Here are answers to frequently asked questions about patient responsibilities, hospital notice provisions, and effective date and enforcement in the Hospital Uninsured Patient Discount Act.
Does a patient have to apply for the discount or should it be given automatically?
Nothing in the law prohibits a hospital from providing the specified discount to any uninsured patient. However, a hospital may require a patient to apply for the discount within 60 days of the date of discharge or date of service. Patients who may be eligible for coverage under public programs may be required to first apply to those programs.
What type of documentation must an uninsured patient supply?
Hospitals may require documentation of family income, Illinois residency and existence and value of assets owned by the patient as outlined in the Patient Eligibility. Hospitals may always be more generous with financial assistance and may choose to forgo documentation verification.
What are a hospital’s obligations if the patient fails to provide documentation or apply for public programs?
The hospital’s obligation toward an uninsured patient shall cease if the patient fails to provide the documentation requested or apply for coverage under public programs within 30 days of the hospital’s request.
What happens if a patient has not been fully truthful on the application?
The patient forfeits the discount and may be responsible for payment of the hospital’s full charges.
Hospital Notice Provisions
What notice provisions are included in this law?
The law requires:
“Each hospital bill, invoice, or other summary of charges to an uninsured patient shall include with it, or on it, a prominent statement that an uninsured patient who meets certain income requirements may qualify for an uninsured discount and information regarding how an uninsured patient may apply for consideration under the hospital’s financial assistance policy.”
It’s very similar to the notice requirement already in place under the Fair Patient Billing Act. Hospitals should verify that their current statement would cover the notice requirement under this law or modify such statement.
Effective Date and Enforcement
When is the law effective?
The effective date of Public Act 95-965 was effective April 1, 2009. The effective date of amendments to the law, Public Act 97-690, was June 14, 2012.
How will this bill be enforced?
The Attorney General’s Office will enforce the provisions in this law. The process will be complaint-driven and the Attorney General will investigate allegations of violations. If there is reason to believe a violation has occurred, the Attorney General will allow a hospital to submit a correction plan before bringing a civil action against the hospital to obtain injunctive relief. The Attorney General may fine hospitals if there has been a pattern or practice of not applying the proper discount and cap to the accounts of eligible uninsured patients.