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20 Ill. Comp. Stat. § 215/5-1. Mandatory Utilization Review: Illinois Health Finance Reform Act – Illinois
Introduced:    Status: Enacted
Any third party payor shall have the option to require utilization review for hospital admissions and continued hospital stays
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20 Ill. Comp. Stat. § 2215/5-1 – Illinois
Introduced:    Status: Enacted
Permits any third party payer to require a utilization review for hospital admissions and continued hospital stays for payment of hospital services. The third party payer may contract to withhold payment for hospital services to …

215 Ill. Comp. Stat. § 134/10. Definitions: Managed Care Reform and Patient Rights Act – Illinois
Introduced:    Status: Enacted
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
Introduced:    Status: Enacted
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
Introduced:    Status: Enacted
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. § 134/80. Quality assessment program: Managed Care Reform and Patient Rights Act – Illinois
Introduced:    Status: Enacted
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
Introduced:    Status: Enacted
Plans must have utilization review programs filed with the department, and shall comply with these probisions.
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215 Ill. Comp. Stat. § 180/10. Definitions: Health Carrier External Review Act – Illinois
Introduced:    Status: Enacted
Definitions for the Health Carrier External Review Act.
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215 Ill. Comp. Stat. § 5/356z.18. Prosthetic and customized orthotic devices: Accident and Health Insurance – Illinois
Introduced:    Status: Enacted
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
Introduced:    Status:
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. § 5/370n. Utilization Review Requirements: Health Care Reimbursement – Illinois
Introduced:    Status: Enacted
Any PPO providing hospital, medical or dental services must include a program of utilization review.
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23 R.I. Gen. Laws § 23-17.17-10. Reporting requirements for the health care database: Health Care Quality Program – Rhode Island
Introduced:    Status: Enacted
Insurers, health care providers, health care facilities and governmental agencies shall file reports, data, schedules, statistics or other information determined by the director to be necessary to carry out the purposes of this chapter. The …
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23 R.I. Gen. Laws § 23-17.17-11. Data collection and information sharing for the health care database: Health Care Quality Program – Rhode Island
Introduced:    Status: Enacted
All insurers shall electronically provide to the director in accordance with standards and procedures adopted by the director in regulation: (1) their health insurance claims data; (2) cross-matched claims data on requested members, subscribers or …
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23 R.I. Gen. Laws § 23-81-3.1. Establishment of health care planning and accountability advisory council: Rhode Island Coordinated Health Planning Act of 2006 – Rhode Island
Introduced:    Status: Enacted
Establishes the Rhode Island health care planning and accountability advisory council, comprised of members of government and the health care community, with duties to do the following: recommend a unified health plan for the state; …
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23 R.I. Gen. Laws § 23-93-5. Moratorium — Statewide health plan — Inventory of healthcare facilities, equipment and services: Rhode Island Access to Medical Technology Innovation Act – Rhode Island
Introduced:    Status: Enacted
During the moratorium period provided in subsection (a) above, the department of health (for purposes of this section referred to as the “department”) shall conduct, and shall conduct on a biennial basis thereafter, a statewide …
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27 R.I. Gen. Laws § 27-18.9-1. Purpose of chapter: Benefit Determination and Utilization Review Act – Rhode Island
Introduced:    Status: Enacted
Describes the purpose of the Benefit Determination and Utilization Review Act
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