210 Ill. Comp. Stat. §§ 49/1-101.3 through 49/1-102: Specialized Mental Health Rehabilitation Act of 2013 – Illinois
Status: Enacted Year Enacted: 2013
Statutes promote community-integrated behavioral health services for people with serious mental illnesses. Statutes recognize alternatives are necessary because inpatient hospitalization rates for behavioral health services are high in Illinois and are the least cost effective …
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210 Ill. Comp. Stat. §§ 89/1 through 89/25: Hospital Uninsured Patient Discount Act – Illinois
Status: Enacted Year Enacted: 2008
For all health care services exceeding $300 in any one inpatient admission or outpatient encounter, a hospital shall not collect from an uninsured patient, deemed eligible under subsection (a), more than its charges less the …
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215 Ill. Comp. Stat. § 105/15. Alternative portable coverage for federally eligible individuals: Comprehensive Health Insurance Plan Act – Illinois
Status: Enacted Year Enacted: 1997
Statute governs portability provisions of comprehensive health insurance plan and requires that the coverages offered under this statute, the schedule of benefits, deductibles, co-payments, exclusions and other limitations be approved by the board.The board is …
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215 Ill. Comp. Stat. § 125/1-2. Definitions: Health Maintenance Organization Act – Illinois
Status: Enacted Year Enacted: 1974
Definitions for the Health Maintenance Organization Act.
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215 Ill. Comp. Stat. § 125/4-10. Medical necessity; dispute resolution; independent second opinion: Health Maintenance Organization Act – Illinois
Status: Enacted Year Enacted: 1987
There is an indepenent review process for what constitutes “medically necessary“ for a certain patient.
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215 Ill. Comp. Stat. § 125/4.5-1. Point-of-service health service contracts: Health Maintenance Organization Act – Illinois
Status: Enacted Year Enacted: 2002
HMOs may offer point-of-service contracts must abide by these limitations, including that the contract must include as in-plan covered services all services required by law to be provided by a health maintenance organization; must provide …
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215 Ill. Comp. Stat. § 125/5-7. Rules and regulations to carry out provisions of Act: General Provisions– Health Maintenance Organization Act – Illinois
Status: Enacted Year Enacted: 1974
Statute allows Director to promulgate reasonable rules and regulations that are necessary and proper to establish specific standards including full and fair disclosure of health care services provided by group contracts or evidences of coverage …
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215 Ill. Comp. Stat. § 130/1002. Definitions: Limited Health Service Organization Act – Illinois
Status: Enacted Year Enacted: 1989
Statute includes definitions relevant to the Limited Health Service Organization Act including a definition of per capita prepayment for providers.
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215 Ill. Comp. Stat. § 130/3008. Evidence of coverage: Limited Health Service Organization Act – Illinois
Status: Enacted Year Enacted: 1989
Every subscriber of a limited health service organization shall be issued an evidence of coverage, which must contain a clear and complete statement of any limitation of the services or benefits to be provided, and …
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215 Ill. Comp. Stat. § 134/1 et seq. – Illinois
Status: Enacted
The “Managed Care Reform and Patient Rights Act,” states that, among other things, a patient has the right to a examine and receive an reasonable explanation of the total bill for health care services rendered, …
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. § 134/25. 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. § 134/30. 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. § 134/40. Access to specialists: Managed Care Reform and Patient Rights Act – Illinois
Status: Enacted Year Enacted: 2000
A health care plan shall establish a procedure by which an enrollee who has a condition that requires ongoing care from a specialist physician or other health care provider may apply for a standing referral …
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215 Ill. Comp. Stat. § 134/43. Utilization of health care facilities: Managed Care and Patients Rights Act – Illinois
Status: Enacted Year Enacted: 2003
A health care plan must provide its enrollees with a description of their rights and responsibilities in obtaining referrals to and making appropriate use of health care facilities when access to their primary care physician …
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