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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. § 134/65. Emergency services prior to stabilization: Managed Care Reform and Patient Rights Act – Illinois
Status: Enacted     Year Enacted: 2000
A health care plan that provides or that is required by law to provide coverage for emergency services shall provide coverage such that payment under this coverage is not dependent upon whether the services are …
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215 Ill. Comp. Stat. § 134/70. Post-stabilization medical services: Managed Care Reform and Patient Rights Act – Illinois
Status: Enacted     Year Enacted: 2000
If prior authorization for covered post-stabilization services is required by the health care plan, the plan shall provide access 24 hours a day, 7 days a week to persons designated by the plan to make …
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215 Ill. Comp. Stat. § 5/356z.3a. Nonparticipating facility-based physicians and providers: Accident and Health Insurance – Illinois
Status: Enacted     Year Enacted: 2011
When a beneficiary, insured, or enrollee utilizes a participating network hospital or a participating network ambulatory surgery center and, due to any reason, in network services for radiology, anesthesiology, pathology, emergency physician, or neonatology are …
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215 Ill. Comp. Stat. §§ 124/1 through 124/25: Network Adequacy and Transparency Act – Illinois
Status: Enacted     Year Enacted: 2017
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 …
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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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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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27 R.I. Gen. Laws § 27-19-66. Emergency services: Nonprofit Hospital Service Corporations – 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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27 R.I. Gen. Laws § 27-20-62. Emergency services: Nonprofit Medical Service Corporations – 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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27 R.I. Gen. Laws § 27-41-79. Emergency services: Health Maintenance Organization Act – 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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28 Pa. Code §§ 9.601, 9.602, 9.651, 9.671, 9.672: Managed Care Organizations – Pennsylvania
Status: Enacted     Year Enacted: 2001
Sections relate to billing practices for emergency services for managed care organizations.
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A 00264 (see companion bill S 01371) – New York
Introduced: 2019    Status: Enacted    
Establishes patient protections from excessive hospital emergency charges; includes hospital charges, including hospital charges for inpatient services which follow an emergency room visit.

A 00264 (see companion bill S 01371) – New York
Introduced: 2019    Status: Enacted    
Establishes patient protections from excessive hospital emergency charges; includes hospital charges, including hospital charges for inpatient services which follow an emergency room visit.

A 00598 (see companion bill S 03461) – New York
Introduced: 2019    Status: Inactive / Dead    
Requires health insurers to offer coverage of health care provided by out-of-network providers.

A 02859 (see companion bill S 03295) – New York
Introduced: 2019    Status: Inactive / Dead    
Establishes the transparency in health care fees act requiring health care providers to submit bills to patients prior to performing services.

A 02975 – New York
Introduced: 2019    Status: Inactive / Dead    
Directs health insurers to provide enrollees the option to assign the payment of emergency services benefits directly to an out of network health care provider.

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