SB 3188

Abstract

Amends the State Employees Group Insurance Act of 1971, Counties Code, Illinois Municipal Code, School Code, Illinois Insurance Code, Health Maintenance Organization Act, and Voluntary Health Services Plans Act. Provides that when a beneficiary utilizes a participating network hospital or a participating network ambulatory surgery center and services at the network hospital or network ambulatory surgery center are provided by a nonparticipating facility-based physician or provider, the insurer shall ensure that the beneficiary shall incur no greater out-of-pocket liability than had the beneficiary received services from a participating physician or provider for covered services. Sets forth conditions under which an insurer may initiate binding arbitration regarding the reasonableness of the charges of the nonparticipating physician or provider. Provides that the Department of Insurance shall publish a list of approved arbitrators or entities that shall provide binding arbitration. Provides that the nonprevailing party shall pay the arbitrator's fees. Makes other changes. Contains a nonacceleration clause. Effective January 1, 2011.