Illinois General Assembly - Full Text of HB2222
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Full Text of HB2222  103rd General Assembly


Sen. Ann Gillespie

Filed: 5/2/2023





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2    AMENDMENT NO. ______. Amend House Bill 2222 by replacing
3everything after the enacting clause with the following:
4    "Section 5. The Illinois Health Facilities Planning Act is
5amended by changing Section 8.5 as follows:
6    (20 ILCS 3960/8.5)
7    (Section scheduled to be repealed on December 31, 2029)
8    Sec. 8.5. Certificate of exemption for change of ownership
9of a health care facility; discontinuation of a category of
10service; public notice and public hearing.
11    (a) Upon a finding that an application for a change of
12ownership is complete, the State Board shall publish a legal
13notice on 3 consecutive days in a newspaper of general
14circulation in the area or community to be affected and afford
15the public an opportunity to request a hearing. If the
16application is for a facility located in a Metropolitan



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1Statistical Area, an additional legal notice shall be
2published in a newspaper of limited circulation, if one
3exists, in the area in which the facility is located. If the
4newspaper of limited circulation is published on a daily
5basis, the additional legal notice shall be published on 3
6consecutive days. The applicant shall pay the cost incurred by
7the Board in publishing the change of ownership notice in
8newspapers as required under this subsection. The legal notice
9shall also be posted on the Health Facilities and Services
10Review Board's web site and sent to the State Representative
11and State Senator of the district in which the health care
12facility is located and to the Office of the Attorney General.
13An application for change of ownership of a hospital shall not
14be deemed complete without a signed certification that for a
15period of 2 years after the change of ownership transaction is
16effective, the hospital will not adopt a charity care policy
17that is more restrictive than the policy in effect during the
18year prior to the transaction. An application for a change of
19ownership need not contain signed transaction documents so
20long as it includes the following key terms of the
21transaction: names and background of the parties; structure of
22the transaction; the person who will be the licensed or
23certified entity after the transaction; the ownership or
24membership interests in such licensed or certified entity both
25prior to and after the transaction; fair market value of
26assets to be transferred; and the purchase price or other form



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1of consideration to be provided for those assets. The issuance
2of the certificate of exemption shall be contingent upon the
3applicant submitting a statement to the Board within 90 days
4after the closing date of the transaction, or such longer
5period as provided by the Board, certifying that the change of
6ownership has been completed in accordance with the key terms
7contained in the application. If such key terms of the
8transaction change, a new application shall be required.
9    Where a change of ownership is among related persons, and
10there are no other changes being proposed at the health care
11facility that would otherwise require a permit or exemption
12under this Act, the applicant shall submit an application
13consisting of a standard notice in a form set forth by the
14Board briefly explaining the reasons for the proposed change
15of ownership. Once such an application is submitted to the
16Board and reviewed by the Board staff, the Board Chair shall
17take action on an application for an exemption for a change of
18ownership among related persons within 45 days after the
19application has been deemed complete, provided the application
20meets the applicable standards under this Section. If the
21Board Chair has a conflict of interest or for other good cause,
22the Chair may request review by the Board. Notwithstanding any
23other provision of this Act, for purposes of this Section, a
24change of ownership among related persons means a transaction
25where the parties to the transaction are under common control
26or ownership before and after the transaction is completed.



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1    Nothing in this Act shall be construed as authorizing the
2Board to impose any conditions, obligations, or limitations,
3other than those required by this Section, with respect to the
4issuance of an exemption for a change of ownership, including,
5but not limited to, the time period before which a subsequent
6change of ownership of the health care facility could be
7sought, or the commitment to continue to offer for a specified
8time period any services currently offered by the health care
10    The changes made by this amendatory Act of the 103rd
11General Assembly are inoperative on and after January 1, 2027.
12    (a-3) (Blank).
13    (a-5) Upon a finding that an application to discontinue a
14category of service is complete and provides the requested
15information, as specified by the State Board, an exemption
16shall be issued. No later than 30 days after the issuance of
17the exemption, the health care facility must give written
18notice of the discontinuation of the category of service to
19the State Senator and State Representative serving the
20legislative district in which the health care facility is
21located. No later than 90 days after a discontinuation of a
22category of service, the applicant must submit a statement to
23the State Board certifying that the discontinuation is
25    (b) If a public hearing is requested, it shall be held at
26least 15 days but no more than 30 days after the date of



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1publication of the legal notice in the community in which the
2facility is located. The hearing shall be held in the affected
3area or community in a place of reasonable size and
4accessibility and a full and complete written transcript of
5the proceedings shall be made. All interested persons
6attending the hearing shall be given a reasonable opportunity
7to present their positions in writing or orally. The applicant
8shall provide a summary or describe the proposed change of
9ownership at the public hearing.
10    (c) For the purposes of this Section "newspaper of limited
11circulation" means a newspaper intended to serve a particular
12or defined population of a specific geographic area within a
13Metropolitan Statistical Area such as a municipality, town,
14village, township, or community area, but does not include
15publications of professional and trade associations.
16    (d) The changes made to this Section by this amendatory
17Act of the 101st General Assembly shall apply to all
18applications submitted after the effective date of this
19amendatory Act of the 101st General Assembly.
20(Source: P.A. 100-201, eff. 8-18-17; 101-83, eff. 7-15-19.)
21    Section 10. The State Finance Act is amended by adding
22Section 5.990 as follows:
23    (30 ILCS 105/5.990 new)
24    Sec. 5.990. The Antitrust Enforcement Fund. This Section



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1is repealed on January 1, 2027.
2    Section 15. The Illinois Antitrust Act is amended by
3changing Section 7.2 and by adding Sections 7.2a and 13 as
5    (740 ILCS 10/7.2)  (from Ch. 38, par. 60-7.2)
6    Sec. 7.2. (1) Whenever it appears to the Attorney General
7that any person has engaged in, is engaging in, or is about to
8engage in any act or practice prohibited by this Act, or that
9any person has assisted or participated in any agreement or
10combination of the nature described herein, he may, in his
11discretion, conduct an investigation as he deems necessary in
12connection with the matter and has the authority prior to the
13commencement of any civil or criminal action as provided for
14in the Act to subpoena witnesses, and pursuant to a subpoena
15(i) compel their attendance for the purpose of examining them
16under oath, (ii) require the production of any books,
17documents, records, writings or tangible things hereafter
18referred to as "documentary material" which the Attorney
19General deems relevant or material to his investigation, for
20inspection, reproducing or copying under such terms and
21conditions as hereafter set forth, (iii) require written
22answers under oath to written interrogatories, or (iv) require
23compliance with a combination of the foregoing. Any subpoena
24issued by the Attorney General shall contain the following



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2        (a) The statute and section thereof, the alleged
3    violation of which is under investigation and the general
4    subject matter of the investigation.
5        (b) The date and place at which time the person is
6    required to appear or produce documentary material in his
7    possession, custody or control or submit answers to
8    interrogatories in the office of the Attorney General
9    located in Springfield or Chicago. Said date shall not be
10    less than 10 days from date of service of the subpoena.
11        (c) Where documentary material is required to be
12    produced, the same shall be described by class so as to
13    clearly indicate the material demanded.
14    The Attorney General is hereby authorized, and may so
15elect, to require the production, pursuant to this section, of
16documentary material or interrogatory answers prior to the
17taking of any testimony of the person subpoenaed. Said
18documentary material shall be made available for inspection
19and copying during normal business hours at the principal
20place of business of the person served, or at such other time
21and place, as may be agreed upon by the person served and the
22Attorney General. When documentary material is demanded by
23subpoena, said subpoena shall not:
24        (i) contain any requirement which would be
25    unreasonable or improper if contained in a subpoena duces
26    tecum issued by a court of this State; or



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1        (ii) require the disclosure of any documentary
2    material which would be privileged, or which for any other
3    reason would not be required by a subpoena duces tecum
4    issued by a court of this State.
5    (2) The production of documentary material in response to
6a subpoena served pursuant to this Section shall be made under
7a sworn certificate, in such form as the subpoena designates,
8by the person, if a natural person, to whom the demand is
9directed or, if not a natural person, by a person or persons
10having knowledge of the facts and circumstances relating to
11such production, to the effect that all of the documentary
12material required by the demand and in the possession,
13custody, or control of the person to whom the demand is
14directed has been produced and made available to the
15custodian. Answers to interrogatories shall be accompanied by
16a statement under oath attesting to the accuracy of the
18    While in the possession of the Attorney General and under
19such reasonable terms and conditions as the Attorney General
20shall prescribe: (A) documentary material shall be available
21for examination by the person who produced such material or by
22any duly authorized representative of such person, (B)
23transcript of oral testimony shall be available for
24examination by the person who produced such testimony, or his
25or her counsel and (C) answers to interrogatories shall be
26available for examination by the person who swore to their



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2    Except as otherwise provided in this Section, no
3documentary material, transcripts of oral testimony, or
4answers to interrogatories, or copies thereof, in the
5possession of the Attorney General shall be available for
6examination by any individual other than an authorized
7employee of the Attorney General or other law enforcement
8officials, federal, State, or local, without the consent of
9the person who produced such material, transcripts, or
10interrogatory answers. Such documentary material, transcripts
11of oral testimony, or answers to interrogatories, or copies
12thereof may be used by the Attorney General in any
13administrative or judicial action or proceeding.
14    For purposes of this Section, all documentary materials,
15transcripts of oral testimony, or answers to interrogatories
16obtained by the Attorney General from other law enforcement
17officials, information voluntarily produced to the Attorney
18General for purposes of any investigation conducted under
19subsection (1), or information provided to the Attorney
20General pursuant to the notice requirement of Section 7.2a
21shall be treated as if produced pursuant to a subpoena served
22pursuant to this Section for purposes of maintaining the
23confidentiality of such information.
24    The changes made by this amendatory Act of the 103rd
25General Assembly are inoperative on and after January 1, 2027.
26    (3) No person shall, with intent to avoid, evade, prevent,



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1or obstruct compliance in whole or in part by any person with
2any duly served subpoena of the Attorney General under this
3Act, knowingly remove from any place, conceal, withhold,
4destroy, mutilate, alter, or by any other means falsify any
5documentary material that is the subject of such subpoena. A
6violation of this subsection is a Class A misdemeanor. The
7Attorney General, with such assistance as he may from time to
8time require of the State's Attorneys in the several counties,
9shall investigate suspected violations of this subsection and
10shall commence and try all prosecutions under this subsection.
11(Source: P.A. 96-751, eff. 1-1-10; 96-1000, eff. 7-2-10.)
12    (740 ILCS 10/7.2a new)
13    Sec. 7.2a. Notification to the Attorney General.
14    (a) As used in this Section:
15    "Acquisition" means an agreement, arrangement, or activity
16the consummation of which results in a person acquiring
17directly or indirectly the control of another person.
18"Acquisition" includes the acquisition of voting securities
19and noncorporate interests, such as assets, capital stock,
20membership interests, or equity interests.
21    "Contracting affiliation" means the formation of a
22relationship between 2 or more entities that permits the
23entities to negotiate jointly with health carriers or
24third-party administrators over rates for professional medical
25services, or for one entity to negotiate on behalf of the other



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1entity with health carriers or third-party administrators over
2rates for professional medical services. "Contracting
3affiliation" does not include arrangements among entities
4under common ownership.
5    "Covered transaction" means any merger, acquisition, or
6contracting affiliation between 2 or more health care
7facilities or provider organizations not previously under
8common ownership or contracting affiliation.
9    "Health care facility" means the following facilities,
10organizations, and related persons:
11        (1) An ambulatory surgical treatment center required
12    to be licensed under the Ambulatory Surgical Treatment
13    Center Act.
14        (2) An institution, place, building, or agency
15    required to be licensed under the Hospital Licensing Act.
16        (3) A hospital, ambulatory surgical treatment center,
17    or kidney disease treatment center maintained by the State
18    or any department or agency thereof.
19        (4) A kidney disease treatment center, including a
20    free-standing hemodialysis unit required to meet the
21    requirements of 42 CFR 494 in order to be certified for
22    participation in Medicare and Medicaid under Titles XVIII
23    and XIX of the federal Social Security Act of 1935.
24        (5) An institution, place, building, or room used for
25    the performance of outpatient surgical procedures that is
26    leased, owned, or operated by or on behalf of an



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1    out-of-state facility.
2        (6) An institution, place, building, or room used for
3    provision of a health care category of service, as defined
4    under the Illinois Health Facilities Planning Act,
5    including, but not limited to, cardiac catheterization and
6    open heart surgery.
7    With the exception of those health care facilities
8specifically included in this Section, nothing in this Section
9shall be intended to include facilities operated as a part of
10the practice of a physician or other licensed health care
11professional, whether practicing in his or her individual
12capacity or within the legal structure of any partnership,
13medical or professional corporation, or unincorporated medical
14or professional group. Further, this Section shall not apply
15to physicians or other licensed health care professional's
16practices where such practices are carried out in a portion of
17a health care facility under contract with such health care
18facility by a physician or by other licensed health care
19professionals, whether practicing in his or her individual
20capacity or within the legal structure of any partnership,
21medical or professional corporation, or unincorporated medical
22or professional groups, unless the entity constructs,
23modifies, or establishes a health care facility as
24specifically defined in this Section.
25    "Health care services revenue" means the total revenue
26received for health care services in the previous 12 months.



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1    "Health carriers" has the meaning given to that term in
2Section 10 of the Health Carrier External Review Act.
3    "Illinois health care entity" means a health care facility
4or provider organization that has an office in or is doing
5business in this State.
6    "Merger" means the consolidation of 2 or more
7organizations, including 2 or more organizations joining
8through a common parent organization or 2 or more
9organizations forming a new organization, but does not include
10a corporate reorganization.
11    "Out-of-state health care entity" means a health care
12facility or provider organization that is not headquartered in
13this State and does not do business in this State.
14    "Provider organization" means a corporation, partnership,
15business trust, association, or organized group of persons,
16whether incorporated or not, which is in the business of
17health care delivery or management and that represents 20 or
18more health care providers in contracting with health carriers
19or third-party administrators for the payment of health care
20services. "Provider organization" includes physician
21organizations, physician-hospital organizations, independent
22practice associations, provider networks, and accountable care
24    "Third-party administrator" means an entity that
25administers payments for health care services on behalf of a
26client in exchange for an administrative fee.



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1    (b) Health care facilities or provider organizations that
2are party to a covered transaction shall provide notice of
3such transaction to the Attorney General no later than 30 days
4prior to the transaction closing or effective date of the
6    Covered transactions between an Illinois health care
7entity and an out-of-state health care entity must provide
8notice under this subsection where the out-of-state entity
9generates $10,000,000 or more in annual revenue from patients
10residing in this State.
11    (c) The written notice provided by the parties under
12subsection (b) shall be provided as follows:
13        (1) For any health care facility or provider
14    organization that is a party to a covered transaction and
15    files a premerger notification with the Federal Trade
16    Commission or the United States Department of Justice, in
17    compliance with the Hart-Scott-Rodino Antitrust
18    Improvements Act of 1976, 15 U.S.C. 18a, the notice
19    requirement is satisfied by providing a copy of such
20    filing to the Attorney General at the same time as it is
21    provided to the federal government.
22        (2) For any health care facility that is a party to a
23    covered transaction that is not described in paragraph
24    (1), the notice requirement is satisfied when the
25    healthcare facility files an application for a change of
26    ownership with the Health Facilities and Services Review



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1    Board, in compliance with the Illinois Health Facilities
2    Planning Act. The Health Facilities and Services Review
3    Board shall provide a copy of such filing to the Attorney
4    General at the same time as it is provided to the
5    applicable State legislators under subsection (a) of
6    Section 8.5 of the Illinois Health Facilities Planning
7    Act.
8        (3) For any health care facility or provider
9    organization that is a party to a covered transaction that
10    is not described in paragraph (1) or (2), written notice
11    provided by the parties must include:
12            (A) the names of the parties and their current
13        business address;
14            (B) identification of all locations where health
15        care services are currently provided by each party;
16            (C) a brief description of the nature and purpose
17        of the proposed transaction; and
18            (D) the anticipated effective date of the proposed
19        transaction.
20    Nothing in this subsection prohibits the parties to a
21covered transaction from voluntarily providing additional
22information to the Attorney General.
23    (d) The Attorney General may make any requests for
24additional information from the parties that is relevant to
25its investigation of the covered transaction within 30 days of
26the date notice is received under subsections (b) and (c). If



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1the Attorney General requests additional information, the
2covered transaction may not proceed until 30 days after the
3parties have substantially complied with the request. Any
4subsequent request for additional information by the Attorney
5General shall not further delay the covered transaction from
6proceeding. Nothing in this Section precludes the Attorney
7General from conducting an investigation or enforcing State or
8federal antitrust laws at a later date.
9    (e) Any health care facility or provider organization that
10fails to comply with any provision of this Section is subject
11to a civil penalty of not more than $500 per day for each day
12during which the health care facility or provider organization
13is in violation of this Section.
14    Whenever the Attorney General has reason to believe that a
15health care facility or provider organization has engaged in
16or is engaging in a covered transaction without complying with
17the provisions of this Section, the Attorney General may apply
18for and obtain, in an action in the Circuit Court of Sangamon
19or Cook County, a temporary restraining order or injunction,
20or both, prohibiting the health care facility or provider
21organization from continuing its noncompliance or doing any
22act in furtherance thereof. The court may make such further
23orders or judgments, at law or in equity, as may be necessary
24to remedy such noncompliance.
25    Before bringing such an action or seeking to recover a
26civil penalty, the Attorney General shall permit the health



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1care facility or provider organization to come into compliance
2with this Section within 10 days of being notified of its
3alleged noncompliance. The right to cure noncompliance does
4not exist on or after the covered transaction's proposed or
5actual closing date of the covered transaction, whichever is
7    (f) This Section is repealed on January 1, 2027.
8    (740 ILCS 10/13 new)
9    Sec. 13. Antitrust Enforcement Fund. Any penalties
10collected from an entity for violations of this Act shall be
11deposited into the Antitrust Enforcement Fund, a special fund
12created in the State treasury that is dedicated to enforcing
13this Act.
14    This Section is repealed on January 1, 2027.
15    Section 99. Effective date. This Act takes effect January
161, 2024.".