Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 4500 - HOSPITAL FINANCIAL ASSISTANCE UNDER THE FAIR PATIENT BILLING ACT › Section 4500.10 - Definitions

Current through Register Vol. 48, No. 28, July 12, 2024
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).