Illinois Medical Bill Rights

42 U.S.C. § 300gg-111 (No Surprises Act)

Federal law (effective January 1, 2022) prohibits surprise out-of-network bills for emergency services, air ambulance services, and most non-emergency services at in-network facilities. Patients owe no more than the in-network cost-share. Providers and insurers must resolve payment disputes through Independent Dispute Resolution, not by billing the patient.

215 ILCS 5/356z.3a (Network Adequacy and Transparency Act)

Illinois prohibits balance billing for emergency services and for non-emergency services from out-of-network providers at in-network facilities. Patients owe only the in-network cost-share; the provider and insurer settle the remainder through Department of Insurance dispute resolution.

26 U.S.C. § 501(r) (Nonprofit Hospital Financial Assistance Requirement)

Federal law requires every nonprofit (501(c)(3)) hospital to maintain a written Financial Assistance Policy, publicize it widely, and screen all uninsured/underinsured patients for eligibility before sending unpaid bills to collections. Patients eligible for assistance cannot be charged more than the Amounts Generally Billed (AGB) to insured patients. Applies to roughly 3,000 nonprofit hospitals (about 58% of all US hospitals, 80% of beds).

210 ILCS 89 (Fair Patient Billing Act + Hospital Uninsured Patient Discount Act)

Illinois hospitals must offer discounted care to uninsured patients earning up to 600% of the federal poverty level. Patients may not be sent to collections without a determination of eligibility for charity care.

15 U.S.C. § 1692 et seq. (Fair Debt Collection Practices Act)

Federal law restricts how third-party debt collectors may contact consumers about medical or other debts. Consumers may demand written validation of any debt within 30 days of first contact; collectors must cease communication if requested in writing; harassment, deception, and unfair practices are prohibited.

110 ILCS 89/15 (Medical Debt Credit Reporting Restriction)

Illinois prohibits credit reporting agencies from reporting medical debt under $1,500 and requires a 1-year waiting period before any medical debt may be reported.