HB3771 97TH GENERAL ASSEMBLY

LRB097 11798 RPM 55038 b

97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
HB3771

Introduced 5/4/2011, by Rep. Mary E. Flowers

SYNOPSIS AS INTRODUCED:

215 ILCS 134/37 new

Amends the Managed Care Reform and Patient Rights Act. Provides that the Director of Insurance shall adopt reasonable rules as necessary and proper to ensure that persons enrolled in or covered by a health care plan have adequate access to health care services in each geographic area to be covered by a health care plan. Provides that the Director may annually determine compliance of the health care plan with prescribed standards and shall notify the health care plan of any noncompliance. Provides that failure of the health care plan to comply within one year after such notification shall constitute a violation of the Act.

A BILL FOR

AN ACT concerning insurance.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Managed Care Reform and Patient Rights Act is amended by adding Section 37 as follows:

(215 ILCS 134/37 new)

Sec. 37. Access standards. The Director of Insurance shall adopt reasonable rules as necessary and proper to ensure that enrollees have adequate access to health care services in each geographic area to be covered by a health care plan, including, but not limited to, the establishment of minimum physician-to-patient ratios, mileage requirements for primary and specialty care, a maximum travel time, and a maximum waiting time for obtaining an appointment. The Director may annually determine compliance of the health care plan with prescribed standards and shall notify the health care plan of any noncompliance. Failure of the health care plan to comply within one year after such notification shall constitute a violation of this Act.