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1 | AN ACT concerning retail health care facilities.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 1. Short title. This Act may be cited as the Retail | ||||||||||||||||||||||||||
5 | Health Care Facility Permit Act. | ||||||||||||||||||||||||||
6 | Section 5. Legislative purpose. It is declared to be the | ||||||||||||||||||||||||||
7 | public policy of this State that the State has a legitimate | ||||||||||||||||||||||||||
8 | interest in assuring that health care services are performed | ||||||||||||||||||||||||||
9 | under circumstances that ensure maximum safety. Therefore, the | ||||||||||||||||||||||||||
10 | purpose of this Act is to provide for the better protection of | ||||||||||||||||||||||||||
11 | the public health through the development, establishment, and | ||||||||||||||||||||||||||
12 | enforcement of standards (i) for the care of individuals in | ||||||||||||||||||||||||||
13 | retail health care facilities and (ii) for the construction, | ||||||||||||||||||||||||||
14 | maintenance, and operation of retail health care facilities, | ||||||||||||||||||||||||||
15 | which will promote safe and adequate treatment of individuals | ||||||||||||||||||||||||||
16 | in retail health care facilities. | ||||||||||||||||||||||||||
17 | Section 10. Definitions. In this Act: | ||||||||||||||||||||||||||
18 | "Department" means the Illinois Department of Public | ||||||||||||||||||||||||||
19 | Health or another public health authority designated by the | ||||||||||||||||||||||||||
20 | Director as the Department's agent.
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21 | "Director" means the Director of Public Health or his or | ||||||||||||||||||||||||||
22 | her designee.
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1 | "Operator" means the person designated by a permit holder | ||||||
2 | to operate the facility.
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3 | "Retail health care facility" or "facility" means any | ||||||
4 | institution, place, or building, or any portion thereof, | ||||||
5 | devoted to the maintenance and operation of facilities for the | ||||||
6 | performance of health care services located within a retail | ||||||
7 | store or pharmacy at a specific location. The facility may not | ||||||
8 | provide surgical services or any form of general anesthesia. | ||||||
9 | The facility may not provide beds or other accommodations for | ||||||
10 | either long-term or overnight stay of patients, and individual | ||||||
11 | patients shall be discharged in an ambulatory condition without | ||||||
12 | danger to the continued well-being of the patients or shall be | ||||||
13 | transferred to a hospital. Hospitals, long-term care | ||||||
14 | facilities, ambulatory treatment centers, blood banks, | ||||||
15 | clinical laboratories, and offices of physicians, advanced | ||||||
16 | practice nurses, podiatrists, and physician assistants, as | ||||||
17 | well as pharmacies that provide pharmaceutical services, are | ||||||
18 | not to be construed to be retail health care facilities. | ||||||
19 | Section 15. Permit; fees; application. | ||||||
20 | (a) A permit issued by the Department shall be required | ||||||
21 | prior to the operation of any facility. The owner of the | ||||||
22 | facility shall file an application for a permit with the | ||||||
23 | Department on a form prescribed by the Department that shall | ||||||
24 | include at least the following information:
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25 | (1) Applicant's (owner's) name, address, and telephone |
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1 | number.
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2 | (2) Name of the facility and its address and telephone | ||||||
3 | number.
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4 | (3) Nature of services to be provided at the facility.
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5 | (4) Primary function of the business in which the | ||||||
6 | facility is located.
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7 | (5) Operating procedures to be used in the facility.
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8 | (b) A fee established by rule, not to exceed the cost of | ||||||
9 | administration and enforcement of the permit program under this | ||||||
10 | Act, shall be submitted with the application to the Department.
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11 | (c) If a facility owner owns or operates more than one | ||||||
12 | facility, the owner shall file a separate application for each | ||||||
13 | facility owned or operated.
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14 | (d) Within 90 days after receipt of an application, the | ||||||
15 | Department's personnel shall complete the initial inspection | ||||||
16 | of the premises of the facility and ensure that the premises | ||||||
17 | and the facilities are or will be operated in accordance with | ||||||
18 | this Act.
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19 | (e) Upon submission of the application and the required | ||||||
20 | fee, and if the initial inspection of the premises indicates | ||||||
21 | that the premises and the facilities are or will be operated in | ||||||
22 | accordance with this Act, the Department shall issue a permit | ||||||
23 | to the owner.
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24 | (f) The permit issued by the Department shall be effective | ||||||
25 | for one year following the date of issuance. The Department may | ||||||
26 | stagger permit renewal dates on a quarterly basis with an |
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1 | initial permit being effective for at least 9 months but not | ||||||
2 | more than 15 months. The permit shall be valid only for the | ||||||
3 | location and owner stated on the permit and is not | ||||||
4 | transferable.
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5 | (g) The permit shall be displayed in a place within sight | ||||||
6 | of the public when a member of the public enters the premises | ||||||
7 | of the facility.
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8 | (h) In the event of a change of ownership, the new owner | ||||||
9 | must apply for a permit to own and operate a facility prior to | ||||||
10 | taking possession of the property. A provisional license may be | ||||||
11 | issued by the Department until an initial inspection for a | ||||||
12 | permit can be performed by the Department.
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13 | Section 20. Permit renewal procedures; inspections. | ||||||
14 | (a) All permits issued by the Department under this Act | ||||||
15 | shall expire on a specified date and may be renewed by | ||||||
16 | submitting to the Department, at least 30 days before the | ||||||
17 | expiration date, a permit renewal application and the annual | ||||||
18 | renewal fee established by rule.
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19 | (b) The Department may refuse to renew the permit of any | ||||||
20 | owner or operator who has been found to be in violation of this | ||||||
21 | Act for the safe operation of facilities.
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22 | Section 25. Requirements for a permit. | ||||||
23 | (a) Every retail health care facility shall have policies | ||||||
24 | that ensure the following:
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1 | (1) All health care services provided must be in | ||||||
2 | accordance with a limited scope of services as determined | ||||||
3 | by the facility's medical director and approved by the | ||||||
4 | Department. These services shall be minor, with no invasive | ||||||
5 | or surgical care.
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6 | (2) No health care services may be provided at the | ||||||
7 | facility unless a physician licensed to practice medicine | ||||||
8 | in all its branches, an advanced practice nurse, or a | ||||||
9 | physician assistant is on the facility premises at the time | ||||||
10 | the services are provided.
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11 | (3) All health care services provided by an advanced | ||||||
12 | practice nurse shall be in accordance with the advanced | ||||||
13 | practice nurse's collaborative agreement with a physician | ||||||
14 | as required by Section 65-35 of the Nursing Practice Act. A | ||||||
15 | copy of collaborative agreement shall be maintained at the | ||||||
16 | facility. All health care services provided by a physician | ||||||
17 | assistant shall be in accordance with the written | ||||||
18 | guidelines established by the supervising physician or | ||||||
19 | physician/physician assistant team as required by Section | ||||||
20 | 4 of the Physician Assistant Practice Act of 1987. A copy | ||||||
21 | of the written guidelines shall be maintained at the | ||||||
22 | facility.
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23 | (4) The facility must have a medical director who is a | ||||||
24 | physician licensed to practice medicine in all its branches | ||||||
25 | with active medical staff privileges to admit patients to a | ||||||
26 | local licensed hospital. A physician may be a medical |
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1 | director of no more than 2 facilities.
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2 | (5) The facility must have a referral system to | ||||||
3 | physician practices or other health care entities | ||||||
4 | appropriate to the patient's condition for both follow-up | ||||||
5 | care and for symptoms outside the limited scope of services | ||||||
6 | provided by the facility.
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7 | (6) Collaboration of advanced practice nurses or | ||||||
8 | supervision of physician assistants shall not be construed | ||||||
9 | to necessarily require the presence of a collaborating or | ||||||
10 | supervising physician as long as methods of communication | ||||||
11 | are provided by the facility for immediate consultation | ||||||
12 | with the physician in person or by telecommunications for | ||||||
13 | collaboration on medical problems, complications, | ||||||
14 | emergencies, or patient referrals in accordance with | ||||||
15 | written protocols.
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16 | (b) All facility policies must meet the requirements of | ||||||
17 | this Act and the rules adopted by the Department to implement | ||||||
18 | this Act.
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19 | Section 30. Standards for issuance of permit. The Director | ||||||
20 | shall issue a permit under this Act only if he or she finds | ||||||
21 | that the applicant (i) complies with this Act, the rules | ||||||
22 | implementing this Act, and regulations adopted pursuant to the | ||||||
23 | Act and rules, (ii) is under the medical direction of one or | ||||||
24 | more physicians, and (iii) permits only a limited scope of | ||||||
25 | covered services approved by the Department. |
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1 | Section 35. Operating requirements. Each facility shall | ||||||
2 | have on hand at all times an operator adequately trained in the | ||||||
3 | correct operation of the facility. The facility shall comply | ||||||
4 | with the requirements of Section 25 of this Act and the | ||||||
5 | following: | ||||||
6 | (1) The facility must be operated by a physician | ||||||
7 | licensed to practice medicine in all its branches, an | ||||||
8 | advanced practice nurse, or a physician assistant.
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9 | (2) All facility personnel must wear on their persons a | ||||||
10 | clearly visible identification indicating their | ||||||
11 | professional licensure status while acting in the course of | ||||||
12 | their duties.
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13 | (3) The facility must establish appropriate sanitation | ||||||
14 | and hygienic protocols and facilities, including, but not | ||||||
15 | limited to, refrigeration, hazardous waste disposal, | ||||||
16 | separate restrooms, and handwashing stations with running | ||||||
17 | hot water as determined by rule.
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18 | (4) The facility must operate under written protocols | ||||||
19 | approved by the medical director and the advanced practice | ||||||
20 | nurses or the physician assistants providing services at | ||||||
21 | the facility.
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22 | (5) The facility must have a designated receptionist | ||||||
23 | and waiting area.
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24 | (6) At the conclusion of each visit, each patient must | ||||||
25 | be given a written notice stressing the importance of |
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1 | having a personal physician who can provide the full range | ||||||
2 | of health care services. Patients shall be notified in | ||||||
3 | writing of their opportunity to purchase medications from | ||||||
4 | any provider whenever they receive a prescription at a | ||||||
5 | facility.
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6 | (7) The facility must maintain medical records for all | ||||||
7 | patients for the period required of a licensed hospital | ||||||
8 | under the Hospital Licensing Act and State and federal law.
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9 | (8) The facility must provide notification of any | ||||||
10 | patient visits and outcomes to the patient's designated | ||||||
11 | physician. If no physician is designated, then | ||||||
12 | notification shall be made when a patient is referred to a | ||||||
13 | physician for follow-up care.
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14 | (9) Patients must be informed in writing of the | ||||||
15 | opportunity to purchase any medications, fill any | ||||||
16 | prescriptions, or seek any services from any provider not | ||||||
17 | affiliated with the facility or the store or pharmacy in | ||||||
18 | which it is located.
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19 | Section 40. Department standards; rules; regulations. The | ||||||
20 | Department shall adopt rules and regulations deemed necessary | ||||||
21 | for the proper regulation of retail health care facilities. At | ||||||
22 | a minimum, the rules and regulations shall include, but need | ||||||
23 | not be limited to, the following: | ||||||
24 | (1) Construction of the facility, including, but not | ||||||
25 | limited to, plumbing, heating, lighting, and ventilation |
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1 | that will ensure the health, safety, comfort, and privacy | ||||||
2 | of patients and protection from fire hazards.
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3 | (2) Number and qualifications of all personnel, | ||||||
4 | including administrative and nursing personnel, having | ||||||
5 | responsibility for any part of the care provided to the | ||||||
6 | patients.
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7 | (3) Equipment essential to the health, welfare, and | ||||||
8 | safety of the patients.
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9 | (4) Facilities, programs, and services to be provided | ||||||
10 | in connection with the care of patients in a facility.
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11 | Initial rules shall be adopted by November 1, 2008.
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12 | Section 45. Prohibited locations. A retail health care | ||||||
13 | facility may not be located in any store or place that provides | ||||||
14 | alcohol or tobacco products for sale to the public. | ||||||
15 | Section 50. Nondiscrimination in co-payment, deductible, | ||||||
16 | or co-insurance requirement. No health insurer or health plan | ||||||
17 | or health maintenance organization that requires insureds or | ||||||
18 | enrollees to pay co-payments for services may discriminate | ||||||
19 | unreasonably against or among facilities or providers. Retail | ||||||
20 | health care facility services must be subject to the same | ||||||
21 | co-payment, deductible, or co-insurance requirements that are | ||||||
22 | required of an insured or enrollee in the case of services | ||||||
23 | provided by a physician, advanced practice nurse, or physician | ||||||
24 | assistant. Different co-payment requirements may be |
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1 | established for out-patient and in-patient services. | ||||||
2 | Section 55. Denial, suspension, revocation, nonrenewal of | ||||||
3 | permits. A permit may be denied, suspended, or revoked, or the | ||||||
4 | renewal of a permit may be denied, for any of the following | ||||||
5 | reasons: | ||||||
6 | (1) Violation of any of the provisions of this Act or | ||||||
7 | the rules and regulations adopted by the Department under | ||||||
8 | this Act.
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9 | (2) Conviction of an applicant or permit holder for an | ||||||
10 | offense arising from false, fraudulent, deceptive, or | ||||||
11 | misleading advertising. The record of conviction or a | ||||||
12 | certified copy shall be conclusive evidence of the | ||||||
13 | conviction.
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14 | (3) Revocation of a permit during the previous 5 years, | ||||||
15 | or surrender or expiration of the permit during the | ||||||
16 | pendency of action by the Department to revoke or suspend | ||||||
17 | the permit during the previous 5 years. A controlling owner | ||||||
18 | or controlling combination of owners of the applicant; or | ||||||
19 | any affiliate of the individual applicant or controlling | ||||||
20 | owner of the applicant or affiliate of the applicant was a | ||||||
21 | controlling owner of the prior permit.
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22 | Section 60. Administration; enforcement. | ||||||
23 | (a) The Department may establish a training program for the | ||||||
24 | Department's agents who administer and enforce this Act.
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1 | (b) In administering and enforcing this Act, the Department | ||||||
2 | may designate and use full-time municipal, district, county, or | ||||||
3 | multiple-county health departments as its agents in | ||||||
4 | administering and enforcing of this Act and the rules adopted | ||||||
5 | under this Act. | ||||||
6 | Section 65. Investigation; hearing; notice. The | ||||||
7 | Department shall investigate an applicant or permit holder upon | ||||||
8 | the verified complaint in writing of any person setting forth | ||||||
9 | facts that if proven would constitute grounds for the denial of | ||||||
10 | an application for a permit, or for the refusal to renew a | ||||||
11 | permit, or for the revocation or suspension of a permit. The | ||||||
12 | Department may investigate an applicant or permit holder on its | ||||||
13 | own motion. The Department, after notice and an opportunity for | ||||||
14 | a hearing, may deny any application for, or suspend or revoke, | ||||||
15 | a permit or may refuse to renew a permit. Before denying an | ||||||
16 | application, refusing to renew a permit, or suspending or | ||||||
17 | revoking a permit, the Department shall notify the applicant in | ||||||
18 | writing. The notice shall specify the reasons for the | ||||||
19 | Department's contemplated action. The applicant or permit | ||||||
20 | holder must request a hearing within 10 days after receipt of | ||||||
21 | the notice. Failure to request a hearing within 10 days shall | ||||||
22 | constitute a waiver of the right to a hearing. | ||||||
23 | Section 70. Conduct of hearing. | ||||||
24 | (a) If an applicant or permit holder requests a hearing |
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1 | under Section 65, the hearing shall be conducted by the | ||||||
2 | Director or by an individual designated in writing by the | ||||||
3 | Director as a hearing officer. The Director or hearing officer | ||||||
4 | may compel by subpoena or subpoena duces tecum the attendance | ||||||
5 | and testimony of witnesses and the production of books and | ||||||
6 | papers and may administer oaths to witnesses. The hearing shall | ||||||
7 | be conducted at a place designated by the Department. The | ||||||
8 | procedures governing hearings and the issuance of final orders | ||||||
9 | under this Act shall be in accordance with rules adopted by the | ||||||
10 | Department.
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11 | (b) All subpoenas issued by the Director or hearing officer | ||||||
12 | may be served as provided for in civil actions. The fees of | ||||||
13 | witnesses for attendance and travel shall be the same as the | ||||||
14 | fees for witnesses before the circuit court and shall be paid | ||||||
15 | by the party to the proceedings at whose request the subpoena | ||||||
16 | is issued. If a subpoena is issued at the request of the | ||||||
17 | Department, the witness fee shall be paid as an administrative | ||||||
18 | expense.
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19 | (c) In cases of refusal of a witness to attend or testify, | ||||||
20 | or to produce books or papers, concerning any matter upon which | ||||||
21 | he or she might be lawfully examined, the circuit court of the | ||||||
22 | county in which the hearing is held, upon application of any | ||||||
23 | party to the proceeding, may compel obedience by proceeding as | ||||||
24 | for contempt as in cases of a like refusal to obey a similar | ||||||
25 | order of the court.
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1 | Section 75. Findings of fact; conclusions of law; decision. | ||||||
2 | The Director or hearing officer shall make findings of fact and | ||||||
3 | conclusions of law in a hearing conducted under Section 70, and | ||||||
4 | the Director shall render his or her decision, or the hearing | ||||||
5 | officer his or her proposal for decision, within 45 days after | ||||||
6 | the termination of the hearing unless additional time is | ||||||
7 | required by the Director or hearing officer for a proper | ||||||
8 | disposition of the matter. A copy of the final decision of the | ||||||
9 | Director shall be served upon the applicant or permit holder in | ||||||
10 | person or by certified mail. | ||||||
11 | Section 80. Surrender of permit. Upon the revocation of a | ||||||
12 | permit, a permit holder shall be required to surrender the | ||||||
13 | permit to the Department, and upon his or her failure or | ||||||
14 | refusal to do so, the Department shall have the right to seize | ||||||
15 | the same. | ||||||
16 | Section 85. Review under Administrative Review law; venue; | ||||||
17 | costs. All final administrative decisions of the Department | ||||||
18 | under this Act shall be subject to judicial review under the | ||||||
19 | provisions of Article III of the Code of Civil Procedure. The | ||||||
20 | term "administrative decision" is defined as under Section | ||||||
21 | 3-101 of the Code of Civil Procedure. Proceedings for judicial | ||||||
22 | review shall be commenced in the circuit court of the county in | ||||||
23 | which the party applying for review resides, except that if the | ||||||
24 | party is not a resident of this State, the venue shall be in |
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1 | Sangamon County. The Department shall not be required to | ||||||
2 | certify any record or file any answer or otherwise appear in | ||||||
3 | any proceeding for judicial review unless the party filing the | ||||||
4 | complaint deposits with the clerk of the court the sum of $0.95 | ||||||
5 | per page, representing the costs of certification of the record | ||||||
6 | or file. Failure on the part of the plaintiff to make the | ||||||
7 | deposit shall be grounds for dismissal of the action. | ||||||
8 | Section 90. Administrative Procedure Act; application. The | ||||||
9 | provisions of the Illinois Administrative Procedure Act are | ||||||
10 | hereby expressly adopted and shall apply to all administrative | ||||||
11 | rules and procedures of the Department under this Act, except | ||||||
12 | that in case of conflict between the Illinois Administrative | ||||||
13 | Procedure Act and this Act the provisions of this Act shall | ||||||
14 | control, and except that Section 5 of the Illinois | ||||||
15 | Administrative Procedure Act relating to procedures for | ||||||
16 | rulemaking does not apply to the adoption of any rules required | ||||||
17 | by federal law in connection with which the Department is | ||||||
18 | precluded by law from exercising any discretion. | ||||||
19 | Section 95. Penalties. The Department may establish and | ||||||
20 | assess civil monetary penalties against a permit holder for | ||||||
21 | violations of this Act or regulations adopted under this Act. | ||||||
22 | In no circumstance may any such penalty exceed $1,000 per day | ||||||
23 | for each day the permit holder remains in violation. |
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1 | Section 100. Public nuisance. | ||||||
2 | (a) Any facility operating without a valid permit, or | ||||||
3 | operating on a revoked permit, or operating without an | ||||||
4 | operator, as defined in this Act, on duty constitutes a public | ||||||
5 | nuisance.
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6 | (b) A person convicted of knowingly maintaining a public | ||||||
7 | nuisance under this Act commits a Class A misdemeanor. A second | ||||||
8 | or subsequent offense under this subsection is a Class 4 | ||||||
9 | felony.
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10 | (c) The Attorney General of this State or the State's | ||||||
11 | Attorney of the county in which the nuisance exists may | ||||||
12 | commence an action to abate the nuisance. The court, without | ||||||
13 | notice or bond, may enter a temporary restraining order or a | ||||||
14 | preliminary injunction to enjoin the defendant from operating | ||||||
15 | in violation of this Act.
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16 | Section 105. Advertising. | ||||||
17 | (a) Any facility may advertise the availability of | ||||||
18 | professional services in the public media or on the premises | ||||||
19 | where the professional services are rendered. The advertising | ||||||
20 | shall be limited to the following information:
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21 | (1) Publication of the facility's name, office hours, | ||||||
22 | address, and telephone number.
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23 | (2) Information pertaining to the professionals | ||||||
24 | providing services at the facility.
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25 | (3) Information on usual and customary fees for routine |
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1 | professional services offered.
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2 | (4) Announcement of the opening of, change of, absence | ||||||
3 | from, or return to business.
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4 | (5) Announcement of additions to or deletions from | ||||||
5 | professional licensed staff.
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6 | (6) The issuance of business cards.
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7 | (b) It is unlawful for any facility with respect to which a | ||||||
8 | permit has been issued under this Act to use testimonials or | ||||||
9 | claims of superior quality of care to entice the public. It is | ||||||
10 | unlawful for a facility to advertise comparisons of its fees | ||||||
11 | for available services with the fees of other facilities with | ||||||
12 | respect to which a permit has been issued under this Act or | ||||||
13 | that are licensed or otherwise authorized to operate under any | ||||||
14 | other Illinois law.
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15 | (c) This Act does not authorize the advertising of | ||||||
16 | professional services that a facility is not authorized to | ||||||
17 | render, nor shall an advertiser use statements that contain | ||||||
18 | false, fraudulent, deceptive, or misleading material or | ||||||
19 | guarantees of success, statements that play upon the vanity or | ||||||
20 | fears of the public, or statements that promote or produce | ||||||
21 | unfair competition.
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22 | (d) It is unlawful and punishable under Section 95 for any | ||||||
23 | facility licensed under this Act to knowingly advertise that | ||||||
24 | the facility will accept as payment for services rendered by | ||||||
25 | assignment from any third party payor the amount the third | ||||||
26 | party payor covers as payment in full, if the effect is to give |
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1 | the impression of eliminating the need of payment by the | ||||||
2 | patient of any required deductible or copayment applicable in | ||||||
3 | the patient's health benefit plan.
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4 | (e) As used in this Section, "advertise" means solicitation | ||||||
5 | by the permit holder or through another by means of handbills, | ||||||
6 | posters, circulars, motion pictures, radio, newspapers, | ||||||
7 | television, the Internet, or the World Wide Web, or in any | ||||||
8 | other manner.
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9 | Section 110. Retail Health Care Facility Permit Fund. There | ||||||
10 | is created in the State Treasury a special fund to be known as | ||||||
11 | the Retail Health Care Facility Permit Fund. All fees and | ||||||
12 | penalties collected by the Department under this Act, and any | ||||||
13 | federal funds collected pursuant to the administration of this | ||||||
14 | Act, shall be deposited into the Fund. The amounts deposited | ||||||
15 | into the Fund shall be appropriated by the General Assembly to | ||||||
16 | the Department for the purpose of conducting activities | ||||||
17 | relating to retail health care facilities under this Act. | ||||||
18 | Section 115. Severability. The provisions of this Act are | ||||||
19 | severable under Section 1.31 of the Statute on Statutes. | ||||||
20 | Section 900. The State Finance Act is amended by adding | ||||||
21 | Section 5.708 as follows: | ||||||
22 | (30 ILCS 105/5.708 new)
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1 | Sec. 5.708. The Retail Health Care Facility Permit Fund.
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2 | Section 999. Effective date. This Act takes effect June 1, | ||||||
3 | 2008.
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