Illinois General Assembly - Bill Status for HB5313
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 Bill Status of HB5313  103rd General Assembly


Short Description:  INS-NETWORK ADEQUACY-DIRECTORY

House Sponsors
Rep. Margaret Croke - Lindsey LaPointe - Maurice A. West, II - William E Hauter, Bob Morgan, Terra Costa Howard, Gregg Johnson, Kelly M. Cassidy, Daniel Didech, Ann M. Williams, Camille Y. Lilly, Sue Scherer and Emanuel "Chris" Welch

Last Action
DateChamber Action
  4/12/2024HousePlaced on Calendar Order of 3rd Reading - Short Debate

Statutes Amended In Order of Appearance
215 ILCS 124/25
215 ILCS 124/35 new


Synopsis As Introduced
Amends the Network Adequacy and Transparency Act. Provides that a network plan shall, at least annually, audit (instead of audit periodically) at least 25% of its provider directories for accuracy, make any corrections necessary, and retain documentation of the audit. Provides that the network plan shall submit the audit to the Department of Insurance (instead of to the Director of Insurance upon request). Provides that the Department shall make the audit publicly available. Provides that a network plan shall include in the print format provider directory (i) a detailed description of the process to dispute charges for out-of-network providers or facilities that were incorrectly listed as in-network prior to the provision of care and (ii) a telephone number and email address to dispute those charges. Makes changes to the information that must be provided in a network plan's electronic and print directory. Requires the Director to conduct random audits of the accuracy of provider directories for at least 10% of plans each year. Provides that a consumer who incurs a cost for inappropriate out-of-network charges for a provider, facility, or hospital that was listed as in-network prior to the provision of services may file a verified complaint with the Department, and the Department shall conduct an investigation of the verified complaint and determine whether the complaint is sufficient. Provides that, upon a finding of sufficiency, the Director shall have the authority to levy a fine for not less than the cost incurred by the consumer for inappropriate out-of-network charges for a provider, facility, or hospital that was listed in-network. Provides that the fines collected by the Director shall be remitted to the consumer.

Actions 
DateChamber Action
  2/9/2024HouseFiled with the Clerk by Rep. Margaret Croke
  2/9/2024HouseFirst Reading
  2/9/2024HouseReferred to Rules Committee
  2/21/2024HouseAdded Chief Co-Sponsor Rep. Lindsey LaPointe
  2/26/2024HouseAdded Chief Co-Sponsor Rep. Maurice A. West, II
  2/28/2024HouseAssigned to Mental Health & Addiction Committee
  3/13/2024HouseHouse Committee Amendment No. 1 Filed with Clerk by Rep. Margaret Croke
  3/13/2024HouseHouse Committee Amendment No. 1 Referred to Rules Committee
  3/13/2024HouseAdded Co-Sponsor Rep. Bob Morgan
  3/14/2024HouseAdded Co-Sponsor Rep. Terra Costa Howard
  3/14/2024HouseDo Pass / Short Debate Mental Health & Addiction Committee; 021-000-000
  3/14/2024HouseHouse Committee Amendment No. 1 Tabled
  3/14/2024HousePlaced on Calendar 2nd Reading - Short Debate
  3/14/2024HouseAdded Co-Sponsor Rep. Gregg Johnson
  3/20/2024HouseAdded Co-Sponsor Rep. Kelly M. Cassidy
  3/21/2024HouseAdded Chief Co-Sponsor Rep. William E Hauter
  3/21/2024HouseAdded Co-Sponsor Rep. Daniel Didech
  3/21/2024HouseAdded Co-Sponsor Rep. Ann M. Williams
  3/22/2024HouseAdded Co-Sponsor Rep. Camille Y. Lilly
  4/1/2024HouseAdded Co-Sponsor Rep. Sue Scherer
  4/1/2024HouseAdded Co-Sponsor Rep. Emanuel "Chris" Welch
  4/12/2024HouseHouse Floor Amendment No. 2 Filed with Clerk by Rep. Margaret Croke
  4/12/2024HouseHouse Floor Amendment No. 2 Referred to Rules Committee
  4/12/2024HouseHouse Floor Amendment No. 2 Tabled
  4/12/2024HouseSecond Reading - Short Debate
  4/12/2024HousePlaced on Calendar Order of 3rd Reading - Short Debate

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