093_HB0081enr

 
HB0081 Enrolled                      LRB093 03479 AMC 03507 b

 1        AN ACT concerning health care.

 2        Be  it  enacted  by  the People of the State of Illinois,
 3    represented in the General Assembly:

 4        Section 5.  The Department of Public  Health  Powers  and
 5    Duties  Law  of  the Civil Administrative Code of Illinois is
 6    amended by adding Section 2310-543 as follows:

 7        (20 ILCS 2310/2310-543 new)
 8        Sec.   2310-543.  Information   regarding   health   care
 9    services.  With funds made available for  this  purpose,  the
10    Department   may,  in  conjunction  with  other  programs  or
11    activities related to accessing  medical  care,  develop  and
12    provide  to  the  public and health care patients information
13    regarding the categories or types  of  health  care  services
14    available   and  their  appropriate  use,  paying  particular
15    attention to seeking care in hospital emergency departments.

16        Section 10.   The  Emergency  Medical  Treatment  Act  is
17    amended by changing Section 2 as follows:

18        (210 ILCS 70/2 new)
19        Sec. 2.  Findings; prohibited terms.
20        (a)  The  Illinois  General  Assembly  makes  all  of the
21    following findings:
22             (1)  Hospital emergency services are not always  the
23        most  appropriate  level  of  care  for  patients seeking
24        unscheduled medical care or for patients who do not  have
25        a  regular physician who can treat a significant or acute
26        medical condition not considered critical,  debilitating,
27        or life-threatening.
28             (2)  Hospital  emergency rooms are over-utilized and
29        too often over-burdened with many injuries  or  illnesses
 
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 1        that  could  be  managed  in  a  less  intensive clinical
 2        setting or physician's office.
 3             (3)  Over-utilization    of    hospital    emergency
 4        departments contributes  to  excess  medical  and  health
 5        insurance costs.
 6             (4)  The  use of the term "urgent" or "emergi-" or a
 7        similar term in a facility's posted  or  advertised  name
 8        may confuse the public and prospective patients regarding
 9        the  type  of services offered relative to those provided
10        by a hospital emergency department.  There is significant
11        risk to the public health and safety if persons requiring
12        treatment for a critical  or  life-threatening  condition
13        inappropriately use such facilities.
14             (5)  Many  times  patients  are not clearly aware of
15        the policies and procedures of their  insurer  or  health
16        plan  that must be followed in the use of emergency rooms
17        versus non-emergent clinics and  what  rights  they  have
18        under the law in regard to appropriately sought emergency
19        care.
20             (6)  There  is  a  need  to more effectively educate
21        health  care  payers  and  consumers   about   the   most
22        appropriate  use  of  the  various  available  levels  of
23        medical   care  and  particularly  the  use  of  hospital
24        emergency rooms and walk-in medical clinics that  do  not
25        require appointments.
26        (b)  After  the  effective date of this amendatory Act of
27    the 93rd General Assembly, no  person,  facility,  or  entity
28    shall  hold itself out to the public as an "urgent", "urgi-",
29    "emergi-", or "emergent" care center or use any similar term,
30    as defined by rule,  that  would  give  the  impression  that
31    emergency  medical  treatment  is  provided  by the person or
32    entity  or  at  the  facility  unless  the  facility  is  the
33    emergency room of a facility licensed as a hospital under the
34    Hospital  Licensing  Act  or  a  facility   licensed   as   a
 
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 1    freestanding  emergency  center  under  the Emergency Medical
 2    Services (EMS) Systems Act.
 3        (c)  Violation of this  Section  constitutes  a  business
 4    offense with a minimum fine of $5,000 plus $1,000 per day for
 5    a continuing violation, with a maximum of $25,000.
 6        (d)  The  Director  of  Public  Health in the name of the
 7    people of the State, through the Attorney General, may  bring
 8    an  action  for  an  injunction or to restrain a violation of
 9    this Section or the rules adopted pursuant to this Section or
10    to enjoin the future operation or maintenance of any facility
11    in violation of this Section or the rules adopted pursuant to
12    this Section.
13        (e)  The Department of Public Health  shall  adopt  rules
14    necessary for the implementation of this Section.

15        Section  15.   The Managed Care Reform and Patient Rights
16    Act is amended by adding Section 43 as follows:

17        (215 ILCS 134/43 new)
18        Sec. 43.  Utilization of health care facilities.
19        (a)  A health care plan must provide its enrollees with a
20    description of their rights and responsibilities in obtaining
21    referrals to  and  making  appropriate  use  of  health  care
22    facilities when access to their primary care physician is not
23    readily available.
24        (b)  Nothing  in  this  Section is intended to affect the
25    rights of enrollees or relieve a  health  care  plan  of  its
26    responsibilities   with  respect  to  the  provision  of  and
27    coverage of emergency services or treatment of  an  emergency
28    medical  condition,  as  those terms are defined by this Act,
29    and  as  those  responsibilities  and  rights  are  otherwise
30    provided under this Act, especially Section 65 of this Act.

31        Section 99.  Effective date.  This Act takes effect  upon
 
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 1    becoming law.