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 […]
Status: Enacted
Year Enacted: 1974
Definitions for the Health Maintenance Organization Act.
Status: Enacted
Year Enacted: 1987
HMO Provider agreements must include a hold-harmless clause. All HMO providers shall participate in the quality assurance program.
Status: Enacted
Year Enacted: 1987
There is an indepenent review process for what constitutes “medically necessary“ for a certain patient.
Status: Enacted
Year Enacted: 1989
A health maintenance organization shall file with the Director, prior to use, a notice of any change in rate methodology, or benefits and of any material modification of any matter or document furnished pursuant to […]
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 […]
Status: Enacted
Year Enacted: 1987
Statute requires the Director to give primary consideration to the continuation of benefits to enrollees and financial conditions of the acquired HMO when considering the merger, consolidation or other acquisition of control. The Director does […]
Status: Enacted
Year Enacted: 2000
HMOs are subject to the provisions of the Managed Care Reform and Patient Rights Act.
Status: Enacted
Year Enacted: 1974
The Director of Public Health shall make an examination concerning the quality of health care services of any health maintenance organization and providers with whom the organization has contracts, agreements, or other arrangements pursuant to […]
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 […]
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.
215 Ill. Comp. Stat. § 130/2008. Provider Contracts: Limited Health Service Organization Act – Illinois
Status: Enacted
Year Enacted: 1989
All contracts with providers shall contain a clause that prohibits the provider from seeking payment from an enrollee for services provided if the limited health service organization does not pay for the services or becomes […]
Status: Enacted
Year Enacted: 1989
Statute requires that limited health service organizations file with the Director prior to use a notice of any change in rate methodology, charges or benefits.
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 […]
Status: Enacted
Year Enacted: 1989
The Director has the power to examine limited health service organizations to ensure the quality of limited health services and providers with whom the organization has contracts, agreements or other arrangements as he deems necessary […]
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, […]
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