SB 1974

Abstract

Amends the Illinois Insurance Code. Provides that an insurer, health maintenance organization, independent practice association, or physician hospital organization may not attempt a recoupment or offset until all appeal rights of a health care professional or health care provider are exhausted. Provides that no recoupment or offset may be requested or withheld from future payments 6 months or more after the original payment is made (rather than 18 months or more after the original payment is made). Effective January 1, 2022. Senate Committee Amendment No. 1 In provisions concerning recoupment by an insurer, health maintenance organization, independent practice association, or physician hospital organization, provides that no recoupment or offset may be requested or withheld from future payments 12 months or more (rather than 6 months or more) after the original payment is made. Removes language that provides that an insurer, health maintenance organization, independent practice association, or physician hospital organization may not attempt a recoupment or offset until all appeal rights are exhausted. House Committee Amendment No. 1 In provisions concerning recoupment by an insurer, health maintenance organization, independent practice association, or physician hospital organization, provides that no recoupment or offset may be requested or withheld from future payments 12 months or more after the original payment is made, except in cases in which an insurer contracted with the Department of Healthcare and Family Services is required by the Department of Healthcare and Family Services to recoup or offset payments due to a federal Medicaid requirement.