215 Ill. Comp. Stat. § 134/80. Quality assessment program: Managed Care Reform and Patient Rights Act – Illinois
Status: Enacted Year Enacted: 2000
A health care plan shall develop and implement a quality assessment and improvement strategy designed to identify and evaluate accessibility, continuity, and quality of care.
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215 Ill. Comp. Stat. § 134/85. Utilization review program registration: Managed Care Reform and Patient Rights Act – Illinois
Status: Enacted Year Enacted: 2000
Plans must have utilization review programs filed with the department, and shall comply with these probisions.
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215 Ill. Comp. Stat. § 5/356r. Woman’s principal health care provider: Accident and Health Insurance – Illinois
Status: Enacted Year Enacted: 1997
Women shall have the right to select a female principal health provider. If a female insured or enrollee has designated a woman’s principal health care provider, then the insured or enrollee must be given direct …
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215 Ill. Comp. Stat. § 5/356z.17. Wellness coverage: Accident and Health Insurance – Illinois
Status: Enacted Year Enacted: 2010
A group or individual policy of health insurance or managed care plan may offer a reasonably designed program for wellness coverage that allows for a reward, a contribution, a reduction in premiums or reduced copayments, …
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215 Ill. Comp. Stat. § 5/356z.18. Prosthetic and customized orthotic devices: Accident and Health Insurance – Illinois
Status: Enacted Year Enacted: 2010
Expenses incurred in obtaining a prosthetic or custom orthotic device shall be a covered benefit. The policy or plan or contract may require prior authorization for the prosthetic or orthotic devices in the same manner …
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215 Ill. Comp. Stat. § 5/356z.21. Tobacco use cessation programs; coverage offer: Accident and Health Insurance –
Status: Year Enacted: 2012
Comprehensive smoking cessation treatment is one of the 3 most important and cost effective preventive services that can be provided in medical practice. The coverage required by this Section shall be subject to other general …
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215 Ill. Comp. Stat. § 5/356z.27. Preexisting condition exclusion: Accident and Health Insurance – Illinois
Status: Enacted Year Enacted: 2018
No policy of individual or group accident and health insurance issued, amended, delivered, or renewed on or after January 1, 2018 (the effective date of Public Act 100-386)may impose any preexisting condition exclusion, as defined …
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215 Ill. Comp. Stat. § 5/356z.3a. Nonparticipating facility-based physicians and providers: Accident and Health Insurance – Illinois
Status: Enacted Year Enacted: 2011
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 …
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215 Ill. Comp. Stat. § 5/356z.4. Coverage for contraceptives: Accident and Health Insurance – Illinois
Status: Enacted Year Enacted: 2004
The General Assembly hereby finds and declares medical management techniques such as denials, step therapy, or prior authorization in public and private health care coverage can impede access to the most effective contraceptive methods. All …
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215 Ill. Comp. Stat. § 5/363. Medicare supplement policies; minimum standards: Accident and Health Insurance – Illinois
Status: Enacted Year Enacted: 1977
Statute governs Medicare supplement policies.
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215 Ill. Comp. Stat. § 5/370b. Reimbursement on equal basis: Accident and Health Insurance – Illinois
Status: Enacted Year Enacted: 1969
Notwithstanding any provision of any individual or group policy of accident and health insurance, or any provision of a policy, contract, plan or agreement for hospital or medical service or indemnity, wherever such policy, contract, …
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215 Ill. Comp. Stat. § 5/370c. Mental and emotional disorders: Accident and Health Insurance – Illinois
Status: Enacted Year Enacted: 1977
Plans shall shall provide coverage based upon medical necessity for the treatment of a mental, emotional, nervous, or substance use disorder or condition in parity with physical treatments. Plans shall not impose additional prior authorization …
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215 Ill. Comp. Stat. § 5/370c.1. Mental, emotional, nervous, or substance use disorder or condition parity: Accident and Health Insurance – Illinois
Status: Enacted Year Enacted: 2011
Every insurer providing coverage for hospital or medical treatment and for the treatment of mental, emotional, nervous, or substance use disorders or conditions shall ensure that the financial requirements applicable to such mental, emotional, nervous, …
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215 Ill. Comp. Stat. §§ 105/1 through 105/8: Comprehensive Health Insurance Plan Act – Illinois
Status: Enacted Year Enacted: 1987
Statutes create a board to supervise and control the Illinois Comprehensive Health Insurance Plan, the board may provide for and employ cost containment measures and requirements including utilization programs. The board has authority to establish …
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215 Ill. Comp. Stat. §§ 106/1 through 106/30: Children’s Health Insurance Program Act – Illinois
Status: Enacted Year Enacted: 1998
The Act enables low-income children of Illinois to access health benefits coverage, especially preventative health care. Statute requires that at least 50% of recipients eligible for comprehensive medical benefits be enrolled in a care coordination …
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215 Ill. Comp. Stat. §§ 124/1 through 124/25: Network Adequacy and Transparency Act – Illinois
Status: Enacted Year Enacted: 2017
Statutes prohibit an insurer from prohibiting a preferred provider from discussing any specific or all treatment options with beneficiaries or from advocating on behalf of beneficiaries within utilization review. If the insurer does not have …
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