Illinois General Assembly - Bill Status for HB5405

Amends the Managed Care Reform and Patient Rights Act. Expands the definition of "health care plan" to include Health Maintenance Organizations, Managed Care Community Networks, Care Coordination Entities, and Accountable Care Entities. Amends the Medical Assistance Article of the Illinois Public Aid Code. In provisions concerning the Department of Healthcare and Family Services' contracts with Managed Care Organizations and other entities reimbursed by risk based capitation, provides that such contracts shall require the entity to (i) be accredited by the National Committee for Quality Assurance, (ii) establish an appeals and grievances process for consumers and providers, and (iii) provide a quality assurance and utilization review program that meets the requirements established by the Department in rules that incorporate those standards set forth in the Health Maintenance Organization Act.

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