Illinois joins a growing number of states to pass laws requiring that hospitals provide notice to patients who are placed under observation status. 210 ILCS 86/6.09b As with the recent federal NOTICE Act, the laws respond to patients not understanding the difference between observation in a hospital bed and inpatient admission. The Illinois law requires a hospital to notify patients who have been placed in observation status that they have not been admitted as an inpatient and inform them that observation status may affect cost-sharing requirements as well as coverage under Medicare, Medicaid or insurance plans.

A number of states including New York, Connecticut, Maryland, Pennsylvania, and Virginia have enacted laws requiring hospitals to provide observation care notices. Similar to the regulatory framework of those states, Illinois law requires oral and written notice within 24 hours after a patient is placed under observation status. Illinois’ requirement is more stringent than the federal law, requiring notice within 36 hours. The written notice must state that the patient is not admitted to the hospital as an inpatient, but is under observation status, with a description of the financial implications. The notice must be signed by the patient or patient’s legal representative, acknowledging receipt.

Under the federal NOTICE Act, hospitals were given one year, until August 2016, to develop and implement the notice requirements. Illinois hospitals are required to provide patients with observation care notices beginning August 2015.