HB 4703

  • Illinois House Bill
  • 102nd Regular Session
  • Introduced in House Mar 04, 2022
  • Passed House Mar 03, 2022
  • Passed Senate Mar 30, 2022
  • Became Law May 26, 2022

Insurance-Billing

Abstract

Amends the Illinois Insurance Code. Provides that when an insured receives emergency services or covered ancillary services from a nonparticipating provider or a nonparticipating facility, the health insurance issuer shall ensure that cost-sharing requirements are applied as though the services had been received from a participating provider or facility, and that the insured or any group policyholder or plan sponsor shall not be liable to or billed by the health insurance issuer, the nonparticipating provider, or the facility beyond the cost-sharing amount. Contains provisions concerning a notice and consent process for out-of-network coverage; billing for reasonable administrative fees; assignment of benefits to nonparticipating providers; and cost-sharing amounts and deductibles. Amends the Illinois Insurance Code and the Health Maintenance Organization Act to make a change in provisions concerning disclosure of nonparticipating provider benefits. Amends the Network Adequacy and Transparency Act. Provides that a beneficiary who receives care at a participating health care facility shall not be required to search for participating providers under certain circumstances. Amends the Managed Care Reform and Patient Rights Act. Provides that prior authorization or approval by the plan shall not be required for post-stabilization services that constitute emergency services. Amends the Health Maintenance Organization Act and the Voluntary Health Services Plans Act to provide that health maintenance organizations and voluntary health services plans are subject to provisions of the Illinois Insurance Code concerning billing and cost sharing. Makes other changes. Effective July 1, 2022, except that certain changes take effect January 1, 2023. House Floor Amendment No. 1 In provisions concerning cost sharing for emergency services and cost sharing for non-emergency services, provides that if the cost sharing for the same item or service furnished by a participating provider would have been a flat-dollar copayment, that amount shall be the cost-sharing amount unless the provider has billed a lesser total amount. Provides that upon receipt of the provider's bill or facility's bill, the health insurance issuer shall provide the nonparticipating provider or the facility with a written explanation of benefits (rather than the health insurance issuer shall provide the nonparticipating provider or the facility with a written explanation of benefits). Provides that the arbitrator shall not establish a rebuttable presumption that the qualifying payment amount should be the total amount owed to the provider or facility by the combination of the issuer and the insured, beneficiary, or enrollee. Defines "qualifying payment amount". Makes other changes.

Bill Sponsors (26)

Votes


Actions


Jul 01, 2022

Senate

Added as Alternate Co-Sponsor Sen. Doris Turner

Jun 03, 2022

Senate

Added as Alternate Co-Sponsor Sen. Bill Cunningham

May 26, 2022

House

Public Act . . . . . . . . . 102-0901

House

Effective Date July 1, 2022; - Some Provisions Effective January 1, 2023

House

Governor Approved

May 25, 2022

Senate

Added as Alternate Co-Sponsor Sen. Christopher Belt

Senate

Added as Alternate Co-Sponsor Sen. Ram Villivalam

Senate

Added as Alternate Co-Sponsor Sen. Celina Villanueva

Senate

Added as Alternate Co-Sponsor Sen. Meg Loughran Cappel

Senate

Added as Alternate Co-Sponsor Sen. Omar Aquino

Senate

Added as Alternate Co-Sponsor Sen. Michael E. Hastings

Senate

Added as Alternate Co-Sponsor Sen. Scott M. Bennett

Senate

Added as Alternate Co-Sponsor Sen. Eric Mattson

Apr 28, 2022

House

Sent to the Governor

Apr 08, 2022

Senate

Added as Alternate Co-Sponsor Sen. Robert F. Martwick

Mar 31, 2022

Senate

Added as Alternate Co-Sponsor Sen. Kimberly A. Lightford

Mar 30, 2022

Senate

Added as Alternate Co-Sponsor Sen. Diane Pappas

Senate

Added as Alternate Chief Co-Sponsor Sen. Laura Fine

Senate

Added as Alternate Chief Co-Sponsor Sen. Mike Simmons

House

Passed Both Houses

Senate

Third Reading - Passed; 055-000-000

Senate

Added as Alternate Co-Sponsor Sen. Steve Stadelman

Senate

Added as Alternate Co-Sponsor Sen. Karina Villa

Mar 29, 2022

Senate

Added as Alternate Co-Sponsor Sen. Napoleon Harris, III

Senate

Added as Alternate Co-Sponsor Sen. Mattie Hunter

Senate

Added as Alternate Co-Sponsor Sen. Suzy Glowiak Hilton

Senate

Added as Alternate Co-Sponsor Sen. Cristina Castro

Mar 24, 2022

Senate

Added as Alternate Co-Sponsor Sen. John Connor

Mar 23, 2022

Senate

Placed on Calendar Order of 3rd Reading March 24, 2022

Senate

Second Reading

Senate

Placed on Calendar Order of 2nd Reading

Senate

Do Pass Insurance; 011-000-000

Mar 16, 2022

Senate

Assigned to Insurance

Mar 04, 2022

Senate

Placed on Calendar Order of First Reading

Senate

Referred to Assignments

Senate

First Reading

Senate

Chief Senate Sponsor Sen. Ann Gillespie

Senate

Arrive in Senate

Mar 03, 2022

House

Placed on Calendar Order of 3rd Reading - Short Debate

House

Added Chief Co-Sponsor Rep. Mary E. Flowers

House

Third Reading - Short Debate - Passed 105-000-000

House

House Floor Amendment No. 1 Adopted

Mar 02, 2022

House

House Floor Amendment No. 1 Recommends Be Adopted Insurance Committee; 012-000-000

House

Held on Calendar Order of Second Reading - Short Debate

House

Second Reading - Short Debate

Mar 01, 2022

House

House Floor Amendment No. 1 Rules Refers to Insurance Committee

Feb 25, 2022

House

House Floor Amendment No. 1 Referred to Rules Committee

House

House Floor Amendment No. 1 Filed with Clerk by Rep. Bob Morgan

Feb 15, 2022

House

Added Chief Co-Sponsor Rep. Michael Kelly

House

Placed on Calendar 2nd Reading - Short Debate

Feb 10, 2022

House

Do Pass / Short Debate Insurance Committee; 017-000-000

Feb 01, 2022

House

Assigned to Insurance Committee

Jan 27, 2022

House

First Reading

House

Referred to Rules Committee

Jan 21, 2022

House

Filed with the Clerk by Rep. Bob Morgan

Bill Text

Bill Text Versions Format
Introduced HTML PDF
Engrossed HTML PDF
Enrolled HTML PDF
House Amendment 001 HTML PDF

Related Documents

Document Format
Public Act

Sources

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