  in  conjunction  with  other  programs   or
11    activities  related  to  accessing  medical care, develop and
12    provide to the public and health  care  patients  information
13    regarding  the  categories  or  types of health care services
14    available  and  their  appropriate  use,  paying   particular
15    attention to seeking care in hospital emergency departments.

16        Section  10.   The  Emergency  Medical  Treatment  Act is
17    amended by changing Section 2 as follows:

18        (210 ILCS 70/2 new)
19        Sec. 2.  Findings; prohibited terms.
20        (a)  The Illinois  General  Assembly  makes  all  of  the
 
                            -2-      LRB093 03659 AMC 12257 a
 1    following findings:
 2             (1)  Hospital  emergency services are not always the
 3        most appropriate  level  of  care  for  patients  seeking
 4        unscheduled  medical care or for patients who do not have
 5        a regular physician who can treat a significant or  acute
 6        medical  condition not considered critical, debilitating,
 7        or life-threatening.
 8             (2)  Hospital emergency rooms are over-utilized  and
 9        too  often  over-burdened with many injuries or illnesses
10        that could  be  managed  in  a  less  intensive  clinical
11        setting or physician's office.
12             (3)  Over-utilization    of    hospital    emergency
13        departments  contributes  to  excess  medical  and health
14        insurance costs.
15             (4)  The use of the term "urgent" or "emergi-" or  a
16        similar  term  in  a facility's posted or advertised name
17        may confuse the public and prospective patients regarding
18        the type of services offered relative to  those  provided
19        by a hospital emergency department.  There is significant
20        risk to the public health and safety if persons requiring
21        treatment  for  a  critical or life-threatening condition
22        inappropriately use such facilities.
23             (5)  Many times patients are not  clearly  aware  of
24        the  policies  and  procedures of their insurer or health
25        plan that must be followed in the use of emergency  rooms
26        versus  non-emergent  clinics  and  what rights they have
27        under the law in regard to appropriately sought emergency
28        care.
29             (6)  There is a need  to  more  effectively  educate
30        health   care   payers   and  consumers  about  the  most
31        appropriate  use  of  the  various  available  levels  of
32        medical  care  and  particularly  the  use  of   hospital
33        emergency  rooms  and walk-in medical clinics that do not
34        require appointments.
 
                            -3-      LRB093 03659 AMC 12257 a
 1        (b)  After the effective date of this amendatory  Act  of
 2    the  93rd  General  Assembly,  no person, facility, or entity
 3    shall hold itself out to the public as an "urgent",  "urgi-",
 4    "emergi-", or "emergent" care center or use any similar term,
 5    as  defined  by  rule,  that  would  give the impression that
 6    emergency medical treatment is  provided  by  the  person  or
 7    entity  or  at  the  facility  unless  the  facility  is  the
 8    emergency room of a facility licensed as a hospital under the
 9    Hospital   Licensing   Act   or  a  facility  licensed  as  a
10    freestanding emergency center  under  the  Emergency  Medical
11    Services (EMS) Systems Act.
12        (c)  Violation  of  this  Section  constitutes a business
13    offense with a minimum fine of $5,000 plus $1,000 per day for
14    a continuing violation, with a maximum of $25,000.
15        (d)  The Director of Public Health in  the  name  of  the
16    people  of the State, through the Attorney General, may bring
17    an action for an injunction or to  restrain  a  violation  of
18    this Section or the rules adopted pursuant to this Section or
19    to enjoin the future operation or maintenance of any facility
20    in violation of this Section or the rules adopted pursuant to
21    this Section.
22        (e)  The  Department  of  Public Health shall adopt rules
23    necessary for the implementation of this Section.

24        Section 15.  The Managed Care Reform and  Patient  Rights
25    Act is amended by adding Section 43 as follows:

26        (215 ILCS 134/43 new)
27        Sec. 43.  Utilization of health care facilities.
28        (a)  A  health  care plan must provide its enrollees with
29    clear information about their rights and responsibilities  in
30    obtaining  referrals  to and making appropriate use of health
31    care facilities when access to their primary  care  physician
32    is not readily available.
 
                            -4-      LRB093 03659 AMC 12257 a
 1        (b)  Nothing  in  this  Section is intended to affect the
 2    rights of enrollees or relieve a  health  care  plan  of  its
 3    responsibilities   with  respect  to  the  provision  of  and
 4    coverage of emergency services or treatment of  an  emergency
 5    medical  condition,  as  those terms are defined by this Act,
 6    and  as  those  responsibilities  and  rights  are  otherwise
 7    provided under this Act, especially Section 65 of this Act.

 8        Section 99.  Effective date.  This Act takes effect  upon
 9    becoming law.".