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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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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. § 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. § 134/25. 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. § 134/60. Choosing a physician: Managed Care Reform and Patient Rights Act – Illinois
Status: Enacted     Year Enacted: 2000
Statute governs how an enrollee may access specialist physicians. The Director and Department of Public Health may promulgate rules to ensure appropriate access to and quality of care for enrollees in any plan that allows …
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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. §§ 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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225 Ill. Comp. Stat. §§ 61/1 through 61/10: Patients’ Right to Know Act – Illinois
Status: Enacted     Year Enacted: 2011
The Department shall make available to the public a profile of each physician. The Department shall make this information available through an Internet web site and, if requested, in writing. The profile shall contain information …
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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 §§ 23-81-1 through 21-81-6: Rhode Island Coordinated Health Planning Act of 2006 – Rhode Island
Status: Enacted     Year Enacted: 2007
The general assembly finds that the people of this state have a fundamental interest in the establishment of a comprehensive strategic health care planning process and the preparation, maintenance, and implementation of plans to improve …
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27 R.I. Gen. Laws § 27-41-16. Examination: Health Maintenance Organization Act – Rhode Island
Status: Enacted     Year Enacted: 1983
The director of health may make an examination concerning the quality of health care services of any health maintenance organization and the providers with whom the organization has contracts, agreements, or other arrangements as often …
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305 Ill. Comp. Stat. § 5/5-30. Care coordination: Medical Assistance – Illinois
Status: Enacted     Year Enacted: 2011
At least 50% of eligible patients shall be enrolled in the coordinated care program. Payments can be based on the coordination of care. There is a specific program for patients with chronic illnesses, and the …
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305 Ill. Comp. Stat. § 5/5-30.2. Monthly reports; managed care enrollment: Medical Assistance – Illinois
Status: Enacted     Year Enacted: 2015
The department must publish monthly enrollment reports on the website. The Department must annually publish on its website each Medicaid Managed Care Entity’s quality metrics outcomes and must make public an independent annual quality review …
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