Bill
HB 3593
HB 3593 extends hospital financial assistance and billing protections to third-party providers on hospital premises, requiring contracts and compliance with the Act.
Status and key dates
- Bill number: HB 3593 (Fair Patient Billing)
- Sponsor: Rep. Dagmara Avelar
- Introduced: February 18, 2025 (filed with Clerk by Rep. Avelar)
- House Amendment 001 filed: April 7, 2025
- Current status (as of April 11, 2025): House Floor Amendment No. 1, Rule 19(c) — Re‑referred to Rules Committee
- Statutes amended: Fair Patient Billing Act (210 ILCS 88) and Hospital Uninsured Patient Discount Act (210 ILCS 89)
Purpose and intent
- To extend the consumer protections of the Fair Patient Billing Act (and parallel provisions of the Hospital Uninsured Patient Discount Act) to health care services provided by third parties (outsourced providers) that deliver care inside a hospital building or on the hospital site. The bill clarifies that a hospital’s billing, screening, financial assistance, discount, and collections obligations apply to outsourced services as if the hospital itself had provided them.
Key provisions (House Amendment 001)
- Expanded definition of “outsource/outsourcing”: contracting with a person or entity not employed by the hospital (i.e., third‑party providers) to perform services on the hospital site or in a hospital facility; distinguished from insurer network relationships.
- Hospital responsibility continues: When the hospital outsources services, the hospital’s obligations under the Act remain in force “as though the hospital provided the health care services.”
- Written contract requirement: Hospitals must execute written agreements with outsourced providers specifying how the contractor will operate under the hospital’s financial assistance policy, screening procedures, reasonable payment plan obligations, collections provisions, and all applicable provisions of the Act.
- Provider obligations: Outsourced providers must (i) establish standards/procedures to comply with the Act, (ii) cooperate with hospitals by providing reasonable access to billing records/documents upon request, and (iii) monitor billing activity to ensure compliance.
- Notification and enforcement: The outsourced provider becomes responsible for complying with the hospital’s policies upon notification by the hospital that a patient qualifies for assistance, before or after bills are submitted to the billing agent.
- Charge/discount calculations: Hospitals must include charges from third‑party individuals or entities when calculating the charge, discount, or collectible amount under the Act.
- Community benefit: Charity care/financial assistance provided by an outsourced provider may constitute a community benefit provided by the hospital.
- Liability clarification: The amendment states it does not increase the hospital’s medical liability (i.e., does not alter medical malpractice exposure).
Who is affected
- Patients (insured, uninsured, and those seeking financial assistance) — expanded protections for outsourced services delivered on hospital premises.
- Hospitals — increased contractual, monitoring, and compliance obligations; must ensure contracted providers follow hospital policies and include third‑party charges in discount/discountable calculations.
- Third‑party/outsourced providers (contract nurses, surgical or diagnostic contractors, physician groups, billing contractors) — required to comply with hospital financial assistance and collections rules and to provide billing records on request.
- Collection agencies and billing agents engaged by hospitals — already covered and required to comply; amendment strengthens links between hospital and third‑party billers.
Procedural notes and likely impacts
- Amendment clarifies practical enforcement mechanics (written agreements, access to records) and places onus on hospitals to secure compliance from contractors.
- Operational impacts may include renegotiation of contracts, increased administrative/recordkeeping burdens, and closer oversight of third‑party billing practices.
- The bill aims to reduce surprise bills and ensure uninsured or low‑income patients are screened and offered hospital financial assistance regardless of which entity provided care at the hospital site.
Next steps
- HB 3593 and House Amendment 001 are pending in the House Rules Committee following amendment filing (April 7) and subsequent referrals (April 8–11). Further floor action or committee consideration will determine final passage and any additional changes.
Compiled from official sources — confirm details with the bill’s official record.
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