Bill Text: IL SB2294 | 2023-2024 | 103rd General Assembly | Chaptered

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Bill Title: Amends the Illinois Health Information Exchange and Technology Act. Provides that the Act is repealed on July 1, 2023. Amends the Department of Healthcare and Family Services Law. Provides that staff employed by the Illinois Health Information Exchange Office (Office) on the effective date of the amendatory Act shall remain employed and continue their service within the Department of Healthcare and Family Services after the repeal of the Act and the dissolution of the Office. Provides that the status and rights of such employees shall not be affected by the repeal of the Act or the dissolution of the Office except that, notwithstanding any other State law to the contrary, those employees shall maintain their seniority and their positions shall convert to titles of a comparable organizational level under the Personnel Code and become subject to the Personnel Code. Provides that on the effective date of the amendatory Act, or as soon thereafter as practical, the State Comptroller shall direct and the State Treasurer shall transfer the remaining balance from the Health Information Exchange Fund to the General Revenue Fund; and that upon completion of the transfer, the Health Information Exchange Fund is dissolved, and any future deposits due to that Fund and any outstanding obligations or liabilities of that Fund shall pass to the General Revenue Fund. Removes all reference to the Illinois Health Information Exchange Office in various Acts. Amends the Administration Article of the Illinois Public Aid Code. Replaces references to the Long-Term Services and Supports Disparities Task Force with the Long-Term Services and Supports Disparities Workgroup. Provides that the Department of Healthcare and Family Services shall establish the Workgroup within the Medicaid Advisory Committee in accordance with certain federal requirements. Makes changes to provisions concerning the Workgroup's membership and duties. Effective July 1, 2023.

Spectrum: Partisan Bill (Democrat 2-0)

Status: (Passed) 2023-08-04 - Public Act . . . . . . . . . 103-0508 [SB2294 Detail]

Download: Illinois-2023-SB2294-Chaptered.html

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Public Act 103-0508
SB2294 Enrolled LRB103 26927 KTG 53291 b
AN ACT concerning State government.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 1. The Freedom of Information Act is amended by
changing Section 7.5 as follows:
(5 ILCS 140/7.5)
Sec. 7.5. Statutory exemptions. To the extent provided for
by the statutes referenced below, the following shall be
exempt from inspection and copying:
(a) All information determined to be confidential
under Section 4002 of the Technology Advancement and
Development Act.
(b) Library circulation and order records identifying
library users with specific materials under the Library
Records Confidentiality Act.
(c) Applications, related documents, and medical
records received by the Experimental Organ Transplantation
Procedures Board and any and all documents or other
records prepared by the Experimental Organ Transplantation
Procedures Board or its staff relating to applications it
has received.
(d) Information and records held by the Department of
Public Health and its authorized representatives relating

to known or suspected cases of sexually transmissible
disease or any information the disclosure of which is
restricted under the Illinois Sexually Transmissible
Disease Control Act.
(e) Information the disclosure of which is exempted
under Section 30 of the Radon Industry Licensing Act.
(f) Firm performance evaluations under Section 55 of
the Architectural, Engineering, and Land Surveying
Qualifications Based Selection Act.
(g) Information the disclosure of which is restricted
and exempted under Section 50 of the Illinois Prepaid
Tuition Act.
(h) Information the disclosure of which is exempted
under the State Officials and Employees Ethics Act, and
records of any lawfully created State or local inspector
general's office that would be exempt if created or
obtained by an Executive Inspector General's office under
that Act.
(i) Information contained in a local emergency energy
plan submitted to a municipality in accordance with a
local emergency energy plan ordinance that is adopted
under Section 11-21.5-5 of the Illinois Municipal Code.
(j) Information and data concerning the distribution
of surcharge moneys collected and remitted by carriers
under the Emergency Telephone System Act.
(k) Law enforcement officer identification information

or driver identification information compiled by a law
enforcement agency or the Department of Transportation
under Section 11-212 of the Illinois Vehicle Code.
(l) Records and information provided to a residential
health care facility resident sexual assault and death
review team or the Executive Council under the Abuse
Prevention Review Team Act.
(m) Information provided to the predatory lending
database created pursuant to Article 3 of the Residential
Real Property Disclosure Act, except to the extent
authorized under that Article.
(n) Defense budgets and petitions for certification of
compensation and expenses for court appointed trial
counsel as provided under Sections 10 and 15 of the
Capital Crimes Litigation Act. This subsection (n) shall
apply until the conclusion of the trial of the case, even
if the prosecution chooses not to pursue the death penalty
prior to trial or sentencing.
(o) Information that is prohibited from being
disclosed under Section 4 of the Illinois Health and
Hazardous Substances Registry Act.
(p) Security portions of system safety program plans,
investigation reports, surveys, schedules, lists, data, or
information compiled, collected, or prepared by or for the
Department of Transportation under Sections 2705-300 and
2705-616 of the Department of Transportation Law of the

Civil Administrative Code of Illinois, the Regional
Transportation Authority under Section 2.11 of the
Regional Transportation Authority Act, or the St. Clair
County Transit District under the Bi-State Transit Safety
Act.
(q) Information prohibited from being disclosed by the
Personnel Record Review Act.
(r) Information prohibited from being disclosed by the
Illinois School Student Records Act.
(s) Information the disclosure of which is restricted
under Section 5-108 of the Public Utilities Act.
(t) (Blank). All identified or deidentified health
information in the form of health data or medical records
contained in, stored in, submitted to, transferred by, or
released from the Illinois Health Information Exchange,
and identified or deidentified health information in the
form of health data and medical records of the Illinois
Health Information Exchange in the possession of the
Illinois Health Information Exchange Office due to its
administration of the Illinois Health Information
Exchange. The terms "identified" and "deidentified" shall
be given the same meaning as in the Health Insurance
Portability and Accountability Act of 1996, Public Law
104-191, or any subsequent amendments thereto, and any
regulations promulgated thereunder.
(u) Records and information provided to an independent

team of experts under the Developmental Disability and
Mental Health Safety Act (also known as Brian's Law).
(v) Names and information of people who have applied
for or received Firearm Owner's Identification Cards under
the Firearm Owners Identification Card Act or applied for
or received a concealed carry license under the Firearm
Concealed Carry Act, unless otherwise authorized by the
Firearm Concealed Carry Act; and databases under the
Firearm Concealed Carry Act, records of the Concealed
Carry Licensing Review Board under the Firearm Concealed
Carry Act, and law enforcement agency objections under the
Firearm Concealed Carry Act.
(v-5) Records of the Firearm Owner's Identification
Card Review Board that are exempted from disclosure under
Section 10 of the Firearm Owners Identification Card Act.
(w) Personally identifiable information which is
exempted from disclosure under subsection (g) of Section
19.1 of the Toll Highway Act.
(x) Information which is exempted from disclosure
under Section 5-1014.3 of the Counties Code or Section
8-11-21 of the Illinois Municipal Code.
(y) Confidential information under the Adult
Protective Services Act and its predecessor enabling
statute, the Elder Abuse and Neglect Act, including
information about the identity and administrative finding
against any caregiver of a verified and substantiated

decision of abuse, neglect, or financial exploitation of
an eligible adult maintained in the Registry established
under Section 7.5 of the Adult Protective Services Act.
(z) Records and information provided to a fatality
review team or the Illinois Fatality Review Team Advisory
Council under Section 15 of the Adult Protective Services
Act.
(aa) Information which is exempted from disclosure
under Section 2.37 of the Wildlife Code.
(bb) Information which is or was prohibited from
disclosure by the Juvenile Court Act of 1987.
(cc) Recordings made under the Law Enforcement
Officer-Worn Body Camera Act, except to the extent
authorized under that Act.
(dd) Information that is prohibited from being
disclosed under Section 45 of the Condominium and Common
Interest Community Ombudsperson Act.
(ee) Information that is exempted from disclosure
under Section 30.1 of the Pharmacy Practice Act.
(ff) Information that is exempted from disclosure
under the Revised Uniform Unclaimed Property Act.
(gg) Information that is prohibited from being
disclosed under Section 7-603.5 of the Illinois Vehicle
Code.
(hh) Records that are exempt from disclosure under
Section 1A-16.7 of the Election Code.

(ii) Information which is exempted from disclosure
under Section 2505-800 of the Department of Revenue Law of
the Civil Administrative Code of Illinois.
(jj) Information and reports that are required to be
submitted to the Department of Labor by registering day
and temporary labor service agencies but are exempt from
disclosure under subsection (a-1) of Section 45 of the Day
and Temporary Labor Services Act.
(kk) Information prohibited from disclosure under the
Seizure and Forfeiture Reporting Act.
(ll) Information the disclosure of which is restricted
and exempted under Section 5-30.8 of the Illinois Public
Aid Code.
(mm) Records that are exempt from disclosure under
Section 4.2 of the Crime Victims Compensation Act.
(nn) Information that is exempt from disclosure under
Section 70 of the Higher Education Student Assistance Act.
(oo) Communications, notes, records, and reports
arising out of a peer support counseling session
prohibited from disclosure under the First Responders
Suicide Prevention Act.
(pp) Names and all identifying information relating to
an employee of an emergency services provider or law
enforcement agency under the First Responders Suicide
Prevention Act.
(qq) Information and records held by the Department of

Public Health and its authorized representatives collected
under the Reproductive Health Act.
(rr) Information that is exempt from disclosure under
the Cannabis Regulation and Tax Act.
(ss) Data reported by an employer to the Department of
Human Rights pursuant to Section 2-108 of the Illinois
Human Rights Act.
(tt) Recordings made under the Children's Advocacy
Center Act, except to the extent authorized under that
Act.
(uu) Information that is exempt from disclosure under
Section 50 of the Sexual Assault Evidence Submission Act.
(vv) Information that is exempt from disclosure under
subsections (f) and (j) of Section 5-36 of the Illinois
Public Aid Code.
(ww) Information that is exempt from disclosure under
Section 16.8 of the State Treasurer Act.
(xx) Information that is exempt from disclosure or
information that shall not be made public under the
Illinois Insurance Code.
(yy) Information prohibited from being disclosed under
the Illinois Educational Labor Relations Act.
(zz) Information prohibited from being disclosed under
the Illinois Public Labor Relations Act.
(aaa) Information prohibited from being disclosed
under Section 1-167 of the Illinois Pension Code.

(bbb) Information that is prohibited from disclosure
by the Illinois Police Training Act and the Illinois State
Police Act.
(ccc) Records exempt from disclosure under Section
2605-304 of the Illinois State Police Law of the Civil
Administrative Code of Illinois.
(ddd) Information prohibited from being disclosed
under Section 35 of the Address Confidentiality for
Victims of Domestic Violence, Sexual Assault, Human
Trafficking, or Stalking Act.
(eee) Information prohibited from being disclosed
under subsection (b) of Section 75 of the Domestic
Violence Fatality Review Act.
(fff) Images from cameras under the Expressway Camera
Act. This subsection (fff) is inoperative on and after
July 1, 2023.
(ggg) Information prohibited from disclosure under
paragraph (3) of subsection (a) of Section 14 of the Nurse
Agency Licensing Act.
(hhh) Information submitted to the Department of State
Police in an affidavit or application for an assault
weapon endorsement, assault weapon attachment endorsement,
.50 caliber rifle endorsement, or .50 caliber cartridge
endorsement under the Firearm Owners Identification Card
Act.
(Source: P.A. 101-13, eff. 6-12-19; 101-27, eff. 6-25-19;

101-81, eff. 7-12-19; 101-221, eff. 1-1-20; 101-236, eff.
1-1-20; 101-375, eff. 8-16-19; 101-377, eff. 8-16-19; 101-452,
eff. 1-1-20; 101-466, eff. 1-1-20; 101-600, eff. 12-6-19;
101-620, eff 12-20-19; 101-649, eff. 7-7-20; 101-652, eff.
1-1-22; 101-656, eff. 3-23-21; 102-36, eff. 6-25-21; 102-237,
eff. 1-1-22; 102-292, eff. 1-1-22; 102-520, eff. 8-20-21;
102-559, eff. 8-20-21; 102-813, eff. 5-13-22; 102-946, eff.
7-1-22; 102-1042, eff. 6-3-22; 102-1116, eff. 1-10-23.)
Section 5. The Department of Healthcare and Family
Services Law is amended by adding Section 2205-40 as follows:
(20 ILCS 2205/2205-40 new)
Sec. 2205-40. Dissolution of the Health Information
Exchange Office and Fund.
(a) Staff employed by the Illinois Health Information
Exchange Office (Office) on the effective date of this
amendatory Act of the 103rd General Assembly shall remain
employed and continue their service within the Department of
Healthcare and Family Services after the repeal of the
Illinois Health Information Exchange and Technology Act and
the cessation or dissolution of the Office. The status and
rights of such employees shall not be affected by the repeal of
the Illinois Health Information Exchange and Technology Act or
the cessation of the Office except that, notwithstanding any
other State law to the contrary, those employees shall

maintain their seniority and their positions shall convert to
titles of comparable organizational level under the Personnel
Code and become subject to the Personnel Code. Other than the
changes described in this paragraph, the rights of employees,
the State of Illinois, and State agencies under the Personnel
Code or under any pension, retirement, or annuity plan shall
not be affected by this amendatory Act of the 103rd General
Assembly.
(b) Notwithstanding any other provision of law to the
contrary, and in addition to any other transfers that may be
provided by law, on the effective date of this amendatory Act
of the 103rd General Assembly, or as soon thereafter as
practical, the State Comptroller shall direct and the State
Treasurer shall transfer the remaining balance from the Health
Information Exchange Fund to the General Revenue Fund. Upon
completion of the transfer, the Health Information Exchange
Fund is dissolved, and any future deposits due to that Fund and
any outstanding obligations or liabilities of that Fund shall
pass to the General Revenue Fund.
Section 10. The Illinois Health Information Exchange and
Technology Act is amended by changing Section 997 as follows:
(20 ILCS 3860/997)
(Section scheduled to be repealed on January 1, 2027)
Sec. 997. Repealer. This Act is repealed on July 1, 2023

January 1, 2027.
(Source: P.A. 102-43, eff. 7-6-21.)
Section 15. The Illinois Public Aid Code is amended by
changing Section 12-4.48 as follows:
(305 ILCS 5/12-4.48)
Sec. 12-4.48. Long-Term Services and Supports Disparities
Workgroup Task Force.
(a) The Department of Healthcare and Family Services shall
establish a Long-Term Services and Supports Disparities
Workgroup of the Medicaid Advisory Committee in accordance
with the requirements of 42 CFR 431.12 Task Force.
(b) Members of the Workgroup Task Force shall be appointed
by the Director of the Department of Healthcare and Family
Services and may shall include representatives of the
following agencies, organizations, or groups:
(1) (Blank). The Governor's office.
(2) (Blank). The Department of Healthcare and Family
Services.
(3) (Blank). The Department of Human Services.
(4) (Blank). The Department on Aging.
(5) (Blank). The Department of Human Rights.
(6) (Blank). Area Agencies on Aging.
(7) (Blank). The Department of Public Health.
(8) Managed Care Plans.

(9) The for-profit urban nursing home or assisted
living industry.
(10) The for-profit rural nursing home or assisted
living industry.
(11) The not-for-profit nursing home or assisted
living industry.
(12) The home care association or home care industry.
(13) The adult day care association or adult day care
industry.
(14) An association representing workers who provide
long-term services and supports.
(15) A representative of providers that serve the
predominantly ethnic minority populations.
(16) Case Management Organizations.
(17) Three consumer representatives which may include
a consumer of long-term services and supports or an
individual who advocates for such consumers. For purposes
of this provision, "consumer representative" means a
person who is not an elected official and who has no
financial interest in a health or long-term care delivery
system.
(b-5) In addition, one representative from each of the
following may serve ex officio: the Governor's Office; the
Department of Healthcare and Family Services; the Department
of Human Services; the Department on Aging; the Department of
Public Health; and the Department of Human Rights.

(c) The Workgroup The Task Force shall not meet unless all
consumer representative positions are filled. The Task Force
shall reflect diversity in race, ethnicity, and gender.
(d) The Chair of the Workgroup Task Force shall be
appointed by the Director of the Department of Healthcare and
Family Services.
(e) The Director of the Department of Healthcare and
Family Services shall assign appropriate staff and resources
to support the efforts of the Workgroup. The Workgroup Task
Force. The Task Force shall meet as often as necessary but not
less than 4 times per calendar year.
(f) The Workgroup Task Force shall promote and facilitate
communication, coordination, and collaboration among relevant
State agencies and communities of color, limited
English-speaking communities, and the private and public
entities providing services to those communities.
(g) The Workgroup Task Force shall do all of the
following:
(1) Document the number and types of Long-Term
Services and Supports (LTSS) providers in the State and
the number of clients served in each setting.
(2) Document the number and racial profiles of
residents using LTSS, including, but not limited to,
residential nursing facilities, assisted living
facilities, adult day care, home health services, and
other home and community based long-term care services.

(3) Document the number and profiles of family or
informal caregivers who provide care for minority elders.
(4) Compare data over multiple years to identify
trends in the delivery of LTSS for each racial or ethnic
category including: Alaskan Native or American Indian,
Asian or Pacific Islander, black or African American,
Hispanic, or white.
(5) Identify any racial disparities in the provision
of care in various LTSS settings and determine factors
that might influence the disparities found.
(6) Identify any disparities uniquely experienced in
metropolitan or rural areas and make recommendations to
address these areas.
(7) Assess whether the LTSS industry, including
managed care plans and independent providers, is equipped
to offer culturally sensitive, competent, and
linguistically appropriate care to meet the needs of a
diverse aging population and their informal and formal
caregivers.
(8) Consider whether to recommend that the State
require all home and community based services as a
condition of licensure to report data similar to that
gathered under the Minimum Data Set and required when a
new resident is admitted to a nursing home.
(9) Identify and prioritize recommendations for
actions to be taken by the State to address disparity

issues identified in the course of these studies.
(10) Monitor the progress of the State in eliminating
racial disparities in the delivery of LTSS.
(h) The Workgroup may Task Force shall conduct public
hearings, inquiries, studies, and other forms of information
gathering to identify how the actions of State government
contribute to or reduce racial disparities in long-term care
settings.
(i) The Workgroup Task Force shall report its findings and
recommendations to the Governor and the General Assembly with
annual no later than one year after the effective date of this
amendatory Act of the 98th General Assembly. Annual reports
shall be issued every year thereafter and shall include
documentation of progress made to eliminate disparities in
long-term care service settings.
(Source: P.A. 98-825, eff. 8-1-14; 99-78, eff. 7-20-15.)
Section 20. The Medical Patient Rights Act is amended by
changing Section 3 as follows:
(410 ILCS 50/3) (from Ch. 111 1/2, par. 5403)
Sec. 3. The following rights are hereby established:
(a) The right of each patient to care consistent with
sound nursing and medical practices, to be informed of the
name of the physician responsible for coordinating his or
her care, to receive information concerning his or her

condition and proposed treatment, to refuse any treatment
to the extent permitted by law, and to privacy and
confidentiality of records except as otherwise provided by
law.
(b) The right of each patient, regardless of source of
payment, to examine and receive a reasonable explanation
of his total bill for services rendered by his physician
or health care provider, including the itemized charges
for specific services received. Each physician or health
care provider shall be responsible only for a reasonable
explanation of those specific services provided by such
physician or health care provider.
(c) In the event an insurance company or health
services corporation cancels or refuses to renew an
individual policy or plan, the insured patient shall be
entitled to timely, prior notice of the termination of
such policy or plan.
An insurance company or health services corporation
that requires any insured patient or applicant for new or
continued insurance or coverage to be tested for infection
with human immunodeficiency virus (HIV) or any other
identified causative agent of acquired immunodeficiency
syndrome (AIDS) shall (1) give the patient or applicant
prior written notice of such requirement, (2) proceed with
such testing only upon the written authorization of the
applicant or patient, and (3) keep the results of such

testing confidential. Notice of an adverse underwriting or
coverage decision may be given to any appropriately
interested party, but the insurer may only disclose the
test result itself to a physician designated by the
applicant or patient, and any such disclosure shall be in
a manner that assures confidentiality.
The Department of Insurance shall enforce the
provisions of this subsection.
(d) The right of each patient to privacy and
confidentiality in health care. Each physician, health
care provider, health services corporation and insurance
company shall refrain from disclosing the nature or
details of services provided to patients, except that such
information may be disclosed: (1) to the patient, (2) to
the party making treatment decisions if the patient is
incapable of making decisions regarding the health
services provided, (3) for treatment in accordance with 45
CFR 164.501 and 164.506, (4) for payment in accordance
with 45 CFR 164.501 and 164.506, (5) to those parties
responsible for peer review, utilization review, and
quality assurance, (6) for health care operations in
accordance with 45 CFR 164.501 and 164.506, (7) to those
parties required to be notified under the Abused and
Neglected Child Reporting Act or the Illinois Sexually
Transmissible Disease Control Act, or (8) as otherwise
permitted, authorized, or required by State or federal

law. This right may be waived in writing by the patient or
the patient's guardian or legal representative, but a
physician or other health care provider may not condition
the provision of services on the patient's, guardian's, or
legal representative's agreement to sign such a waiver. In
the interest of public health, safety, and welfare,
patient information, including, but not limited to, health
information, demographic information, and information
about the services provided to patients, may be
transmitted to or through a health information exchange,
as that term is defined in Section 2 of the Mental Health
and Developmental Disabilities Confidentiality Act, in
accordance with the disclosures permitted pursuant to this
Section. Patients shall be provided the opportunity to opt
out of their health information being transmitted to or
through a health information exchange in accordance with
the regulations, standards, or contractual obligations
adopted by the Illinois Health Information Exchange Office
in accordance with Section 9.6 of the Mental Health and
Developmental Disabilities Confidentiality Act, Section
9.6 of the AIDS Confidentiality Act, or Section 31.8 of
the Genetic Information Privacy Act, as applicable. In the
case of a patient choosing to opt out of having his or her
information available on an HIE, nothing in this Act shall
cause the physician or health care provider to be liable
for the release of a patient's health information by other

entities that may possess such information, including, but
not limited to, other health professionals, providers,
laboratories, pharmacies, hospitals, ambulatory surgical
centers, and nursing homes.
(Source: P.A. 101-649, eff. 7-7-20.)
Section 25. The AIDS Confidentiality Act is amended by
changing Section 3 as follows:
(410 ILCS 305/3) (from Ch. 111 1/2, par. 7303)
Sec. 3. Definitions. When used in this Act:
(a) "AIDS" means acquired immunodeficiency syndrome.
(b) "Authority" means the Illinois Health Information
Exchange Authority established pursuant to the Illinois Health
Information Exchange and Technology Act.
(c) "Business associate" has the meaning ascribed to it
under HIPAA, as specified in 45 CFR 160.103.
(d) "Covered entity" has the meaning ascribed to it under
HIPAA, as specified in 45 CFR 160.103.
(e) "De-identified information" means health information
that is not individually identifiable as described under
HIPAA, as specified in 45 CFR 164.514(b).
(f) "Department" means the Illinois Department of Public
Health or its designated agents.
(g) "Disclosure" has the meaning ascribed to it under
HIPAA, as specified in 45 CFR 160.103.

(h) "Health care operations" has the meaning ascribed to
it under HIPAA, as specified in 45 CFR 164.501.
(i) "Health care professional" means (i) a licensed
physician, (ii) a licensed physician assistant, (iii) a
licensed advanced practice registered nurse, (iv) an advanced
practice registered nurse or physician assistant who practices
in a hospital or ambulatory surgical treatment center and
possesses appropriate clinical privileges, (v) a licensed
dentist, (vi) a licensed podiatric physician, or (vii) an
individual certified to provide HIV testing and counseling by
a state or local public health department.
(j) "Health care provider" has the meaning ascribed to it
under HIPAA, as specified in 45 CFR 160.103.
(k) "Health facility" means a hospital, nursing home,
blood bank, blood center, sperm bank, or other health care
institution, including any "health facility" as that term is
defined in the Illinois Finance Authority Act.
(l) "Health information exchange" or "HIE" means a health
information exchange or health information organization that
oversees and governs the electronic exchange of health
information that (i) is established pursuant to the Illinois
Health Information Exchange and Technology Act, or any
subsequent amendments thereto, and any administrative rules
adopted thereunder; (ii) has established a data sharing
arrangement with the Authority; or (iii) as of August 16,
2013, was designated by the Authority Board as a member of, or

was represented on, the Authority Board's Regional Health
Information Exchange Workgroup; provided that such designation
shall not require the establishment of a data sharing
arrangement or other participation with the Illinois Health
Information Exchange or the payment of any fee. In certain
circumstances, in accordance with HIPAA, an HIE will be a
business associate.
(m) "Health oversight agency" has the meaning ascribed to
it under HIPAA, as specified in 45 CFR 164.501.
(n) "HIPAA" means the Health Insurance Portability and
Accountability Act of 1996, Public Law 104-191, as amended by
the Health Information Technology for Economic and Clinical
Health Act of 2009, Public Law 111-05, and any subsequent
amendments thereto and any regulations promulgated thereunder.
(o) "HIV" means the human immunodeficiency virus.
(p) "HIV-related information" means the identity of a
person upon whom an HIV test is performed, the results of an
HIV test, as well as diagnosis, treatment, and prescription
information that reveals a patient is HIV-positive, including
such information contained in a limited data set. "HIV-related
information" does not include information that has been
de-identified in accordance with HIPAA.
(q) "Informed consent" means:
(1) where a health care provider, health care
professional, or health facility has implemented opt-in
testing, a process by which an individual or their legal

representative receives pre-test information, has an
opportunity to ask questions, and consents verbally or in
writing to the test without undue inducement or any
element of force, fraud, deceit, duress, or other form of
constraint or coercion; or
(2) where a health care provider, health care
professional, or health facility has implemented opt-out
testing, the individual or their legal representative has
been notified verbally or in writing that the test is
planned, has received pre-test information, has been given
the opportunity to ask questions and the opportunity to
decline testing, and has not declined testing; where such
notice is provided, consent for opt-out HIV testing may be
incorporated into the patient's general consent for
medical care on the same basis as are other screening or
diagnostic tests; a separate consent for opt-out HIV
testing is not required.
In addition, where the person providing informed consent
is a participant in an HIE, informed consent requires a fair
explanation that the results of the patient's HIV test will be
accessible through an HIE and meaningful disclosure of the
patient's opt-out right under Section 9.6 of this Act.
A health care provider, health care professional, or
health facility undertaking an informed consent process for
HIV testing under this subsection may combine a form used to
obtain informed consent for HIV testing with forms used to

obtain written consent for general medical care or any other
medical test or procedure, provided that the forms make it
clear that the subject may consent to general medical care,
tests, or procedures without being required to consent to HIV
testing, and clearly explain how the subject may decline HIV
testing. Health facility clerical staff or other staff
responsible for the consent form for general medical care may
obtain consent for HIV testing through a general consent form.
(r) "Limited data set" has the meaning ascribed to it
under HIPAA, as described in 45 CFR 164.514(e)(2).
(s) "Minimum necessary" means the HIPAA standard for
using, disclosing, and requesting protected health information
found in 45 CFR 164.502(b) and 164.514(d).
(s-1) "Opt-in testing" means an approach where an HIV test
is presented by offering the test and the patient accepts or
declines testing.
(s-3) "Opt-out testing" means an approach where an HIV
test is presented such that a patient is notified that HIV
testing may occur unless the patient declines.
(t) "Organized health care arrangement" has the meaning
ascribed to it under HIPAA, as specified in 45 CFR 160.103.
(u) "Patient safety activities" has the meaning ascribed
to it under 42 CFR 3.20.
(v) "Payment" has the meaning ascribed to it under HIPAA,
as specified in 45 CFR 164.501.
(w) "Person" includes any natural person, partnership,

association, joint venture, trust, governmental entity, public
or private corporation, health facility, or other legal
entity.
(w-5) "Pre-test information" means:
(1) a reasonable explanation of the test, including
its purpose, potential uses, limitations, and the meaning
of its results; and
(2) a reasonable explanation of the procedures to be
followed, including the voluntary nature of the test, the
availability of a qualified person to answer questions,
the right to withdraw consent to the testing process at
any time, the right to anonymity to the extent provided by
law with respect to participation in the test and
disclosure of test results, and the right to confidential
treatment of information identifying the subject of the
test and the results of the test, to the extent provided by
law.
Pre-test information may be provided in writing, verbally,
or by video, electronic, or other means and may be provided as
designated by the supervising health care professional or the
health facility.
For the purposes of this definition, a qualified person to
answer questions is a health care professional or, when acting
under the supervision of a health care professional, a
registered nurse, medical assistant, or other person
determined to be sufficiently knowledgeable about HIV testing,

its purpose, potential uses, limitations, the meaning of the
test results, and the testing procedures in the professional
judgment of a supervising health care professional or as
designated by a health care facility.
(x) "Protected health information" has the meaning
ascribed to it under HIPAA, as specified in 45 CFR 160.103.
(y) "Research" has the meaning ascribed to it under HIPAA,
as specified in 45 CFR 164.501.
(z) "State agency" means an instrumentality of the State
of Illinois and any instrumentality of another state that,
pursuant to applicable law or a written undertaking with an
instrumentality of the State of Illinois, is bound to protect
the privacy of HIV-related information of Illinois persons.
(aa) "Test" or "HIV test" means a test to determine the
presence of the antibody or antigen to HIV, or of HIV
infection.
(bb) "Treatment" has the meaning ascribed to it under
HIPAA, as specified in 45 CFR 164.501.
(cc) "Use" has the meaning ascribed to it under HIPAA, as
specified in 45 CFR 160.103, where context dictates.
(Source: P.A. 99-54, eff. 1-1-16; 99-173, eff. 7-29-15;
99-642, eff. 7-28-16; 100-513, eff. 1-1-18.)
Section 30. The Genetic Information Privacy Act is amended
by changing Section 10 as follows:

(410 ILCS 513/10)
Sec. 10. Definitions. As used in this Act:
"Office" means the Illinois Health Information Exchange
Office established pursuant to the Illinois Health Information
Exchange and Technology Act.
"Business associate" has the meaning ascribed to it under
HIPAA, as specified in 45 CFR 160.103.
"Covered entity" has the meaning ascribed to it under
HIPAA, as specified in 45 CFR 160.103.
"De-identified information" means health information that
is not individually identifiable as described under HIPAA, as
specified in 45 CFR 164.514(b).
"Disclosure" has the meaning ascribed to it under HIPAA,
as specified in 45 CFR 160.103.
"Employer" means the State of Illinois, any unit of local
government, and any board, commission, department,
institution, or school district, any party to a public
contract, any joint apprenticeship or training committee
within the State, and every other person employing employees
within the State.
"Employment agency" means both public and private
employment agencies and any person, labor organization, or
labor union having a hiring hall or hiring office regularly
undertaking, with or without compensation, to procure
opportunities to work, or to procure, recruit, refer, or place
employees.

"Family member" means, with respect to an individual, (i)
the spouse of the individual; (ii) a dependent child of the
individual, including a child who is born to or placed for
adoption with the individual; (iii) any other person
qualifying as a covered dependent under a managed care plan;
and (iv) all other individuals related by blood or law to the
individual or the spouse or child described in subsections (i)
through (iii) of this definition.
"Genetic information" has the meaning ascribed to it under
HIPAA, as specified in 45 CFR 160.103.
"Genetic monitoring" means the periodic examination of
employees to evaluate acquired modifications to their genetic
material, such as chromosomal damage or evidence of increased
occurrence of mutations that may have developed in the course
of employment due to exposure to toxic substances in the
workplace in order to identify, evaluate, and respond to
effects of or control adverse environmental exposures in the
workplace.
"Genetic services" has the meaning ascribed to it under
HIPAA, as specified in 45 CFR 160.103.
"Genetic testing" and "genetic test" have the meaning
ascribed to "genetic test" under HIPAA, as specified in 45 CFR
160.103. "Genetic testing" includes direct-to-consumer
commercial genetic testing.
"Health care operations" has the meaning ascribed to it
under HIPAA, as specified in 45 CFR 164.501.

"Health care professional" means (i) a licensed physician,
(ii) a licensed physician assistant, (iii) a licensed advanced
practice registered nurse, (iv) a licensed dentist, (v) a
licensed podiatrist, (vi) a licensed genetic counselor, or
(vii) an individual certified to provide genetic testing by a
state or local public health department.
"Health care provider" has the meaning ascribed to it
under HIPAA, as specified in 45 CFR 160.103.
"Health facility" means a hospital, blood bank, blood
center, sperm bank, or other health care institution,
including any "health facility" as that term is defined in the
Illinois Finance Authority Act.
"Health information exchange" or "HIE" means a health
information exchange or health information organization that
exchanges health information electronically that (i) is
established pursuant to the Illinois Health Information
Exchange and Technology Act, or any subsequent amendments
thereto, and any administrative rules promulgated thereunder;
(ii) has established a data sharing arrangement with the
Office; or (iii) as of August 16, 2013, was designated by the
Illinois Health Information Exchange Authority (now Office)
Board as a member of, or was represented on, the Authority
Board's Regional Health Information Exchange Workgroup;
provided that such designation shall not require the
establishment of a data sharing arrangement or other
participation with the Illinois Health Information Exchange or

the payment of any fee. In certain circumstances, in
accordance with HIPAA, an HIE will be a business associate.
"Health oversight agency" has the meaning ascribed to it
under HIPAA, as specified in 45 CFR 164.501.
"HIPAA" means the Health Insurance Portability and
Accountability Act of 1996, Public Law 104-191, as amended by
the Health Information Technology for Economic and Clinical
Health Act of 2009, Public Law 111-05, and any subsequent
amendments thereto and any regulations promulgated thereunder.
"Insurer" means (i) an entity that is subject to the
jurisdiction of the Director of Insurance and (ii) a managed
care plan.
"Labor organization" includes any organization, labor
union, craft union, or any voluntary unincorporated
association designed to further the cause of the rights of
union labor that is constituted for the purpose, in whole or in
part, of collective bargaining or of dealing with employers
concerning grievances, terms or conditions of employment, or
apprenticeships or applications for apprenticeships, or of
other mutual aid or protection in connection with employment,
including apprenticeships or applications for apprenticeships.
"Licensing agency" means a board, commission, committee,
council, department, or officers, except a judicial officer,
in this State or any political subdivision authorized to
grant, deny, renew, revoke, suspend, annul, withdraw, or amend
a license or certificate of registration.

"Limited data set" has the meaning ascribed to it under
HIPAA, as described in 45 CFR 164.514(e)(2).
"Managed care plan" means a plan that establishes,
operates, or maintains a network of health care providers that
have entered into agreements with the plan to provide health
care services to enrollees where the plan has the ultimate and
direct contractual obligation to the enrollee to arrange for
the provision of or pay for services through:
(1) organizational arrangements for ongoing quality
assurance, utilization review programs, or dispute
resolution; or
(2) financial incentives for persons enrolled in the
plan to use the participating providers and procedures
covered by the plan.
A managed care plan may be established or operated by any
entity including a licensed insurance company, hospital or
medical service plan, health maintenance organization, limited
health service organization, preferred provider organization,
third party administrator, or an employer or employee
organization.
"Minimum necessary" means HIPAA's standard for using,
disclosing, and requesting protected health information found
in 45 CFR 164.502(b) and 164.514(d).
"Nontherapeutic purpose" means a purpose that is not
intended to improve or preserve the life or health of the
individual whom the information concerns.

"Organized health care arrangement" has the meaning
ascribed to it under HIPAA, as specified in 45 CFR 160.103.
"Patient safety activities" has the meaning ascribed to it
under 42 CFR 3.20.
"Payment" has the meaning ascribed to it under HIPAA, as
specified in 45 CFR 164.501.
"Person" includes any natural person, partnership,
association, joint venture, trust, governmental entity, public
or private corporation, health facility, or other legal
entity.
"Protected health information" has the meaning ascribed to
it under HIPAA, as specified in 45 CFR 164.103.
"Research" has the meaning ascribed to it under HIPAA, as
specified in 45 CFR 164.501.
"State agency" means an instrumentality of the State of
Illinois and any instrumentality of another state which
pursuant to applicable law or a written undertaking with an
instrumentality of the State of Illinois is bound to protect
the privacy of genetic information of Illinois persons.
"Treatment" has the meaning ascribed to it under HIPAA, as
specified in 45 CFR 164.501.
"Use" has the meaning ascribed to it under HIPAA, as
specified in 45 CFR 160.103, where context dictates.
(Source: P.A. 100-513, eff. 1-1-18; 101-132, eff. 1-1-20;
101-649, eff. 7-7-20.)

Section 35. The Mental Health and Developmental
Disabilities Confidentiality Act is amended by changing
Sections 2, 9.5, 9.6, 9.8, 9.9, and 9.11 as follows:
(740 ILCS 110/2) (from Ch. 91 1/2, par. 802)
Sec. 2. The terms used in this Act, unless the context
requires otherwise, have the meanings ascribed to them in this
Section.
"Agent" means a person who has been legally appointed as
an individual's agent under a power of attorney for health
care or for property.
"Business associate" has the meaning ascribed to it under
HIPAA, as specified in 45 CFR 160.103.
"Confidential communication" or "communication" means any
communication made by a recipient or other person to a
therapist or to or in the presence of other persons during or
in connection with providing mental health or developmental
disability services to a recipient. Communication includes
information which indicates that a person is a recipient.
"Communication" does not include information that has been
de-identified in accordance with HIPAA, as specified in 45 CFR
164.514.
"Covered entity" has the meaning ascribed to it under
HIPAA, as specified in 45 CFR 160.103.
"Guardian" means a legally appointed guardian or
conservator of the person.

"Health information exchange" or "HIE" means a health
information exchange or health information organization that
oversees and governs the electronic exchange of health
information that (i) is established pursuant to the Illinois
Health Information Exchange and Technology Act, or any
subsequent amendments thereto, and any administrative rules
promulgated thereunder; or (ii) has established a data sharing
arrangement with the Illinois Health Information Exchange; or
(iii) as of the effective date of this amendatory Act of the
98th General Assembly, was designated by the Illinois Health
Information Exchange Office Board as a member of, or was
represented on, the Office Board's Regional Health Information
Exchange Workgroup; provided that such designation shall not
require the establishment of a data sharing arrangement or
other participation with the Illinois Health Information
Exchange or the payment of any fee.
"HIE purposes" means those uses and disclosures (as those
terms are defined under HIPAA, as specified in 45 CFR 160.103)
for activities of an HIE: (i) set forth in the Illinois Health
Information Exchange and Technology Act or any subsequent
amendments thereto and any administrative rules promulgated
thereunder; or (ii) which are permitted under federal law.
"HIPAA" means the Health Insurance Portability and
Accountability Act of 1996, Public Law 104-191, and any
subsequent amendments thereto and any regulations promulgated
thereunder, including the Security Rule, as specified in 45

CFR 164.302-18, and the Privacy Rule, as specified in 45 CFR
164.500-34.
"Integrated health system" means an organization with a
system of care which incorporates physical and behavioral
healthcare and includes care delivered in an inpatient and
outpatient setting.
"Interdisciplinary team" means a group of persons
representing different clinical disciplines, such as medicine,
nursing, social work, and psychology, providing and
coordinating the care and treatment for a recipient of mental
health or developmental disability services. The group may be
composed of individuals employed by one provider or multiple
providers.
"Mental health or developmental disabilities services" or
"services" includes but is not limited to examination,
diagnosis, evaluation, treatment, training, pharmaceuticals,
aftercare, habilitation or rehabilitation.
"Personal notes" means:
(i) information disclosed to the therapist in
confidence by other persons on condition that such
information would never be disclosed to the recipient or
other persons;
(ii) information disclosed to the therapist by the
recipient which would be injurious to the recipient's
relationships to other persons, and
(iii) the therapist's speculations, impressions,

hunches, and reminders.
"Parent" means a parent or, in the absence of a parent or
guardian, a person in loco parentis.
"Recipient" means a person who is receiving or has
received mental health or developmental disabilities services.
"Record" means any record kept by a therapist or by an
agency in the course of providing mental health or
developmental disabilities service to a recipient concerning
the recipient and the services provided. "Records" includes
all records maintained by a court that have been created in
connection with, in preparation for, or as a result of the
filing of any petition or certificate under Chapter II,
Chapter III, or Chapter IV of the Mental Health and
Developmental Disabilities Code and includes the petitions,
certificates, dispositional reports, treatment plans, and
reports of diagnostic evaluations and of hearings under
Article VIII of Chapter III or under Article V of Chapter IV of
that Code. Record does not include the therapist's personal
notes, if such notes are kept in the therapist's sole
possession for his own personal use and are not disclosed to
any other person, except the therapist's supervisor,
consulting therapist or attorney. If at any time such notes
are disclosed, they shall be considered part of the
recipient's record for purposes of this Act. "Record" does not
include information that has been de-identified in accordance
with HIPAA, as specified in 45 CFR 164.514. "Record" does not

include a reference to the receipt of mental health or
developmental disabilities services noted during a patient
history and physical or other summary of care.
"Record custodian" means a person responsible for
maintaining a recipient's record.
"Therapist" means a psychiatrist, physician, psychologist,
social worker, or nurse providing mental health or
developmental disabilities services or any other person not
prohibited by law from providing such services or from holding
himself out as a therapist if the recipient reasonably
believes that such person is permitted to do so. Therapist
includes any successor of the therapist.
"Therapeutic relationship" means the receipt by a
recipient of mental health or developmental disabilities
services from a therapist. "Therapeutic relationship" does not
include independent evaluations for a purpose other than the
provision of mental health or developmental disabilities
services.
(Source: P.A. 101-649, eff. 7-7-20.)
(740 ILCS 110/9.5)
Sec. 9.5. Use and disclosure of information to an HIE.
(a) An HIE, person, therapist, facility, agency,
interdisciplinary team, integrated health system, business
associate, or covered entity may, without a recipient's
consent, use or disclose information from a recipient's record

in connection with an HIE, including disclosure to the
Illinois Health Information Exchange Office, an HIE, or the
business associate of either. An HIE and its business
associate may, without a recipient's consent, use or disclose
and re-disclose such information for HIE purposes or for such
other purposes as are specifically allowed under this Act.
(b) As used in this Section:
(1) "facility" means a developmental disability
facility as defined in Section 1-107 of the Mental Health
and Developmental Disabilities Code or a mental health
facility as defined in Section 1-114 of the Mental Health
and Developmental Disabilities Code; and
(2) the terms "disclosure" and "use" have the meanings
ascribed to them under HIPAA, as specified in 45 CFR
160.103.
(Source: P.A. 101-649, eff. 7-7-20.)
(740 ILCS 110/9.6)
Sec. 9.6. HIE opt-out. Participants of The Illinois Health
Information Exchange Office shall, through appropriate rules,
standards, or contractual obligations, which shall be binding
upon any HIE, as defined under Section 2, shall allow require
that participants of such HIE provide each recipient whose
record is accessible through the health information exchange
the reasonable opportunity to expressly decline the further
disclosure of the record by the health information exchange to

third parties, except to the extent permitted by law such as
for purposes of public health reporting. The HIE participants
These rules, standards, or contractual obligations shall
permit a recipient to revoke a prior decision to opt-out or a
decision not to opt-out. These rules, standards, or
contractual obligations shall provide for written notice of a
recipient's right to opt-out which directs the recipient to a
health information exchange website containing (i) an
explanation of the purposes of the health information
exchange; and (ii) audio, visual, and written instructions on
how to opt-out of participation in whole or in part to the
extent possible. The process for effectuating an opt-out These
rules, standards, or contractual obligations shall be reviewed
by the HIE participants annually and updated as the technical
options develop. The recipient shall be provided meaningful
disclosure regarding the health information exchange, and the
recipient's decision whether to opt-out should be obtained
without undue inducement or any element of force, fraud,
deceit, duress, or other form of constraint or coercion. To
the extent that HIPAA, as specified in 45 CFR 164.508(b)(4),
prohibits a covered entity from conditioning the provision of
its services upon an individual's provision of an
authorization, an HIE participant shall not condition the
provision of its services upon a recipient's decision to
opt-out of further disclosure of the record by an HIE to third
parties. The Illinois Health Information Exchange Office

shall, through appropriate rules, standards, or contractual
obligations, which shall be binding upon any HIE, as defined
under Section 2, give consideration to the format and content
of the meaningful disclosure and the availability to
recipients of information regarding an HIE and the rights of
recipients under this Section to expressly decline the further
disclosure of the record by an HIE to third parties. The HIE
participants Illinois Health Information Exchange Office shall
also give annual consideration to enable a recipient to
expressly decline the further disclosure by an HIE to third
parties of selected portions of the recipient's record while
permitting disclosure of the recipient's remaining patient
health information. In giving establishing rules, standards,
or contractual obligations binding upon HIEs under this
Section to give effect to recipient disclosure preferences,
the HIE participants Illinois Health Information Exchange
Office in its discretion may consider the extent to which
relevant health information technologies reasonably available
to therapists and HIEs in this State reasonably enable the
effective segmentation of specific information within a
recipient's electronic medical record and reasonably enable
the effective exclusion of specific information from
disclosure by an HIE to third parties, as well as the
availability of sufficient authoritative clinical guidance to
enable the practical application of such technologies to
effect recipient disclosure preferences. The provisions of

this Section 9.6 shall not apply to the secure electronic
transmission of data which is point-to-point communication
directed by the data custodian. Any rules or standards
promulgated under this Section which apply to HIEs shall be
limited to that subject matter required by this Section and
shall not include any requirement that an HIE enter a data
sharing arrangement or otherwise participate with the Illinois
Health Information Exchange. In connection with its annual
consideration regarding the issue of segmentation of
information within a medical record and prior to the adoption
of any rules or standards regarding that issue, the Office
Board shall consider information provided by affected persons
or organizations regarding the feasibility, availability,
cost, reliability, and interoperability of any technology or
process under consideration by the Board. Nothing in this Act
shall be construed to limit the authority of the Illinois
Health Information Exchange Office to impose limits or
conditions on consent for disclosures to or through any HIE,
as defined under Section 2, which are more restrictive than
the requirements under this Act or under HIPAA.
(Source: P.A. 101-649, eff. 7-7-20.)
(740 ILCS 110/9.8)
Sec. 9.8. Business associates. An HIE, person, therapist,
facility, agency, interdisciplinary team, integrated health
system, business associate, covered entity, the Illinois

Health Information Exchange Office, or entity facilitating the
establishment or operation of an HIE may, without a
recipient's consent, utilize the services of and disclose
information from a recipient's record to a business associate,
as defined by and in accordance with the requirements set
forth under HIPAA. As used in this Section, the term
"disclosure" has the meaning ascribed to it by HIPAA, as
specified in 45 CFR 160.103.
(Source: P.A. 101-649, eff. 7-7-20.)
(740 ILCS 110/9.9)
Sec. 9.9. Record locator service.
(a) An HIE, person, therapist, facility, agency,
interdisciplinary team, integrated health system, business
associate, covered entity, the Illinois Health Information
Exchange Office, or entity facilitating the establishment or
operation of an HIE may, without a recipient's consent,
disclose the existence of a recipient's record to a record
locator service, master patient index, or other directory or
services necessary to support and enable the establishment and
operation of an HIE.
(b) As used in this Section:
(1) the term "disclosure" has the meaning ascribed to
it under HIPAA, as specified in 45 CFR 160.103; and
(2) "facility" means a developmental disability
facility as defined in Section 1-107 of the Mental Health

and Developmental Disabilities Code or a mental health
facility as defined in Section 1-114 of the Mental Health
and Developmental Disabilities Code.
(Source: P.A. 101-649, eff. 7-7-20.)
(740 ILCS 110/9.11)
Sec. 9.11. Establishment and disclosure of limited data
sets and de-identified information.
(a) An HIE, person, therapist, facility, agency,
interdisciplinary team, integrated health system, business
associate, covered entity, the Illinois Health Information
Exchange Office, or entity facilitating the establishment or
operation of an HIE may, without a recipient's consent, use
information from a recipient's record to establish, or
disclose such information to a business associate to
establish, and further disclose information from a recipient's
record as part of a limited data set as defined by and in
accordance with the requirements set forth under HIPAA, as
specified in 45 CFR 164.514(e). An HIE, person, therapist,
facility, agency, interdisciplinary team, integrated health
system, business associate, covered entity, the Illinois
Health Information Exchange Office, or entity facilitating the
establishment or operation of an HIE may, without a
recipient's consent, use information from a recipient's record
or disclose information from a recipient's record to a
business associate to de-identity the information in

accordance with HIPAA, as specified in 45 CFR 164.514.
(b) As used in this Section:
(1) the terms "disclosure" and "use" shall have the
meanings ascribed to them by HIPAA, as specified in 45 CFR
160.103; and
(2) "facility" means a developmental disability
facility as defined in Section 1-107 of the Mental Health
and Developmental Disabilities Code or a mental health
facility as defined in Section 1-114 of the Mental Health
and Developmental Disabilities Code.
(Source: P.A. 101-649, eff. 7-7-20.)
Section 40. The Workers' Compensation Act is amended by
changing Section 8.2a as follows:
(820 ILCS 305/8.2a)
Sec. 8.2a. Electronic claims.
(a) The Director of Insurance shall adopt rules to do all
of the following:
(1) Ensure that all health care providers and
facilities submit medical bills for payment on
standardized forms.
(2) Require acceptance by employers and insurers of
electronic claims for payment of medical services.
(3) Ensure confidentiality of medical information
submitted on electronic claims for payment of medical

services.
(4) Ensure that health care providers have an
opportunity to comply with requests for records by
employers and insurers for the authorization of the
payment of workers' compensation claims.
(5) Ensure that health care providers are responsible
for supplying only those medical records pertaining to the
provider's own claims that are minimally necessary under
the federal Health Insurance Portability and
Accountability Act of 1996.
(6) Provide that any electronically submitted bill
determined to be complete but not paid or objected to
within 30 days shall be subject to interest pursuant to
item (3) of subsection (d) of Section 8.2.
(7) Provide that the Department of Insurance shall
impose an administrative fine if it determines that an
employer or insurer has failed to comply with the
electronic claims acceptance and response process. The
amount of the administrative fine shall be no greater than
$1,000 per each violation, but shall not exceed $10,000
for identical violations during a calendar year.
(b) To the extent feasible, standards adopted pursuant to
subdivision (a) shall be consistent with existing standards
under the federal Health Insurance Portability and
Accountability Act of 1996 and standards adopted under the
Illinois Health Information Exchange and Technology Act.

(c) The rules requiring employers and insurers to accept
electronic claims for payment of medical services shall be
proposed on or before January 1, 2012, and shall require all
employers and insurers to accept electronic claims for payment
of medical services on or before June 30, 2012. The Director of
Insurance shall adopt rules by January 1, 2019 to implement
the changes to this Section made by this amendatory Act of the
100th General Assembly. The Commission, with assistance from
the Department and the Medical Fee Advisory Board, shall
publish on its Internet website a companion guide to assist
with compliance with electronic claims rules. The Medical Fee
Advisory Board shall periodically review the companion guide.
(d) The Director of Insurance shall by rule establish
criteria for granting exceptions to employers, insurance
carriers, and health care providers who are unable to submit
or accept medical bills electronically.
(Source: P.A. 100-1117, eff. 11-27-18.)
Section 99. Effective date. This Act takes effect July 1,
2023.
INDEX
Statutes amended in order of appearance