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Status: Enacted   Year Enacted: 2000
A health care plan shall apply the same co-insurance, copayment, and deductible factors to all drug prescriptions filled by a pharmacy provider that participates in the health care plan’s network. A health care plan may […]

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.

Status: Enacted   Year Enacted: 2000
Plans must have utilization review programs filed with the department, and shall comply with these probisions.

Status: Enacted   Year Enacted: 1937
Except as provided in subsections (b), (c), (d), and (e), this Article shall apply to all companies transacting in this State the kinds of business enumerated in clause (b) of Class 1 and clause (a) […]

Status: Enacted   Year Enacted: 1937
The purposes of this Section shall be (a) to provide reasonable standardization and simplification of terms and coverages of individual accident and health insurance policies to facilitate public understanding and comparisons; (b) to eliminate provisions […]

Status: Enacted   Year Enacted: 1997
Women shall have the right to select a female principal health provider. If a female insured or enrollee has designated a woman’s principal health care provider, then the insured or enrollee must be given direct […]

Status: Enacted   Year Enacted: 2010
A group or individual policy of health insurance or managed care plan may offer a reasonably designed program for wellness coverage that allows for a reward, a contribution, a reduction in premiums or reduced copayments, […]

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 […]

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 […]

Status: Enacted   Year Enacted: 2018
No policy of individual or group accident and health insurance issued, amended, delivered, or renewed on or after January 1, 2018 (the effective date of Public Act 100-386)may impose any preexisting condition exclusion, as defined […]

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 […]

Status: Enacted   Year Enacted: 2004
The General Assembly hereby finds and declares medical management techniques such as denials, step therapy, or prior authorization in public and private health care coverage can impede access to the most effective contraceptive methods. All […]

Status: Enacted   Year Enacted: 1977
Statute governs Medicare supplement policies.

Status: Enacted   Year Enacted: 1969
Notwithstanding any provision of any individual or group policy of accident and health insurance, or any provision of a policy, contract, plan or agreement for hospital or medical service or indemnity, wherever such policy, contract, […]

Status: Enacted   Year Enacted: 1977
Plans shall shall provide coverage based upon medical necessity for the treatment of a mental, emotional, nervous, or substance use disorder or condition in parity with physical treatments. Plans shall not impose additional prior authorization […]

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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© 2018- The SLIHCQ Database. Initial funding for this project was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.
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