Bob Morgan
- Democratic
- Representative
- District 58
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.
Added as Alternate Co-Sponsor Sen. Doris Turner
Added as Alternate Co-Sponsor Sen. Bill Cunningham
Public Act . . . . . . . . . 102-0901
Effective Date July 1, 2022; - Some Provisions Effective January 1, 2023
Governor Approved
Added as Alternate Co-Sponsor Sen. Christopher Belt
Added as Alternate Co-Sponsor Sen. Ram Villivalam
Added as Alternate Co-Sponsor Sen. Celina Villanueva
Added as Alternate Co-Sponsor Sen. Meg Loughran Cappel
Added as Alternate Co-Sponsor Sen. Omar Aquino
Added as Alternate Co-Sponsor Sen. Michael E. Hastings
Added as Alternate Co-Sponsor Sen. Scott M. Bennett
Added as Alternate Co-Sponsor Sen. Eric Mattson
Sent to the Governor
Added as Alternate Co-Sponsor Sen. Robert F. Martwick
Added as Alternate Co-Sponsor Sen. Kimberly A. Lightford
Added as Alternate Co-Sponsor Sen. Diane Pappas
Added as Alternate Chief Co-Sponsor Sen. Laura Fine
Added as Alternate Chief Co-Sponsor Sen. Mike Simmons
Passed Both Houses
Third Reading - Passed; 055-000-000
Added as Alternate Co-Sponsor Sen. Steve Stadelman
Added as Alternate Co-Sponsor Sen. Karina Villa
Added as Alternate Co-Sponsor Sen. Napoleon Harris, III
Added as Alternate Co-Sponsor Sen. Mattie Hunter
Added as Alternate Co-Sponsor Sen. Suzy Glowiak Hilton
Added as Alternate Co-Sponsor Sen. Cristina Castro
Added as Alternate Co-Sponsor Sen. John Connor
Placed on Calendar Order of 3rd Reading March 24, 2022
Second Reading
Placed on Calendar Order of 2nd Reading
Do Pass Insurance; 011-000-000
Assigned to Insurance
Placed on Calendar Order of First Reading
Referred to Assignments
First Reading
Chief Senate Sponsor Sen. Ann Gillespie
Arrive in Senate
Placed on Calendar Order of 3rd Reading - Short Debate
Added Chief Co-Sponsor Rep. Mary E. Flowers
Third Reading - Short Debate - Passed 105-000-000
House Floor Amendment No. 1 Adopted
House Floor Amendment No. 1 Recommends Be Adopted Insurance Committee; 012-000-000
Held on Calendar Order of Second Reading - Short Debate
Second Reading - Short Debate
House Floor Amendment No. 1 Rules Refers to Insurance Committee
House Floor Amendment No. 1 Referred to Rules Committee
House Floor Amendment No. 1 Filed with Clerk by Rep. Bob Morgan
Added Chief Co-Sponsor Rep. Michael Kelly
Placed on Calendar 2nd Reading - Short Debate
Do Pass / Short Debate Insurance Committee; 017-000-000
Assigned to Insurance Committee
First Reading
Referred to Rules Committee
Filed with the Clerk by Rep. Bob Morgan
Bill Text Versions | Format |
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Introduced | HTML PDF |
Engrossed | HTML PDF |
Enrolled | HTML PDF |
House Amendment 001 | HTML PDF |
Document | Format |
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Public Act |
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