These are the legal provisions related to hospital financial assistance/charity care in the state of Illinois. This is intended for educational use and should not be treated as legal advice.
Is there a state charity care law?
Yes, Illinois has its own law.
Qualifications for charity care in Illinois
Does the law specify a minimum Federal Poverty Level (FPL) for charity care?
Illinois law specifies the minimum at 600% of the Federal Poverty Level.
Does the law specify a minimum deadline for applying for charity care?
Illinois's law regarding a minimum deadline is as follows: Illinois law requires a hospital to give an uninsured patient 90 days to apply. Under federal law non-profit hospitals must accept an applicaiton submitted within 240 days from when they sent the first post-discharge bill.
Does the law specify that having insurance disqualifies a patient for charity care?
Illinois law does not address this matter, so federal law would apply.
Federal law does not directly answer this. However, we think that federal law prohibits nonprofit hospitals from denying patients charity care because they are insured.
Does the law specify that patients must be residents to be eligible for charity care?
State charity care law requires patient to be an Illinois resident.
Does the law specify that patients must be US citizens or documented immigrants/lawful permanent residents to be eligible for charity care?
Illinois law does not address this matter, so federal law would apply.
Federal law does not directly answer this. However, we think that federal law prohibits nonprofit hospitals from denying patients charity care because of their immigration status.
Does the law specify that patients must owe a minimum bill amount in order to be eligible for charity care?
Under state law, the minimum bill must be $300 for rural or critical access hospitals or $150 for all other hospitals (except for with respect to emergency services conducted at non-profit hospitals under federal law).
How the law applies to copays in Illinois
Does the law specify that patients cannot be responsible for a copay if they are eligible for charity care?
Illinois prohibits requiring a copay for emergency services.
Does the law specify that hospitals cannot deny financial assistance to cover patient copays, coinsurance, or deductibles?
Illinois prohibits requiring a copay for emergency services.
Collections laws related to charity care in Illinois
Does the law specify that hospitals cannot deny financial assistance to cover patient copays, coinsurance, or deductibles?
A nonprofit hospital must have and follow its Billing and Collections policy. At a minimum it cannot sell a debt, refer it to a credit reporting bureau, or engage in a judicial process (such as filing a lawsuit or garnishing wages) for at least 120 days after it sent the patient the first post-discharge bill. Under Illinois state law, if you are uninsured and eligible for charity care, the hospital can only collect up 20% of your household income in a 12-month period.
Length of time charity care can be applied to future bills in Illinois
Does the law specify that hospitals must honor a charity care decision for future bills for a specific length of time?
Illinois law states that An eligible patient under Illinois state law cannot be charged more than 20% of their household income in a 12 month period, even if bills result from multiple stays at a hospital in that 12 month period.