215 Ill. Comp. Stat. §§ 124/1 through 124/25: Network Adequacy and Transparency Act – Illinois

Status: Enacted
Year Enacted: 2017
Year Amended: 2018
File: Download

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 the appropriate preferred providers due to insufficient number, type, unreasonable travel distance or delay, the insurer shall ensure that the beneficiary will be provided the covered service at no greater cost than if it was provided by a preferred provider. The rate of physicians to plan beneficiaries shall be established annually and the network plan may consider use of other health care service delivery options, such as telemedicine or telehealth.

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