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20 Ill. Comp. Stat. § 2215/5-1. Mandatory Utilization Review: Illinois Health Finance Reform Act – Illinois
Status: Enacted     Year Enacted: 1984
Statute grants any third party payor the option to require utilization review for hospital admissions and continued hospital stays.
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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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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. § 134/30. 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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215 Ill. Comp. Stat. § 134/55. Record of complaints: Managed Care Reform and Patient Rights Act – Illinois
Status: Enacted     Year Enacted: 2000
The Department shall make a summary of all data collected of complaints against health care plans available upon request and publish the summary on the internet. The complaints shall be classified under several categories, including, …
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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. § 5/356z.18. Prosthetic and customized orthotic devices: Accident and Health Insurance – Illinois
Status: Enacted     Year Enacted: 2010
Expenses incurred in obtaining a prosthetic or custom orthotic device shall be a covered benefit. The policy or plan or contract may require prior authorization for the prosthetic or orthotic devices in the same manner …
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215 Ill. Comp. Stat. § 5/356z.21. Tobacco use cessation programs; coverage offer: Accident and Health Insurance
Status:     Year Enacted: 2012
Comprehensive smoking cessation treatment is one of the 3 most important and cost effective preventive services that can be provided in medical practice. The coverage required by this Section shall be subject to other general …
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215 Ill. Comp. Stat. §§ 105/1 through 105/8: Comprehensive Health Insurance Plan Act – Illinois
Status: Enacted     Year Enacted: 1987
Statutes create a board to supervise and control the Illinois Comprehensive Health Insurance Plan, the board may provide for and employ cost containment measures and requirements including utilization programs. The board has authority to establish …
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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. §§ 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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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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23 R.I. Gen. Laws §§ 23-93-1 through 23-93-5: Rhode Island Access to Medical Technology Innovation Act – Rhode Island
Status: Enacted     Year Enacted: 2014
For purposes of this chapter, “Domestic Medical Tourism” means the practice of patients traveling to states other than their residence for the provision of healthcare services.
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27 R.I. Gen. Laws § 27-20-5. Contracts with subscribers: Nonprofit Medical Service Corporations – Rhode Island
Status: Enacted     Year Enacted: 1945
Each nonprofit medical service corporation may contract with its subscribers for any medical service as may be provided under any nonprofit medical service plan adopted by the corporation.
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