BERMAN-HALVORSON-SILVERSTEIN. New Act 5 ILCS 375/6.12 new 20 ILCS 1405/56.3 new 20 ILCS 1405/56.4 new 20 ILCS 1405/56.5 new 20 ILCS 1405/56.6 new 20 ILCS 1405/56.7 new 30 ILCS 105/5.490 new 30 ILCS 805/8.23 new 55 ILCS 5/5-1069.8 new 65 ILCS 5/10-4-2.8 new 105 ILCS 5/10-22.3g new 215 ILCS 125/2-2 from Ch. 111 1/2, par. 1404 215 ILCS 125/6-7 from Ch. 111 1/2, par. 1418.7 Creates the Managed Care Reform Act. Specifies information that must be disclosed by a managed care plan. Establishes a multi-level grievance procedure and also provides for an independent external review. Requires a managed care plan to maintain a grievance register. Requires managed care plans to be certified by the Director of Public Health with respect to adequacy of provider networks. Authorizes the Department of Public Health to impose civil penalties. Establishes a process, including hearings, for termination of a health care provider. Requires managed care plans to report to professional disciplinary agencies. Provides for the registration of utilization service agents. Establishes utilization review program standards. Provides that health insurance carriers, health care plans, and other managed care entities for health care plans have the duty to exercise ordinary care when making health care treatment decisions and are liable for damages for harm to an insured or enrollee proximately caused by the failure to exercise ordinary care. Authorizes a private right of action. Defines terms. Applies only to causes of action that accrue on or after the effective date of the Act. Amends the Civil Administrative Code of Illinois to establish the Office of Health Care Consumer Assistance, Advocacy, and Information. Establishes a Managed Care Ombudsman Program to be a part of the Office of Health Care Consumer Assistance, Advocacy, and Information. Amends the State Finance Act to create the Managed Care Reform Fund. Amends the State Mandates Act to require implementation without reimbursement. Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, and the School Code to impose the requirements of the Managed Care Reform Act upon the provision of health care under those Acts. Amends the Health Maintenance Organization Act to provide for 2 public members to be appointed to the Health Maintenance Organization Guaranty Association Board. Effective January 1, 2000. 99-02-24 S FIRST READING 99-02-24 S REFERRED TO SENATE RULES COMMITTEE RULES 99-02-24 S ASSIGNED TO COMMITTEE INS & PENS. 99-03-10 S POSTPONED 99-03-16 S HELD IN COMMITTEE 99-03-16 S COMMITTEE INS & PENS. 99-03-20 S RE-REFERRED TO RULES COMM/RULE 3-9(A) RULES 01-01-09 S SESSION SINE DIE END OF INQUIRY Full Text Bill Summary