215 Ill. Comp. Stat. §§ 125/4-10 through 125/4-20: Health Maintenance Organization Act — Delivery of Services – Required Provisions and Marketing – Illinois
Status: Enacted Year Enacted: 1987
Statutes lay out indepenent review process for what constitutes “medically necessary” for a certain patient. Statutes require a health maintenance organization to file with the Director, prior to use, a notice of any change in …
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215 Ill. Comp. Stat. §§ 170/1 through 170/40: Covering All Kids Health Insurance Act – Illinois
Status: Enacted Year Enacted: 2006
The Covering All Kids Health Insurance Act was created to enable all children to access affordable health insurance that offers comprehensive coverage and emphasizes preventive healthcare. The Department shall adopt rules regarding performance standards and …
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215 Ill. Comp. Stat. §§ 180/1 through 180/42: Health Carrier External Review Act – Illinois
Status: Enacted Year Enacted: 2010
The Health Carrier External Review Act’s purpose is to provide uniform standards for the establishment and maintenance of external review procedures. Statutes set out timeline and process for a standard review.
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215 Ill. Comp. Stat. §§ 190/1 through 190/20: Short-Term, Limited-Duration Health Insurance Coverage Act – Illinois
Status: Enacted Year Enacted: 2018
Statutes set out the requirements of short-term, limited-duration health insurance coverage. A health insurance issuer that offers short-term, limited-duration health insurance coverage shall provide the policy, membership booklet, description of appeals and external review rights …
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215 Ill. Comp. Stat. §§ 5/2 through 5/5.5: Illinois Insurance Code — Short Title, Definitions and Classifications – Illinois
Status: Enacted Year Enacted: 1937
Statutes contain general definitions and the public policy for the Illinois Insurance Code, and also contains provisions regarding payment for services through claims submitted by the Department of Healthcare and Family Services.
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215 Ill. Comp. Stat. §§ 5/370g through 5/370o: Health Care Reimbursement Reform Act of 1985 – Illinois
Status: Enacted Year Enacted: 1985
Statutes prohibit an insurer or administrator from refusing to contract with any noninstitutional provider who meets the terms and conditions established by the insurer. Statutes allow an insurer to issue or administer programs or policies …
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215 Ill. Comp. Stat. §§ 97/1 through 97/60: Illinois Health Insurance Portability and Accountability Act – Illinois
Status: Enacted Year Enacted: 1997
Statutes limit preexisting condition exclusions and govern when health insurance issuers must renew coverage and when issuers may discontinue coverage in connection with a group health plan. Statutes prohibit eligibility and rates from being contingent …
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23 R.I. Gen. Laws § 23-17.22-1. Short title: Healthy Rhode Island Reform Act of 2008 – Rhode Island
Status: Enacted Year Enacted: 2008
This chapter shall be known and may be cited as the “Healthy Rhode Island Reform Act of 2008.”
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23 R.I. Gen. Laws § 23-17.22-2. Establishment of healthy Rhode Island strategic plan: Healthy Rhode Island Reform Act of 2008 – Rhode Island
Status: Enacted Year Enacted: 2008
The director of health in consultation with the health care planning and accountability advisory council established pursuant to chapter 81 of title 23, shall be responsible for the development and implementation of a five (5) …
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23 R.I. Gen. Laws § 23-17.22-3. Healthy Rhode Island chronic care management program: Healthy Rhode Island Reform Act of 2008 – Rhode Island
Status: Enacted Year Enacted: 2008
The “Healthy Rhode Island Chronic Care Management Program” may provide incentive payments to physicians based on the quality of their care.
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23 R.I. Gen. Laws §§ 23-17.17-1 through 23-17.17-11: Health Care Quality Program – Rhode Island
Status: Enacted Year Enacted: 1998
Estbalishes the Health Care Quality Program and the state’s all-payer claims database, requiring insurers, health care providers, health care facilities and governmental agencies to file reports, data, schedules, statistics or other information determined by the …
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27 R.I. §§ 27-18.5-1 through 27-18.5-10: Individual Health Insurance Coverage – Rhode Island
Status: Enacted Year Enacted: 2000
The purpose of this chapter is, among other things, to insure compliance of all policies, contracts, certificates, and agreements of individual health insurance coverage offered or delivered in this state with the Health Insurance Portability …
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27 R.I. §§ 27-18.6-1 through 27-18.6-10: Large Group Health Insurance Coverage – Rhode Island
Status: Enacted Year Enacted: 2000
The purpose of this chapter is to insure compliance of all policies, contracts, certificates, and agreements of group health insurance coverage offered or delivered in this state with the Health Insurance Portability and Accountability Act …
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27 R.I. Gen. Laws § 27-18-71. Prohibition on preexisting condition exclusions: Accident and Sickness Insurance Policies – Rhode Island
Status: Enacted Year Enacted: 2012
A health insurance policy, subscriber contract, or health plan offered, issued, issued for delivery, or issued to cover a resident of this state by a health insurance company licensed pursuant to this title and/or chapter …
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27 R.I. Gen. Laws § 27-18-75. Medical loss ratio reporting and rebates: Accident and Sickness Insurance Policies – Rhode Island
Status: Enacted Year Enacted: 2012
Health insurance carriers required to report medical loss ratio and rebate calculations and other medical loss ratio and rebate information to the U.S. Department of Health and Human Services shall concurrently file such information with …
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27 R.I. Gen. Laws § 27-18-76. Emergency services: Accident and Sickness Insurance Policies – Rhode Island
Status: Enacted Year Enacted: 2012
If a nonprofit medical service corporation offering health insurance coverage provides any benefits with respect to services in an emergency department of a hospital, it must cover emergency services consistent with the rules of this …
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