INS - APPEALS House SponsorsRep. Mary E. Flowers-Jack D. Franks-Linda Chapa LaVia-Keith Farnham-Monique D. Davis Senate Sponsors(Sen. Bill Brady) 1/11/2011HouseSession Sine Die 5 ILCS 375/6.1155 ILCS 5/5-1069.365 ILCS 5/10-4-2.3105 ILCS 5/10-22.3f215 ILCS 5/356f.1 new215 ILCS 125/5-3from Ch. 111 1/2, par. 1411.2215 ILCS 130/4003from Ch. 73, par. 1504-3215 ILCS 134/45215 ILCS 165/10from Ch. 32, par. 604 Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Illinois Insurance Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, and the Voluntary Health Services Plans Act. Provides that a policy of accident or health insurance or managed care plan shall establish and maintain an appeals procedure related to the denial of health care benefits. Sets forth guidelines for maintaining an appeals procedure, including an expedited process for an enrollee with (1) an ongoing course of treatment ordered by a health care provider, the denial of which could significantly increase the risk to an enrollee's health, (2) a treatment referral, service, procedure, or other health care service, the denial of which could significantly increase the risk to an enrollee's health, or (3) nonrenewal or termination of a plan. Provides that if an initial appeal is denied by the policy or plan, an enrollee is entitled to seek external independent review of the decision made by the policy or plan. Sets forth guidelines and requirements for the external independent review process. Provides that nothing in the provision shall be construed to require a policy or plan to pay for a health care service not covered under the enrollee's certificate of coverage or policy. Provides that a policy or plan shall provide each enrollee, prospective enrollee, and enrollee representative with written notification of the policy's or plan's appeal processes. Amends the Managed Care Reform and Patient Rights Act to provide that when an appeal concerns a decision or action by a health care plan, its employees, or its subcontractors that relates to the nonrenewal or termination of a plan, the health care plan must allow for the filing of an appeal either orally or in writing. Makes other changes. 2/24/2009HouseFiled with the Clerk by Rep. Mary E. Flowers 2/24/2009HouseFirst Reading 2/24/2009HouseReferred to Rules Committee 3/3/2009HouseAssigned to Health Care Availability and Accessibility Committee 3/10/2009HouseDo Pass / Short Debate Health Care Availability and Accessibility Committee; 012-000-000 3/11/2009HousePlaced on Calendar 2nd Reading - Short Debate 4/1/2009HouseSecond Reading - Short Debate 4/1/2009HouseHeld on Calendar Order of Second Reading - Short Debate 4/3/2009HousePlaced on Calendar Order of 3rd Reading - Short Debate 4/3/2009HouseThird Reading - Short Debate - Passed 067-045-000 4/3/2009HouseAdded Chief Co-Sponsor Rep. Jack D. Franks 4/3/2009HouseAdded Chief Co-Sponsor Rep. Linda Chapa LaVia 4/3/2009HouseAdded Chief Co-Sponsor Rep. Keith Farnham 4/3/2009HouseAdded Chief Co-Sponsor Rep. Monique D. Davis 4/15/2009SenateArrive in Senate 4/15/2009SenatePlaced on Calendar Order of First Reading 4/15/2009SenateChief Senate Sponsor Sen. Bill Brady 4/15/2009SenateFirst Reading 4/15/2009SenateReferred to Assignments 4/22/2009SenateAssigned to Insurance 4/30/2009SenateTo Insurance Subcommittee on Insurance Mandates 5/8/2009SenateRule 3-9(a) / Re-referred to Assignments 1/11/2011HouseSession Sine Die