Bill Text: IL HB3848 | 2015-2016 | 99th General Assembly | Engrossed

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Amends the Sexual Assault Survivors Emergency Treatment Act. Creates the Illinois Sexual Assault Emergency Treatment Program Fund. Prohibits a hospital, health care professional, ambulance provider, laboratory, or pharmacy furnishing hospital emergency services, forensic services, transportation, or medication to a sexual assault survivor from directly billing the survivor. Requires every hospital and health care professional to establish a billing protocol to ensure that no sexual assault survivor is billed for treatment. Contains penalty provisions. Makes other changes. Amends the State Finance Act. Creates the Illinois Sexual Assault Emergency Treatment Program Fund as a special fund in the State treasury.

Spectrum: Partisan Bill (Democrat 45-1)

Status: (Passed) 2015-08-24 - Public Act . . . . . . . . . 99-0454 [HB3848 Detail]

Download: Illinois-2015-HB3848-Engrossed.html

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AN ACT concerning public health.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The State Finance Act is amended by adding
Section 5.866 as follows:
(30 ILCS 105/5.866 new)
Sec. 5.866. The Illinois Sexual Assault Emergency
Treatment Program Fund.
Section 10. The Sexual Assault Survivors Emergency
Treatment Act is amended by changing Sections 1a, 5, 7, and 8
and by adding Section 7.5 as follows:
(410 ILCS 70/1a) (from Ch. 111 1/2, par. 87-1a)
Sec. 1a. Definitions. In this Act:
"Ambulance provider" means an individual or entity that
owns and operates a business or service using ambulances or
emergency medical services vehicles to transport emergency
patients.
"Areawide sexual assault treatment plan" means a plan,
developed by the hospitals in the community or area to be
served, which provides for hospital emergency services to
sexual assault survivors that shall be made available by each

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of the participating hospitals.
"Department" means the Department of Public Health.
"Emergency contraception" means medication as approved by
the federal Food and Drug Administration (FDA) that can
significantly reduce the risk of pregnancy if taken within 72
hours after sexual assault.
"Follow-up healthcare" means healthcare services related
to a sexual assault, including laboratory services and pharmacy
services, rendered within 90 days of the initial visit for
hospital emergency services.
"Forensic services" means the collection of evidence
pursuant to a statewide sexual assault evidence collection
program administered by the Department of State Police, using
the Illinois State Police Sexual Assault Evidence Collection
Kit.
"Health care professional" means a physician, a physician
assistant, or an advanced practice nurse.
"Hospital" has the meaning given to that term in the
Hospital Licensing Act.
"Hospital emergency services" means healthcare delivered
to outpatients within or under the care and supervision of
personnel working in a designated emergency department of a
hospital, including, but not limited to, care ordered by such
personnel for a sexual assault survivor in the emergency
department.
"Illinois State Police Sexual Assault Evidence Collection

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Kit" means a prepackaged set of materials and forms to be used
for the collection of evidence relating to sexual assault. The
standardized evidence collection kit for the State of Illinois
shall be the Illinois State Police Sexual Assault Evidence
Collection Kit.
"Nurse" means a nurse licensed under the Nurse Practice
Act.
"Physician" means a person licensed to practice medicine in
all its branches.
"Sexual assault" means an act of nonconsensual sexual
conduct or sexual penetration, as defined in Section 11-0.1 of
the Criminal Code of 2012, including, without limitation, acts
prohibited under Sections 11-1.20 through 11-1.60 of the
Criminal Code of 2012.
"Sexual assault survivor" means a person who presents for
hospital emergency services in relation to injuries or trauma
resulting from a sexual assault.
"Sexual assault transfer plan" means a written plan
developed by a hospital and approved by the Department, which
describes the hospital's procedures for transferring sexual
assault survivors to another hospital in order to receive
emergency treatment.
"Sexual assault treatment plan" means a written plan
developed by a hospital that describes the hospital's
procedures and protocols for providing hospital emergency
services and forensic services to sexual assault survivors who

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present themselves for such services, either directly or
through transfer from another hospital.
"Transfer services" means the appropriate medical
screening examination and necessary stabilizing treatment
prior to the transfer of a sexual assault survivor to a
hospital that provides hospital emergency services and
forensic services to sexual assault survivors pursuant to a
sexual assault treatment plan or areawide sexual assault
treatment plan.
"Voucher" means a document generated by a hospital at the
time the sexual assault survivor receives hospital emergency
and forensic services that a sexual assault survivor may
present to providers for follow-up healthcare.
(Source: P.A. 96-328, eff. 8-11-09; 96-1551, eff. 7-1-11;
97-1150, eff. 1-25-13.)
(410 ILCS 70/5) (from Ch. 111 1/2, par. 87-5)
Sec. 5. Minimum requirements for hospitals providing
hospital emergency services and forensic services to sexual
assault survivors.
(a) Every hospital providing hospital emergency services
and forensic services to sexual assault survivors under this
Act shall, as minimum requirements for such services, provide,
with the consent of the sexual assault survivor, and as ordered
by the attending physician, an advanced practice nurse who has
a written collaborative agreement with a collaborating

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physician that authorizes provision of emergency services, or a
physician assistant who has been delegated authority to provide
hospital emergency services and forensic services, the
following:
(1) appropriate medical examinations and laboratory
tests required to ensure the health, safety, and welfare of
a sexual assault survivor or which may be used as evidence
in a criminal proceeding against a person accused of the
sexual assault, or both; and records of the results of such
examinations and tests shall be maintained by the hospital
and made available to law enforcement officials upon the
request of the sexual assault survivor;
(2) appropriate oral and written information
concerning the possibility of infection, sexually
transmitted disease and pregnancy resulting from sexual
assault;
(3) appropriate oral and written information
concerning accepted medical procedures, medication, and
possible contraindications of such medication available
for the prevention or treatment of infection or disease
resulting from sexual assault;
(4) an amount of medication for treatment at the
hospital and after discharge as is deemed appropriate by
the attending physician, an advanced practice nurse, or a
physician assistant and consistent with the hospital's
current approved protocol for sexual assault survivors;

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(5) an evaluation of the sexual assault survivor's risk
of contracting human immunodeficiency virus (HIV) from the
sexual assault;
(6) written and oral instructions indicating the need
for follow-up examinations and laboratory tests after the
sexual assault to determine the presence or absence of
sexually transmitted disease;
(7) referral by hospital personnel for appropriate
counseling; and
(8) when HIV prophylaxis is deemed appropriate, an
initial dose or doses of HIV prophylaxis, along with
written and oral instructions indicating the importance of
timely follow-up healthcare.
(b) Any person who is a sexual assault survivor who seeks
emergency hospital services and forensic services or follow-up
healthcare under this Act shall be provided such services
without the consent of any parent, guardian, custodian,
surrogate, or agent.
(b-5) Every treating hospital providing hospital emergency
and forensic services to sexual assault survivors shall issue a
voucher to any sexual assault survivor who is eligible to
receive one. The hospital shall make a copy of the voucher and
place it in the medical record of the sexual assault survivor.
The hospital shall provide a copy of the voucher to the sexual
assault survivor after discharge upon request.
(c) Nothing in this Section creates a physician-patient

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relationship that extends beyond discharge from the hospital
emergency department.
(Source: P.A. 95-432, eff. 1-1-08; 96-318, eff. 1-1-10.)
(410 ILCS 70/7) (from Ch. 111 1/2, par. 87-7)
Sec. 7. Reimbursement.
(a) A hospital or health care professional furnishing
hospital emergency services or forensic services, an ambulance
provider furnishing transportation to a sexual assault
survivor, a hospital, health care professional, or laboratory
providing follow-up healthcare, or a pharmacy dispensing
prescribed medications to any sexual assault survivor shall
furnish such services or medications to that person without
charge and shall seek payment as follows:
(1) If a sexual assault survivor is eligible to receive
benefits under the medical assistance program under
Article V of the Illinois Public Aid Code, the ambulance
provider, hospital, health care professional, laboratory,
or pharmacy must submit the bill to the Department of
Healthcare and Family Services and accept the amount paid
as full payment.
(2) If a sexual assault survivor is covered by one or
more policies of health insurance or is a beneficiary under
a public or private health coverage program, the ambulance
provider, hospital, health care professional, laboratory,
or pharmacy shall bill the insurance company or program.

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With respect to such insured patients, applicable
deductible, co-pay, co-insurance, denial of claim, or any
other out-of-pocket insurance-related expense may be
submitted to the Illinois Sexual Assault Emergency
Treatment Program of the Department of Healthcare and
Family Services in accordance with 89 Ill. Adm. Code
148.510 for payment at the Department of Healthcare and
Family Services' allowable rates under the Illinois Public
Aid Code. The ambulance provider, hospital, health care
professional, laboratory, or pharmacy shall accept the
amounts paid by the insurance company or health coverage
program and the Illinois Sexual Assault Treatment Program
as full payment.
(3) If a sexual assault survivor is neither eligible to
receive benefits under the medical assistance program
under Article V of the Public Aid Code nor covered by a
policy of insurance or a public or private health coverage
program, the ambulance provider, hospital, health care
professional, laboratory, or pharmacy shall submit the
request for reimbursement to the Illinois Sexual Assault
Emergency Treatment Program under the Department of
Healthcare and Family Services in accordance with 89 Ill.
Adm. Code 148.510 at the Department of Healthcare and
Family Services' allowable rates under the Illinois Public
Aid Code.
(4) If a sexual assault survivor presents a voucher for

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follow-up healthcare, the healthcare professional or
laboratory that provides follow-up healthcare or the
pharmacy that dispenses prescribed medications to a sexual
assault survivor shall submit the request for
reimbursement for follow-up healthcare, laboratory, or
pharmacy services to the Illinois Sexual Assault Emergency
Treatment Program under the Department of Healthcare and
Family Services in accordance with 89 Ill. Adm. Code
148.510 at the Department of Healthcare and Family
Services' allowable rates under the Illinois Public Aid
Code. Nothing in this subsection (a) precludes hospitals
from providing follow-up healthcare and receiving
reimbursement under this Section.
When any ambulance provider furnishes transportation, hospital
provides hospital emergency services and forensic services,
hospital or health care professional or laboratory provides
follow-up healthcare, or pharmacy dispenses prescribed
medications to any sexual assault survivor, as defined by the
Department of Healthcare and Family Services, who is neither
eligible to receive such services under the Illinois Public Aid
Code nor covered as to such services by a policy of insurance,
the ambulance provider, hospital, health care professional,
pharmacy, or laboratory shall furnish such services to that
person without charge and shall be entitled to be reimbursed
for providing such services by the Illinois Sexual Assault
Emergency Treatment Program under the Department of Healthcare

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and Family Services and at the Department of Healthcare and
Family Services' allowable rates under the Illinois Public Aid
Code.
(b) Nothing in this Section precludes a hospital, health
care provider, ambulance provider, laboratory, or pharmacy
from billing the sexual assault survivor or any applicable
health insurance or coverage for inpatient services. The
hospital is responsible for submitting the request for
reimbursement for ambulance services, hospital emergency
services, and forensic services to the Illinois Sexual Assault
Emergency Treatment Program. Nothing in this Section precludes
hospitals from providing follow-up healthcare and receiving
reimbursement under this Section.
(c) (Blank). The health care professional who provides
follow-up healthcare and the pharmacy that dispenses
prescribed medications to a sexual assault survivor are
responsible for submitting the request for reimbursement for
follow-up healthcare or pharmacy services to the Illinois
Sexual Assault Emergency Treatment Program.
(d) On and after July 1, 2012, the Department shall reduce
any rate of reimbursement for services or other payments or
alter any methodologies authorized by this Act or the Illinois
Public Aid Code to reduce any rate of reimbursement for
services or other payments in accordance with Section 5-5e of
the Illinois Public Aid Code.
(e) The Department of Healthcare and Family Services shall

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establish standards, rules, and regulations to implement this
Section.
(Source: P.A. 97-689, eff. 6-14-12; 98-463, eff. 8-16-13.)
(410 ILCS 70/7.5 new)
Sec. 7.5. Prohibition on billing sexual assault survivors
directly for certain services; written notice; billing
protocols.
(a) A hospital, health care professional, ambulance
provider, laboratory, or pharmacy furnishing hospital
emergency services, forensic services, transportation,
follow-up healthcare, or medication to a sexual assault
survivor shall not:
(1) charge or submit a bill for any portion of the
costs of the services, transportation, or medications to
the sexual assault survivor, including any insurance
deductible, co-pay, co-insurance, denial of claim by an
insurer, spenddown, or any other out-of-pocket expense;
(2) communicate with, harass, or intimidate the sexual
assault survivor for payment of services, including, but
not limited to, repeatedly calling or writing to the sexual
assault survivor and threatening to refer the matter to a
debt collection agency or to an attorney for collection,
enforcement, or filing of other process.
(3) refer a bill to a collection agency or attorney for
collection action against the sexual assault survivor;

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(4) contact or distribute information to affect the
sexual assault survivor's credit rating; or
(5) take any other action adverse to the sexual assault
survivor or his or her family on account of providing
services to the sexual assault survivor.
(b) Nothing in this Section precludes a hospital, health
care provider, ambulance provider, laboratory, or pharmacy
from billing the sexual assault survivor or any applicable
health insurance or coverage for inpatient services.
(c) Within 60 days after the effective date of this
amendatory Act of the 99th General Assembly, every hospital
providing treatment services to sexual assault survivors in
accordance with a plan approved under Section 2 of this Act
shall provide a written notice to a sexual assault survivor.
The written notice must include, but is not limited to, the
following:
(1) a statement that the sexual assault survivor should
not be directly billed by any ambulance provider providing
transportation services, or by any hospital, health care
professional, laboratory, or pharmacy for the services the
sexual assault survivor received as an outpatient at the
hospital;
(2) a statement that a sexual assault survivor who is
admitted to a hospital may be billed for inpatient services
provided by a hospital, health care professional,
laboratory, or pharmacy;

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(3) a statement that prior to leaving the emergency
department of the treating facility, the hospital will give
the sexual assault survivor a voucher for follow-up
healthcare if the sexual assault survivor is eligible to
receive a voucher;
(4) the definition of "follow-up healthcare" as set
forth in Section 1a of this Act;
(5) a phone number the sexual assault survivor may call
should the sexual assault survivor receive a bill from the
hospital for hospital emergency services and forensic
services;
(6) the toll-free phone number of the Office of the
Illinois Attorney General, Crime Victim Services Division,
which the sexual assault survivor may call should the
sexual assault survivor receive a bill from an ambulance
provider, a health care professional, a laboratory, or a
pharmacy.
This subsection (c) shall not apply to hospitals that
provide transfer services as defined under Section 1a of this
Act.
(d) Within 60 days after the effective date of this
amendatory Act of the 99th General Assembly, every health care
professional, except for those employed by a hospital or
hospital affiliate, as defined in the Hospital Licensing Act,
or those employed by a hospital operated under the University
of Illinois Hospital Act who bills separately for hospital

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emergency services or forensic services must develop a billing
protocol that ensures that no survivor of sexual assault will
be sent a bill for any hospital emergency services or forensic
services and submit the billing protocol to the Crime Victim
Services Division of the Office of the Attorney General for
approval. Health care professionals who bill as a legal entity
may submit a single billing protocol for the billing entity.
The billing protocol must include at a minimum:
(1) a description of training for persons who prepare
bills for hospital emergency services and forensic
services;
(2) a written acknowledgement signed by a person who
has completed the training sign that the person will not
bill survivors of sexual assault;
(3) prohibitions on submitting any bill for any portion
of hospital emergency services or forensic services
provided to a survivor of sexual assault to a collection
agency;
(4) prohibitions on taking any action that would
adversely affect the credit of the survivor of sexual
assault;
(5) the termination of all collection activities if the
protocol is violated, and
(6) the actions to be taken if a bill is sent to a
collection agency or the failure to pay is reported to any
credit reporting agency.

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The Crime Victim Services Division of the Office of the
Attorney General may provide a sample acceptable billing
protocol upon request.
The Office of the Attorney General shall approve a proposed
protocol if it finds that the implementation of the protocol
would result in no survivor of sexual assault being billed or
sent a bill for hospital emergency services or forensic
services.
If the Office of the Attorney General determines that
implementation of the protocol could result in the billing of a
survivor of sexual assault for hospital emergency services or
forensic services, the Office of the Attorney General shall
provide the health care professional with a written statement
of the deficiencies in the protocol. The health care
professional shall have 30 days to submit a revised billing
protocol addressing the deficiencies to the Office of the
Attorney General. The health care professional shall implement
the protocol upon approval by the Crime Victim Services
Division of the Office of the Attorney General.
The health care professional shall submit any proposed
revision to or modification of an approved billing protocol to
the Crime Victim Services Division of the Office of the
Attorney General for approval. The health care professional
shall implement the revised or modified billing protocol upon
approval by the Crime Victim Services Division of the Office of
the Illinois Attorney General.

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(410 ILCS 70/8) (from Ch. 111 1/2, par. 87-8)
Sec. 8. Penalties.
(a) Any hospital violating any provisions of this Act other
than Section 7.5 shall be guilty of a petty offense for each
violation, and any fine imposed shall be paid into the general
corporate funds of the city, incorporated town or village in
which the hospital is located, or of the county, in case such
hospital is outside the limits of any incorporated
municipality.
(b) The Attorney General may seek the assessment of one or
more of the following civil monetary penalties in any action
filed in any action filed under this Act where the hospital,
health care professional, ambulance provider, laboratory, or
pharmacy knowingly violates Section 7.5 of the Act:
(1) For willful violations of paragraphs (1), (2), (4),
or (5) of subsection (a) of Section 7.5 or subsection (c)
of Section 7.5, the civil monetary penalty shall not exceed
$500 per violation.
(2) For violations of paragraphs (1), (2), (4), or (5)
of subsection (a) of Section 7.5 or subsection (c) of
Section 7.5 involving a pattern or practice, the civil
monetary penalty shall not exceed $500 per violation.
(3) For violations of paragraph (3) of subsection (a)
of Section 7.5, the civil monetary penalty shall not exceed
$500 for each day the bill is with a collection agency.

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(4) For violations involving the failure to submit
billing protocols within the time period required under
subsection (d) of Section 7.5, the civil monetary penalty
shall not exceed $100 per day until the health care
professional complies with subsection (d) of Section 7.5.
All civil monetary penalties shall be deposited in the
Illinois Sexual Assault Emergency Treatment Program Fund to pay
for hospital emergency services, forensic services, follow-up
healthcare, and medications for sexual assault survivors.
(Source: P.A. 79-564.)