On August 25th, 2021, Illinois Governor J.B. Pritzker signed Senate Bill 1840 into law – requiring every nonprofit hospital in Illinois to update their Financial Assistance Policies, change their Financial Assistance Application forms, and track and report application data according to race, ethnicity, sex, and preferred language. The goal of SB 1840 is to advance health equity by lowering costs and improving access to care for low-income and uninsured residents. Worthy aims, to be sure. That said, Illinois nonprofit hospitals will need to comply with SB 1840 starting on January 1, 2022, and this page is meant to help you understand and navigate those requirements, while offering resources to help you reach compliance.

SB 1840 requires all nonprofit hospitals in Illinois to make two changes to their Financial Assistance Application forms.

  1.  “Hospitals shall ask for an applicant’s race, ethnicity, sex, and preferred language on the financial assistance application. However, the questions shall be clearly marked as optional responses for the patient and shall note that responses or nonresponses by the patient will not have any impact on the outcome of the application.”
  2.  “The hospital’s financial assistance application shall include language that directs the uninsured patient to contact the hospital’s financial counseling department with questions or concerns, along with contact information for the financial counseling department, and shall state: “Complaints or concerns with the uninsured patient discount application process or hospital financial assistance process may be reported to the Health Care Bureau of the Illinois Attorney General.”. A website, phone number, or both provided by the Attorney General shall be included with this statement.”

HFA has developed a compliant, patient-friendly Financial Assistance Application form template that your hospital can adopt to comply with these requirements. Please complete our “Contact Us” form to receive this free resource.

SB 1840 requires all nonprofit hospitals in Illinois to:

  1. Reduce their “Maximum Collectible Amount” for qualifying uninsured patients from 25% to 20%.
  2. Lower the cost threshold of services that qualify for uninsured patient discounts from $300 to $150. (Non-rural and non-Critical Access Hospitals, only.)

SB 1840 requires all nonprofit hospitals in Illinois to:

“Describe activities the hospital is undertaking to address health equity, reduce health disparities, and improve community health. This may include, but is not limited to:

  • Efforts to recruit and promote a racially and culturally diverse and representative workforce;
  • Efforts to procure goods and services locally and from historically underrepresented communities;
  • Training that addresses cultural competency and implicit bias; and
  • Partnerships and investments to address social needs such as food, housing, and community safety.”

HFA has developed a free “Starting Points” document with examples of activities to address health equity, disparities, and community health that other organizations have used in similar contexts. Please complete our “Contact Us” form to receive this free resource.

SB 1840 requires all nonprofit hospitals in Illinois to report “details about financial assistance applications received and processed by the hospital.” These details include:

  • The number of applications submitted to the hospital, both complete and incomplete;
  • The number of applications approved; and
  • The number of applications denied; and
  • The 5 most frequent reasons for denial.

Additionally, that data must be reported by the demographics now required (race, ethnicity, sex, and preferred language).

For a health system that includes more than one hospital, charity care spending and financial assistance application data must be reported separately for each individual hospital within the health system.

Lastly, charity care costs currently reported on the annual Community Benefits Plan Report shall now be reported as:

  • Total charity care costs
  • Charity care costs associated with services provided in a hospital’s emergency department

HFA has developed an SB 1840-compliant reporting tool that allows hospitals to capture all required data efficiently and securely, and produce the reports required for your annual Community Benefits Plan Report. Please complete our “Contact Us” form to receive more information on this solution.

SB 1840 clarifies which documents Illinois nonprofit hospitals may use in verify income, assets, and residency of Financial Assistance applicants.

  • Hospitals may only require uninsured patients to apply for Medicaid or other insurance “if there is a reasonable basis to believe that the uninsured patient may be eligible for such program.”
  • Hospitals may not consider the following assets in determining Financial Assistance eligibility:
    • Primary residence
    • Personal property
    • Amounts held in pension or retirement accounts
  • Hospitals must now also accept a temporary visitor’s driver’s license as proof of residency.


“Up and running in less than 30 days. A low impact implementation that will not take your team away from their work.”

“Immediately begin receiving organized, electronic applications and documents instead of stacks of paper. Happy staff. Happy Patients.”

“All your financial assistance records and documents in one, simple to access location.  Eliminate the expense of your paper based system.”

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