HEALTH FACILITIES PLANNING

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104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
SB3463

Introduced 2/5/2026, by Sen. Graciela Guzmán

SYNOPSIS AS INTRODUCED:

20 ILCS 3960/8.5
740 ILCS 10/7.2a

Amends the Illinois Health Care Facilities Planning Act. Repeals the
January 1, 2027 inoperative date affecting a change of ownership among
related persons. Amends the Illinois Antitrust Act. Repeals the January 1,
2027 inoperative date affecting notice provisions to the Attorney General
before a health care merger or affiliation. Amends provisions requiring
health care entities to notify the Attorney General within 30 days before a
merger or affiliation to include a "covered transaction" even if the
parties to the transaction are not themselves a health care facility or
provider organization but own or control, directly or indirectly, one or
more of the 2 or more health care facilities or provider organizations that
will be under common ownership or contracting affiliation if the
transaction is consummated, including if parties to the covered
transaction are private equity companies. Defines "private equity company"
to mean any company or partnership that collects capital investments from
individuals or entities and purchases, as a parent company, at any level of
corporate ownership, or through another entity or entities so that the
company completely or partially owns or controls, a direct or indirect
ownership share of an Illinois health care entity or an out-of-state
health care entity that generates $10,000,000 or more in annual revenue
from patients residing in this State. Changes notice provisions. Defines
terms.
LRB104 18142 JRC 31581 b

A BILL FOR

SB3463
LRB104 18142 JRC 31581 b
1

AN ACT concerning State government.

2

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

4

Section 5.
The Illinois Health Facilities Planning Act is
5
amended by changing Section 8.5 as follows:

6

(20 ILCS 3960/8.5)
7

(Section scheduled to be repealed on December 31, 2029)
8

Sec. 8.5.
Certificate of exemption for change of ownership
9
of a health care facility; discontinuation of a category of
10
service; public notice and public hearing.
11

(a) Upon a finding that an application for a change of
12
ownership is complete, the State Board shall publish a legal
13
notice on 3 consecutive days in a newspaper of general
14
circulation in the area or community to be affected and afford
15
the public an opportunity to request a hearing. If the
16
application is for a facility located in a Metropolitan
17
Statistical Area, an additional legal notice shall be
18
published in a newspaper of limited circulation, if one
19
exists, in the area in which the facility is located. If the
20
newspaper of limited circulation is published on a daily
21
basis, the additional legal notice shall be published on 3
22
consecutive days. The applicant shall pay the cost incurred by
23
the Board in publishing the change of ownership notice in

SB3463
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LRB104 18142 JRC 31581 b
1
newspapers as required under this subsection. The legal notice
2
shall also be posted on the Health Facilities and Services
3
Review Board's web site and sent to the State Representative
4
and State Senator of the district in which the health care
5
facility is located and to the Office of the Attorney General.
6
An application for change of ownership of a hospital shall not
7
be deemed complete without a signed certification that for a
8
period of 2 years after the change of ownership transaction is
9
effective, the hospital will not adopt a charity care policy
10
that is more restrictive than the policy in effect during the
11
year prior to the transaction. An application for a change of
12
ownership need not contain signed transaction documents so
13
long as it includes the following key terms of the
14
transaction: names and background of the parties; structure of
15
the transaction; the person who will be the licensed or
16
certified entity after the transaction; the ownership or
17
membership interests in such licensed or certified entity both
18
prior to and after the transaction; fair market value of
19
assets to be transferred; and the purchase price or other form
20
of consideration to be provided for those assets. The issuance
21
of the certificate of exemption shall be contingent upon the
22
applicant submitting a statement to the Board within 90 days
23
after the closing date of the transaction, or such longer
24
period as provided by the Board, certifying that the change of
25
ownership has been completed in accordance with the key terms
26
contained in the application. If such key terms of the

SB3463
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LRB104 18142 JRC 31581 b
1
transaction change, a new application shall be required.
2

Where a change of ownership is among related persons, and
3
there are no other changes being proposed at the health care
4
facility that would otherwise require a permit or exemption
5
under this Act, the applicant shall submit an application
6
consisting of a standard notice in a form set forth by the
7
Board briefly explaining the reasons for the proposed change
8
of ownership. Once such an application is submitted to the
9
Board and reviewed by the Board staff, the Board Chair shall
10
take action on an application for an exemption for a change of
11
ownership among related persons within 45 days after the
12
application has been deemed complete, provided the application
13
meets the applicable standards under this Section. If the
14
Board Chair has a conflict of interest or for other good cause,
15
the Chair may request review by the Board. Notwithstanding any
16
other provision of this Act, for purposes of this Section, a
17
change of ownership among related persons means a transaction
18
where the parties to the transaction are under common control
19
or ownership before and after the transaction is completed.
20

Nothing in this Act shall be construed as authorizing the
21
Board to impose any conditions, obligations, or limitations,
22
other than those required by this Section, with respect to the
23
issuance of an exemption for a change of ownership, including,
24
but not limited to, the time period before which a subsequent
25
change of ownership of the health care facility could be
26
sought, or the commitment to continue to offer for a specified

SB3463
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LRB104 18142 JRC 31581 b
1
time period any services currently offered by the health care
2
facility.
3

The changes made by this amendatory Act of the 103rd
4
General Assembly are inoperative on and after January 1, 2027.
5

(a-3) (Blank).
6

(a-5) Upon a finding that an application to discontinue a
7
category of service is complete and provides the requested
8
information, as specified by the State Board, an exemption
9
shall be issued. No later than 30 days after the issuance of
10
the exemption, the health care facility must give written
11
notice of the discontinuation of the category of service to
12
the State Senator and State Representative serving the
13
legislative district in which the health care facility is
14
located. No later than 90 days after a discontinuation of a
15
category of service, the applicant must submit a statement to
16
the State Board certifying that the discontinuation is
17
complete.
18

(b) If a public hearing is requested, it shall be held at
19
least 15 days but no more than 30 days after the date of
20
publication of the legal notice in the community in which the
21
facility is located. The hearing shall be held in the affected
22
area or community in a place of reasonable size and
23
accessibility and a full and complete written transcript of
24
the proceedings shall be made. All interested persons
25
attending the hearing shall be given a reasonable opportunity
26
to present their positions in writing or orally. The applicant

SB3463
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LRB104 18142 JRC 31581 b
1
shall provide a summary or describe the proposed change of
2
ownership at the public hearing.
3

(c) For the purposes of this Section "newspaper of limited
4
circulation" means a newspaper intended to serve a particular
5
or defined population of a specific geographic area within a
6
Metropolitan Statistical Area such as a municipality, town,
7
village, township, or community area, but does not include
8
publications of professional and trade associations.
9

(d) The changes made to this Section by this amendatory
10
Act of the 101st General Assembly shall apply to all
11
applications submitted after the effective date of this
12
amendatory Act of the 101st General Assembly.
13
(Source: P.A. 103-526, eff. 1-1-24
.)

14

Section 10.
The Illinois Antitrust Act is amended by
15
changing Section 7.2a as follows:

16

(740 ILCS 10/7.2a)
17

(Section scheduled to be repealed on January 1, 2027)
18

Sec. 7.2a.
Notification to the Attorney General.
19

(a) As used in this Section:
20

"Acquisition" means an agreement, arrangement, or activity
21
the consummation of which results in a person acquiring
22
directly or indirectly the control of another person.
23
"Acquisition" includes the acquisition of voting securities
24
and noncorporate interests, such as assets, capital stock,

SB3463
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LRB104 18142 JRC 31581 b
1
membership interests, or equity interests.
2

"Contracting affiliation" means the formation of a
3
relationship between 2 or more entities that permits the
4
entities to negotiate jointly with health carriers or
5
third-party administrators over rates for professional medical
6
services, or for one entity to negotiate on behalf of the other
7
entity with health carriers or third-party administrators over
8
rates for professional medical services. "Contracting
9
affiliation" does not include arrangements among entities
10
under common ownership.
11

"Covered transaction" means any merger, acquisition, or
12
contracting affiliation
involving

between
2 or more health
13
care facilities
,

or
provider organizations not previously
14
under common ownership or contracting affiliation.
A
15
transaction is a "covered transaction" subject to the notice
16
requirements even if the parties to the transaction are not
17
themselves a health care facility or provider organization but
18
own or control, directly or indirectly, one or more of the 2 or
19
more health care facilities or provider organizations that
20
will be under common ownership or contracting affiliation if
21
the transaction is consummated, including if parties to the
22
covered transaction are private equity companies.

23

"Health care facility" means the following facilities,
24
organizations, and related persons:
25

(1) An ambulatory surgical treatment center required
26

to be licensed under the Ambulatory Surgical Treatment

SB3463
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LRB104 18142 JRC 31581 b
1

Center Act.
2

(2) An institution, place, building, or agency
3

required to be licensed under the Hospital Licensing Act.
4

(3) A hospital, ambulatory surgical treatment center,
5

or kidney disease treatment center maintained by the State
6

or any department or agency thereof.
7

(4) A kidney disease treatment center, including a
8

free-standing hemodialysis unit required to meet the
9

requirements of 42 CFR 494 in order to be certified for
10

participation in Medicare and Medicaid under Titles XVIII
11

and XIX of the federal Social Security Act of 1935.
12

(5) An institution, place, building, or room used for
13

the performance of outpatient surgical procedures that is
14

leased, owned, or operated by or on behalf of an
15

out-of-state facility.
16

(6) An institution, place, building, or room used for
17

provision of a health care category of service, as defined
18

under the Illinois Health Facilities Planning Act,
19

including, but not limited to, cardiac catheterization and
20

open heart surgery.
21

With the exception of those health care facilities
22
specifically included in this Section, nothing in this Section
23
shall be intended to include facilities operated as a part of
24
the practice of a physician or other licensed health care
25
professional, whether practicing in his or her individual
26
capacity or within the legal structure of any partnership,

SB3463
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LRB104 18142 JRC 31581 b
1
medical or professional corporation, or unincorporated medical
2
or professional group. Further, this Section shall not apply
3
to physicians or other licensed health care professional's
4
practices where such practices are carried out in a portion of
5
a health care facility under contract with such health care
6
facility by a physician or by other licensed health care
7
professionals, whether practicing in his or her individual
8
capacity or within the legal structure of any partnership,
9
medical or professional corporation, or unincorporated medical
10
or professional groups, unless the entity constructs,
11
modifies, or establishes a health care facility as
12
specifically defined in this Section.
13

"Health care provider" means an individual or entity duly
14
licensed or legally authorized to provide health care
15
services.
16

"Health care services" means health care services or
17
products rendered or sold by a health care provider within the
18
scope of the health care provider's license or legal
19
authorization. The term includes, but is not limited to,
20
hospital, medical, surgical, dental, vision, and
21
pharmaceutical services or products.

22

"Health care services revenue" means the total revenue
23
received for health care services in the previous 12 months.
24

"Health carriers" has the meaning given to that term in
25
Section 10 of the Health Carrier External Review Act.
26

"Illinois health care entity" means a health care facility

SB3463
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LRB104 18142 JRC 31581 b
1
or provider organization that has an office in or is doing
2
business in this State.
3

"Merger" means the consolidation of 2 or more
4
organizations, including 2 or more organizations joining
5
through a common parent organization or 2 or more
6
organizations forming a new organization, but does not include
7
a corporate reorganization.
8

"Out-of-state health care entity" means a health care
9
facility or provider organization that is not headquartered in
10
this State and does not do business in this State.
11

"Private equity company" means any company or partnership
12
that collects capital investments from individuals or entities
13
and purchases, as a parent company, at any level of corporate
14
ownership, or through another entity or entities so that the
15
company completely or partially owns or controls a direct or
16
indirect ownership share of an Illinois health care entity or
17
an out-of-state health care entity that generates $10,000,000
18
or more in annual revenue from patients residing in this
19
State.

20

"Provider organization" means a corporation, partnership,
21
business trust, association, or organized group of persons,
22
whether incorporated or not, which is in the business of
23
health care delivery or management and that represents 20 or
24
more health care providers in contracting with health carriers
25
or third-party administrators for the payment of health care
26
services. "Provider organization" includes physician

SB3463
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LRB104 18142 JRC 31581 b
1
organizations, physician-hospital organizations, independent
2
practice associations, provider networks, and accountable care
3
organizations.
4

"Third-party administrator" means an entity that
5
administers payments for health care services on behalf of a
6
client in exchange for an administrative fee.
7

(b)
Notice of

Health care facilities or provider
8
organizations that are party to
a covered transaction shall
be
9
provided

provide notice of such transaction
to the Attorney
10
General no later than 30 days prior to the transaction closing
11
or effective date of the transaction.
12

Notice of a covered transaction

Covered transactions

13
between an Illinois health care entity and an out-of-state
14
health care entity
shall be provided

must provide notice
under
15
this subsection where the out-of-state entity generates
16
$10,000,000 or more in annual revenue from patients residing
17
in this State.
18

(c) The written notice provided by the parties under
19
subsection (b) shall be provided as follows:
20

(1) For
any health care facility or provider
21

organization that is a party to
a covered transaction
that
22

is the subject of

and files
a premerger notification
23

filing
with the Federal Trade Commission or the United
24

States Department of Justice, in compliance with the
25

Hart-Scott-Rodino Antitrust Improvements Act of 1976, 15
26

U.S.C. 18a, the notice requirement is satisfied by

SB3463
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LRB104 18142 JRC 31581 b
1

providing a copy of such filing
with all attachments
to
2

the Attorney General at the same time as it is provided to
3

the federal government.
4

(2) For any health care facility
involved in

that is a
5

party to
a covered transaction that is not described in
6

paragraph (1), the notice requirement is satisfied when
7

the healthcare facility files an application for a change
8

of ownership with the Health Facilities and Services
9

Review Board, in compliance with the Illinois Health
10

Facilities Planning Act. The Health Facilities and
11

Services Review Board shall provide a copy of such filing
12

to the Attorney General at the same time as it is provided
13

to the applicable State legislators under subsection (a)
14

of Section 8.5 of the Illinois Health Facilities Planning
15

Act.
16

(3) For any health care facility
,

or
provider
17

organization, or any entity that owns or controls,
18

directly or indirectly, a health care facility or provider
19

organization that is involved in

organization that is a
20

party to
a covered transaction that is not described in
21

paragraph (1) or (2), written notice provided by the
22

parties must include:
23

(A) the names of
all health care facilities,
24

provider organizations involved in
the
covered
25

transaction and

parties and
their current business
26

addresses

address
;

SB3463
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LRB104 18142 JRC 31581 b
1

(B) identification of all locations where health
2

care services are currently provided by each
entity
3

disclosed in subparagraph (A)

party
;
4

(C) a brief description of the nature and purpose
5

of the proposed transaction; and
6

(D) the anticipated effective date of the proposed
7

transaction.
8

Nothing in this subsection prohibits
any entity

the
9
parties to a covered transaction
from voluntarily providing
10
additional information to the Attorney General.
11

(d) The Attorney General may make any requests for
12
additional information from the
filing
parties that is
13
relevant to its investigation of the covered transaction
14
within 30 days of the date notice is received under
15
subsections (b) and (c). If the Attorney General requests
16
additional information, the covered transaction may not
17
proceed until 30 days after the
filing
parties have
18
substantially complied with the request. Any subsequent
19
request for additional information by the Attorney General
20
shall not further delay the covered transaction from
21
proceeding. Nothing in this Section precludes the Attorney
22
General from conducting an investigation or enforcing State or
23
federal antitrust laws at a later date.
24

(e) Any
party to a covered transaction that

health care
25
facility or provider organization that
fails to comply with
26
any provision of this Section is subject to a civil penalty of

SB3463
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LRB104 18142 JRC 31581 b
1
not more than $500 per day for each day during which the
party

2
health care facility or provider organization
is in violation
3
of this Section.
4

Whenever the Attorney General has reason to believe that a
5
party to a covered transaction

health care facility or
6
provider organization
has engaged in or is engaging in a
7
covered transaction without complying with the provisions of
8
this Section, the Attorney General may apply for and obtain,
9
in an action in the Circuit Court of Sangamon or Cook County, a
10
temporary restraining order or injunction, or both,
11
prohibiting the
party

health care facility or provider
12
organization
from continuing its noncompliance or doing any
13
act in furtherance thereof. The court may make such further
14
orders or judgments, at law or in equity, as may be necessary
15
to remedy such noncompliance.
16

Before bringing such an action or seeking to recover a
17
civil penalty, the Attorney General shall permit the
party to
18
the covered transaction

health care facility or provider
19
organization
to come into compliance with this Section within
20
10 days of being notified of its alleged noncompliance. The
21
right to cure noncompliance does not exist on or after the
22
covered transaction's proposed or actual closing date of the
23
covered transaction, whichever is sooner.
24

(f)
(Blank).

This Section is repealed on January 1, 2027.
25
(Source: P.A. 103-526, eff. 1-1-24
.)

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