Full Text of HB0311 100th General Assembly
HB0311ham002 100TH GENERAL ASSEMBLY | Rep. Gregory Harris Filed: 3/29/2017
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| 1 | | AMENDMENT TO HOUSE BILL 311
| 2 | | AMENDMENT NO. ______. Amend House Bill 311, AS AMENDED, | 3 | | with reference to page and line numbers of House Amendment No. | 4 | | 1, on page 1, immediately below line 5, by inserting the | 5 | | following:
| 6 | | "Section 3. Applicability of Act. This Act applies to an | 7 | | individual or group policy of accident and health insurance | 8 | | with a network plan amended, delivered, issued, or renewed in | 9 | | this State on or after January 1, 2019."; and | 10 | | on page 1, immediately below line 6, by inserting the | 11 | | following: | 12 | | ""Authorized representative" means a person to whom a | 13 | | beneficiary has given express written consent to represent the | 14 | | beneficiary; a person authorized by law to provide substituted | 15 | | consent for a beneficiary; or the beneficiary's treating |
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| 1 | | provider only when the beneficiary or his or her family member | 2 | | is unable to provide consent."; and | 3 | | on page 3, line 20, by replacing "256z.22 of the Insurance | 4 | | Code" with "356z.22 of the Illinois Insurance Code"; and | 5 | | on page 5, by replacing lines 1 and 2 with the following: | 6 | | "(b) Insurers must file for review a description of the | 7 | | services"; and | 8 | | on page 5, line 25, by deleting "full-time equivalent"; and | 9 | | on page 6, line 22, by replacing "apply to" with "apply to: | 10 | | (A)"; and | 11 | | on page 6, line 25, by replacing "providers." with "providers, | 12 | | or (B) a beneficiary enrolled in a health maintenance | 13 | | organization."; and | 14 | | on page 7, by replacing lines 17 and 18 with the following: | 15 | | "(c) The network plan shall demonstrate to the Director a | 16 | | minimum ratio of"; and | 17 | | on page 7, line 20, by deleting "full-time equivalent"; and |
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| 1 | | on page 7, line 25, by deleting "concerning exchange plans or | 2 | | Medicare Advantage Plans"; and | 3 | | on page 9, lines 6 and 22, by deleting "annual" each time it | 4 | | appears; and | 5 | | on page 9, lines 9 and 10, by deleting ", prior to approval,"; | 6 | | and | 7 | | on page 9, by replacing lines 14 and 15 with "and Medicaid | 8 | | Services. These standards shall consist of the maximum"; and | 9 | | on page 9, line 26, by replacing "These" with "Except for | 10 | | network plans solely offered as a group health plan, these"; | 11 | | and | 12 | | by replacing line 15 on page 11 through line 1 on page 12 with | 13 | | the following: | 14 | | "Section 15. Notice of renewal or termination. | 15 | | (a) A network plan must give at least 60 days' notice of | 16 | | nonrenewal or termination of a provider to the provider and to | 17 | | the beneficiaries served by the provider. The notice shall | 18 | | include a name and address to which a beneficiary or provider | 19 | | may direct comments and concerns regarding the nonrenewal or |
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| 1 | | termination and the telephone number maintained by the | 2 | | Department for consumer complaints. Immediate written notice | 3 | | may be provided without 60 days' notice when a provider's | 4 | | license has been disciplined by a State licensing board or when | 5 | | the network plan reasonably believes direct imminent physical | 6 | | harm to patients under the providers care may occur. | 7 | | (b) Primary care providers must notify active affected | 8 | | patients of nonrenewal or termination of the provider from the | 9 | | network plan, except in the case of incapacitation."; and | 10 | | on page 14, by replacing line 9 with the following: | 11 | | "(2) If a beneficiary, or a beneficiary's authorized | 12 | | representative, elects in writing to continue to receive | 13 | | care"; and | 14 | | on page 16, line 8, by deleting "annually"; and | 15 | | on page 16, line 9, after "Director", by inserting "upon | 16 | | request"; and | 17 | | on page 20, immediately below line 23, by inserting the | 18 | | following: | 19 | | "Section 30. Facility nonparticipating provider | 20 | | transparency. Prior to providing a non-emergency outpatient |
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| 1 | | procedure to a beneficiary in an in-network facility or during | 2 | | the admission or as soon as practicable thereafter, the | 3 | | hospital must provide an insured patient with written notice | 4 | | that: | 5 | | (1) the patient may receive separate bills for services | 6 | | provided by health care professionals affiliated with the | 7 | | hospital; | 8 | | (2) if applicable, some hospital staff members may not | 9 | | be participating providers in the same insurance plans and | 10 | | networks as the hospital; | 11 | | (3) if applicable, the patient may have a greater | 12 | | financial responsibility for services provided by health | 13 | | care professionals at the hospital who are not under | 14 | | contract with the patient's health care plan; and | 15 | | (4) questions about coverage or benefit levels should | 16 | | be directed to the patient's health care plan and the | 17 | | patient's certificate of coverage."; and | 18 | | on page 20, line 24, by replacing "30" with "35"; and | 19 | | on page 21, by replacing lines 12 through 16 with "pursuant to | 20 | | the enforcement powers granted to it by law."; and | 21 | | on page 21, by replacing lines 19 and 20 with the following: | 22 | | "Section 99. Effective date. This Act takes effect upon |
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| 1 | | becoming law.".
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