Sec. 16. Screening patients for health insurance and financial assistance.

530 words·~2 min read·/il/chapter-210/act-88/16

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

(a)All hospitals shall screen each uninsured patient, upon the uninsured patient's agreement, at the earliest reasonable moment for potential eligibility for both:

(1)public health insurance programs; and

(2)any financial assistance offered by the hospital.

(b)All screening activities, including initial screenings and all follow-up assistance, must be provided in compliance with the Language Assistance Services Act.

(c)If a patient declines or fails to respond to the screening described in subsection (a), the hospital shall document in the patient's record the patient's decision to decline or failure to respond to the screening, confirming the date and method by which the patient declined or failed to respond.

(d)If a patient does not decline the screening described in subsection (a), a hospital should screen an uninsured patient during registration unless it would cause a delay of care to the patient, otherwise a hospital must screen an uninsured patient at the earliest reasonable moment.

(e)If a patient does not submit screening, financial assistance application, or reasonable payment plan documentation within 30 days after a request as required under Section 45, the hospital shall document the lack of received documentation, confirming the date that the screening took place and that the 30-day timeline for responding to the hospital's request has lapsed, but may be reopened within 90 days after the date of discharge, date of service, or completion of the screening.

(f)If the screening indicates that the patient may be eligible for a public health insurance program, the hospital shall provide information to the patient about how the patient can apply for the public health insurance program, including, but not limited to, referral to health care navigators who provide free and unbiased eligibility and enrollment assistance, including health care navigators at federally qualified health centers; local, State, or federal government agencies; or any other resources that Illinois recognizes as designed to assist uninsured individuals in obtaining health coverage.

(g)If the uninsured patient's application for a public health insurance program is approved, the hospital shall bill the insuring entity and shall not pursue the patient for any aspect of the bill, except for any required copayment, coinsurance, or other similar payment for which the patient is responsible under the insurance. If the uninsured patient's application for public health insurance is denied, the hospital shall again offer to screen the uninsured patient for hospital financial assistance and the timeline for applying for financial assistance under the Hospital Uninsured Patient Discount Act shall begin again.

(h)A hospital shall offer to screen an insured patient for hospital financial assistance under this Section if the patient requests financial assistance screening, if the hospital is contacted in response to a bill, if the hospital learns information that suggests an inability to pay, or if the circumstances otherwise suggest the patient's inability to pay.

(i)Any hospital that submits an annual hospital community benefits plan report to the Attorney General shall include in that report the number of uninsured patients who have declined or failed to respond to screening under subsection

(a)of Section 16 and the 5 most frequent reasons for declining.