Sen. Omar Aquino
Filed: 3/6/2026
 
 

 
 

 
10400SB3181sam001LRB104 18630 BAB 34576 a

1
AMENDMENT TO SENATE BILL 3181 

2    AMENDMENT NO. ______. Amend Senate Bill 3181 by replacing 
3everything after the enacting clause with the following:
 
4    "Section 5. The Illinois Insurance Code is amended by 
5adding Section 368k as follows:
 
6    (215 ILCS 5/368k new)
7    Sec. 368k. Fair physician payment; minimum reimbursement; 
8penalties.
9    (a) In this Section:
10    "Annual Medical CPI" means the data published periodically 
11by the United States Bureau of Labor Statistics relating to 
12the average change in prices for medical care services and 
13commodities over time. 
14    "County" means one or all of the following 4 counties: 
15Cook, DuPage, Lake, and Will Counties in Illinois.
16    "Covered health care service" means any service for which 
 
 
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1a Medicare rate has been established at the time the physician 
2service is provided.
3    "Health insurance company" means any insurance company, 
4health maintenance organization, preferred provider 
5organization, or other entity that administers a health 
6insurance plan subject to regulation under the laws of 
7Illinois.
8    "Health insurance plan" does not include a noncommercial 
9insurance plan, such as a personal line or a policy of excepted 
10benefits.
11    "Medicare rate" means the applicable Current Procedural 
12Terminology (CPT) Code established under the Medicare 
13Physician Fee Schedule in effect on the date the physician 
14services are rendered.
15    "Physician" means an individual licensed to practice 
16medicine or osteopathy under applicable State law and any 
17advanced practice provider practicing under the supervision of 
18a physician.
19    (b) On and after January 1, 2027 and until December 31, 
202027, a health insurance company shall reimburse a physician 
21providing covered health care services in any county for no 
22less than 200% of the Medicare rate then in effect for the same 
23service. Beginning January 1, 2028 and each January 1 
24thereafter, the 200% of Medicare rate shall increase to 
25reflect the Annual Medical CPI.
26    (c) If Medicare established multiple payment rates for a 
 
 
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1service, the reimbursement floor shall be calculated using the 
2rate that most closely corresponds to the setting and type of 
3service.
4    (d) Any contract, policy, or agreement that provides for 
5reimbursement at a rate lower than the minimum reimbursement 
6in subsections (b) and (c) shall be void and unenforceable to 
7the extent of the conflict.
8    (e) A physician shall not waive the protections of this 
9Section as a condition of participation in a health benefit 
10plan or for any other reason.
11    (f) The Department shall enforce this Section and may 
12adopt rules necessary to implement its provisions.
13    (g) A health insurance company that violates this Section 
14shall be subject to:
15        (1) civil penalties of up to $15,000 per individual 
16    violation;
17        (2) payment of restitution to the affected physician; 
18    and
19        (3) any additional remedies authorized by the 
20    Department.".