Illinois General Assembly - Bill Status for SB0750

Amends the Illinois Insurance Code. Provides that health plan issuers offering health plans through the State health insurance marketplace update their provider directory on a monthly basis. Provides that the information in provider directories shall be offered in a manner that accommodates individuals with limited English proficiency and with disabilities. Provides that, with respect to dental plans, a dentist listed is considered an active network participant from the location published in the provider directory only if the dentist has filed a claim for a patient enrolled with the dental plan at least once in the previous 3-month period. Amends the Dental Care Patient Protection Act. Provides that managed care dental plans must only list participating dentists who have filed a claim for an enrolled patient within the past 3 months. Makes conforming changes in the Dental Service Plan Act.

Replaces everything after the enacting clause. Amends the Illinois Insurance Code. Provides that insurers must list in the provider directory if a provider is accepting new patients at each of the specific locations listing the individual provider. Provides that any provider that has not been actively treating patients at a specific location within the last 6 months, or does not expect to in the next 6 months, shall no longer be listed in the provider directory at that specific location. Makes conforming changes in the Dental Care Patient Protection Act and the Illinois Dental Practice Act. Effective January 1, 2016.

Replaces everything after the enacting clause with the bill as amended by Senate Amendment No. 1 with the following changes: In provisions of the Illinois Insurance Code concerning standardization of terms and coverage, provides that providers shall notify qualified health plans electronically or in writing of any changes to the information listed in the provider directory, and that qualified health plans shall update their directories with the new information within 10 business days after being notified of the changes (rather than requiring provider directories to remove providers that have not been actively treating patients at a specific location within the last 6 months or anticipate to treat patients in the next 6 months). In provisions of the Dental Care Patient Protection Act concerning the provision of information, provides that providers shall notify managed care dental plans electronically or in writing of any changes to the information listed in the provider directory, and that managed care dental plans shall update their directories with the new information within 10 business days after being notified of the changes (rather than requiring provider directories to remove providers that have not been actively treating patients at a specific location within the last 6 months or anticipate to treat patients in the next 6 months). In provisions of the Illinois Dental Practice Act concerning the prohibition of practice by corporations, removes provisions requiring provider directories to remove providers that have not been actively treating patients at a specific location within the last 6 months or anticipate to treat patients in the next 6 months. In provisions of the Illinois Dental Practice Act concerning advertisements, provides that health plans shall remove the provider from directories in accordance with standard practices within 10 business days after the managed care plan is notified electronically or in writing of the changes by the provider (rather than requiring provider directories to remove providers that have not been actively treating patients at a specific location within the last 6 months or anticipate to treat patients in the next 6 months). Effective January 1, 2016.

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