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1 | | indirectly divide, share or split any professional fee or other |
2 | | form of compensation for professional services with anyone in |
3 | | exchange for a referral or otherwise, other than as provided in |
4 | | this Section 22.2. |
5 | | (b) Nothing contained in this Section abrogates the right |
6 | | of 2 or more licensed health care workers as defined in the |
7 | | Health Care Worker Self-referral Act to each receive adequate |
8 | | compensation for concurrently rendering services to a patient |
9 | | and to divide the fee for such service, provided that the |
10 | | patient has full knowledge of the division and the division is |
11 | | made in proportion to the actual services personally performed |
12 | | and responsibility assumed by each licensee consistent with his |
13 | | or her license, except as prohibited by law. |
14 | | (c) Nothing contained in this Section prohibits a licensee |
15 | | under this Act from practicing medicine through or within any |
16 | | form of legal entity authorized to conduct business in this |
17 | | State or from pooling, sharing, dividing, or apportioning the |
18 | | professional fees and other revenues in accordance with the |
19 | | agreements 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 |
17 | | under this Act from paying a fair market value fee to any |
18 | | person or entity whose purpose is to perform billing, |
19 | | administrative preparation, or collection services based upon |
20 | | a percentage of professional service fees billed or collected, |
21 | | a flat fee, or any other arrangement that directly or |
22 | | indirectly divides professional fees, for the administrative |
23 | | preparation of the licensee's claims or the collection of the |
24 | | licensee'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 |
10 | | granting of a security interest in the accounts receivable or |
11 | | fees of a licensee under this Act or the licensee's practice |
12 | | for bona fide advances made to the licensee or licensee's |
13 | | practice provided the licensee retains control and |
14 | | responsibility for the collection of the accounts receivable |
15 | | and fees. |
16 | | (f) Excluding payments that may be made to the owners of or |
17 | | licensees in the licensee's practice under subsection (c), a |
18 | | licensee under this Act may not divide, share or split a |
19 | | professional service fee with, or otherwise directly or |
20 | | indirectly pay a percentage of the licensee's professional |
21 | | service fees, revenues or profits to anyone for: (i) the |
22 | | marketing or management of the licensee's practice, (ii) |
23 | | including the licensee or the licensee's practice on any |
24 | | preferred provider list, (iii) allowing the licensee to |
25 | | participate in any network of health care providers, (iv) |
26 | | negotiating fees, charges or terms of service or payment on |
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1 | | behalf of the licensee, or (v) including the licensee in a |
2 | | program whereby patients or beneficiaries are provided an |
3 | | incentive to use the services of the licensee.
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4 | | (g) A violation of any of the provisions of this Section |
5 | | constitutes an unlawful practice under the Consumer Fraud and |
6 | | Deceptive Business Practices Act. All remedies, penalties, and |
7 | | authority granted to the Attorney General by the Consumer Fraud |
8 | | and Deceptive Business Practices Act shall be available to him |
9 | | or her for the enforcement of this Section. This subsection |
10 | | does not apply to hospitals and hospital affiliates licensed in |
11 | | Illinois. |
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 |
14 | | Practices Act is amended by adding Section 2VVV as follows: |
15 | | (815 ILCS 505/2VVV new) |
16 | | Sec. 2VVV. Deceptive marketing, advertising, and sale of |
17 | | mental 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 |
20 | | 1-10 of the Alcoholism and Other Drug Abuse and Dependency Act. |
21 | | "Hospital affiliate" has the meaning ascribed to that term |
22 | | in Section 10.8 of the Hospital Licensing Act. |
23 | | "Mental health disorder" has the same meaning as "mental |
24 | | illness" under Section 1-129 of the Mental Health and |
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1 | | Developmental Disabilities Code. |
2 | | "Program" has the meaning ascribed to that term in Section |
3 | | 1-10 of the Alcoholism and Other Drug Abuse and Dependency Act. |
4 | | "Substance use disorder" has the same meaning as "substance |
5 | | abuse" under Section 1-10 of the Alcoholism and Other Drug |
6 | | Abuse and Dependency Act. |
7 | | "Treatment" has the meaning ascribed to that term in |
8 | | Section 1-10 of the Alcoholism and Other Drug Abuse and |
9 | | Dependency Act. |
10 | | (b) It is an unlawful practice for any person to engage in |
11 | | misleading or false advertising or promotion that |
12 | | misrepresents the need to seek mental health disorder or |
13 | | substance use disorder treatment outside of the State of |
14 | | Illinois. |
15 | | (c) Any marketing, advertising, promotional, or sales |
16 | | materials directed to Illinois residents concerning mental |
17 | | health 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 |
13 | | an arrangement under which a patient seeking mental health |
14 | | disorder or substance use disorder treatment is referred to a |
15 | | mental health disorder or substance use disorder treatment |
16 | | program or facility in exchange for a fee, a percentage of the |
17 | | treatment program's or facility's revenues that are related to |
18 | | the patient, or any other remuneration that takes into account |
19 | | the volume or value of the referrals to the treatment program |
20 | | or facility. Such practice shall also be considered a violation |
21 | | of the prohibition against fee splitting in Section 22.2 of the |
22 | | Medical Practice Act of 1987 and a violation of the Health Care |
23 | | Worker Self-Referral Act. This Section does not apply to health |
24 | | insurance companies, health maintenance organizations, managed |
25 | | care plans, or organizations, including hospitals and hospital |
26 | | affiliates licensed in Illinois.
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