Sen. Ann Gillespie
Filed: 5/2/2023
 
 


 




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1
AMENDMENT TO HOUSE BILL 2222 




2 AMENDMENT NO. ______. Amend House Bill 2222 by replacing 
3everything after the enacting clause with the following:


4 "Section 5. The Illinois Health Facilities Planning Act is 
5amended by changing Section 8.5 as follows:

6 (20 ILCS 3960/8.5)
7 (Section scheduled to be repealed on December 31, 2029)
8 Sec. 8.5. Certificate of exemption for change of ownership 
9of a health care facility; discontinuation of a category of 
10service; public notice and public hearing.
11 (a) Upon a finding that an application for a change of 
12ownership is complete, the State Board shall publish a legal 
13notice on 3 consecutive days in a newspaper of general 
14circulation in the area or community to be affected and afford 
15the public an opportunity to request a hearing. If the 
16application is for a facility located in a Metropolitan 
 
 
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1Statistical Area, an additional legal notice shall be 
2published in a newspaper of limited circulation, if one 
3exists, in the area in which the facility is located. If the 
4newspaper of limited circulation is published on a daily 
5basis, the additional legal notice shall be published on 3 
6consecutive days. The applicant shall pay the cost incurred by 
7the Board in publishing the change of ownership notice in 
8newspapers as required under this subsection. The legal notice 
9shall also be posted on the Health Facilities and Services 
10Review Board's web site and sent to the State Representative 
11and State Senator of the district in which the health care 
12facility is located and to the Office of the Attorney General. 
13An application for change of ownership of a hospital shall not 
14be deemed complete without a signed certification that for a 
15period of 2 years after the change of ownership transaction is 
16effective, the hospital will not adopt a charity care policy 
17that is
more restrictive than the policy in effect during the 
18year prior to the transaction. An application for a change of 
19ownership need not contain signed transaction documents so 
20long as it includes the following key terms of the 
21transaction: names and background of the parties; structure of 
22the transaction; the person who will be the licensed or 
23certified entity after the transaction; the ownership or 
24membership interests in such licensed or certified entity both 
25prior to and after the transaction; fair market value of 
26assets to be transferred; and the purchase price or other form 
 
 
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1of consideration to be provided for those assets. The issuance 
2of the certificate of exemption shall be contingent upon the 
3applicant submitting a statement to the Board within 90 days 
4after the closing date of the transaction, or such longer 
5period as provided by the Board, certifying that the change of 
6ownership has been completed in accordance with the key terms 
7contained in the application. If such key terms of the 
8transaction change, a new application shall be required. 
9 Where a change of ownership is among related persons, and 
10there are no other changes being proposed at the health care 
11facility that would otherwise require a permit or exemption 
12under this Act, the applicant shall submit an application 
13consisting of a standard notice in a form set forth by the 
14Board briefly explaining the reasons for the proposed change 
15of ownership. Once such an application is submitted to the 
16Board and reviewed by the Board staff, the Board Chair shall 
17take action on an application for an exemption for a change of 
18ownership among related persons within 45 days after the 
19application has been deemed complete, provided the application 
20meets the applicable standards under this Section. If the 
21Board Chair has a conflict of interest or for other good cause, 
22the Chair may request review by the Board. Notwithstanding any 
23other provision of this Act, for purposes of this Section, a 
24change of ownership among related persons means a transaction 
25where the parties to the transaction are under common control 
26or ownership before and after the transaction is completed.
 
 
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1 Nothing in this Act shall be construed as authorizing the 
2Board to impose any conditions, obligations, or limitations, 
3other than those required by this Section, with respect to the 
4issuance of an exemption for a change of ownership, including, 
5but not limited to, the time period before which a subsequent 
6change of ownership of the health care facility could be 
7sought, or the commitment to continue to offer for a specified 
8time period any services currently offered by the health care 
9facility.
10 The changes made by this amendatory Act of the 103rd 
11General Assembly are inoperative on and after January 1, 2027. 
12 (a-3) (Blank). 
13 (a-5) Upon a finding that an application to discontinue a 
14category of service is complete and provides the requested 
15information, as specified by the State Board, an exemption 
16shall be issued. No later than 30 days after the issuance of 
17the exemption, the health care facility must give written 
18notice of the discontinuation of the category of service to 
19the State Senator and State Representative serving the 
20legislative district in which the health care facility is 
21located. No later than 90 days after a discontinuation of a 
22category of service, the applicant must submit a statement to 
23the State Board certifying that the discontinuation is 
24complete. 
25 (b) If a public hearing is requested, it shall be held at 
26least 15 days but no more than 30 days after the date of 
 
 
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1publication of the legal notice in the community in which the 
2facility is located. The hearing shall be held in the affected 
3area or community in a place of reasonable size and 
4accessibility and a full and complete written transcript of 
5the proceedings shall be made. All interested persons 
6attending the hearing shall be given a reasonable opportunity 
7to present their positions in writing or orally. The applicant 
8shall provide a summary or describe the proposed change of 
9ownership at the public hearing.

10 (c) For the purposes of this Section "newspaper of limited 
11circulation" means a newspaper intended to serve a particular 
12or defined population of a specific geographic area within a 
13Metropolitan Statistical Area such as a municipality, town, 
14village, township, or community area, but does not include 
15publications of professional and trade associations. 
16 (d) The changes made to this Section by this amendatory 
17Act of the 101st General Assembly shall apply to all 
18applications submitted after the effective date of this 
19amendatory Act of the 101st General Assembly. 
20(Source: P.A. 100-201, eff. 8-18-17; 101-83, eff. 7-15-19.)

21 Section 10. The State Finance Act is amended by adding 
22Section 5.990 as follows:

23 (30 ILCS 105/5.990 new)
24 Sec. 5.990. The Antitrust Enforcement Fund. This Section 
 
 
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1is repealed on January 1, 2027.

2 Section 15. The Illinois Antitrust Act is amended by 
3changing Section 7.2 and by adding Sections 7.2a and 13 as 
4follows:




5 (740 ILCS 10/7.2) (from Ch. 38, par. 60-7.2)



6 Sec. 7.2. (1) Whenever it appears to the Attorney General 
7that any person has
engaged in, is engaging in, or is about to 
8engage in any act or practice
prohibited by this Act, or that 
9any person has assisted or participated
in any agreement or 
10combination of the nature described herein, he may,
in his 
11discretion, conduct an investigation as he deems necessary in

12connection with the matter and has the authority prior to the

13commencement of any civil or criminal action as provided for 
14in the Act
to subpoena witnesses, and pursuant to a subpoena 
15(i) compel their
attendance for the purpose of examining them 
16under oath, (ii) require the
production of any books, 
17documents, records, writings or tangible things
hereafter 
18referred to as "documentary material" which
the Attorney 
19General deems relevant or material to his investigation,
for 
20inspection, reproducing or copying under such terms and 
21conditions
as hereafter set forth, (iii) require written 
22answers under oath to written
interrogatories, or (iv) require 
23compliance with a combination of the
foregoing. Any subpoena 
24issued by the Attorney General
shall contain the following 
 
 
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1information:

2  (a) The statute and section thereof, the alleged 
3 violation of which
is under investigation and the general 
4 subject matter of the
investigation.

5  (b) The date and place at which time the person is 
6 required to
appear or produce documentary material in his 
7 possession, custody or
control or submit answers to 
8 interrogatories in the office of the Attorney
General 
9 located in Springfield or
Chicago. Said date shall not be 
10 less than 10 days from date of service
of the subpoena.

11  (c) Where documentary material is required to be 
12 produced, the same
shall be described by class so as to 
13 clearly indicate the material
demanded.

14 The Attorney General is hereby authorized, and may so 
15elect, to
require the production, pursuant to this section, of 
16documentary
material or interrogatory answers prior to the 
17taking of any testimony of
the person subpoenaed. Said 
18documentary material shall be made available for
inspection 
19and copying during normal business hours at the principal

20place of business of the person served, or at such other time 
21and place,
as may be agreed upon by the person served and the 
22Attorney General.
When documentary material is demanded by 
23subpoena, said subpoena shall
not:

24  (i) contain any requirement which would be 
25 unreasonable or improper
if contained in a subpoena duces 
26 tecum issued by a court of this State;
or

 
 
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1  (ii) require the disclosure of any documentary 
2 material which would
be privileged, or which for any other 
3 reason would not be required by a
subpoena duces tecum 
4 issued by a court of this State.

5 (2) The production of documentary material in response to 
6a subpoena served
pursuant to this Section shall be made under 
7a sworn certificate, in such
form as the subpoena designates, 
8by the person, if a natural person, to
whom the demand is 
9directed or, if not a natural person, by a person or
persons 
10having knowledge of the facts and circumstances relating to 
11such
production, to the effect that all of the documentary 
12material required
by the demand and in the possession, 
13custody, or control of the person to
whom the demand is 
14directed has been produced and made available to the

15custodian. Answers to interrogatories shall be accompanied by 
16a statement
under oath attesting to the accuracy of the 
17answers.

18 While in the possession of the Attorney General and under 
19such reasonable
terms and conditions as the Attorney General 
20shall prescribe: (A) documentary
material shall be available 
21for examination by the person who produced such
material or by 
22any duly authorized representative of such person, (B)

23transcript of oral testimony shall be available for 
24examination by the person
who produced such testimony, or his 
25or her counsel and (C) answers to
interrogatories shall be 
26available for examination by the person who swore to
their 
 
 
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1accuracy.

2 Except as otherwise provided in this Section, no 
3documentary material,
transcripts of oral testimony, or 
4answers to interrogatories, or copies thereof, in the 
5possession of the
Attorney General shall be available for 
6examination by any individual other
than an authorized 
7employee of the Attorney General or other law enforcement

8officials, federal, State, or local, without the consent of 
9the person who produced
such material, transcripts, or 
10interrogatory answers. Such documentary material, transcripts 
11of oral testimony, or answers to interrogatories, or copies 
12thereof may be used by the Attorney General in any 
13administrative or judicial action or proceeding. 

14 For purposes of this Section, all documentary materials, 
15transcripts of oral testimony, or answers to interrogatories 
16obtained by the Attorney General from other law enforcement 
17officials, information voluntarily produced to the Attorney 
18General for purposes of any investigation conducted under 
19subsection (1), or information provided to the Attorney 
20General pursuant to the notice requirement of Section 7.2a 
21shall be treated as if produced pursuant to a subpoena served 
22pursuant to this Section for purposes of maintaining the 
23confidentiality of such information.
24 The changes made by this amendatory Act of the 103rd 
25General Assembly are inoperative on and after January 1, 2027. 
26 (3) No person shall, with intent to avoid, evade, prevent, 
 
 
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1or obstruct
compliance in whole or in part by any person with 
2any duly served subpoena
of the Attorney General under this 
3Act, knowingly remove from any place,
conceal, withhold, 
4destroy, mutilate, alter, or by any other means falsify
any 
5documentary material that is the subject of such subpoena. A 
6violation
of this subsection is a Class A misdemeanor. The 
7Attorney General, with
such assistance as he may from time to 
8time require of the State's Attorneys
in the several counties, 
9shall investigate suspected violations of this
subsection and 
10shall commence and try all prosecutions under this subsection.

11(Source: P.A. 96-751, eff. 1-1-10; 96-1000, eff. 7-2-10.)


12 (740 ILCS 10/7.2a new)
13 Sec. 7.2a. Notification to the Attorney General.
14 (a) As used in this Section:
15 "Acquisition" means an agreement, arrangement, or activity

16the consummation of which results in a person acquiring

17directly or indirectly the control of another person. 
18"Acquisition"
includes the acquisition of voting securities 
19and noncorporate
interests, such as assets, capital stock, 
20membership
interests, or equity interests.
21 "Contracting affiliation" means the formation of a 
22relationship between 2 or more entities that permits the 
23entities to negotiate jointly with health carriers or 
24third-party administrators over rates for professional medical 
25services, or for one entity to negotiate on behalf of the other 
 
 
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1entity with health carriers or third-party administrators over 
2rates for professional medical services. "Contracting 
3affiliation" does not include arrangements among entities 
4under common ownership.
5 "Covered transaction" means any merger, acquisition, or 
6contracting affiliation between 2 or more health care 
7facilities or provider organizations not previously under 
8common ownership or contracting affiliation.
9 "Health care facility" means the following facilities, 
10organizations, and related persons:
11  (1) An ambulatory surgical treatment center required 
12 to be licensed under the Ambulatory Surgical Treatment 
13 Center Act.
14  (2) An institution, place, building, or agency 
15 required to be licensed under the Hospital Licensing Act.
16  (3) A hospital, ambulatory surgical treatment center, 
17 or kidney disease treatment center maintained by the State 
18 or any department or agency thereof.
19  (4) A kidney disease treatment center, including a 
20 free-standing hemodialysis unit required to meet the 
21 requirements of 42 CFR 494 in order to be certified for 
22 participation in Medicare and Medicaid under Titles XVIII 
23 and XIX of the federal Social Security Act of 1935.
24  (5) An institution, place, building, or room used for 
25 the performance of outpatient surgical procedures that is 
26 leased, owned, or operated by or on behalf of an 
 
 
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1 out-of-state facility.
2  (6) An institution, place, building, or room used for 
3 provision of a health care category of service, as defined 
4 under the Illinois Health Facilities Planning Act, 
5 including, but not limited to, cardiac catheterization and 
6 open heart surgery.
7 With the exception of those health care facilities 
8specifically included in this Section, nothing in this Section 
9shall be intended to include facilities operated as a part of 
10the practice of a physician or other licensed health care 
11professional, whether practicing in his or her individual 
12capacity or within the legal structure of any partnership, 
13medical or professional corporation, or unincorporated medical 
14or professional group. Further, this Section shall not apply 
15to physicians or other licensed health care professional's 
16practices where such practices are carried out in a portion of 
17a health care facility under contract with such health care 
18facility by a physician or by other licensed health care 
19professionals, whether practicing in his or her individual 
20capacity or within the legal structure of any partnership, 
21medical or professional corporation, or unincorporated medical 
22or professional groups, unless the entity constructs, 
23modifies, or establishes a health care facility as 
24specifically defined in this Section.
25 "Health care services revenue" means the total revenue 
26received for health care services in the previous 12 months.
 
 
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1 "Health carriers" has the meaning given to that term in 
2Section 10 of the Health Carrier External Review Act.
3 "Illinois health care entity" means a health care facility 
4or provider organization that has an office in or is doing 
5business in this State.
6 "Merger" means the consolidation of 2 or more 
7organizations, including 2 or more organizations joining 
8through a common parent organization or 2 or more 
9organizations forming a new organization, but does not include 
10a corporate reorganization.
11 "Out-of-state health care entity" means a health care 
12facility or provider organization that is not headquartered in 
13this State and does not do business in this State.
14 "Provider organization" means a corporation, partnership, 
15business trust, association, or organized group of persons, 
16whether incorporated or not, which is in the business of 
17health care delivery or management and that represents 20 or 
18more health care providers in contracting with health carriers 
19or third-party administrators for the payment of health care 
20services. "Provider organization" includes physician 
21organizations, physician-hospital organizations, independent 
22practice associations, provider networks, and accountable care 
23organizations.
24 "Third-party administrator" means an entity that 
25administers payments for health care services on behalf of a 
26client in exchange for an administrative fee.
 
 
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1 (b) Health care facilities or provider organizations that 
2are party to a covered transaction shall provide notice of 
3such transaction to the Attorney General no later than 30 days 
4prior to the transaction closing or effective date of the 
5transaction.
6 Covered transactions between an Illinois health care 
7entity and an out-of-state health care entity must provide 
8notice under this subsection where the out-of-state entity 
9generates $10,000,000 or more in annual revenue from patients 
10residing in this State.
11 (c) The written notice provided by the parties under 
12subsection (b) shall be provided as follows:
13  (1) For any health care facility or provider 
14 organization that is a party to a covered
transaction and 
15 files a premerger notification with the
Federal Trade 
16 Commission or the United States Department
of Justice, in 
17 compliance with the Hart-Scott-Rodino
Antitrust 
18 Improvements Act of 1976, 15 U.S.C. 18a, the
notice 
19 requirement is satisfied by providing a copy of
such 
20 filing to the Attorney General at the same time as it
is 
21 provided to the federal government.
22  (2) For any health care facility that is a party to a

23 covered transaction that is not described in paragraph

24 (1), the notice requirement is satisfied when the 
25 healthcare facility files an application for a change of

26 ownership with the Health Facilities and Services Review 
 
 
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1 Board, in compliance with the Illinois Health Facilities

2 Planning Act. The Health Facilities and Services Review

3 Board shall provide a copy of such filing to the Attorney

4 General at the same time as it is provided to the

5 applicable State legislators under subsection (a) of

6 Section 8.5 of the Illinois Health Facilities Planning

7 Act.
8  (3) For any health care facility or provider 
9 organization that is a party to a covered
transaction that 
10 is not described in paragraph (1) or (2),
written notice 
11 provided by the parties must include:
12   (A) the names of the parties and their current 
13 business address;
14   (B) identification of all locations where health 
15 care services are currently provided by each party;
16   (C) a brief description of the nature and purpose 
17 of the proposed transaction; and
18   (D) the anticipated effective date of the proposed 
19 transaction.
20 Nothing in this subsection prohibits the parties to a 
21covered transaction from voluntarily providing additional 
22information to the Attorney General.
23 (d) The Attorney General may make any requests for 
24additional information from the parties that is relevant to 
25its investigation of the covered transaction within 30 days of 
26the date notice is received under subsections (b) and (c). If 
 
 
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1the Attorney General requests additional information, the 
2covered transaction may not proceed until 30 days after the 
3parties have substantially complied with the request. Any 
4subsequent request for additional information by the Attorney 
5General shall not further delay the covered transaction from 
6proceeding. Nothing in this Section precludes the Attorney 
7General from conducting an investigation or enforcing State or 
8federal antitrust laws at a later date.
9 (e) Any health care facility or provider organization that 
10fails to comply with any provision of this Section is subject 
11to a civil penalty of not more than $500 per day for each day 
12during which the health care facility or provider organization 
13is in violation of this Section.
14 Whenever the Attorney General has reason to believe that a 
15health care facility or provider organization has engaged in 
16or is engaging in a covered transaction without complying with 
17the provisions of this Section, the Attorney General may apply 
18for and obtain, in an action in the Circuit Court of Sangamon 
19or Cook County, a temporary restraining order or injunction, 
20or both, prohibiting the health care facility or provider 
21organization from continuing its noncompliance or doing any 
22act in furtherance thereof. The court may make such further 
23orders or judgments, at law or in equity, as may be necessary 
24to remedy such noncompliance.
25 Before bringing such an action or seeking to recover a 
26civil
penalty, the Attorney General shall permit the health 
 
 
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1care
facility or provider organization to come into compliance 
2with this Section within 10 days of being notified of its 
3alleged noncompliance. The right to cure noncompliance does 
4not exist on or after the covered transaction's proposed or 
5actual closing date of the covered transaction, whichever is 
6sooner.
7 (f) This Section is repealed on January 1, 2027.

8 (740 ILCS 10/13 new)
9 Sec. 13. Antitrust Enforcement Fund. Any penalties 
10collected from an entity for violations of this Act shall be 
11deposited into the Antitrust Enforcement Fund, a special fund 
12created in the State treasury that is dedicated to enforcing 
13this Act.
14 This Section is repealed on January 1, 2027.


15 Section 99. Effective date. This Act takes effect January 
161, 2024.".