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| Public Act 099-0454
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| HB3848 Enrolled | LRB099 09083 JLK 29273 b |
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AN ACT concerning public health.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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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:
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(410 ILCS 70/1a) (from Ch. 111 1/2, par. 87-1a)
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Sec. 1a. Definitions. In this Act:
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"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.
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"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 |
of the participating hospitals.
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"Department" means the Department of Public Health.
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"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.
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"Follow-up healthcare" means healthcare services related |
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to a sexual assault, including laboratory services and pharmacy |
services, rendered within 90 days of the initial visit for |
hospital emergency services.
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"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.
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"Health care professional" means a physician, a physician |
assistant, or an advanced practice nurse.
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"Hospital" has the meaning given to that term in the |
Hospital Licensing Act.
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"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.
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"Illinois State Police Sexual Assault Evidence Collection |
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.
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"Nurse" means a nurse licensed under the Nurse
Practice |
Act.
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"Physician" means a person licensed to practice medicine in |
all its branches.
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"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.
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"Sexual assault survivor" means a person who presents for |
hospital emergency services in relation to injuries or trauma |
resulting from a sexual assault.
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"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.
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"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 |
present themselves for such services, either directly or |
through transfer from another hospital.
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"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 |
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sexual assault treatment plan or areawide sexual assault |
treatment plan.
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"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.)
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(410 ILCS 70/5) (from Ch. 111 1/2, par. 87-5)
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Sec. 5. Minimum requirements for hospitals providing |
hospital emergency services and forensic services
to sexual |
assault survivors.
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(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 |
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:
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(1) appropriate medical examinations and laboratory
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tests required to ensure the health, safety, and welfare
of |
a sexual assault survivor or which may be
used as evidence |
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in a criminal proceeding against a person accused of the
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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;
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(2) appropriate oral and written information |
concerning the possibility
of infection, sexually |
transmitted disease and pregnancy
resulting from sexual |
assault;
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(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;
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(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;
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(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
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sexually transmitted disease;
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(7) referral by hospital personnel for appropriate |
counseling; and
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(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
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timely follow-up healthcare.
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(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.
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(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 |
relationship that extends beyond discharge from the hospital |
emergency department.
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(Source: P.A. 95-432, eff. 1-1-08; 96-318, eff. 1-1-10.)
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(410 ILCS 70/7) (from Ch. 111 1/2, par. 87-7)
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Sec. 7. Reimbursement. |
(a) A hospital or health care professional furnishing |
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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 or the appropriate Medicaid |
managed care organization 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. |
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 |
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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 |
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 |
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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 |
and Family Services and at the Department of Healthcare and |
Family Services' allowable rates under the Illinois Public Aid |
Code.
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(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 |
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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 |
establish standards, rules, and regulations to implement this |
Section.
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(Source: P.A. 97-689, eff. 6-14-12; 98-463, eff. 8-16-13.)
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(410 ILCS 70/7.5 new) |
Sec. 7.5. Prohibition on billing sexual assault survivors |
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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; |
(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 |
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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; |
(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 |
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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 |
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 |
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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 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. |
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 |
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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)
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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 |
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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.
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(b) The Attorney General may seek the assessment of one or |
more of the following civil monetary penalties 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. |
(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 into the |
