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215 Ill. Comp. Stat. § 130/4004. Examination of affairs and quality of services by the Director; books and records: Limited Health Service Organization Act – Illinois
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 …
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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, …
215 Ill. Comp. Stat. § 134/10. Definitions: Managed Care Reform and Patient Rights Act – Illinois
Status:
Enacted Year Enacted: 2000
Definitions for the Managed Care Reform and Patient Rights Act.
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215 Ill. Comp. Stat. § 134/15. Provision of information: Managed Care Reform and Patient Rights Act – Illinois
Status:
Enacted Year Enacted: 2000
A health care plan shall provide annually to enrollees and prospective enrollees, upon request, a complete list of participating health care providers in the health care plan’s service area and a description of the following …
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215 Ill. Comp. Stat. § 134/25. Transition of services: Managed Care Reform and Patient Rights Act – Illinois
Status:
Enacted Year Enacted: 2000
Statute allows an enrollee to continue using a provider that moves out-of-network, but the physician must agree to accept reimbursement from the health care plan at rates established by the health care plan, the physician …
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215 Ill. Comp. Stat. § 134/30, 35 – Illinois
Status:
Enacted
Prevents a healthcare plan from contracting with providers to prohibit or discourage discussing “any health care services and health care providers, utilization review and quality assurance policies, terms and conditions of plans and plan policy …
215 Ill. Comp. Stat. § 134/30. Prohibitions: Managed Care Reform and Patient Rights Act – Illinois
Status:
Enacted Year Enacted: 2000
No health care plan or its subcontractors may prohibit or discourage health care providers by contract or policy from discussing any health care services and health care providers, utilization review and quality assurance policies, terms …
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215 Ill. Comp. Stat. § 134/40. Access to specialists: Managed Care Reform and Patient Rights Act – Illinois
Status:
Enacted Year Enacted: 2000
A health care plan shall establish a procedure by which an enrollee who has a condition that requires ongoing care from a specialist physician or other health care provider may apply for a standing referral …
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215 Ill. Comp. Stat. § 134/43. Utilization of health care facilities: Managed Care and Patients Rights Act – Illinois
Status:
Enacted Year Enacted: 2003
A health care plan must provide its enrollees with a description of their rights and responsibilities in obtaining referrals to and making appropriate use of health care facilities when access to their primary care physician …
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215 Ill. Comp. Stat. § 134/45.1. Medical exceptions procedures required: Managed Care Reform and Patient Rights Act – Illinois
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 …
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215 Ill. Comp. Stat. § 134/45.2. Prior authorization form; prescription benefits: Managed Care Reform and Patient Rights Act – Illinois
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. …
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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 …
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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, …
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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 …
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215 Ill. Comp. Stat. § 134/65. Emergency services prior to stabilization: Managed Care Reform and Patient Rights Act – Illinois
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 …
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215 Ill. Comp. Stat. § 134/70. Post-stabilization medical services: Managed Care Reform and Patient Rights Act – Illinois
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 …
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