215 Ill. Comp. Stat. § 5/356z.27. Preexisting condition exclusion: Accident and Health Insurance – Illinois
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 …
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215 Ill. Comp. Stat. § 5/356z.3a. Nonparticipating facility-based physicians and providers: Accident and Health Insurance – Illinois
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 …
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215 Ill. Comp. Stat. § 5/356z.4. Coverage for contraceptives: Accident and Health Insurance – Illinois
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 …
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215 Ill. Comp. Stat. § 5/363. Medicare supplement policies; minimum standards: Accident and Health Insurance – Illinois
Status: Enacted Year Enacted: 1977
Statute governs Medicare supplement policies.
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215 Ill. Comp. Stat. § 5/368a. Timely payment for health care services: Accident and Health Insurance – Illinois
Status: Enacted Year Enacted: 1999
Statute regulates the payment for health care services by insurers, HMOs, managed care plans, health care plans, preferred provider organizations and third party administrators.
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215 Ill. Comp. Stat. § 5/368b. Contracting procedures: Accident and Health Insurance – Illinois
Status: Enacted Year Enacted: 2004
The fee schedule, the capitation schedule, and the network provider administration manual constitute confidential, proprietary, and trade secret information and are subject to the provisions of the Illinois Trade Secrets Act.
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215 Ill. Comp. Stat. § 5/370b. Reimbursement on equal basis: Accident and Health Insurance – Illinois
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, …
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215 Ill. Comp. Stat. § 5/370c. Mental and emotional disorders: Accident and Health Insurance – Illinois
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 …
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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. §§ 105/1 through 105/8: Comprehensive Health Insurance Plan Act – Illinois
Status: Enacted Year Enacted: 1987
Statutes create a board to supervise and control the Illinois Comprehensive Health Insurance Plan, the board may provide for and employ cost containment measures and requirements including utilization programs. The board has authority to establish …
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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. §§ 122/5-1 through 122/5-10: Health Benefits Exchange Law – Illinois
Status: Enacted Year Enacted: 2011
Statutes creating Illinois Affordable Care Act exchange marketplace.
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215 Ill. Comp. Stat. §§ 124/1 through 124/25: Network Adequacy and Transparency Act – Illinois
Status: Enacted Year Enacted: 2017
Statutes prohibit an insurer from prohibiting a preferred provider from discussing any specific or all treatment options with beneficiaries or from advocating on behalf of beneficiaries within utilization review. If the insurer does not have …
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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. §§ 170/1 through 170/40: Covering All Kids Health Insurance Act – Illinois
Status: Enacted Year Enacted: 2006
The Covering All Kids Health Insurance Act was created to enable all children to access affordable health insurance that offers comprehensive coverage and emphasizes preventive healthcare. The Department shall adopt rules regarding performance standards and …
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215 Ill. Comp. Stat. §§ 170/47 through 170/52: Covering All Kids Health Insurance Act – Illinois
Status: Enacted Year Enacted: 2006
The Department shall report information on the number of professionals serving in the primary care management program and the number of non-primary care providers accepting referrals for counties with a population of 100,000 or greater. …
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