Bill Text: IL HB5776 | 2017-2018 | 100th General Assembly | Introduced

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Bill Title: Amends the Health Care Services Lien Act. Provides that "health care benefit plan" means an insurance plan provided by any public or private medical insurance provider. Adds procedures requiring a health care professional or health care provider to submit all charges to the patient's health care benefit plan prior to filing the notice of the lien. Provides that the patient's health care benefit plan shall not deny payment on the basis that a third party or other insurance carrier is responsible for the patient's injuries. Provides that the amount of the lien shall be limited to the amount the health care professional or the health care provider would have received if the charges were covered by the patient's health care benefit plan. Adds provisions concerning health care benefit plan subrogation claims. Provides that a health care professional or a health care provider that recovers under a judgment, verdict, or settlement is responsible for the pro rata share of the legal and administrative expenses incurred in obtaining the judgment, verdict, or settlement. Makes other changes.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Failed) 2019-01-08 - Session Sine Die [HB5776 Detail]

Download: Illinois-2017-HB5776-Introduced.html

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100TH GENERAL ASSEMBLY State of Illinois 2017 and 2018 HB5776 Introduced , by Rep. Sam Yingling SYNOPSIS AS INTRODUCED:
770 ILCS 23/5
770 ILCS 23/10
770 ILCS 23/45
Amends the Health Care Services Lien Act. Provides that "health care benefit plan" means an insurance plan provided by any public or private medical insurance provider. Adds procedures requiring a health care professional or health care provider to submit all charges to the patient's health care benefit plan prior to filing the notice of the lien. Provides that the patient's health care benefit plan shall not deny payment on the basis that a third party or other insurance carrier is responsible for the patient's injuries. Provides that the amount of the lien shall be limited to the amount the health care professional or the health care provider would have received if the charges were covered by the patient's health care benefit plan. Adds provisions concerning health care benefit plan subrogation claims. Provides that a health care professional or a health care provider that recovers under a judgment, verdict, or settlement is responsible for the pro rata share of the legal and administrative expenses incurred in obtaining the judgment, verdict, or settlement. Makes other changes.
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A BILL FOR
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AN ACT concerning civil law.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Health Care Services Lien Act is amended by
changing Sections 5, 10, and 45 as follows:
(770 ILCS 23/5)
Sec. 5. Definitions. In this Act:
"Health care professional" means any individual in any of
the following license categories: licensed physician, licensed
dentist, licensed optometrist, licensed naprapath, licensed
clinical psychologist, or licensed physical therapist.
"Health care provider" means any entity in any of the
following license categories: licensed hospital, licensed home
health agency, licensed ambulatory surgical treatment center,
licensed long-term care facilities, or licensed emergency
medical services personnel.
"Health care benefit plan" mean an insurance plan provided
by any public or private medical insurance provider.
This amendatory Act of the 94th General Assembly applies to
causes of action accruing on or after its effective date.
(Source: P.A. 93-51, eff. 7-1-03; 94-403, eff. 1-1-06.)
(770 ILCS 23/10)

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Sec. 10. Lien created; limitation.
(a) Every health care professional and health care provider
that renders any service in the treatment, care, or maintenance
of an injured person, except services rendered under the
provisions of the Workers' Compensation Act or the Workers'
Occupational Diseases Act, shall have a lien upon all claims
and causes of action of the injured person for the amount of
the health care professional's or health care provider's
reasonable charges up to the date of payment of damages to the
injured person. The total amount of all liens under this Act,
however, shall not exceed 40% of the verdict, judgment, award,
settlement, or compromise secured by or on behalf of the
injured person on his or her claim or right of action.
(b) The lien shall include a written notice containing the
name and address of the injured person, the date of the injury,
the name and address of the health care professional or health
care provider, and the name of the party alleged to be liable
to make compensation to the injured person for the injuries
received. The lien notice shall be served on both the injured
person and the party against whom the claim or right of action
exists, but shall not be served on the issuer of an automobile
or homeowner's insurance policy that provides for medical
payments. Notwithstanding any other provision of this Act,
payment in good faith to any person other than the healthcare
professional or healthcare provider claiming or asserting such
lien prior to the service of such notice of lien shall, to the

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extent of the payment so made, bar or prevent the creation of
an enforceable lien. Service shall be made by registered or
certified mail or in person.
(b-5) If a patient provides proof of insurance coverage
under any health care benefit plan within 60 days of treatment
from a health care professional or health care provider, the
health care professional or health care provider shall submit
all charges to the patient's health care benefit plan before
filing the notice of the lien; the patient's health care
benefit plan shall not deny payment for the services of either
the health care professional or health care provider on the
basis that a third party or another insurance carrier is
responsible for the payment of the charges for treatment of the
patient's injuries. If the health care benefit plan denies
payment for any other reason, the health care benefit plan
shall provide the health care provider or health care
professional and the patient with a statement detailing the
amount the health care benefit plan would have paid for the
services provided and the amount the patient would have been
responsible for had the claim not been denied. In such a case,
the amount of the lien shall be limited to the amount the
health care professional or the health care provider would have
received if the charges were covered by the patient's health
care benefit plan. The failure of a health care benefit plan to
provide a statement shall not affect the limitations on a lien
under this Section.

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(b-10) If at any time after to the filing of the notice of
the lien, a health care professional or a health care provider
receives health care benefit plan information regarding a
patient, the health care professional or health care provider
is not required to withdraw notice of the lien, but shall
submit the charges for service to the health care benefit plan.
In such a case, the amount of the lien shall be limited as
provided in subsection (b-5).
(c) All health care professionals and health care providers
holding liens under this Act with respect to a particular
injured person shall share proportionate amounts within the
statutory limitation set forth in subsection (a). The statutory
limitations under this Section may be waived or otherwise
reduced only by the lienholder. No individual licensed category
of health care professional (such as physicians) or health care
provider (such as hospitals) as set forth in Section 5,
however, may receive more than one-third of the verdict,
judgment, award, settlement, or compromise secured by or on
behalf of the injured person on his or her claim or right of
action. If the total amount of all liens under this Act meets
or exceeds 40% of the verdict, judgment, award, settlement, or
compromise, then:
(1) all the liens of health care professionals shall
not exceed 20% of the verdict, judgment, award, settlement,
or compromise; and
(2) all the liens of health care providers shall not

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exceed 20% of the verdict, judgment, award, settlement, or
compromise;
provided, however, that health care services liens shall be
satisfied to the extent possible for all health care
professionals and health care providers by reallocating the
amount unused within the aggregate total limitation of 40% for
all health care services liens under this Act; and provided
further that the amounts of liens under paragraphs (1) and (2)
are subject to the one-third limitation under this subsection.
If the total amount of all liens under this Act meets or
exceeds 40% of the verdict, judgment, award, settlement, or
compromise, the total amount of all the liens of attorneys
under the Attorneys Lien Act shall not exceed 30% of the
verdict, judgment, award, settlement, or compromise. If an
appeal is taken by any party to a suit based on the claim or
cause of action, however, the attorney's lien shall not be
affected or limited by the provisions of this Act.
(c-5) If in addition to health care professional liens and
health care provider liens, there also exist health care
benefit plan subrogation claims, including those under the
Medicare Secondary Payer Act and the Illinois Public Aid Code,
and the existence and inclusion of these subrogation claims in
addition to the health care services liens exceed 40% of the
verdict, judgment, award, settlement, or compromise, after
calculations pursuant to Section 50, then:
(1) the liens of the health care professionals shall

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not exceed 10% of the verdict, judgment, award, settlement,
or compromise; and
(2) the liens of the health care providers shall not
exceed 10% of the verdict, judgment, award, settlement, or
compromise.
Notwithstanding any other provision of this subsection,
health care services liens shall be satisfied to the extent
possible for all health care professionals and health care
providers by reallocating the amount unused within the
aggregate total limitation of 40% for all health care services
liens under this Act after satisfaction of health care plan
subrogation claims, and the amounts of liens under paragraphs
(1) and (2) are subject to the one-third limitation under this
subsection.
(d) If services furnished by health care professionals and
health care providers are billed at one all-inclusive rate, the
total reasonable charges for those services shall be reasonably
allocated among the health care professionals and health care
providers and treated as separate liens for purposes of this
Act, including the filing of separate lien notices. For
services provided under an all-inclusive rate, the liens of
health care professionals and health care providers may be
asserted by the entity that bills the all-inclusive rate.
(d-5) A health care professional or a health care provider
that recovers under a judgment, verdict, or settlement is
responsible for the pro rata share of the legal and

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administrative expenses incurred in obtaining the judgment,
verdict, or settlement.
(e) Payments under the liens shall be made directly to the
health care professionals and health care providers. For
services provided under an all-inclusive rate, payments under
liens shall be made directly to the entity that bills the
all-inclusive rate.
(Source: P.A. 93-51, eff. 7-1-03.)
(770 ILCS 23/45)
Sec. 45. Amounts not recovered under lien. Nothing in this
Act shall be construed as limiting the right of a health care
professional or health care provider, or attorney, to pursue
collection, through all available means, of its reasonable
charges for the services it furnishes to an injured person.
Notwithstanding any other provision of law, a lien holder may
seek payment of the amount of its reasonable charges that
remain not paid after the satisfaction of its lien under this
Act, except that any bill from a health care professional or
health care provider must first be reduced by the amount of
benefits to which the patient is entitled under any contract or
health care benefit plan and shall reflect all credits,
adjustments, and write-offs, and the health care provider or
health care professional may not bill the patient the balance
of the bill unless it is the responsibility of the patient
under the health care plan.

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(Source: P.A. 93-51, eff. 7-1-03.)