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20 Ill. Comp. Stat. § 1705/71a. Community Behavioral Health Care: Mental Health and Developmental Disabilities Administrative Act – Illinois
Status: Enacted   Year Enacted: 2011
The Department shall strive to guarantee that persons, including children, suffering from mental illness, substance abuse, and other behavioral disorders have access to locally accessible behavioral health care providers who have the ability to treat …
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210 Ill. Comp. Stat. §§ 155/1 through 155/45: Long Term Acute Care Hospital Quality Improvement Transfer Program Act – Illinois
Status: Enacted   Year Enacted: 2010
Act created as a method to improve health care outcomes of patients, which results in a more efficient use of resources needed to provide care. It is estimated this Act could save $10,000,000 annually. Statutes …
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215 Ill. Comp. Stat. § 170/56. Care coordination: Covering All Kids Health Insurance Act – Illinois
Status: Enacted   Year Enacted: 2011
Payment for such coordinated care shall be based on arrangements where the State pays for performance related to health care outcomes, the use of evidence-based practices, the use of primary care delivered through comprehensive medical …
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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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27 R.I. Gen. Laws § 27-18-51. Restricted annual rate payments prohibited: Accident and Sickness Insurance Policies – Rhode Island
Status: Enacted   Year Enacted: 1998
(a) No policy delivered or issued in this state shall contain a provision for compensating any provider of outpatient mental health and/or substance abuse treatment service by using the restricted annual rate method of payment. …
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27 R.I. Gen. Laws § 27-19-43. Restricted annual rate payments prohibited: Nonprofit Hospital Service Corporations – Rhode Island
Status: Enacted   Year Enacted: 1998
(a) No corporation organized under this chapter shall compensate any provider of outpatient service by using the restricted annual rate method of payment. (b) The “restricted annual rate method of payment” is defined as any …
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27 R.I. Gen. Laws § 27-20-38. Restricted annual rate payments prohibited: Nonprofit Medical Service Corporations – Rhode Island
Status: Enacted   Year Enacted: 1998
(a) No corporation organized under this chapter shall compensate any provider of outpatient service by using the restricted annual rate method of payment. (b) The “restricted annual rate method of payment” is defined as any …
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27 R.I. Gen. Laws § 27-41-52. Restricted annual rate payments prohibited: Health Maintenance Organization Act – Rhode Island
Status: Enacted   Year Enacted: 1998
(a) No corporation organized under this chapter shall compensate any provider of outpatient service by using the restricted annual rate method of payment. (b) The restricted annual rate method of payment is defined as any …
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305 Ill. Comp. Stat. § 5/5-11. Co-operative arrangements; contracts with other State agencies, health care and rehabilitation organizations, and fiscal intermediaries: Medical Assistance – Illinois
Status: Enacted   Year Enacted: 1967
The Illinois Department may enter into co-operative arrangements with State agencies responsible for administering or supervising the administration of health services and vocational rehabilitation services to the end that there may be maximum utilization of …
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40 Pa. Cons. Stat. § 764a. Preferred provider organizations: Health and Accident Insurance – Pennsylvania
Status: Enacted   Year Enacted: 1986
Describes the role of preferred provider organizations, what happens in their assumption of risk and the role of the Insurance Commissioner.
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40 Pa. Cons. Stat. § 991.2112. Financial incentives prohibition: Managed Care Plan Requirements – Pennsylvania
Status: Enacted   Year Enacted: 1998
No managed care plan shall use any financial incentive that compensates a health care provider for providing less than medically necessary and appropriate care to an enrollee. Nothing in this section shall be deemed to …
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40 Pa. Cons. Stat. §§ 3801 through 3806: Retroactive Denial of Reimbursements – Pennsylvania
Status: Enacted   Year Enacted: 2016
An insurer that retroactively denies reimbursement to a health care provider under this chapter shall do so based upon coding guidelines and policies in effect at the time the service subject to the retroactive denial …
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40 Pa. Stat. and Cons. Stat. Ann. § 764a. Preferred provider organizations: Health and Accident Insurance – Pennsylvania
Status: Enacted   Year Enacted: 1986
Governs preferred provider organizations and the powers of the insurance commissioner.
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AB 1124 – California
Introduced: 2020   Status: Enacted  
Health care service plans: regulations: exemptions. Existing federal law defines a voluntary employees’ beneficiary association as an organization composed of a voluntary association of employees that provides for the payment of life, sick, accident, or …

AB 1130 – California
Introduced: 2021   Status: Inactive / Dead  
California Health Care Quality and Affordability Act. Existing law generally requires the State Department of Public Health to license, inspect, and regulate health facilities, including hospitals. Existing law requires health facilities to meet specified cost …

AB 1249 – California
Introduced: 2019   Status: Inactive / Dead  
The Governor VETOED this bill. Health care service plans: regulations: exemptions – This bill would authorize the director, no later than May 1, 2020, to authorize 2 pilot programs, one in northern California and one …

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