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Public Act 094-0577

 

Public Act 0577 94TH GENERAL ASSEMBLY 







 

 		


Public Act 094-0577
 		





SB0538 Enrolled
LRB094 09496 RLC 39747 b






    AN ACT in relation to fraud. 

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

 
    Section 5. The Emergency Medical Services (EMS) Systems Act 
is amended  by adding Section 3.133 as follows:
 
    (210 ILCS 50/3.133  new)
    Sec. 3.133. Suspension of license for failure to pay 
restitution. The Department, without further process or 
hearing, shall suspend the license or other authorization to 
practice of any person issued under this Act who has been 
certified by court order as not having paid restitution to a 
person under Section 8A-3.5 of the Illinois Public Aid Code or 
under Section 46-1 of the Criminal Code of 1961.  A person whose 
license or other authorization to practice is suspended under 
this Section is prohibited from practicing until the 
restitution is made in full.
 
    Section 10. The Acupuncture Practice Act is amended  by 
adding Section 117 as follows:
 
    (225 ILCS 2/117  new)
    Sec. 117. Suspension of license for failure to pay 
restitution. The Department, without further process or 
hearing, shall suspend the license or other authorization to 
practice of any person issued under this Act who has been 
certified by court order as not having paid restitution to a 
person under Section 8A-3.5 of the Illinois Public Aid Code or 
under Section 46-1 of the Criminal Code of 1961.  A person whose 
license or other authorization to practice is suspended under 
this Section is prohibited from practicing until the 
restitution is made in full.
 
    Section 15. The Illinois Athletic Trainers Practice Act is 
amended  by adding Section 16.5 as follows:
 
    (225 ILCS 5/16.5  new)
    Sec. 16.5. Suspension of license for failure to pay 
restitution. The Department, without further process or 
hearing, shall suspend the license or other authorization to 
practice of any person issued under this Act who has been 
certified by court order as not having paid restitution to a 
person under Section 8A-3.5 of the Illinois Public Aid Code or 
under Section 46-1 of the Criminal Code of 1961.  A person whose 
license or other authorization to practice is suspended under 
this Section is prohibited from practicing until the 
restitution is made in full.
 
    Section 20. The Clinical Psychologist Licensing Act is 
amended  by adding Section 15.1 as follows:
 
    (225 ILCS 15/15.1  new)
    Sec. 15.1. Suspension of license for failure to pay 
restitution. The Department, without further process or 
hearing, shall suspend the license or other authorization to 
practice of any person issued under this Act who has been 
certified by court order as not having paid restitution to a 
person under Section 8A-3.5 of the Illinois Public Aid Code or 
under Section 46-1 of the Criminal Code of 1961.  A person whose 
license or other authorization to practice is suspended under 
this Section is prohibited from practicing until the 
restitution is made in full.
 
    Section 25. The Clinical Social Work and Social Work 
Practice Act is amended  by adding Section 19.5 as follows:
 
    (225 ILCS 20/19.5  new)
    Sec. 19.5. Suspension of license for failure to pay 
restitution. The Department, without further process or 
hearing, shall suspend the license or other authorization to 
practice of any person issued under this Act who has been 
certified by court order as not having paid restitution to a 
person under Section 8A-3.5 of the Illinois Public Aid Code or 
under Section 46-1 of the Criminal Code of 1961.  A person whose 
license or other authorization to practice is suspended under 
this Section is prohibited from practicing until the 
restitution is made in full.
 
    Section 30. The Illinois Dental Practice Act is amended  by 
adding Section 23c as follows:
 
    (225 ILCS 25/23c  new)
    Sec. 23c. Suspension of license for failure to pay 
restitution. The Department, without further process or 
hearing, shall suspend the license or other authorization to 
practice of any person issued under this Act who has been 
certified by court order as not having paid restitution to a 
person under Section 8A-3.5 of the Illinois Public Aid Code or 
under Section 46-1 of the Criminal Code of 1961.  A person whose 
license or other authorization to practice is suspended under 
this Section is prohibited from practicing until the 
restitution is made in full.
 
    Section 35. The Hearing Instrument Consumer Protection Act 
is amended  by adding Section 18.5 as follows:
 
    (225 ILCS 50/18.5  new)
    Sec. 18.5. Suspension of license for failure to pay 
restitution. The Department, without further process or 
hearing, shall suspend the license or other authorization to 
practice of any person issued under this Act who has been 
certified by court order as not having paid restitution to a 
person under Section 8A-3.5 of the Illinois Public Aid Code or 
under Section 46-1 of the Criminal Code of 1961.  A person whose 
license or other authorization to practice is suspended under 
this Section is prohibited from practicing until the 
restitution is made in full.
 
    Section 40. The Home Medical Equipment and Services 
Provider License Act is amended  by adding Section 77 as 
follows:
 
    (225 ILCS 51/77  new)
    Sec. 77. Suspension of license for failure to pay 
restitution. The Department, without further process or 
hearing, shall suspend the license or other authorization to 
practice of any person issued under this Act who has been 
certified by court order as not having paid restitution to a 
person under Section 8A-3.5 of the Illinois Public Aid Code or 
under Section 46-1 of the Criminal Code of 1961.  A person whose 
license or other authorization to practice is suspended under 
this Section is prohibited from practicing until the 
restitution is made in full.
 
    Section 45. The Marriage and Family Therapy Licensing Act 
is amended  by adding Section 87 as follows:
 
    (225 ILCS 55/87  new)
    Sec. 87. Suspension of license for failure to pay 
restitution. The Department, without further process or 
hearing, shall suspend the license or other authorization to 
practice of any person issued under this Act who has been 
certified by court order as not having paid restitution to a 
person under Section 8A-3.5 of the Illinois Public Aid Code or 
under Section 46-1 of the Criminal Code of 1961.  A person whose 
license or other authorization to practice is suspended under 
this Section is prohibited from practicing until the 
restitution is made in full.
 
    Section 50. The Medical Practice Act of 1987 is amended  by 
adding Section 22.5 as follows:
 
    (225 ILCS 60/22.5  new)
    Sec. 22.5. Suspension of license for failure to pay 
restitution. The Department, without further process or 
hearing, shall suspend the license or other authorization to 
practice of any person issued under this Act who has been 
certified by court order as not having paid restitution to a 
person under Section 8A-3.5 of the Illinois Public Aid Code or 
under Section 46-1 of the Criminal Code of 1961.  A person whose 
license or other authorization to practice is suspended under 
this Section is prohibited from practicing until the 
restitution is made in full.
 
    Section 55. The Naprapathic Practice Act is amended  by 
adding Section 113 as follows:
 
    (225 ILCS 63/113  new)
    Sec. 113. Suspension of license for failure to pay 
restitution. The Department, without further process or 
hearing, shall suspend the license or other authorization to 
practice of any person issued under this Act who has been 
certified by court order as not having paid restitution to a 
person under Section 8A-3.5 of the Illinois Public Aid Code or 
under Section 46-1 of the Criminal Code of 1961.  A person whose 
license or other authorization to practice is suspended under 
this Section is prohibited from practicing until the 
restitution is made in full.
 
    Section 60. The Nursing and Advanced Practice Nursing Act 
is amended  by adding Section 20-13 as follows:
 
    (225 ILCS 65/20-13  new)
    Sec. 20-13. Suspension of license or registration for 
failure to pay restitution. The Department, without further 
process or hearing, shall suspend the license or other 
authorization to practice of any person issued under this Act 
who has been certified by court order as not having paid 
restitution to a person under Section 8A-3.5 of the Illinois 
Public Aid Code or under Section 46-1 of the Criminal Code of 
1961.  A person whose license or other authorization to practice 
is suspended under this Section is prohibited from practicing 
until the restitution is made in full.
 
    Section 65. The Illinois Occupational Therapy Practice Act 
is amended  by adding Section 19.17 as follows:
 
    (225 ILCS 75/19.17  new)
    Sec. 19.17. Suspension of license for failure to pay 
restitution. The Department, without further process or 
hearing, shall suspend the license or other authorization to 
practice of any person issued under this Act who has been 
certified by court order as not having paid restitution to a 
person under Section 8A-3.5 of the Illinois Public Aid Code or 
under Section 46-1 of the Criminal Code of 1961.  A person whose 
license or other authorization to practice is suspended under 
this Section is prohibited from practicing until the 
restitution is made in full.
 
    Section 70. The Illinois Optometric Practice Act of 1987 is 
amended  by adding Section 24.5 as follows:
 
    (225 ILCS 80/24.5  new)
    Sec. 24.5. Suspension of license for failure to pay 
restitution. The Department, without further process or 
hearing, shall suspend the license or other authorization to 
practice of any person issued under this Act who has been 
certified by court order as not having paid restitution to a 
person under Section 8A-3.5 of the Illinois Public Aid Code or 
under Section 46-1 of the Criminal Code of 1961.  A person whose 
license or other authorization to practice is suspended under 
this Section is prohibited from practicing until the 
restitution is made in full.
 
    Section 75. The Orthotics, Prosthetics, and Pedorthics 
Practice Act is amended  by adding Section 93 as follows:
 
    (225 ILCS 84/93  new)
    Sec. 93. Suspension of license for failure to pay 
restitution. The Department, without further process or 
hearing, shall suspend the license or other authorization to 
practice of any person issued under this Act who has been 
certified by court order as not having paid restitution to a 
person under Section 8A-3.5 of the Illinois Public Aid Code or 
under Section 46-1 of the Criminal Code of 1961.  A person whose 
license or other authorization to practice is suspended under 
this Section is prohibited from practicing until the 
restitution is made in full.
 
    Section 80. The Pharmacy Practice Act of 1987 is amended  by 
adding Section 30.5 as follows:
 
    (225 ILCS 85/30.5  new)
    Sec. 30.5. Suspension of license or certificate for failure 
to pay restitution. The Department, without further process or 
hearing, shall suspend the license or other authorization to 
practice of any person issued under this Act who has been 
certified by court order as not having paid restitution to a 
person under Section 8A-3.5 of the Illinois Public Aid Code or 
under Section 46-1 of the Criminal Code of 1961.  A person whose 
license or other authorization to practice is suspended under 
this Section is prohibited from practicing until the 
restitution is made in full.
 
    Section 85. The Illinois Physical Therapy Act is amended  by 
adding Section 17.5 as follows:
 
    (225 ILCS 90/17.5  new)
    Sec. 17.5. Suspension of license for failure to pay 
restitution. The Department, without further process or 
hearing, shall suspend the license or other authorization to 
practice of any person issued under this Act who has been 
certified by court order as not having paid restitution to a 
person under Section 8A-3.5 of the Illinois Public Aid Code or 
under Section 46-1 of the Criminal Code of 1961.  A person whose 
license or other authorization to practice is suspended under 
this Section is prohibited from practicing until the 
restitution is made in full.
 
    Section 90. The Physician Assistant Practice Act of 1987 is 
amended  by adding Section 21.5 as follows:
 
    (225 ILCS 95/21.5  new)
    Sec. 21.5. Suspension of license for failure to pay 
restitution. The Department, without further process or 
hearing, shall suspend the license or other authorization to 
practice of any person issued under this Act who has been 
certified by court order as not having paid restitution to a 
person under Section 8A-3.5 of the Illinois Public Aid Code or 
under Section 46-1 of the Criminal Code of 1961.  A person whose 
license or other authorization to practice is suspended under 
this Section is prohibited from practicing until the 
restitution is made in full.
 
    Section 95. The Podiatric Medical Practice Act of 1987 is 
amended  by adding Section 24.5 as follows:
 
    (225 ILCS 100/24.5  new)
    Sec. 24.5. Suspension of license for failure to pay 
restitution. The Department, without further process or 
hearing, shall suspend the license or other authorization to 
practice of any person issued under this Act who has been 
certified by court order as not having paid restitution to a 
person under Section 8A-3.5 of the Illinois Public Aid Code or 
under Section 46-1 of the Criminal Code of 1961.  A person whose 
license or other authorization to practice is suspended under 
this Section is prohibited from practicing until the 
restitution is made in full.
 
    Section 100. The Respiratory Care Practice Act is amended  
by adding Section 97 as follows:
 
    (225 ILCS 106/97  new)
    Sec. 97. Suspension of license for failure to pay 
restitution. The Department, without further process or 
hearing, shall suspend the license or other authorization to 
practice of any person issued under this Act who has been 
certified by court order as not having paid restitution to a 
person under Section 8A-3.5 of the Illinois Public Aid Code or 
under Section 46-1 of the Criminal Code of 1961.  A person whose 
license or other authorization to practice is suspended under 
this Section is prohibited from practicing until the 
restitution is made in full.
 
    Section 105. The Professional Counselor and Clinical 
Professional Counselor
Licensing Act is amended  by adding 
Section 83 as follows:
 
    (225 ILCS 107/83  new)
    Sec. 83. Suspension of license for failure to pay 
restitution. The Department, without further process or 
hearing, shall suspend the license or other authorization to 
practice of any person issued under this Act who has been 
certified by court order as not having paid restitution to a 
person under Section 8A-3.5 of the Illinois Public Aid Code or 
under Section 46-1 of the Criminal Code of 1961.  A person whose 
license or other authorization to practice is suspended under 
this Section is prohibited from practicing until the 
restitution is made in full.
 
    Section 110. The Illinois Speech-Language Pathology and

Audiology Practice Act is amended  by adding Section 16.3 as 
follows:
 
    (225 ILCS 110/16.3  new)
    Sec. 16.3. Suspension of license for failure to pay 
restitution. The Department, without further process or 
hearing, shall suspend the license or other authorization to 
practice of any person issued under this Act who has been 
certified by court order as not having paid restitution to a 
person under Section 8A-3.5 of the Illinois Public Aid Code or 
under Section 46-1 of the Criminal Code of 1961.  A person whose 
license or other authorization to practice is suspended under 
this Section is prohibited from practicing until the 
restitution is made in full.
 
    Section 115. The Perfusionist Practice Act is amended  by 
adding Section 107 as follows:
 
    (225 ILCS 125/107  new)
    Sec. 107. Suspension of license for failure to pay 
restitution. The Department, without further process or 
hearing, shall suspend the license or other authorization to 
practice of any person issued under this Act who has been 
certified by court order as not having paid restitution to a 
person under Section 8A-3.5 of the Illinois Public Aid Code or 
under Section 46-1 of the Criminal Code of 1961.  A person whose 
license or other authorization to practice is suspended under 
this Section is prohibited from practicing until the 
restitution is made in full.
 
    Section 120. The Registered Surgical Assistant and 
Registered Surgical
Technologist Title Protection Act is 
amended  by adding Section 77 as follows:
 
    (225 ILCS 130/77  new)
    Sec. 77. Suspension of registration for failure to pay 
restitution. The Department, without further process or 
hearing, shall suspend the license or other authorization to 
practice of any person issued under this Act who has been 
certified by court order as not having paid restitution to a 
person under Section 8A-3.5 of the Illinois Public Aid Code or 
under Section 46-1 of the Criminal Code of 1961.  A person whose 
license or other authorization to practice is suspended under 
this Section is prohibited from practicing until the 
restitution is made in full.
 
    Section 125. The Genetic Counselor Licensing Act is amended  
by adding Section 97 as follows:
 
    (225 ILCS 135/97  new)
    Sec. 97. Suspension of license for failure to pay 
restitution. The Department, without further process or 
hearing, shall suspend the license or other authorization to 
practice of any person issued under this Act who has been 
certified by court order as not having paid restitution to a 
person under Section 8A-3.5 of the Illinois Public Aid Code or 
under Section 46-1 of the Criminal Code of 1961.  A person whose 
license or other authorization to practice is suspended under 
this Section is prohibited from practicing until the 
restitution is made in full.
 
    Section 130. The Illinois Public Aid Code is amended  by 
adding Sections 8A-3.5 and 8A-3.6 as follows:
 
    (305 ILCS 5/8A-3.5  new)
    Sec. 8A-3.5. Vendor fraud and recipient fraud in medical 
assistance; restitution. A person convicted of recipient 
fraud, unauthorized use of medical assistance, vendor  fraud in 
relation to the provision of medical assistance under Article V 
of this Code, or convicted of a federal criminal violation 
associated with defrauding the Medicaid program shall be 
ordered to pay
monetary
restitution to a person for any

financial loss
sustained by that person as a result of a 
violation of Section 8A-2, 8A-2.5, or 8A-3 of this Code, 
including any court costs
and attorney
fees. An order of 
restitution also includes expenses incurred and paid
in 
connection with any medical evaluation or treatment.
 
    (305 ILCS 5/8A-3.6  new)
    Sec. 8A-3.6. Actions by State licensing agencies.

    (a) All State licensing agencies, the Illinois State 
Police, and
the
Department of Financial and Professional 
Regulation shall coordinate enforcement efforts relating to 
acts
of recipient fraud, unauthorized use of medical 
assistance, or vendor  fraud in relation to the provision of 
medical assistance under Article V of this Code.
    (b) If a person who is licensed or registered under the 
laws of the State of
Illinois to engage in a business or 
profession is convicted of or pleads
guilty to engaging
in an 
act of recipient fraud, unauthorized use of medical assistance, 
or vendor  fraud in relation to the provision of medical 
assistance under Article V of this Code, the Illinois State 
Police must forward
to each
State agency by which the person is 
licensed or registered a copy of the
conviction or
plea and all 
supporting evidence.
    (c) Any agency that receives information under this Section 
shall, not later
than
6 months after the date on which it 
receives the information, publicly report the final action

taken
against the convicted person, including but not limited 
to the revocation or
suspension
of the license or any other 
disciplinary action taken.
 
    Section 135. The Criminal Code of 1961 is amended  by 
changing Section 46-1 and  by adding Section 46-6 as follows:
 



    (720 ILCS 5/46-1)



    Sec. 46-1. Insurance fraud. 

    (a) A person commits the offense of insurance fraud when he 
or she knowingly
obtains, attempts to obtain, or causes to be

obtained, by deception, control over the property of an 
insurance
company or self-insured entity by
the making of a 
false claim or by causing a false claim to be made on any

policy of insurance issued by an insurance
company or by the 
making of a false claim to a self-insured entity,
intending to 
deprive an insurance
company or self-insured entity 
permanently of the use and
benefit of that property.

    (b) Sentence.


        (1) A violation of this Section in which the value of 
    the property
obtained or attempted to be obtained is $300 
    or less is a Class A misdemeanor.


        (2) A violation of the Section in which the value of 
    the property
obtained or attempted to be obtained is more 
    than $300 but not more than
$10,000 is a Class 3 felony.


        (3) A violation of this Section in which the value of 
    the property
obtained or attempted to be obtained is more 
    than $10,000 but not more than
$100,000 is a Class 2 
    felony.


        (4) A violation of this Section in which the value of 
    the property
obtained or attempted to be obtained is more 
    than $100,000 is a Class 1 felony.
        (5) A person convicted of insurance fraud, vendor 
    fraud, or a federal criminal violation associated with 
    defrauding the Medicaid program shall be ordered to pay

    monetary
restitution to the insurance company or 
    self-insured entity or any other person for any
financial 
    loss
sustained as a result of a violation of this Section, 
    including any court costs
and attorney
fees. An order of 
    restitution also includes expenses incurred and paid by
the 
    State of Illinois or an insurance company or self-insured 
    entity
in connection with any medical evaluation or 
    treatment services.


    (c) For the purposes of this Article, where the exact value

of property
obtained or attempted to be obtained is either not 
alleged by the accused or
not specifically set by the terms of 
a policy of insurance, the
value of the
property shall be the 
fair market replacement value of the property claimed
to be 
lost, the reasonable costs of reimbursing a vendor or other 
claimant
for services to be rendered, or both.

    (d) Definitions.  For the purposes of this Article:


        (1) "Insurance company" means "company" as defined 
    under Section 2 of the
Illinois Insurance Code.


        (2) "Self-insured entity" means any person, business, 
    partnership,
corporation, or organization that sets aside 
    funds to meet his, her, or its
losses or to absorb 
    fluctuations in the amount of loss, the losses being

    charged against the funds set aside or accumulated.


        (3) "Obtain", "obtains control", "deception", 
    "property" and "permanent
deprivation"
have the meanings 
    ascribed to those terms in Article 15 of this Code.


        (4) "Governmental entity" means each officer, board, 
    commission, and
agency created by the constitution, 
    whether in the executive, legislative, or
judicial branch 
    of State government; each officer, department, board,

    commission, agency, institution, authority, university, 
    and body politic and
corporate of the State; each 
    administrative unit or corporate outgrowth of
State 
    government that is created by or pursuant to
statute, 
    including units of local government and their officers, 
    school
districts, and boards of election commissioners; 
    and each administrative unit
or corporate outgrowth of the 
    above and as may be created by executive order of
the 
    Governor.


        (5) "False claim" means any statement made to any 
    insurer, purported
insurer, servicing corporation, 
    insurance broker, or insurance agent, or any
agent or 
    employee of the entities, and made as part of, or in 
    support of, a
claim for
payment or other benefit under a 
    policy of insurance, or as part of, or
in support of, an 
    application for the issuance of, or the rating of, any

    insurance policy, when the statement contains any false, 
    incomplete, or
misleading information concerning any fact 
    or thing material to the claim, or
conceals the occurrence 
    of an event that is material to any person's initial or

    continued right or entitlement to any insurance benefit or 
    payment, or the
amount of any benefit or payment to which 
    the person is entitled.


        (6) "Statement" means any assertion, oral, written, or 
    otherwise, and
includes, but is not limited to, any notice, 
    letter, or memorandum; proof of
loss; bill of lading; 
    receipt for payment; invoice, account, or other financial

    statement; estimate of property damage; bill for services; 
    diagnosis or
prognosis;
prescription; hospital, medical or 
    dental chart or other record, x-ray,
photograph, 
    videotape, or movie film; test result; other evidence of 
    loss,
injury, or expense; computer-generated document; and 
    data in any form.

(Source: P.A. 90-333, eff. 1-1-98; 91-232, eff. 1-1-00.)

 
    (720 ILCS 5/46-6  new)
    Sec. 46-6. Actions by State licensing agencies.

    (a) All State licensing agencies, the Illinois State 
Police, and
the
Department of Financial and Professional 
Regulation shall coordinate enforcement efforts relating to 
acts
of
insurance fraud.
    (b) If a person who is licensed or registered under the 
laws of the State of
Illinois to engage in a business or 
profession is convicted of or pleads
guilty to engaging
in an 
act of insurance fraud, the Illinois State Police must forward

to each
State agency by which the person is licensed or 
registered a copy of the
conviction or
plea and all supporting 
evidence.
    (c) Any agency that receives information under this Section 
shall, not later
than
6 months after the date on which it 
receives the information, publicly report the final action

taken
against the convicted person, including but not limited 
to the revocation or
suspension
of the license or any other 
disciplinary action taken.
 

    Section 999. Effective date. This Act takes effect January 
1, 2006.




Effective Date:  1/1/2006











  

    

      

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