(215 ILCS 134/60)
Sec. 60.
Choosing a physician.
(a) A health care plan may also offer other arrangements under which
enrollees may
access health care services from contracted providers without a referral or
authorization from their primary care physician.
(b) The enrollee may be required by the health care plan to select a
specialist physician or other health care provider who has a referral
arrangement with the enrollee's
primary care physician or to select a new primary care physician who has a
referral arrangement with the specialist physician or other health care
provider chosen by the enrollee.
If a health care plan requires an enrollee to select a new physician under
this subsection, the health care plan must provide the enrollee with
both
options provided in this subsection.
(c) The Director of Insurance and the Department of Public Health each may
promulgate
rules to ensure appropriate access to and quality of care for enrollees in any
plan that allows enrollees to access health care services from contractual
providers without a referral or authorization from the primary care physician.
The rules may include, but shall not be limited to, a system for the retrieval
and compilation of enrollees' medical records.
(Source: P.A. 91-617, eff. 1-1-00.)
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