Sen. William R. Haine

Filed: 5/25/2011

 

 


 

 


 
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1
AMENDMENT TO HOUSE BILL 1577

2    AMENDMENT NO. ______. Amend House Bill 1577 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. "An Act concerning insurance", approved
5February 14, 2011, Public Act 96-1523, is amended by adding
6Section 99 as follows:
 
7    (P.A. 96-1523, Sec. 99 new)
8    Sec. 99. Effective date. This Act takes effect January 1,
92012.
 
10    Section 10. The Department of Insurance Law of the Civil
11Administrative Code of Illinois is amended by adding Section
121405-40 as follows:
 
13    (20 ILCS 1405/1405-40 new)
14    Sec. 1405-40. Study of out-of-network facility-based

 

 

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1physician and provider claims.
2    (a) The Department shall study the issue of insurance
3claims for medical services submitted by nonparticipating
4facility-based physicians and providers addressed in Section
5356z.3a of the Illinois Insurance Code as added by Public Act
696-1523. The Department shall have the authority to request
7insurers, health plans, and applicable nonparticipating
8facility-based physician and provider trade associations to
9assemble and submit information needed for the purposes of this
10study.
11    (b) The Department shall report its findings and
12recommendations to the General Assembly no later than November
131, 2011.
 
14    Section 15. The Illinois Insurance Code is amended by
15adding Section 356z.3b as follows:
 
16    (215 ILCS 5/356z.3b new)
17    Sec. 356z.3b. Facility-based physicians and providers;
18reimbursement rate. From June 1, 2011 to December 31, 2011,
19facility-based physicians and providers shall be reimbursed at
20the highest participating provider reimbursement rate for the
21same services in the same geographic area by all insurers and
22health plans for claims for medical services submitted for the
23services addressed in Section 356z.3a of the Illinois Insurance
24Code as added by Public Act 96-1523.
 

 

 

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1    Section 99. Effective date. This Act takes effect upon
2becoming law.".