Fair Patient Billing Act

On June 20, 2006, Gov. Blagojevich signed HB 4999, the Fair Patient Billing Act, into law to standardize billing and collection practices for all Illinois hospitals. It applies to services delivered on or after July 1, 2007.

There are four components of the law that require hospitals implementation:

  • Patient notification about financial assistance;
  • Bill information and inquiries;
  • Collection practices and limitations; and
  • Notification of out-of-network providers.

Nothing in this law imposes an obligation on hospitals to provide any particular service or treatment to an uninsured patient. However, your hospital’s policies on financial assistance, payment plan options and billing and collections should be reviewed in light of the requirements of this new law.

Below are frequently asked questions about the law and implementation issues to consider.

Financial Assistance FAQs

How must hospitals inform patients of their ability to apply for financial assistance?
Hospitals must:

  • Post signage in the admission and registration areas with the following language: “You may be eligible for financial assistance under the terms and conditions the hospital offers to qualified patients. For more information contact: XX.”
  • Make available either a brochure, application or other written material in the admission or registration area regarding financial assistance.
  • In a prominent place on your hospital’s website, post that financial assistance is available at the hospital, a description of the application process and a copy of the application.

Must the sign about financial assistance be in any foreign languages?
The sign must be in English and in any other language that is the primary language of at least 5% of the patients the hospital serves annually. This percentage is the same threshold that is found in the Language Assistance Act, which also applies to hospitals.

Hospital Billing FAQs

What information must now be on each patient bill?
Each patient bill must include the following six items:

  • Date(s) of service
  • Description of service
  • Amount owed
  • Hospital billing contact
  • Statement of how an uninsured patient may apply for consideration for financial assistance under the hospital’s financial assistance policy. This can be on separate page.
  • Notice of how to obtain an itemized bill upon request. For any request for an itemized statement, the hospital must provide both inpatient and outpatient service itemization.

How does the law affect billing inquiries?
Hospitals must have a process to address inquiries about and disputes over a hospital bill that includes a contact telephone number. This phone number must be included in all hospital bills and collection notices. The hospital must return calls made by the patient promptly, but in no later than two business days after the call is made. If the process involves correspondence, the hospital must respond within 10 business days of receipt of the patient’s letter.

Does the required response time mandate that the hospital resolve the inquiry within that period?
No. The Act requires a timely response but it does not impose a resolution timeframe.

What happens if the hospital inadvertently fails to respond to an inquiry within the required timeframe?
The law would only be violated if the hospital engages in a “pattern or practice” of failing to meet the required deadlines. An occasional or incidental failure should not rise to the level of a pattern or practice, but if the failures occur regularly over a period of time a violation may exist and result in fines.