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90_HB0364
215 ILCS 125/2-3 from Ch. 111 1/2, par. 1405
Amends the Health Maintenance Organization Act. Removes
the provision that a Health Maintenance Organization may
furnish health care services through providers employed by
the Health Maintenance Organization. Effective January 1,
1998.
LRB9000533LDdv
LRB9000533LDdv
1 AN ACT to amend the Health Maintenance Organization Act.
2 Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4 Section 5. The Health Maintenance Organization Act is
5 amended by changing Section 2-3 as follows:
6 (215 ILCS 125/2-3) (from Ch. 111 1/2, par. 1405)
7 Sec. 2-3. Powers of Health Maintenance Organizations.
8 The powers of a Health Maintenance Organization include, but
9 are not limited to the following:
10 (a) The purchase, lease, construction, renovation,
11 operation, or maintenance of hospitals, medical facilities or
12 both, and their ancillary equipment, and such property as may
13 reasonably be required for its principal office or for such
14 other purposes as may be necessary in the transaction of the
15 business of the organization.
16 (b) The making of loans to a medical group under
17 contract with it and in furtherance of its program or the
18 making of loans to a corporation or corporations under its
19 control for the purpose of acquiring or constructing medical
20 facilities at hospitals or in furtherance of a program
21 providing health care services for enrollees.
22 (c) The furnishing of health care services through
23 providers which are under contract with or employed by the
24 Health Maintenance Organization.
25 (d) The contracting with any person for the performance
26 on its behalf of certain functions such as marketing,
27 enrollment and administration.
28 (e) The contracting with an insurance company licensed
29 in this State, or with a hospital, medical, dental, vision or
30 pharmaceutical service corporation authorized to do business
31 in this State, for the provision of insurance, indemnity, or
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1 reimbursement against the cost of health care service
2 provided by the Health Maintenance Organization.
3 (f) The offering, in addition to basic health care
4 services, of (1) health care services, (2) indemnity benefits
5 covering out of area or emergency services, and (3) indemnity
6 benefits provided through insurers or hospital, medical,
7 dental, vision, or pharmaceutical service corporations.
8 (g) Rendering services related to the functions involved
9 in the operating of its health maintenance organization
10 business including but not limited to providing health
11 services, data processing, accounting, or claims.
12 (g-5) Indemnification for services provided to a child
13 as required under subdivision (e)(3) of Section 4-2.
14 (h) Any other business activity reasonably complementary
15 or supplementary to its health maintenance organization
16 business to the extent approved by the Director.
17 (Source: P.A. 89-183, eff. 1-1-96.)
18 Section 99. Effective date. This Act takes effect
19 January 1, 1998.