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Public Act 102-0632 |
SB1974 Enrolled | LRB102 12035 BMS 17371 b |
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AN ACT concerning regulation.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The Illinois Insurance Code is amended by |
changing Section 368d as follows:
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(215 ILCS 5/368d)
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Sec. 368d. Recoupments.
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(a) A health care professional or health care provider |
shall be provided a
remittance advice, which must include an |
explanation of a
recoupment or
offset taken by an insurer, |
health maintenance organization,
independent practice |
association, or physician hospital
organization, if any. The |
recoupment explanation shall, at a minimum, include
the name
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of the patient; the date of service; the service code or if no |
service code is
available a service description;
the |
recoupment amount; and the reason for the recoupment or |
offset. In
addition,
an insurer,
health maintenance |
organization, independent
practice association, or physician
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hospital organization shall provide with the remittance |
advice, or with any demand for recoupment or offset, a |
telephone
number or mailing address to initiate an appeal of |
the recoupment or offset together with the deadline for |
initiating an appeal. Such information shall be prominently |