Illinois § 15

§ 15.

Patient responsibility. (a) Hospitals may make the availability of a discount and the maximum collectible amount under this Act contingent upon the uninsured patient first applying for coverage under public health insurance programs, such as Medicare, Medicaid, AllKids, the State Children's Health Insurance Program, the Health Benefits for Immigrants program, or any other program, if there is a reasonable basis to believe that the uninsured patient may be eligible for such program. If the patient declines to apply for a public health insurance program on the basis of concern for immigration-related consequences, the hospital may refer the patient to a free, unbiased resource, such as an Immigrant Family Resource Program, to address the patient's immigration-related concerns and assist in enrolling the patient in a public health insurance program. The hospital may still screen the patient for eligibility under its financial assistance policy. (b) Hospitals shall permit an uninsured patient to apply for a discount within 90 days of the date of discharge, date of service, completion of the screening under the Fair Patient Billing Act, or denial of an application for a public health insurance program. Hospitals shall offer uninsured patients who receive community-based primary care provided by a community health center or a free and charitable clinic, are referred by such an entity to the hospital, and seek access to nonemergency hospital-based health care services with an opportunity to be screened for and assistance with applying for public health insurance programs if there is a reasonable basis to believe that the uninsured patient may be eligible for a public health insurance program. An uninsured patient who receives community-based primary care provided by a community health center or free and charitable clinic and is referred by such an entity to the hospital for whom there is not a reasonable basis to believe that the uninsured patient may be eligible for a public health insurance program shall be given the opportunity to apply for hospital financial assistance when hospital services are scheduled. (1) Income verification. Hospitals may require an uninsured patient who is requesting an uninsured discount to provide documentation of family income. Acceptable family income documentation shall include any one of the following: (A) a copy of the most recent tax return; (B) a copy of the most recent W-2 form and 1099 forms; (C) copies of the 2 most recent pay stubs; (D) written income verification from an employer if paid in cash; or (E) one other reasonable form of third-party income verification deemed acceptable to the hospital. (2) Asset verification. Hospitals may require an uninsured patient who is requesting an uninsured discount to certify the existence or absence of assets owned by the patient and to provide documentation of the value of such assets, except for those assets referenced in paragraph (4) of subsection (c) of Section 10. Acceptable documentation may include statements from financial institutions or some other third-party verification of an asset's value. If no third-party verification exists, then the patient shall certify as to the estimated value of the asset. (3) Illinois resident verification. Hospitals may require an uninsured patient who is requesting an uninsured discount to verify Illinois residency. Acceptable verification of Illinois residency shall include any one of the following: (A) any of the documents listed in paragraph (1); (B) a valid state-issued identification card; (C) a recent residential utility bill; (D) a lease agreement; (E) a vehicle registration card; (F) a voter registration card; (G) mail addressed to the uninsured patient at an Illinois address from a government or other credible source; (H) a statement from a family member of the uninsured patient who resides at the same address and presents verification of residency; (I) a letter from a homeless shelter, transitional house or other similar facility verifying that the uninsured patient resides at the facility; or (J) a temporary visitor's drivers license. (c) Hospital obligations toward an individual uninsured patient under this Act shall cease if that patient unreasonably fails or refuses to provide the hospital with information or documentation requested under subsection (b) or to apply for coverage under public programs when requested under subsection (a) within 30 days of the hospital's request. (d) In order for a hospital to determine the 12 month maximum amount that can be collected from a patient deemed eligible under Section 10, an uninsured patient shall inform the hospital in subsequent inpatient admissions or outpatient encounters that the patient has previously received health care services from that hospital and was determined to be entitled to the uninsured discount. (e) Hospitals may require patients to certify that all of the information provided in the application is true. The application may state that if any of the information is untrue, any discount granted to the patient is forfeited and the patient is responsible for payment of the hospital's full charges. (f) Hospitals shall ask for an applicant's race, ethnicity, sex, and preferred language on the financial assistance application. However, the questions shall be clearly marked as optional responses for the patient and shall note that responses or nonresponses by the patient will not have any impact on the outcome of the application. (Source: P.A. 102-581, eff. 1-1-22; 103-323, eff. 1-1-24; 103-492, eff. 1-1-24; 103-605, eff. 7-1-24.)