Section 4500.10  Definitions

As used in this Part, the term:

"Act" means the Fair Patient Billing Act [210 ILCS 88].

"Critical Access Hospital" means a hospital that is designated as a critical access hospital under the federal Medicare Rural Hospital Flexibility Program (42 U.S.C. 1395i-4).

"Electronic and Information Technology" or "EIT" means electronic information, software, systems and equipment used in the creation, manipulation, storage, display or transmission of data, including Internet and intranet systems, software applications, operating systems, video and multimedia, telecommunications products, kiosks, information transaction machines, copiers, printers and desktop and portable computers.

"Family Income" means the sum of a family's annual earnings and cash benefits from all sources before taxes, less payments made for child support.

"Federal Poverty Income Guidelines" means the federal poverty guidelines updated periodically in the Federal Register by the United States Department of Health and Human Services under authority of 42 U.S.C. 9902(2) and available at https://aspe.hhs.gov/poverty-guidelines.

"Health Care Services" means any medically necessary inpatient or outpatient hospital service, including pharmaceuticals or supplies provided by a hospital to a patient.

"Hospital" means any facility or institution required to be licensed pursuant to the Hospital Licensing Act [210 ILCS 85] or operated under the University of Illinois Hospital Act [110 ILCS 330].

"Hospital Financial Assistance" means free or discounted health care services provided to patients who meet a hospital's criteria for financial assistance and are unable to pay for all or a portion of the health services. Hospital financial assistance does not include bad debt or uncollectible charges that the hospital recorded as revenue but wrote off due to a patient's failure to pay, or the cost of providing that care to patients; the difference between the cost of care provided under Medicaid or other means-tested government programs or under Medicare and the revenue derived from those programs; or contractual adjustments with any third party payors.

"Hospital Financial Assistance Application" means the form provided by a hospital and used by patients to apply for hospital financial assistance.

"Illinois Resident" means a person who lives in Illinois and who intends to remain living in Illinois indefinitely. Relocation to Illinois for the sole purpose of receiving health care benefits does not satisfy the residency requirement under this Part.

"Partner" means a person who has established a civil union pursuant to the Illinois Religious Freedom Protection and Civil Union Act [750 ILCS 75] or similar law.

"Patient" means the individual receiving services from the hospital or any individual who is the guarantor of the payment for services received from a hospital.

"Presumptive Eligibility" means eligibility for hospital financial assistance determined by reference to criteria demonstrating financial need on the part of a patient.

"Presumptive Eligibility Criteria" means the categories identified as demonstrating financial need on the part of a patient used by the hospital in the implementation of presumptive eligibility.

"Presumptive Eligibility Policy" means a written document that sets forth the presumptive eligibility criteria by which a patient's financial need is determined and used by the hospital to deem a patient eligible for hospital financial assistance without further scrutiny by the hospital.

"Rural Hospital" means a hospital that is located outside a metropolitan statistical area as defined by the United States Office of Management and Budget.

"Women, Infants and Children Nutrition Program" and "WIC" mean the federal Special Supplemental Nutrition Program for Women, Infants and Children authorized by section 17 of the Child Nutrition Act of 1966, as amended (42 U.S.C. 1786).

(Source:  Amended at 47 Ill. Reg. 1305, effective January 11, 2023)