State of Illinois
91st General Assembly
Legislation

   [ Search ]   [ Legislation ]
[ Home ]   [ Back ]   [ Bottom ]


[ Introduced ][ House Amendment 001 ][ House Amendment 002 ]
[ Senate Amendment 001 ][ Senate Amendment 002 ]

91_SB0646eng

 
SB646 Engrossed                                LRB9105880MWgc

 1        AN  ACT  concerning health care providers, amending named
 2    Acts.

 3        Be it enacted by the People of  the  State  of  Illinois,
 4    represented in the General Assembly:

 5        Section  5.  The  Illinois Health Facilities Planning Act
 6    is amended by  adding  Sections  13.5,  13.9,  13.10,  13.15,
 7    13.20, 13.25, 13.30, and 13.35 as follows:

 8        (20 ILCS 3960/13.5 new)
 9        Sec. 13.5.  Health care provider cooperative agreements.
10        The  General Assembly finds that the goals of controlling
11    health care costs and improving the quality of and access  to
12    health  care  services will be significantly enhanced by some
13    cooperative arrangements involving providers  that  might  be
14    prohibited  by State and federal antitrust laws if undertaken
15    without  governmental  involvement.    Both   currently   and
16    historically  Illinois,  other  states, and the United States
17    have determined that unrestricted marketplace competition may
18    not produce the optimum mix of cost, access, and quality that
19    can be achieved in health care. The purpose of Sections  13.5
20    through  13.35  is  to create an opportunity for the State to
21    review proposed arrangements and to substitute regulation for
22    competition when an arrangement is likely to result in  lower
23    costs,  or  greater  access,  or improved quality, than would
24    otherwise occur in the competitive marketplace.  The  General
25    Assembly   intends   that   approval   of   relationships  be
26    accompanied  by  appropriate  conditions,  supervision,   and
27    regulation  to  protect  against  private  abuses of economic
28    power, and that an arrangement or  relationship  approved  by
29    the   Attorney   General   and   accompanied  by  appropriate
30    conditions, supervision, and regulation shall not be  subject
31    to State or federal antitrust liability.
 
SB646 Engrossed             -2-                LRB9105880MWgc
 1        The  General  Assembly  finds  that the market for health
 2    care services is extremely diverse in Illinois.   Some  parts
 3    of  Illinois  are  national  destinations for tertiary health
 4    care services and receive patients from throughout the United
 5    States and the Western Hemisphere.  Other regions of Illinois
 6    have extraordinary  rates  of  outmigration,  with  residents
 7    traveling  hundreds  of  miles, often out-of-state, for care.
 8    Providing health care close to home is medically useful to  a
 9    patient's  recovery,  because  visits of families and friends
10    can improve a patient's psycho-social capacity to  cope  with
11    disease.   Providing  incentives  to increase quality care in
12    areas without it is desirable.

13        (20 ILCS 3960/13.9 new)
14        Sec. 13.9.  Regional application.
15        (a)  The provisions of this law shall apply to any region
16    in Illinois where the following health care conditions exist:
17             (1)  in any area of at least 25 contiguous  counties
18        containing  at  least  20  facilities  licensed under the
19        Hospital Licensing Act;
20             (2)  where during the calendar  year  preceding  the
21        effective date of this amendatory Act of the 91st General
22        Assembly,  no  facility  has  been approved or received a
23        permit to establish neo-natal intensive care,  open-heart
24        surgery, level-one trauma, or organ transplantation;
25             (3)  where  at  least  50%  of  residents  receiving
26        open-heart  surgery procedures at Illinois hospitals must
27        travel at least 75 miles; and
28             (4)  where no Illinois  university  with  a  medical
29        school  has  a  primary  medical school campus within 100
30        miles of the most distant point in the region.
31        (b)  For purposes of  this  law,  health  care  providers
32    shall  include  any institution or individual licensed by the
33    State under the Medical Practice Act of 1987 or the  Hospital
 
SB646 Engrossed             -3-                LRB9105880MWgc
 1    Licensing Act.

 2        (20 ILCS 3960/13.10 new)
 3        Sec. 13.10.  Health care provider cooperative agreements;
 4    goals.   Acting  by  their  boards  of directors or boards of
 5    trustees or as individuals, 2 or more health care  providers,
 6    at  least  one  of  which must be licensed under the Hospital
 7    Licensing  Act,  may  enter  into  a  cooperative   agreement
 8    concerning  the allocation of health care equipment or health
 9    care services among themselves for  the  provision  of  major
10    medical  procedures  such  as  open-heart  surgery, neo-natal
11    intensive care, level-one trauma, or  organ  transplantation.
12    The  agreement  shall  not  involve price-fixing or predatory
13    pricing and shall be designed to achieve one or more  of  the
14    following goals:
15             (1)  Reducing   health   care   costs  for  Illinois
16        consumers.
17             (2)  Improving access to  health  care  services  in
18        Illinois.
19             (3)  Improving   the  quality  of  patient  care  in
20        Illinois.

21        (20 ILCS 3960/13.15 new )
22        Sec. 13.15.  Health care provider cooperative agreements;
23    approval.
24        (a)  No  cooperative  agreement   between   health   care
25    providers implemented without first obtaining a review by the
26    Health  Facilities  Planning  Board  and  approval  from  the
27    Attorney  General  as  provided  in  this  Section  shall  be
28    eligible  for  any  protection or immunity created by Section
29    13.30.
30        (b)  Health  care  providers  desiring  to  implement   a
31    cooperative  agreement  authorized under Section 13.10 and to
32    obtain the antitrust  exception  provided  by  Section  13.30
 
SB646 Engrossed             -4-                LRB9105880MWgc
 1    shall  apply  to  the  Attorney  General  for approval of the
 2    agreement. Applications for  approval  shall  be  in  a  form
 3    prescribed by the Attorney General but shall contain at least
 4    the following:
 5             (1)  A verified copy of the proposed agreement.
 6             (2)  An implementation plan that states how and when
 7        the  cooperative  action identified in the agreement will
 8        meet one or more of the goals specified in Section 13.10,
 9        and how the benefits will outweigh any negatives.
10             (3)  A statement of any consideration received or to
11        be received under the proposed agreement.
12        (c)  Each application  shall  be  accompanied  by  a  fee
13    determined   by  the  Attorney  General,  but  in  an  amount
14    sufficient to cover the cost of processing  the  application.
15    All  payments  made  to the Attorney General pursuant to this
16    Section shall be deposited into the Attorney  General  Health
17    Care  Cooperative Agreement and Antitrust Enforcement Fund, a
18    special fund created in the State  treasury.  Moneys  in  the
19    fund   shall   be  used  subject  to  appropriation  for  the
20    performance of any function pertaining to the exercise of the
21    duties of the Attorney General in carrying out the provisions
22    of this Act.
23        (d)  The Attorney  General  shall  adopt  rules  for  the
24    operation  of  this  Act  under  the  Illinois Administrative
25    Procedure Act. The General Assembly finds  that  the  current
26    health  care  situation constitutes an emergency for purposes
27    of the Illinois Administrative Procedure Act.  Therefore, the
28    Attorney General may implement  the  provisions  of  Sections
29    13.5 through 13.30 by emergency rulemaking under the Illinois
30    Administrative Procedure Act.
31        (e)  The  rules shall require applicants to provide clear
32    and convincing evidence in the application demonstrating that
33    quality, cost, or access improvements cannot be  accomplished
34    by the applicants without the agreement.
 
SB646 Engrossed             -5-                LRB9105880MWgc
 1        (f)  A  copy  of an application submitted to the Attorney
 2    General pursuant to subsection (b)  shall  simultaneously  be
 3    submitted  to  the  Health  Facilities  Planning Board, which
 4    shall hold public hearings on the application.  The  hearings
 5    may  be  combined  with hearings relating to the provision by
 6    the State Board of a Certificate of Need, if applicable.  The
 7    State Board shall issue a report, including findings of  fact
 8    and  recommendations,  and provide it, together with a record
 9    of proceedings,  to the Attorney General as expeditiously  as
10    possible.
11        (g)  Upon receiving a report and recommendations from the
12    Health  Facilities  Planning  Board, the Attorney General may
13    approve an  agreement  if  he  or  she  finds  by  clear  and
14    convincing  evidence that its implementation will lead to the
15    improvements in cost, access, or  quality  described  in  the
16    application,  that  these improvements are likely to outweigh
17    any probable negative results, that  predatory  pricing  will
18    not occur, and that the agreement is in the public interest.
19        (h)  The  Attorney  General may condition his approval of
20    the agreement upon terms he or she finds necessary to protect
21    consumers and to be in the public interest.

22        (20 ILCS 3960/13.20 new)
23        Sec. 13.20.  Health care provider cooperative agreements;
24    annual review. The Attorney General shall  require  from  the
25    parties  to  a  cooperative agreement annual progress reports
26    concerning the implementation of the agreement.  The  reports
27    shall  contain any information and be accompanied by any fees
28    that are required by rule.
29        A copy of each report shall simultaneously be filed  with
30    the  Health  Facilities Planning Board, which shall review it
31    and make recommendations to the Attorney General.

32        (20 ILCS 3960/13.25 new)
 
SB646 Engrossed             -6-                LRB9105880MWgc
 1        Sec. 13.25.  Health care provider cooperative agreements;
 2    rescinding approval.  If the Attorney General finds that  any
 3    of  the  following circumstances exist, he or she may issue a
 4    decision  rescinding  his  or  her  approval  of  a  hospital
 5    cooperative agreement:
 6             (1)  The parties to the  agreement  fail  to  submit
 7        annual progress reports;
 8             (2)  Materially misleading information was submitted
 9        in  the  application or in any subsequent report filed by
10        the parties with the Health Facilities Planning Board and
11        the Attorney General pursuant to this Act;
12             (3)  The  parties  have  failed  to  implement   the
13        agreement with due diligence;
14             (4)  The  agreement  has  failed  to  accomplish its
15        purposes as described in the application; or
16             (5)  The Attorney General has subsequently found  by
17        substantial  evidence  that the benefits of the agreement
18        do not substantially outweigh the negative results.

19        (20 ILCS 3960/13.30 new)
20        Sec. 13.30.  Health care provider cooperative agreements;
21    antitrust exception.
22        (a)  Neither this subsection nor any other  provision  of
23    this  Act  is  intended  to  confer,  and  does  not  confer,
24    authority   to  engage  in  agreements,  tacit,  implied,  or
25    express, which are not submitted to the Attorney General  for
26    approval,  if  those  agreements are in violation of State or
27    federal antitrust laws.  Conduct seemingly  pursuant  to  the
28    provisions  of this law done without the good faith intention
29    to accomplish an agreement approved by the  Attorney  General
30    is  not  entitled  to  the protections and immunities of this
31    Section 13.30.
32        (b)  It is the  intent  of  Sections  13.5  through  this
33    Section  to  require  the State, through the Attorney General
 
SB646 Engrossed             -7-                LRB9105880MWgc
 1    and  the  Health  Facilities  Planning  Board,   to   provide
 2    direction,   supervision,   and   control   over  cooperative
 3    agreements approved under  Section  13.15.   To  achieve  the
 4    goals  specified  in  Section  13.10,  this  State direction,
 5    supervision, and control will provide immunity from any civil
 6    or criminal liability under the Illinois  Antitrust  Act  and
 7    state-action  immunity  under  federal  antitrust laws to (i)
 8    health care providers, their  governing  board  members,  and
 9    their  officers,  agents,  and  employees who take authorized
10    actions to implement a cooperative agreement  approved  under
11    Section 13.15 and (ii) health care providers' governing board
12    members   who  participate  in  discussions  or  negotiations
13    concerning the allocation of health care equipment or  health
14    care services as authorized under Section 13.10.

15        (20 ILCS 3960/13.35 new)
16        Sec.    13.35.  Health    care   providers'   cooperative
17    agreements; Attorney General  action.   Nothing  in  Sections
18    13.5  through 13.30 shall limit the authority of the Attorney
19    General to  initiate  an  action  to  enforce  the  civil  or
20    criminal  liability provisions of the Illinois Antitrust Act,
21    or to take any other measures that he or she deems necessary,
22    if  the  Attorney  General  determines  that  a  health  care
23    provider,  the  members  of  its  governing  board,  or   its
24    officers, agents, or employees have exceeded the scope of the
25    actions  authorized  under  those  Sections,  have  failed to
26    comply  with  the  terms  and  conditions  of  an   agreement
27    authorized  under  Section   13.15,  or have failed to comply
28    with the reporting requirements of Section 13.20.
29        The Attorney General is authorized to  use  the  subpoena
30    and  investigative  powers  available to him or her under the
31    Illinois Antitrust Act and the Consumer Fraud  and  Deceptive
32    Business Practices Act to facilitate his or her review of any
33    application  or  report  submitted  to him or her pursuant to
 
SB646 Engrossed             -8-                LRB9105880MWgc
 1    Sections  13.15  and  13.20,  and  to  investigate   possible
 2    violations of Sections 13.5 through 13.30 of the Act.

 3        Section  10.  The  State Finance Act is amended by adding
 4    Section 5.490 as follows:

 5        (30 ILCS 105/5.490 new)
 6        Sec. 5.490.  The Attorney General Health Care Cooperative
 7    Agreement and Antitrust Enforcement Fund.

 8        Section 15.  The Illinois Antitrust  Act  is  amended  by
 9    changing Section 5 as follows:

10        (740 ILCS 10/5) (from Ch. 38, par. 60-5)
11        Sec.  5.  No provisions of this Act shall be construed to
12    make illegal:
13        (1)  the activities  of  any  labor  organization  or  of
14    individual members thereof which are directed solely to labor
15    objectives  which are legitimate under the laws of either the
16    State of Illinois or the United States;
17        (2)  the activities of any agricultural or  horticultural
18    cooperative    organization,    whether    incorporated    or
19    unincorporated,  or  of individual members thereof, which are
20    directed   solely   to   objectives   of   such   cooperative
21    organizations which are legitimate under the laws  of  either
22    the State of Illinois or the United States;
23        (3)  the  activities of any public utility, as defined in
24    Section 3-105 of the Public Utilities Act to the extent  that
25    such  activities  are  subject  to  a clearly articulated and
26    affirmatively expressed State policy to  replace  competition
27    with regulation, where the conduct to be exempted is actively
28    supervised by the State itself;
29        (4)  The  activities  of a telecommunications carrier, as
30    defined in Section 13-202 of the Public Utilities Act, to the
 
SB646 Engrossed             -9-                LRB9105880MWgc
 1    extent  those  activities  relate   to   the   provision   of
 2    noncompetitive  telecommunications  services under the Public
 3    Utilities Act and are subject  to  the  jurisdiction  of  the
 4    Illinois   Commerce   Commission  or  to  the  activities  of
 5    telephone mutual concerns referred to in  Section  13-202  of
 6    the  Public  Utilities  Act  to  the  extent those activities
 7    relate to the provision and maintenance of telephone  service
 8    to owners and customers;
 9        (5)  the  activities  (including, but not limited to, the
10    making of or participating in  joint  underwriting  or  joint
11    reinsurance  arrangement)  of  any  insurer, insurance agent,
12    insurance broker, independent insurance  adjuster  or  rating
13    organization  to  the extent that such activities are subject
14    to regulation by the Director  of  Insurance  of  this  State
15    under,  or  are permitted or are authorized by, the Insurance
16    Code or any other law of this State;
17        (6)  the  religious  and  charitable  activities  of  any
18    not-for-profit corporation, trust or organization established
19    exclusively for religious or charitable purposes, or for both
20    purposes;
21        (7)  the activities  of  any  not-for-profit  corporation
22    organized  to  provide  telephone  service  on  a  mutual  or
23    co-operative  basis  or  electrification  on  a  co-operative
24    basis,  to the extent such activities relate to the marketing
25    and distribution of telephone or electrical service to owners
26    and customers;
27        (8)  the activities engaged in by securities dealers  who
28    are  (i) licensed by the State of Illinois or (ii) members of
29    the National  Association  of  Securities  Dealers  or  (iii)
30    members  of  any National Securities Exchange registered with
31    the Securities and Exchange Commission under  the  Securities
32    Exchange  Act  of  1934,  as  amended, in the course of their
33    business  of  offering,  selling,  buying  and  selling,   or
34    otherwise  trading  in  or underwriting securities, as agent,
 
SB646 Engrossed             -10-               LRB9105880MWgc
 1    broker,  or  principal,  and  activities  of   any   National
 2    Securities    Exchange    so    registered,   including   the
 3    establishment of commission rates and schedules of charges;
 4        (9)  the activities of any board of trade designated as a
 5    "contract market" by the  Secretary  of  Agriculture  of  the
 6    United States pursuant to Section 5 of the Commodity Exchange
 7    Act, as amended;
 8        (10)  the  activities of any motor carrier, rail carrier,
 9    or common carrier by  pipeline,  as  defined  in  the  Common
10    Carrier  by  Pipeline Law of the Public Utilities Act, to the
11    extent that such activities are permitted  or  authorized  by
12    the Act or are subject to regulation by the Illinois Commerce
13    Commission;
14        (11)  the activities of any state or national bank to the
15    extent  that  such  activities are regulated or supervised by
16    officers of the state or federal government under the banking
17    laws of this State or the United States;
18        (12)  the activities of any state or federal savings  and
19    loan  association  to  the  extent  that  such activities are
20    regulated or supervised by officers of the state  or  federal
21    government  under  the savings and loan laws of this State or
22    the United States;
23        (13)  the activities  of  any  bona  fide  not-for-profit
24    association, society or board, of attorneys, practitioners of
25    medicine,  architects,  engineers,  land  surveyors  or  real
26    estate  brokers  licensed  and  regulated by an agency of the
27    State of Illinois, in  recommending  schedules  of  suggested
28    fees,  rates  or  commissions for use solely as guidelines in
29    determining charges for professional and technical services;
30        (14)  Conduct involving trade  or  commerce  (other  than
31    import trade or import commerce) with foreign nations unless:
32             (a)  such  conduct  has  a  direct, substantial, and
33        reasonably foreseeable effect:
34                  (i)  on trade or commerce which is not trade or
 
SB646 Engrossed             -11-               LRB9105880MWgc
 1             commerce with foreign nations, or on import trade or
 2             import commerce with foreign nations; or
 3                  (ii)  on export trade or export  commerce  with
 4             foreign nations of a person engaged in such trade or
 5             commerce in the United States; and
 6             (b)  such  effect  gives  rise  to a claim under the
 7        provisions of this Act, other than this subsection (14).
 8             (c)  If this Act applies to conduct referred  to  in
 9        this  subsection  (14)  only because of the provisions of
10        paragraph (a)(ii), then this  Act  shall  apply  to  such
11        conduct  only for injury to export business in the United
12        States which affects this State; or
13        (15)  the activities of a unit  of  local  government  or
14    school  district  and the activities of the employees, agents
15    and officers of a unit of local government or school district
16    ; or
17        (16)  the activities of a health care  provider  and  the
18    activities  of  its governing board members and its officers,
19    agents, and employees in  discussing,  negotiating,  entering
20    into,  or implementing a cooperative agreement concerning the
21    allocation of health care equipment or health  care  services
22    resulting  in  one  or  more proposals or agreements that are
23    approved by the Attorney General,  or  if  submitted  to  the
24    Attorney  General  might  reasonably  have  been approved, as
25    authorized under Sections 13.5 through 13.35 of the  Illinois
26    Health Facilities Planning Act.
27    (Source: P.A. 90-185, eff. 7-23-97; 90-561, eff. 12-16-97.)

[ Top ]