215 Ill. Comp. Stat. § 5/370c.1. Mental, emotional, nervous, or substance use disorder or condition parity: Accident and Health Insurance – Illinois
Status: Enacted Year Enacted: 2011
Every insurer providing coverage for hospital or medical treatment and for the treatment of mental, emotional, nervous, or substance use disorders or conditions shall ensure that the financial requirements applicable to such mental, emotional, nervous, …
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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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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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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. §§ 5/2 through 5/5.5: Illinois Insurance Code — Short Title, Definitions and Classifications – Illinois
Status: Enacted Year Enacted: 1937
Statutes contain general definitions and the public policy for the Illinois Insurance Code, and also contains provisions regarding payment for services through claims submitted by the Department of Healthcare and Family Services.
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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 § 23-17-28. Health care cost containment: Health Care Facility Licensing Act of Rhode Island – Rhode Island
Status: Enacted Year Enacted: 1981
Authorizes a health care facility to enter into agreement with other facilities, third-party payers, and branches of government for the purpose of reducing, limiting, or containing health care costs and improving the efficiency with which …
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23 R.I. Gen. Laws § 23-17.22-2. Establishment of healthy Rhode Island strategic plan: Healthy Rhode Island Reform Act of 2008 – Rhode Island
Status: Enacted Year Enacted: 2008
The director of health in consultation with the health care planning and accountability advisory council established pursuant to chapter 81 of title 23, shall be responsible for the development and implementation of a five (5) …
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23 R.I. Gen. Laws § 23-17.22-3. Healthy Rhode Island chronic care management program: Healthy Rhode Island Reform Act of 2008 – Rhode Island
Status: Enacted Year Enacted: 2008
The “Healthy Rhode Island Chronic Care Management Program” may provide incentive payments to physicians based on the quality of their care.
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23 R.I. Gen. Laws §§ 23-81-1 through 21-81-6: Rhode Island Coordinated Health Planning Act of 2006 – Rhode Island
Status: Enacted Year Enacted: 2007
The general assembly finds that the people of this state have a fundamental interest in the establishment of a comprehensive strategic health care planning process and the preparation, maintenance, and implementation of plans to improve …
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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 § 27-19-5. Contracts with subscribers, hospitals, and other eligible entities: Nonprofit Hospital Service Corporations – Rhode Island
Status: Enacted Year Enacted: 1939
Each nonprofit hospital service corporation may contract with its subscribers and with any eligible hospital for hospital service to be rendered by the contracting hospital to the subscribers and as to the nature and extent …
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27 R.I. Gen. Laws § 27-19-56. Post-payment audits: Nonprofit Hospital Service Corporations – Rhode Island
Status: Enacted Year Enacted: 2006
any review, audit, or investigation by a nonprofit hospital service corporation of a health-care provider’s claims that results in the recoupment or set-off of funds previously paid to the health-care provider in respect to such …
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27 R.I. Gen. Laws § 27-19-7. Rates charged by hospitals: Nonprofit Hospital Service Corporations – Rhode Island
Status: Enacted Year Enacted: 1939
The rates charged by contracting hospitals to any nonprofit hospital service corporation for hospital services rendered by the hospitals to the subscribers of the corporation shall be established from time to time by agreement between …
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27 R.I. Gen. Laws § 27-20-1. Definitions: Nonprofit Medical Service Corporations – Rhode Island
Status: Enacted Year Enacted: 1945
Definitions related to Nonprofit Medical Service Corporations
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