SB 3233

Abstract

Amends the Department of Insurance Law of the Civil Administrative Code of Illinois. Provides that the Department of Insurance shall study the frequency and economic impact of nonparticipating facility-based physician and provider claims concerning the issue of when a beneficiary, insured, or enrollee utilizes a participating network hospital or a participating network ambulatory surgery center and, due to any reason, in-network services for radiology, anesthesiology, pathology, emergency physician, or neonatology are unavailable and are provided by a nonparticipating facility-based physician or provider and the insurer's or health plan's responsibility to ensure that the beneficiary, insured, or enrollee incurs no greater out-of-pocket costs than the beneficiary, insured, or enrollee would have incurred with a participating physician or provider for covered services. Provides that the Department shall report its findings and recommendations to the General Assembly no later than October 1, 2012. Amends the Illinois Insurance Code to provide that nothing in the provision concerning nonparticipating facility-based physicians and providers shall be interpreted to change the prudent layperson provisions with respect to emergency services under the Managed Care Reform and Patient Rights Act. Effective immediately.