LIMITATIONS FACILITY FEES ACT

Illinois General Assembly - Full Text of HB4701

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HB4701 - 104th General Assembly

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104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB4701

Introduced , by Rep. Tracy Katz Muhl

SYNOPSIS AS INTRODUCED:

New Act
210 ILCS 88/12
815 ILCS 505/2MMMM new

Creates the Limitations on Facility Fees Act. Provides that no health
care provider shall charge, bill, or collect a facility fee, except for:
(i) services provided on a hospital's campus; (ii) services provided at a
facility that includes a licensed hospital emergency department; or (iii)
emergency services provided at a freestanding emergency center. Provides
that, except as specified, no health care provider shall charge, bill, or
collect a facility fee for: (i) outpatient evaluation and management
services; or (ii) any other outpatient, diagnostic, or imaging services
identified by the Department of Public Health. Requires the Department to
annually identify services subject to the limitations on specified
facility fees that may reliably be provided safely and effectively in
settings other than hospitals. Sets forth provisions concerning reporting,
rulemaking, and enforcement of the Act. Amends the Fair Patient Billing
Act to make a conforming change. Amends the Consumer Fraud and Deceptive
Business Practices Act. Provides that any person who violates the
Limitations on Facility Fees Act commits an unlawful practice.
LRB104 17497 BAB 30923 b

A BILL FOR

HB4701
LRB104 17497 BAB 30923 b
1

AN ACT concerning regulation.

2

Be it enacted by the People of the State of Illinois,
3
represented in the General Assembly:

4

Section 1.
Short title.
This Act may be cited as the
5
Limitations on Facility Fees Act.

6

Section 5.
Definitions.
As used in this Act:
7

"Campus" means: (i) a hospital's main buildings; (ii) the
8
physical area immediately adjacent to a hospital's main
9
buildings and other areas and structures that are not strictly
10
contiguous to the main buildings but are located within 250
11
yards of the main buildings; or (iii) any other area that has
12
been determined on an individual case basis by the Centers for
13
Medicare and Medicaid Services to be part of a hospital's
14
campus.
15

"Department" means the Department of Public Health.
16

"Facility fee" means any fee charged or billed by a health
17
care provider for outpatient services provided in a
18
hospital-based facility or freestanding emergency center that
19
is: (i) intended to compensate the health care provider for
20
the operational expenses of the health care provider; (ii)
21
separate and distinct from a professional fee; and (iii)
22
regardless of the modality through which the health care
23
services were provided.

HB4701
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LRB104 17497 BAB 30923 b
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"Freestanding emergency center" means a freestanding
2
emergency center licensed under Section 32.5 of the Emergency
3
Medical Services (EMS) Systems Act. "Freestanding emergency
4
center" does not include an urgent care clinic.
5

"Health care provider" means an individual, entity,
6
corporation, person, or organization, whether for profit or
7
nonprofit, that furnishes, bills, or is paid for health care
8
service delivery in the normal course of business, and
9
includes, without limitation, health systems, hospitals,
10
hospital-based facilities, freestanding emergency centers, and
11
urgent care clinics.
12

"Health system" means: (i) a parent corporation of one or
13
more hospitals and any entity affiliated with the parent
14
corporation through ownership, governance, membership, or
15
other means, or (ii) a hospital and any entity affiliated with
16
the hospital through ownership, governance, membership, or
17
other means.
18

"Hospital" means a hospital licensed under the Hospital
19
Licensing Act.
20

"Hospital-based facility" means a facility that is owned
21
or operated, in whole or in part, by a hospital where hospital
22
or professional medical services are provided.
23

"Professional fee" means any fee charged or billed by a
24
provider for professional medical services provided in a
25
hospital-based facility.

HB4701
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LRB104 17497 BAB 30923 b
1

Section 10.
Limits on facility fees.
2

(a) Site-specific limits. No health care provider shall
3
charge, bill, or collect a facility fee, except for: (i)
4
services provided on a hospital's campus; (ii) services
5
provided at a facility that includes a licensed hospital
6
emergency department; or (iii) emergency services provided at
7
a freestanding emergency center.
8

(b) Service-specific limits. Notwithstanding subsection
9
(a) and whether or not the services are provided on a
10
hospital's campus, no health care provider shall charge, bill,
11
or collect a facility fee for: (i) outpatient evaluation and
12
management services; or (ii) any other outpatient, diagnostic,
13
or imaging services identified by the Department pursuant to
14
subsection (c).
15

(c) Identification of services. The Department shall
16
annually identify services subject to the limitations on
17
facility fees provided in subsection (b) that may reliably be
18
provided safely and effectively in settings other than
19
hospitals.

20

Section 15.
Reporting.
21

(a) Each hospital, health system, and freestanding
22
emergency center shall submit a report annually to the
23
Department concerning facility fees charged or billed during
24
the preceding calendar year. The Department shall publish the
25
information reported on a publicly accessible website

HB4701
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LRB104 17497 BAB 30923 b
1
designated by the Department.
2

(b) The report shall include, without limitation, the
3
following information:
4

(1) the name and full address of each facility owned
5

or operated by the hospital, health system, or
6

freestanding emergency center that provides services for
7

which a facility fee is charged or billed;
8

(2) the number of patient visits at each
9

hospital-based facility or freestanding emergency center
10

for which a facility fee was charged or billed;
11

(3) the number, total amount, and range of allowable
12

facility fees paid at each facility by Medicare, Medicaid,
13

and private insurance;
14

(4) for each hospital-based facility, and for the
15

hospital or health system as a whole or freestanding
16

emergency center, the total amount billed and the total
17

revenue received from facility fees;
18

(5) the top 10 procedures or services, identified by
19

current procedural terminology (CPT) category I codes,
20

provided by the hospital, health system, or freestanding
21

emergency center overall that generated the greatest
22

amount of facility fee gross revenue, the volume each of
23

these 10 procedures or services and gross and net revenue
24

totals, for each of the procedures or services, and, for
25

each of the procedures or services, the total net amount
26

of revenue received by the hospital, health system, or

HB4701
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LRB104 17497 BAB 30923 b
1

freestanding emergency center derived from facility fees;
2

(6) the top 10 procedures or services, identified by
3

current procedural terminology (CPT) category I codes,
4

based on patient volume, provided by the hospital, health
5

system, or freestanding emergency center overall for which
6

facility fees are billed or charged based on patient
7

volume, including the gross and net revenue totals
8

received for each such procedure or service; and
9

(7) any other information related to facility fees
10

that the Department may require.
11

(c) Until the expiration of 4 years after the furnishing
12
of any services for which a facility fee was charged, billed,
13
or collected, each health care provider shall make available,
14
upon written request by the Department or its designee, copies
15
of any books, documents, records, or data that are necessary
16
for the purposes of completing the audit.

17

Section 20.
Rulemaking.
The Department may adopt rules
18
necessary to implement the provisions of this Act, specify the
19
format and content of reports, and impose penalties for
20
noncompliance consistent with the Department's authority to
21
regulate health care providers.

22

Section 25.
Enforcement.
23

(a) Any violation of this Act shall be considered an
24
unlawful practice within the meaning of the Consumer Fraud and

HB4701
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LRB104 17497 BAB 30923 b
1
Deceptive Business Practices Act.
2

(b) A health care provider that violates this Act or the
3
rules adopted pursuant to this Act shall be subject to an
4
administrative penalty of not more than $1,000 per occurrence.
5

(c) The Department or its designee may audit any health
6
care provider for compliance with the requirements of this
7
Act.

8

Section 30.
The Fair Patient Billing Act is amended by
9
changing Section 12 as follows:

10

(210 ILCS 88/12)
11

Sec. 12.
Facility fee disclosure.
Notwithstanding the
12
provisions set forth in the Limitations on Facility Fees Act,
13
if

If
a hospital charges a facility fee for outpatient
14
services separate and distinct from a professional fee, then
15
the hospital shall develop a policy to inform patients as soon
16
as reasonably practicable that they may be subject to a
17
facility fee. The policy shall include, but not be limited to,
18
the method the facility will use to inform patients that they
19
may be charged a facility fee; the services and operating
20
expenses generally covered by facility fees; the reason for
21
charging a facility fee on the patient or patient's health
22
plan; and contact information to allow the patient to request
23
more information.
24
(Source: P.A. 104-181, eff. 1-1-26
.)

HB4701
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LRB104 17497 BAB 30923 b
1

Section 35.
The Consumer Fraud and Deceptive Business
2
Practices Act is amended by adding Section 2MMMM as follows:

3

(815 ILCS 505/2MMMM new)
4

Sec. 2MMMM.
Violations of the Limitations on Facility Fees
5
Act.
Any person who violates the Limitations on Facility Fees
6
Act commits an unlawful practice within the meaning of this
7
Act.

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