91st General Assembly
Summary of HB0579
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House Sponsors:
SCHOENBERG-CAPPARELLI-KRAUSE-KLINGLER-FEIGENHOLTZ, CROSS, 
   MOORE,ANDREA, ERWIN, ACEVEDO, BEAUBIEN, BIGGINS, BOST, 
   BUGIELSKI, BURKE, COULSON, COWLISHAW, CROTTY, CURRY,JULIE, 
   FRITCHEY, GARRETT, GASH, GIGLIO, GRANBERG, HAMOS, HANNIG, 
   HOEFT, HOLBROOK, HOWARD, JONES,LOU, JONES,SHIRLEY, KENNER, 
   LYONS,JOSEPH, MCAULIFFE, MEYER, MOFFITT, MULLIGAN, MURPHY, 
   O'BRIEN, PANKAU, PERSICO, RYDER, SAVIANO, SCOTT, 
   SMITH,MICHAEL, SOMMER, WINTERS, WOJCIK, ZICKUS, LANG, 
   DAVIS,MONIQUE, JOHNSON,TIM, FOWLER, REITZ, 
   BOLAND AND BROSNAHAN.

Short description: 
MANAGED CARE PATIENT RGHTS ACT                                             

Synopsis of Bill as introduced:
        Creates the Managed Care Patient Rights Act.  Enumerates  certain      
   information  and  quality  of  care  standards  to  which a patient is      
   entitled.  Requires health care plans to  disclose  to  enrollees  and      
   prospective  enrollees  specific  information  concerning benefits and      
   coverages, emergency services,  out-of-area  coverages,  service  area      
   covered,  access to specialists, and grievance procedures.  Sets forth      
   requirements  for  continuity  of  care.   Prohibits   restraints   on      
   communications  between health care providers and enrollees and others      
   regarding care alternatives, quality, and utilization  review  issues.      
   Establishes  requirements for access to specialists and the mechanisms      
   for second opinions.  Requires health care plans to  have  a  consumer      
   advisory  committee  made  up  of enrollees and to establish a quality      
   assessment program.  Provides  for  the  registration  of  utilization      
   review  programs.   Amends  the  Health  Care  Purchasing Group Act to      
   provide that a purchasing group may be formed by 2 or  more  employers      
   having  no  more than 500 covered employees each rather than having an      
   aggregate limit of 2,500 covered individuals. Authorizes the sponsor-       
   ship of health care purchasing groups with up to 100,000 (rather            
   than  10,000) covered  individuals.   Amends the State Employees Group      
   Insurance Plan of 1971, the  Counties  Code,  the  Illinois  Municipal      
   Code,   the  Comprehensive  Health  Insurance  Plan  Act,  the  Health      
   Maintenance Organization Act, the Limited Health Service  Organization      
   Act,  the Voluntary Health Services Plans Act, and the Illinois Public      
   Aid Code to require that health care coverage under those Acts  comply      
   with  Managed  Care Patient Rights Act.  Amends the Illinois Insurance      
   Code to require compliance with provisions of the Managed Care Patient      
   Rights Act concerning utilization  review  and  complaint  procedures.      
   Amends the State Mandates Act to provide reimbursement by the State is      
   not required.  Effective January 1, 2000.                                   
          FISCAL NOTE (Dept. of Insurance)                                     
          There may be a fiscal impact to the Department that exceeds          
          $200,000. These costs would result from the hiring of addi-          
          tional staff to implement the (UR) program registration pro-         
          vision. Additionally, there would be some cost for the re-           
          structuring of the Dept's database to accommodate for UR firms.      
 
Last action on Bill: SESSION SINE DIE

   Last action date: 01-01-09

           Location: House

 Amendments to Bill: AMENDMENTS ADOPTED: HOUSE -   0     SENATE -   0


   END OF INQUIRY 



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