Date	Chamber	Action
1/11/2011	House	Session Sine Die

Statutes Amended In Order of Appearance

5 ILCS 375/6.11

55 ILCS 5/5-1069.3

65 ILCS 5/10-4-2.3

105 ILCS 5/10-22.3f

215 ILCS 5/356f.1 new

215 ILCS 125/5-3

from Ch. 111 1/2, par. 1411.2

215 ILCS 130/4003

from Ch. 73, par. 1504-3

215 ILCS 134/45

215 ILCS 165/10

from Ch. 32, par. 604

Synopsis As Introduced
Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Illinois Insurance Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, and the Voluntary Health Services Plans Act. Provides that a policy of accident or health insurance or managed care plan shall establish and maintain an appeals procedure related to the denial of health care benefits. Sets forth guidelines for maintaining an appeals procedure, including an expedited process for an enrollee with (1) an ongoing course of treatment ordered by a health care provider, the denial of which could significantly increase the risk to an enrollee's health, (2) a treatment referral, service, procedure, or other health care service, the denial of which could significantly increase the risk to an enrollee's health, or (3) nonrenewal or termination of a plan. Provides that if an initial appeal is denied by the policy or plan, an enrollee is entitled to seek external independent review of the decision made by the policy or plan. Sets forth guidelines and requirements for the external independent review process. Provides that nothing in the provision shall be construed to require a policy or plan to pay for a health care service not covered under the enrollee's certificate of coverage or policy. Provides that a policy or plan shall provide each enrollee, prospective enrollee, and enrollee representative with written notification of the policy's or plan's appeal processes. Amends the Managed Care Reform and Patient Rights Act to provide that when an appeal concerns a decision or action by a health care plan, its employees, or its subcontractors that relates to the nonrenewal or termination of a plan, the health care plan must allow for the filing of an appeal either orally or in writing. Makes other changes.

Actions 

Date	Chamber	Action
2/24/2009	House	Filed with the Clerk by Rep. Mary E. Flowers
2/24/2009	House	First Reading
2/24/2009	House	Referred to Rules Committee
3/3/2009	House	Assigned to Health Care Availability and Accessibility Committee
3/10/2009	House	Do Pass / Short Debate Health Care Availability and Accessibility Committee; 012-000-000
3/11/2009	House	Placed on Calendar 2nd Reading - Short Debate
4/1/2009	House	Second Reading - Short Debate
4/1/2009	House	Held on Calendar Order of Second Reading - Short Debate
4/3/2009	House	Placed on Calendar Order of 3rd Reading - Short Debate
4/3/2009	House	Third Reading - Short Debate - Passed 067-045-000
4/3/2009	House	Added Chief Co-Sponsor Rep. Jack D. Franks
4/3/2009	House	Added Chief Co-Sponsor Rep. Linda Chapa LaVia
4/3/2009	House	Added Chief Co-Sponsor Rep. Keith Farnham
4/3/2009	House	Added Chief Co-Sponsor Rep. Monique D. Davis
4/15/2009	Senate	Arrive in Senate
4/15/2009	Senate	Placed on Calendar Order of First Reading
4/15/2009	Senate	Chief Senate Sponsor Sen. Bill Brady
4/15/2009	Senate	First Reading
4/15/2009	Senate	Referred to Assignments
4/22/2009	Senate	Assigned to Insurance
4/30/2009	Senate	To Insurance Subcommittee on Insurance Mandates
5/8/2009	Senate	Rule 3-9(a) / Re-referred to Assignments
1/11/2011	House	Session Sine Die

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