Hospital Uninsured Patient Discount Act
The Hospital Uninsured Patient Discount Act (Public Act 95-0965) offers discounts and caps hospital bills for uninsured patients in Illinois. Effective 4/1/09, hospital charges to eligible uninsured cannot exceed the costs of the services plus 35 percent. This law also puts an annual cap on the amount of money hospitals can collect for services from eligible uninsured patients to no more than 25 percent of a patient's family income.
- Uninsured - You must have no health insurance coverage under any health benefit plan.
- Residency - You must live in Illinois. Financial Status - You must have a family income and assets of not more than 600 percent of the federal poverty level ($132,300 for a family of four) at non-rural hospitals, and 300 percent of the federal poverty level ($66,150) for a family of four at rural or critical access hospitals. Hospitals may make availability of a discount dependent upon first applying for coverage under public programs, such as Medicare or Medicaid, if the patient is likely to be eligible.
- Verification - Hospitals may require an uninsured patient who is requesting a discount to provide documentation that verifies income and Illinois residency. Any hospital obligation to an uninsured patient who fails to provide the requested documentation within 30 days of request will cease.
- Application - You must apply for a discount within 60 days of the date of hospital discharge or service.
The uninsured discount applies to medically necessary hospital services that exceed $300. It does not include physician services.
Each hospital bill, invoice or other summary of charges to an uninsured patient must include a statement of the availability of the uninsured discount and how to apply for consideration.
Attorney General of Illinois is responsible for administering and ensuring compliance with this law. For further information or if you need help with a dispute over a bill you may contact the Health Care Bureau hotline of the Attorney General's Office at 877-305-5145 (or TTY 800-964-3013) or online at: illinoisattorneygeneral.gov
For Hospital Full Text of the Uninsured Patient Discount Act: ilga.gov
Fair Patient Billing Act
This law was passed to promote fair and reasonable billing and collection practices amongst hospitals by providing a set of responsible standards.
Hospitals must make financial assistance information available on signs in the admission and registration areas of the hospital with the following notice:
- “You may be eligible for financial assistance under the terms and conditions the hospital offers to qualified patients. For more information, contact (hospital financial assistance representative).”
- The sign should be in English and in any other language that is the primary language of at least 5 percent of the patients served by the hospital.
- If the hospital has a Web site, this information should be posted in a prominent place on the site. In addition, hospitals must make information regarding financial assistance available in the form of either a brochure, application or other written materials in the hospital admission or registration area.
When billing patients, hospitals must provide the following information:
- The date(s) of health care service
- A brief description of services provided
- The amount owed for the hospital services
- Hospital contact information for questions about bills
- A statement regarding how an uninsured patient may apply for consideration under the hospitals financial assistance policy.
- Notice that a patient may obtain an itemized bill upon request.
Every hospital must have a process for patients to inquire about or dispute a bill, including a telephone number to contact the hospital. Hospitals may also provide additional ways for contacting them about bills, including a toll-free number, a mailing address, a department or identified person that a patient may call or write, a Web site, or an e-mail address. A hospital must respond to a call within two business days after the call is made. A written request must be responded to within 10 business days of receipt.
Bill Collection Action
Before hospitals can refer a patient’s bill to a collection agency, they must give the patient an opportunity to:
- Assess the accuracy of the bill
- Apply for financial assistance under the hospital’s financial assistance policy (the hospital must give a patient 60 days from the date of discharge or receipt of outpatient care to submit an application for financial assistance)
- Request a reasonable payment plan. Hospitals may require patients to provide verification of inability to pay the full amount in one payment.
Hospitals cannot refer a bill to a collection agency without first offering the opportunity for patients to request a reasonable payment plan. Such an opportunity must be provided by hospitals for 30 days following the date of the original bill. If a patient fails to agree to a reasonable payment plan within 30 days of the request, the hospital may proceed with collection efforts.
Bill Collection Limitations
Hospitals cannot pursue legal action for non-payment of a hospital bill against uninsured patients who have clearly demonstrated that they do not have sufficient income or assets to meet their financial obligations. To receive this protection, patients must provide the hospital with all of the reasonably requested financial information and documentation needed to determine the patient’s eligibility for financial assistance and payment plan options.
Notification of Out-of-Network Providers for Insured Patients
During hospital admission or as soon as is practicable, the hospital must provide insured patients with written notice that
- Patients may receive separate bills for services provided by health care professionals affiliated with the hospital.
- Some hospital staff members may not be participating providers in the same insurance plan and networks as the hospital.
- Patients may have a greater financial responsibility for services provided at the hospital by providers who are not under contract with their insurance plan.
- Patient questions about coverage or benefit levels should be directed to their insurance plan.
The Illinois Attorney General is responsible for administering and ensuring compliance with this law. For assistance to help deal with a billing or other health care dispute, patients may contact the Attorney General’s Health Care Bureau toll-free hotline at 1-877-305-5145 (TTY: 1-800-964-3013). Information is available on the Web at: www.IllinoisAttorneyGeneral.gov
The Fair Patient Billing Act is available online.
Language Assistance Services Act Summary
This law was passed to ensure access to health care information and services for limited-English-speaking, non-English-speaking and deaf patients whose primary language is sign language.
Health facilities are required to:
- Use interpreters that are fluent in English and the necessary language of the patient and can accurately speak, read, and readily interpret the necessary second language. Interpreters must be able to translate the names of body parts and to completely describe symptoms and injuries in both languages.
- Adopt and review annually a policy for providing language assistance services to patients with language or communication barriers. The policy shall include procedures for providing an interpreter where limited-English-speaking or non-English-speaking individuals constitute at least five percent of the patients served annually by the health facility.
- Post notices that advise patients about the availability of interpreters, the languages offered, the procedure for obtaining an interpreter, and a contact number to submit any complaints concerning interpreter services. The notices must be posted in the emergency room, the admitting area, the facility entrance, and the outpatient area.
- Inform employees of the language services available at the facility and that employees are required to make those services available.
Health facilities may do one or more of the following:
- Record the patient's primary language and dialect on the patient's medical chart, hospital bracelet, bedside notice, or nursing card,
- Prepare and maintain, as needed, a list of interpreters who are proficient in sign language and a list of languages of the population of the geographical area served by the facility.
- Review standardized written forms, waivers, documents, and informational materials available to patients on admission to determine which of the documents should be translated into languages other than English,
- Provide non-bilingual staff with standardized pictures and phrase sheets for use in routine communication with patients or residents who have language or communication barriers.
- Develop community liaison groups to enable the facility and the limited-English-speaking, non-English-speaking, and deaf communities to ensure the adequacy of the interpreter services.
Health Facility Language Assistance Services Complaints
A person who believes that the act or its rules may have been violated may submit a complaint to the Illinois Department of Public Health (IDPH) by calling the hotline at 800-252-4343 during regular business hours or address written complaints by mail to:
Illinois Department of Public Health
525 W. Jefferson Longterm Care CCR
Springfield, Illinois 62761-0001
Address email complaints to: firstname.lastname@example.org
View the Language Assistance Services Act here.