Illinois General Assembly - Full Text of HB4703
Illinois General Assembly

  Bills & Resolutions  
  Compiled Statutes  
  Public Acts  
  Legislative Reports  
  IL Constitution  
  Legislative Guide  
  Legislative Glossary  

 Search By Number
 (example: HB0001)
Search Tips

Search By Keyword

Full Text of HB4703  102nd General Assembly

HB4703ham001 102ND GENERAL ASSEMBLY

Rep. Bob Morgan

Filed: 2/25/2022

 

 


 

 


 
10200HB4703ham001LRB102 24386 BMS 36889 a

1
AMENDMENT TO HOUSE BILL 4703

2    AMENDMENT NO. ______. Amend House Bill 4703 on page 3, by
3replacing lines 15 and 16 with the following:
4    "laboratory services, except for advanced diagnostic
5    laboratory tests identified on the most current list
6    published by the United States Secretary of Health and
7    Human Services under 42 U.S.C. 300gg-132(b)(3);
8        (4) items and services provided by other specialty
9    practitioners as the United States Secretary of Health and
10    Human Services specifies through rulemaking under 42
11    U.S.C. 300gg-132(b)(3); and
12        (5) items and services provided by a
13    nonparticipating"; and
 
14on page 8, by replacing lines 9 through 13 with the following:
15    ""Qualifying payment amount" has the meaning given to that
16term in 42 U.S.C. 300gg-111(a)(3)(E) and the regulations
17promulgated thereunder.

 

 

10200HB4703ham001- 2 -LRB102 24386 BMS 36889 a

1    "Recognized amount" means the lesser of the amount
2initially billed by the provider or the qualifying payment
3amount."; and
 
4on page 9, line 10, after "services.", by inserting "If the
5cost sharing for the same item or service furnished by a
6participating provider would have been a flat-dollar
7copayment, that amount shall be the cost-sharing amount unless
8the provider has billed a lesser total amount."; and
 
9on page 10, line 13, after "services.", by inserting "If the
10cost sharing for the same item or service furnished by a
11participating provider would have been a flat-dollar
12copayment, that amount shall be the cost-sharing amount unless
13the provider has billed a lesser total amount."; and
 
14on page 12, line 10, by replacing "The health insurance
15issuer" with "Upon receipt of the provider's bill or
16facility's bill, the health insurance issuer The"; and
 
17on page 14, line 15, after "parties.", by inserting "The
18arbitrator shall not establish a rebuttable presumption that
19the qualifying payment amount should be the total amount owed
20to the provider or facility by the combination of the issuer
21and the insured, beneficiary, or enrollee.".