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| | 100TH GENERAL ASSEMBLY
State of Illinois
2017 and 2018
SB0634 Introduced 1/25/2017, by Sen. Scott M. Bennett SYNOPSIS AS INTRODUCED:
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Amends the State Employees Group Insurance Act of 1971. Provides that the failure of the State of Illinois to adequately reimburse a dental provider for a period of 6 months from the date a claim was submitted may be considered by the provider to be a material breach of any associated participating provider contract utilized by the State for its employees. Provides that a dental provider who has an existing contract that provides services to State employees under this Act and who has not received timely reimbursement for services for a period of 6 months: (1) may consider the associated provider contract null and void for the State of Illinois; (2) may opt out of the obligation to provide services under the terms and conditions of the associated provider contract without penalty by the State or the administrator of the dental plan including any provision that allows for termination from any other commercial plans administered by the dental insurer without cause; and (3) shall, upon providing notice, be deemed an out-of-network provider from that time forward. Effective immediately.
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| | | FISCAL NOTE ACT MAY APPLY | |
| | A BILL FOR |
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| | SB0634 | | LRB100 05383 RJF 15394 b |
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| 1 | | AN ACT concerning regulation.
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| 2 | | Be it enacted by the People of the State of Illinois,
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| 3 | | represented in the General Assembly:
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| 4 | | Section 5. The State Employees Group Insurance Act of 1971 |
| 5 | | is amended by adding Section 6.12a as follows:
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| 6 | | (5 ILCS 375/6.12a new) |
| 7 | | Sec. 6.12a. Nullification of in-network dental provider |
| 8 | | contracts. The failure of the State of Illinois to adequately |
| 9 | | reimburse a dental provider for a period of 6 months from the |
| 10 | | date a claim was submitted may be considered by the provider to |
| 11 | | be a material breach of any associated participating provider |
| 12 | | contract utilized by the State for its employees. |
| 13 | | Notwithstanding the provisions of Section 6.12, a dental |
| 14 | | provider who has an existing contract that provides services to |
| 15 | | State employees under this Act and who has not received timely |
| 16 | | reimbursement for services for a period of 6 months: (1) may |
| 17 | | consider the associated provider contract null and void for the |
| 18 | | State of Illinois; (2) may opt out of the obligation to provide |
| 19 | | services under the terms and conditions of the associated |
| 20 | | provider contract without penalty by the State or the |
| 21 | | administrator of the dental plan including any provision that |
| 22 | | allows for termination from any other commercial plans |
| 23 | | administered by the dental insurer without cause; and (3) |