Status: Enacted
Year Enacted: 2014
Notwithstanding any other provision of law, on or after the effective date of this amendatory Act of the 99th General Assembly, every insurer licensed in this State to sell a policy of group or individual […]
Status: Enacted
Year Enacted: 2014
A health insurer that provides prescription drug benefits must, within 72 hours after receipt of a paper or electronic prior authorization form from a prescribing provider or pharmacist, either approve or deny the prior authorization. […]
215 Ill. Comp. Stat. § 134/5. Health care patient rights: Managed Care Reform and Patient Rights Act – Illinois
Status: Enacted
Year Enacted: 2000
A patient has the right, regardless of source of payment, to examine and to receive a reasonable explanation of his or her total bill for health care services rendered by his or her physician or […]
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, […]
215 Ill. Comp. Stat. § 134/60. Choosing a physician: Managed Care Reform and Patient Rights Act – Illinois
Status: Enacted
Year Enacted: 2000
Statute governs how an enrollee may access specialist physicians. The Director and Department of Public Health may promulgate rules to ensure appropriate access to and quality of care for enrollees in any plan that allows […]
Status: Enacted
Year Enacted: 2000
A health care plan that provides or that is required by law to provide coverage for emergency services shall provide coverage such that payment under this coverage is not dependent upon whether the services are […]
Status: Enacted
Year Enacted: 2000
If prior authorization for covered post-stabilization services is required by the health care plan, the plan shall provide access 24 hours a day, 7 days a week to persons designated by the plan to make […]
215 Ill. Comp. Stat. § 134/72. Pharmacy providers: Managed Care Reform and Patient Rights Act – Illinois
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: 2011
Payment for such coordinated care shall be based on arrangements where the State pays for performance related to health care outcomes, the use of evidence-based practices, the use of primary care delivered through comprehensive medical […]
Status: Enacted
Year Enacted: 1994
When a health insurer sends an explanation of benefits paid statements or claims summary statements to an insured it shall be in a format and written in a manner that promotes understanding by the insured […]
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
Any contract entered into or renewed on or after the effective date of this amendatory Act of the 99th General Assembly that allows the rights and obligations of the contract to be assigned or leased […]
215 Ill. Comp. Stat. § 5/355a. Standardization of terms and coverage: Accident and Health Insurance – Illinois
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 […]
215 Ill. Comp. Stat. § 5/356r. Woman’s principal health care provider: Accident and Health Insurance – Illinois
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 […]
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