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20 Ill. Comp. Stat. § 505/5.45. Managed care plan services: Children and Family Services Act – Illinois
Status: Enacted     Year Enacted: 2018
Statute regulates Medicaid managed care organizations and plans that cover children. Statute requires managed care organizations to post certain information on its website, including defined prior authorization requirements. Prior to transitioning a child to managed …
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20 Ill. Comp. Stat. §§ 1705/4 through 1705/4.4: Mental Health and Developmental Disabilities Administrative Act – Illinois
Status: Enacted     Year Enacted: 1961
Statutes require certain services to be provided in a State-operated facility and require such services to be monitored for quality. Statutes also require regular and ongoing on-site inspections of each facility under its jurisdiction. Statutes …
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20 Ill. Comp. Stat. §§ 2215/4-1 through 2215/4-4: Illinois Health Finance Reform Act – Illinois
Status: Enacted     Year Enacted: 1984
Statutes require hospitals to make information available about the normal charge incurred for any procedure or operation to prospective patients. Statutes require the Department to make available the “Consumer Guide to Health Care” and the …
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210 Ill. Comp. Stat. §§ 86/1 through 86/30: Hospital Report Card Act – Illinois
Status: Enacted     Year Enacted: 2004
Illinois consumers have a right to access information about the qualit of health care provided in Illinois hospitals in order to make better decisions about their choice of health care provider. Act requires individual hospitals …
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210 Ill. Comp. Stat. §§ 88/1 through 88/55: Fair Patient Billing Act – Illinois
Status: Enacted     Year Enacted: 2007
The purpose of this act is to advance the prompt and accurate payment of health care services through fair and reasonable billing and collection practices of hospitals. Statutes require a hospital to provide specified information …
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210 Ill. Comp. Stat. §§ 89/1 through 89/25: Hospital Uninsured Patient Discount Act – Illinois
Status: Enacted     Year Enacted: 2008
For all health care services exceeding $300 in any one inpatient admission or outpatient encounter, a hospital shall not collect from an uninsured patient, deemed eligible under subsection (a), more than its charges less the …
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215 Ill. Comp. Stat. § 125/4-12. Changes in Rate Methodology and Benefits, Material Modifications: Health Maintenance Organization Act – Illinois
Status: Enacted     Year Enacted: 1989
A health maintenance organization shall file with the Director, prior to use, a notice of any change in rate methodology, or benefits and of any material modification of any matter or document furnished pursuant to …
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215 Ill. Comp. Stat. § 125/5-4. Examination of affairs and quality of services by the Director; books and records: Health Maintenance Organization Act – Illinois
Status: Enacted     Year Enacted: 1974
The Director of Public Health shall make an examination concerning the quality of health care services of any health maintenance organization and providers with whom the organization has contracts, agreements, or other arrangements pursuant to …
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215 Ill. Comp. Stat. § 125/5-7. Rules and regulations to carry out provisions of Act: General Provisions– Health Maintenance Organization Act – Illinois
Status: Enacted     Year Enacted: 1974
Statute allows Director to promulgate reasonable rules and regulations that are necessary and proper to establish specific standards including full and fair disclosure of health care services provided by group contracts or evidences of coverage …
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215 Ill. Comp. Stat. § 130/2008. Provider Contracts: Limited Health Service Organization Act – Illinois
Status: Enacted     Year Enacted: 1989
All contracts with providers shall contain a clause that prohibits the provider from seeking payment from an enrollee for services provided if the limited health service organization does not pay for the services or becomes …
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215 Ill. Comp. Stat. § 130/3008. Evidence of coverage: Limited Health Service Organization Act – Illinois
Status: Enacted     Year Enacted: 1989
Every subscriber of a limited health service organization shall be issued an evidence of coverage, which must contain a clear and complete statement of any limitation of the services or benefits to be provided, and …
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215 Ill. Comp. Stat. § 130/4004. Examination of affairs and quality of services by the Director; books and records: Limited Health Service Organization Act – Illinois
Status: Enacted     Year Enacted: 1989
The Director has the power to examine limited health service organizations to ensure the quality of limited health services and providers with whom the organization has contracts, agreements or other arrangements as he deems necessary …
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215 Ill. Comp. Stat. § 134/10. Definitions: Managed Care Reform and Patient Rights Act – Illinois
Status: Enacted     Year Enacted: 2000
Definitions for the Managed Care Reform and Patient Rights Act.
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215 Ill. Comp. Stat. § 134/15. Provision of information: Managed Care Reform and Patient Rights Act – Illinois
Status: Enacted     Year Enacted: 2000
A health care plan shall provide annually to enrollees and prospective enrollees, upon request, a complete list of participating health care providers in the health care plan’s service area and a description of the following …
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215 Ill. Comp. Stat. § 134/25. Transition of services: Managed Care Reform and Patient Rights Act – Illinois
Status: Enacted     Year Enacted: 2000
Statute allows an enrollee to continue using a provider that moves out-of-network, but the physician must agree to accept reimbursement from the health care plan at rates established by the health care plan, the physician …
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215 Ill. Comp. Stat. § 134/30. Prohibitions: Managed Care Reform and Patient Rights Act – Illinois
Status: Enacted     Year Enacted: 2000
No health care plan or its subcontractors may prohibit or discourage health care providers by contract or policy from discussing any health care services and health care providers, utilization review and quality assurance policies, terms …
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