BELLOCK, CROTTY, MCGUIRE, BROSNAHAN, SHARP, LYONS,EILEEN,
KLINGLER, LINDNER, GASH AND BRADLEY.
MEDICAL NEED EXTERNAL APPEAL
Synopsis of Bill as introduced:
Amends the Health Maintenance Organization Act. Adds an Article
to provide for an external appeal process for adverse determinations
of health care treatment decisions. Authorizes the Director of
Insurance to certify external appeal agents. Establishes standards for
certification. Establishes the procedures for the appeal of adverse
determinations of health care treatment decisions. Amends the State
Employees Group Insurance Act of 1971, the Counties Code, the Illinois
Municipal Code, the School Code, the Illinois Insurance Code, and the
Voluntary Health Services Plans Act to require that health care
determinations be made subject to the external appeals process.
Amends the State Mandates Act to provide an exemption from that Act
for costs of implementing the external appeals process.
FISCAL NOTE (Department of Insurance)
Fiscal impact to the Dpt. could exceed $200,000 for personnel
and equipment, and more for assigning and investigating exter-
nal appeal agents.
STATE MANDATES NOTE (Dept. of Commerce and Community Affairs)
Creates a personnel mandate for which State reimbursement of
increased costs to local gov't. is normally required; however,
the State Mandates Act is amended to exempt the State from
HOME RULE NOTE (Department of Commerce and Community Affairs)
Preempts home rule authority.
Last action on Bill: SESSION SINE DIE
Last action date: 01-01-09
Amendments to Bill: AMENDMENTS ADOPTED: HOUSE - 0 SENATE - 0
END OF INQUIRY
Full Text Bill Status