Illinois General Assembly - Bill Status for HB4703
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 Bill Status of HB4703  102nd General Assembly


Short Description:  INSURANCE-BILLING

House Sponsors
Rep. Bob Morgan - Michael Kelly - Mary E. Flowers

Senate Sponsors
(Sen. Ann Gillespie - Mike Simmons - Laura Fine, John Connor, Cristina Castro, Napoleon Harris, III, Suzy Glowiak Hilton, Mattie Hunter, Karina Villa, Diane Pappas, Steve Stadelman, Kimberly A. Lightford, Robert F. Martwick, Meg Loughran Cappel, Celina Villanueva, Ram Villivalam, Christopher Belt, Eric Mattson, Scott M. Bennett, Michael E. Hastings, Omar Aquino and Bill Cunningham)

Last Action
DateChamber Action
  5/26/2022HousePublic Act . . . . . . . . . 102-0901

Statutes Amended In Order of Appearance
215 ILCS 5/356z.3
215 ILCS 5/356z.3a
215 ILCS 124/10
215 ILCS 125/4.5-1
215 ILCS 125/5-3from Ch. 111 1/2, par. 1411.2
215 ILCS 134/70
215 ILCS 165/10from Ch. 32, par. 604


Synopsis As Introduced
Amends the Illinois Insurance Code. Provides that when an insured receives emergency services or covered ancillary services from a nonparticipating provider or a nonparticipating facility, the health insurance issuer shall ensure that cost-sharing requirements are applied as though the services had been received from a participating provider or facility, and that the insured or any group policyholder or plan sponsor shall not be liable to or billed by the health insurance issuer, the nonparticipating provider, or the facility beyond the cost-sharing amount. Contains provisions concerning a notice and consent process for out-of-network coverage; billing for reasonable administrative fees; assignment of benefits to nonparticipating providers; and cost-sharing amounts and deductibles. Amends the Illinois Insurance Code and the Health Maintenance Organization Act to make a change in provisions concerning disclosure of nonparticipating provider benefits. Amends the Network Adequacy and Transparency Act. Provides that a beneficiary who receives care at a participating health care facility shall not be required to search for participating providers under certain circumstances. Amends the Managed Care Reform and Patient Rights Act. Provides that prior authorization or approval by the plan shall not be required for post-stabilization services that constitute emergency services. Amends the Health Maintenance Organization Act and the Voluntary Health Services Plans Act to provide that health maintenance organizations and voluntary health services plans are subject to provisions of the Illinois Insurance Code concerning billing and cost sharing. Makes other changes. Effective July 1, 2022, except that certain changes take effect January 1, 2023.

House Floor Amendment No. 1
In provisions concerning cost sharing for emergency services and cost sharing for non-emergency services, provides that if the cost sharing for the same item or service furnished by a participating provider would have been a flat-dollar copayment, that amount shall be the cost-sharing amount unless the provider has billed a lesser total amount. Provides that upon receipt of the provider's bill or facility's bill, the health insurance issuer shall provide the nonparticipating provider or the facility with a written explanation of benefits (rather than the health insurance issuer shall provide the nonparticipating provider or the facility with a written explanation of benefits). Provides that the arbitrator shall not establish a rebuttable presumption that the qualifying payment amount should be the total amount owed to the provider or facility by the combination of the issuer and the insured, beneficiary, or enrollee. Defines "qualifying payment amount". Makes other changes.

Actions 
DateChamber Action
  1/21/2022HouseFiled with the Clerk by Rep. Bob Morgan
  1/27/2022HouseFirst Reading
  1/27/2022HouseReferred to Rules Committee
  2/1/2022HouseAssigned to Insurance Committee
  2/10/2022HouseDo Pass / Short Debate Insurance Committee; 017-000-000
  2/15/2022HousePlaced on Calendar 2nd Reading - Short Debate
  2/15/2022HouseAdded Chief Co-Sponsor Rep. Michael Kelly
  2/25/2022HouseHouse Floor Amendment No. 1 Filed with Clerk by Rep. Bob Morgan
  2/25/2022HouseHouse Floor Amendment No. 1 Referred to Rules Committee
  3/1/2022HouseHouse Floor Amendment No. 1 Rules Refers to Insurance Committee
  3/2/2022HouseHouse Floor Amendment No. 1 Recommends Be Adopted Insurance Committee; 012-000-000
  3/2/2022HouseSecond Reading - Short Debate
  3/2/2022HouseHeld on Calendar Order of Second Reading - Short Debate
  3/3/2022HouseHouse Floor Amendment No. 1 Adopted
  3/3/2022HousePlaced on Calendar Order of 3rd Reading - Short Debate
  3/3/2022HouseThird Reading - Short Debate - Passed 105-000-000
  3/3/2022HouseAdded Chief Co-Sponsor Rep. Mary E. Flowers
  3/4/2022SenateArrive in Senate
  3/4/2022SenatePlaced on Calendar Order of First Reading
  3/4/2022SenateChief Senate Sponsor Sen. Ann Gillespie
  3/4/2022SenateFirst Reading
  3/4/2022SenateReferred to Assignments
  3/16/2022SenateAssigned to Insurance
  3/23/2022SenateDo Pass Insurance; 011-000-000
  3/23/2022SenatePlaced on Calendar Order of 2nd Reading
  3/23/2022SenateSecond Reading
  3/23/2022SenatePlaced on Calendar Order of 3rd Reading March 24, 2022
  3/24/2022SenateAdded as Alternate Co-Sponsor Sen. John Connor
  3/29/2022SenateAdded as Alternate Co-Sponsor Sen. Cristina Castro
  3/29/2022SenateAdded as Alternate Co-Sponsor Sen. Napoleon Harris, III
  3/29/2022SenateAdded as Alternate Co-Sponsor Sen. Suzy Glowiak Hilton
  3/29/2022SenateAdded as Alternate Co-Sponsor Sen. Mattie Hunter
  3/30/2022SenateAdded as Alternate Co-Sponsor Sen. Karina Villa
  3/30/2022SenateAdded as Alternate Co-Sponsor Sen. Diane Pappas
  3/30/2022SenateAdded as Alternate Co-Sponsor Sen. Steve Stadelman
  3/30/2022SenateThird Reading - Passed; 055-000-000
  3/30/2022HousePassed Both Houses
  3/30/2022SenateAdded as Alternate Chief Co-Sponsor Sen. Mike Simmons
  3/30/2022SenateAdded as Alternate Chief Co-Sponsor Sen. Laura Fine
  3/31/2022SenateAdded as Alternate Co-Sponsor Sen. Kimberly A. Lightford
  4/8/2022SenateAdded as Alternate Co-Sponsor Sen. Robert F. Martwick
  4/28/2022HouseSent to the Governor
  5/25/2022SenateAdded as Alternate Co-Sponsor Sen. Meg Loughran Cappel
  5/25/2022SenateAdded as Alternate Co-Sponsor Sen. Celina Villanueva
  5/25/2022SenateAdded as Alternate Co-Sponsor Sen. Ram Villivalam
  5/25/2022SenateAdded as Alternate Co-Sponsor Sen. Christopher Belt
  5/25/2022SenateAdded as Alternate Co-Sponsor Sen. Eric Mattson
  5/25/2022SenateAdded as Alternate Co-Sponsor Sen. Scott M. Bennett
  5/25/2022SenateAdded as Alternate Co-Sponsor Sen. Michael E. Hastings
  5/25/2022SenateAdded as Alternate Co-Sponsor Sen. Omar Aquino
  5/26/2022HouseGovernor Approved
  5/26/2022HouseEffective Date July 1, 2022; - Some Provisions Effective January 1, 2023
  5/26/2022HousePublic Act . . . . . . . . . 102-0901
  6/3/2022SenateAdded as Alternate Co-Sponsor Sen. Bill Cunningham

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