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| Public Act 096-1126 | ||||
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AN ACT concerning professional regulation.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The Medical Practice Act of 1987 is amended by | ||||
changing Section 22.2 as follows: | ||||
(225 ILCS 60/22.2)
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(Section scheduled to be repealed on December 31, 2010) | ||||
Sec. 22.2. Prohibition against fee splitting. | ||||
(a) A licensee under this Act may not directly or | ||||
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 | ||
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; or | ||
(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 | ||
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 | ||
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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(Source: P.A. 96-608, eff. 8-24-09.)
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Section 99. Effective date. This Act takes effect upon | ||
becoming law.
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