Bill Status of HB 3749   96th General Assembly


Short Description:  INS CD - CHANGES IN COVERAGE

House Sponsors
Rep. Mary E. Flowers

Last Action  View All Actions

DateChamber Action
  1/11/2011HouseSession Sine Die

Statutes Amended In Order of Appearance
215 ILCS 5/357.9from Ch. 73, par. 969.9
215 ILCS 5/357.9afrom Ch. 73, par. 969.9a
215 ILCS 5/368c
215 ILCS 5/368d
215 ILCS 5/368g new

Synopsis As Introduced
Amends the Illinois Insurance Code. Provides that an insured may be entitled to interest at the rate of 10% (instead of 9%) if an insurer fails to pay a claim within a specified time frame. Provides that an insurer may not (1) reduce the amount of a claim or (2) recoup or offset any amount of a claim unless that reduction or recoupment or offset results from an arbitration process that has been authorized by the Director of Insurance. Provides that no policy or plan may deny, discontinue, or alter coverage of a treatment method that follows a prescribed standard of care for any illness, condition, injury, disease, or disability during a benefit period if the illness, condition, injury, disease, or disability was covered at any time during the benefit period or if a claim regarding the treatment method is paid during the benefit period. Provides that insurers may not change certain fee calculations more frequently than once each year. Grants the Director of Insurance specific authority to issue a cease and desist order against, fine, or otherwise penalize any company that violates the provisions concerning coverage and rates. Makes other changes. Effective immediately.

House Committee Amendment No. 1
Adds reference to:
215 ILCS 5/370afrom Ch. 73, par. 982a
215 ILCS 5/370bfrom Ch. 73, par. 982b

Deletes everything after the enacting clause. Reinserts the contents of the bill as introduced with the following changes. Deletes a provision requiring that an insurer or certain other entities may not reduce the amount of a claim unless that reduction results from an arbitration process. Provides instead that an insurer or certain other entities may not reduce the amount for which a claim is submitted other than pursuant to the terms of a contract signed by the health care professional or health care provider and that if no contract exists, then the health care professional's or health care provider's charges shall be paid with the patient's responsibility being no more than 30% of the charges, not including any applicable deductible. Deletes a provision prohibiting an insurer or certain other entities from recouping or offsetting any amount unless that recoupment or offset results from an arbitration process. Provides instead that an insurer or certain other entities may not recoup any amount unless the recoupment request is submitted within 60 days after the payment of the claim. Provides that offsets are prohibited. Deletes language prohibiting an issuer of a policy or plan from doing either of the following more frequently than once each calendar year: (1) increasing its stated usual and customary fee rate for services covered by the policy or plan or (2) altering any fee schedules, fee methodologies, or other methods used to calculate payment. Contains provisions concerning the assignability of accident and health insurance and reimbursement on equal basis. Makes other changes.

Actions 
DateChamber Action
  2/25/2009HouseFiled with the Clerk by Rep. Mary E. Flowers
  2/25/2009HouseFirst Reading
  2/25/2009HouseReferred to Rules Committee
  3/3/2009HouseAssigned to Health Care Availability and Accessibility Committee
  3/10/2009HouseHouse Committee Amendment No. 1 Filed with Clerk by Health Care Availability and Accessibility Committee
  3/10/2009HouseHouse Committee Amendment No. 1 Adopted in Health Care Availability and Accessibility Committee; by Voice Vote
  3/10/2009HouseDo Pass as Amended / Short Debate Health Care Availability and Accessibility Committee; 011-001-000
  3/11/2009HousePlaced on Calendar 2nd Reading - Short Debate
  4/1/2009HouseSecond Reading - Short Debate
  4/1/2009HouseHeld on Calendar Order of Second Reading - Short Debate
  4/3/2009HouseRule 19(a) / Re-referred to Rules Committee
  1/11/2011HouseSession Sine Die

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