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indirectly divide, share or split any professional fee or other |
form of compensation for professional services with anyone in |
exchange for a referral or otherwise, other than as provided in |
this Section 22.2. |
(b) Nothing contained in this Section abrogates the right |
of 2 or more licensed health care workers as defined in the |
Health Care Worker Self-referral Act to each receive adequate |
compensation for concurrently rendering services to a patient |
and to divide the fee for such service, provided that the |
patient has full knowledge of the division and the division is |
made in proportion to the actual services personally performed |
and responsibility assumed by each licensee consistent with his |
or her license, except as prohibited by law. |
(c) Nothing contained in this Section prohibits a licensee |
under this Act from practicing medicine through or within any |
form of legal entity authorized to conduct business in this |
State or from pooling, sharing, dividing, or apportioning the |
professional fees and other revenues in accordance with the |
agreements and policies of the entity provided: |
(1) each owner of the entity is licensed under this |
Act; |
(2) the entity is organized under the Medical |
Corporation Act, the Professional Services Corporation |
Act, the Professional Association Act, or the Limited |
Liability Company Act; |
(3) the entity is allowed by Illinois law to provide |
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physician services or employ physicians such as a licensed |
hospital or hospital affiliate or licensed ambulatory |
surgical treatment center owned in full or in part by |
Illinois-licensed physicians; |
(4) the entity is a combination or joint venture of the |
entities authorized under this subsection (c); or |
(5) the entity is an Illinois not for profit |
corporation that is recognized as exempt from the payment |
of federal income taxes as an organization described in |
Section 501(c)(3) of the Internal Revenue Code and all of |
its members are full-time faculty members of a medical |
school that offers a M.D. degree program that is accredited |
by the Liaison Committee on Medical Education and a program |
of graduate medical education that is accredited by the |
Accreditation Council for Graduate Medical Education. |
(d) Nothing contained in this Section prohibits a licensee |
under this Act from paying a fair market value fee to any |
person or entity whose purpose is to perform billing, |
administrative preparation, or collection services based upon |
a percentage of professional service fees billed or collected, |
a flat fee, or any other arrangement that directly or |
indirectly divides professional fees, for the administrative |
preparation of the licensee's claims or the collection of the |
licensee's charges for professional services, provided that: |
(i) the licensee or the licensee's practice under |
subsection (c) of this Section at all times controls the |
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amount of fees charged and collected; and |
(ii) all charges collected are paid directly to the |
licensee or the licensee's practice or are deposited |
directly into an account in the name of and under the sole |
control of the licensee or the licensee's practice or |
deposited into a "Trust Account" by a licensed collection |
agency in accordance with the requirements of Section 8(c) |
of the Illinois Collection Agency Act. |
(e) Nothing contained in this Section prohibits the |
granting of a security interest in the accounts receivable or |
fees of a licensee under this Act or the licensee's practice |
for bona fide advances made to the licensee or licensee's |
practice provided the licensee retains control and |
responsibility for the collection of the accounts receivable |
and fees. |
(f) Excluding payments that may be made to the owners of or |
licensees in the licensee's practice under subsection (c), a |
licensee under this Act may not divide, share or split a |
professional service fee with, or otherwise directly or |
indirectly pay a percentage of the licensee's professional |
service fees, revenues or profits to anyone for: (i) the |
marketing or management of the licensee's practice, (ii) |
including the licensee or the licensee's practice on any |
preferred provider list, (iii) allowing the licensee to |
participate in any network of health care providers, (iv) |
negotiating fees, charges or terms of service or payment on |
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behalf of the licensee, or (v) including the licensee in a |
program whereby patients or beneficiaries are provided an |
incentive to use the services of the licensee.
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(g) A violation of any of the provisions of this Section |
constitutes an unlawful practice under the Consumer Fraud and |
Deceptive Business Practices Act. All remedies, penalties, and |
authority granted to the Attorney General by the Consumer Fraud |
and Deceptive Business Practices Act shall be available to him |
or her for the enforcement of this Section. This subsection |
does not apply to hospitals and hospital affiliates licensed in |
Illinois. |
(Source: P.A. 96-608, eff. 8-24-09; 96-1126, eff. 7-20-10.)
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Section 10. The Consumer Fraud and Deceptive Business |
Practices Act is amended by adding Section 2VVV as follows:
|
(815 ILCS 505/2VVV new) |
Sec. 2VVV. Deceptive marketing, advertising, and sale of |
mental health disorder and substance use disorder treatment. |
(a) As used in this Section: |
"Facility" has the meaning ascribed to that term in Section |
1-10 of the Alcoholism and Other Drug Abuse and Dependency Act. |
"Hospital affiliate" has the meaning ascribed to that term |
in Section 10.8 of the Hospital Licensing Act. |
"Mental health disorder" has the same meaning as "mental |
illness" under Section 1-129 of the Mental Health and |
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Developmental Disabilities Code. |
"Program" has the meaning ascribed to that term in Section |
1-10 of the Alcoholism and Other Drug Abuse and Dependency Act. |
"Substance use disorder" has the same meaning as "substance |
abuse" under Section 1-10 of the Alcoholism and Other Drug |
Abuse and Dependency Act. |
"Treatment" has the meaning ascribed to that term in |
Section 1-10 of the Alcoholism and Other Drug Abuse and |
Dependency Act. |
(b) It is an unlawful practice for any person to engage in |
misleading or false advertising or promotion that |
misrepresents the need to seek mental health disorder or |
substance use disorder treatment outside of the State of |
Illinois. |
(c) Any marketing, advertising, promotional, or sales |
materials directed to Illinois residents concerning mental |
health disorder or substance use disorder treatment must: |
(1) prominently display or announce the full physical |
address of the treatment program or facility; |
(2) display whether the treatment program or facility |
is licensed in the State of Illinois; |
(3) display whether the treatment program or facility |
has locations in Illinois; |
(4) display whether the services provided by the |
treatment program or facility are covered by an insurance |
policy issued to an Illinois resident; |
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(5) display whether the treatment program or facility |
is an in-network or out-of-network provider; |
(6) include a link to the Internet website for the |
Department of Human Services' Division of Mental Health and |
Division of Alcoholism and Substance Abuse, or any |
successor State agency that provides information regarding |
licensed providers of services; and |
(7) disclose that mental health disorder and substance |
use disorder treatment may be available at a reduced cost |
or for free for Illinois residents within the State of |
Illinois. |
(d) It is an unlawful practice for any person to enter into |
an arrangement under which a patient seeking mental health |
disorder or substance use disorder treatment is referred to a |
mental health disorder or substance use disorder treatment |
program or facility in exchange for a fee, a percentage of the |
treatment program's or facility's revenues that are related to |
the patient, or any other remuneration that takes into account |
the volume or value of the referrals to the treatment program |
or facility. Such practice shall also be considered a violation |
of the prohibition against fee splitting in Section 22.2 of the |
Medical Practice Act of 1987 and a violation of the Health Care |
Worker Self-Referral Act. This Section does not apply to health |
insurance companies, health maintenance organizations, managed |
care plans, or organizations, including hospitals and hospital |
affiliates licensed in Illinois.
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