FLOWERS-KLINGLER-SCOTT-MCKEON-GASH, SILVA, FANTIN, JONES,LOU, BURKE, PHELPS, PUGH, REITZ, RODRIGUEZ, SCHAKOWSKY, SCULLY, SLONE, MCAULIFFE, DEUCHLER, DART, HANNIG, GIGLIO, CURRY,JULIE, ACEVEDO, BOLAND, BRADLEY, BUGIELSKI, CAPPARELLI, CROTTY, CURRIE, DAVIS,STEVE, ERWIN, FEIGENHOLTZ, FRITCHEY, GILES, HARTKE, HOFFMAN, HOWARD, JONES,SHIRLEY, KENNER, LANG, LOPEZ, LYONS,JOSEPH, MORROW, MURPHY, NOVAK, SMITH,MICHAEL, STROGER, YOUNGE, GRANBERG, MCGUIRE AND MOORE,EUGENE. 215 ILCS 125/5-10 new 215 ILCS 125/5-11 new 215 ILCS 125/5-12 new 215 ILCS 125/5-13 new Amends the Health Maintenance Organization Act. Establishes the office of health care consumer assistance, advocacy, and information within the Department of Insurance. Provides for an executive director appointed by the Governor to a 3-year term. Directs the office to assist health care consumers on a statewide basis in asserting their contractual and legal rights, resolving consumer complaints, and obtaining appropriate referrals. Requires the executive director to make quarterly reports to the Director of Insurance and the Governor. Requires an annual report to the General Assembly including recommendations for improving the health care consumer assistance and complaint resolution process. Effective immediately. HOUSE AMENDMENT NO. 1. Adds reference to: New Act 5 ILCS 375/6.12 new 30 ILCS 105/5.480 new 30 ILCS 805/8.22 new 55 ILCS 5/5-1069.8 new 65 ILCS 5/10-4-2.8 new 105 ILCS 5/10-22.3g new 215 ILCS 125/2-2 from Ch. 111 1/2, par. 1404 215 ILCS 125/6-7 from Ch. 111 1/2, par. 1418.7 Creates the Managed Care Reform Act. Specifies information that must be disclosed by a managed care plan. Establishes a multi-level grievance procedure and also provides for an independent external review. Requires a managed care plan to maintain a grievance register. Requires managed care plans to be certified by the Director of Public Health with respect to adequacy of provider networks. Authorizes the Department of Public Health to impose civil penalties. Establishes a process, including hearing, for termination of a health care provider. Requires managed care plans to report to professional disciplinary agencies. Provides for the registration of utilization service agents. Establishes utilization review program standards. Requires the Department of Public Health to establish a Managed Care Ombudsman Program. Amends the State Finance Act to create the Managed Care Entity Responsibility and Patients Rights Fund. Amends the State Mandates Act to require implementation without reimbursement. Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, and the School Code to impose the requirements of the Managed Care Reform Act upon the provision of health care under those Acts. Amends the Health Maintenance Organization Act to provide for 2 public members to be appointed to the Health Maintenance Organization Guaranty Association Board. Effective July 1, 1999. HOUSE AMENDMENT NO. 2. Provides that health insurance carriers, health care plans, and other managed care entities for health care plans have the duty to exercise ordinary care when making health care treatment decisions and are liable for damages for harm to an insured or enrollee proximately caused by the failure to exercise ordinary care. Authorizes a private right of action. Defines terms. Applies only to causes of action that accrue on or after the effective date of the Act. FISCAL NOTE, AMENDED (Dpt. of Insurance) Staffing could cost as much as $250,000 annually. STATE MANDATES ACT FISCAL NOTE, H-AMS 1 & 2 Creates a "personnel mandate" requiring 100% reimbursement. 98-02-17 H FILED WITH CLERK 98-02-17 H FIRST READING 98-02-17 H REFERRED TO HOUSE RULES COMMITTEE RULES 98-03-11 H ASSIGNED TO COMMITTEE HEALTH CARE 98-03-19 H AMENDMENT NO. 01-HTHCR-AVB-ACS H 98-03-19 H ADOPTED 98-03-19 H AMENDMENT NO. 02-HTHCR-AVB-ACS H 98-03-19 H ADOPTED 98-03-19 H DO PASS AS AMENDED/STANDARD DEBATE 016-010-004 HCAA 98-03-19 H PLACED CAL 2ND READING-STANDARD DEBATE 98-03-20 H FISCAL NOTE REQUESTED AS AMENDED BLACK 98-03-20 H STATE MNDT FISCAL NOTE RQSTD AS AMENDED BLACK 98-03-20 H CALENDAR ORDER 2ND READING-STANDARD DBT 98-03-24 H ADDED AS A JOINT SPONSOR MCKEON 98-03-24 H ADDED AS A CO-SPONSOR GASH 98-03-24 H ADDED AS A CO-SPONSOR FANTIN 98-03-25 H FISCAL NOTE FILED AS AMENDED 98-03-25 H ADDED AS A CO-SPONSOR SILVA 98-03-25 H ADDED AS A CO-SPONSOR O'BRIEN 98-03-25 H AMENDMENT NO. 03-ZICKUS 98-03-25 H AMENDMENT REFERRED TO HRUL 98-03-25 H RULES REFERS TO HCAA 98-03-25 H ADDED AS A CO-SPONSOR RONEN 98-03-25 H SECOND READING-STANDARD DEBATE 98-03-25 H HELD CAL ORDER 2ND READING-STANDARD DBT 98-03-26 H ADDED AS A CO-SPONSOR JONES,LOU 98-03-26 H JOINT-SPONSOR CHANGED TO KLINGLER 98-03-26 H ADDED AS A CO-SPONSOR SCOTT 98-03-26 H ADDED AS A CO-SPONSOR SILVA 98-03-26 H ADDED AS A CO-SPONSOR BURKE 98-03-26 H ADDED AS A CO-SPONSOR PHELPS 98-03-26 H ADDED AS A CO-SPONSOR PUGH 98-03-26 H ADDED AS A CO-SPONSOR REITZ 98-03-26 H ADDED AS A CO-SPONSOR RODRIGUEZ 98-03-26 H ADDED AS A CO-SPONSOR SCHAKOWSKY 98-03-26 H ADDED AS A CO-SPONSOR SCULLY 98-03-26 H ADDED AS A CO-SPONSOR SLONE 98-03-26 H ADDED AS A CO-SPONSOR MCAULIFFE 98-03-26 H ADDED AS A CO-SPONSOR DEUCHLER 98-03-26 H ADDED AS A CO-SPONSOR DART 98-03-26 H ADDED AS A CO-SPONSOR SAVIANO 98-03-26 H ADDED AS A CO-SPONSOR HANNIG 98-03-26 H ADDED AS A CO-SPONSOR GIGLIO 98-03-26 H ADDED AS A CO-SPONSOR CURRY,JULIE 98-03-26 H ADDED AS A CO-SPONSOR ACEVEDO 98-03-26 H ADDED AS A CO-SPONSOR BOLAND 98-03-26 H ADDED AS A CO-SPONSOR BRADLEY 98-03-26 H ADDED AS A CO-SPONSOR BROSNAHAN 98-03-26 H ADDED AS A CO-SPONSOR BUGIELSKI 98-03-26 H ADDED AS A CO-SPONSOR CAPPARELLI 98-03-26 H ADDED AS A CO-SPONSOR CROTTY 98-03-26 H ADDED AS A CO-SPONSOR CURRIE 98-03-26 H ADDED AS A CO-SPONSOR DAVIS,STEVE 98-03-26 H ADDED AS A CO-SPONSOR DAVIS,MONIQUE 98-03-26 H ADDED AS A CO-SPONSOR ERWIN 98-03-26 H ADDED AS A CO-SPONSOR FEIGENHOLTZ 98-03-26 H ADDED AS A CO-SPONSOR FRITCHEY 98-03-26 H ADDED AS A CO-SPONSOR GILES 98-03-26 H ADDED AS A CO-SPONSOR HARTKE 98-03-26 H ADDED AS A CO-SPONSOR HOFFMAN 98-03-26 H ADDED AS A CO-SPONSOR HOLBROOK 98-03-26 H ADDED AS A CO-SPONSOR HOWARD 98-03-26 H ADDED AS A CO-SPONSOR JONES,SHIRLEY 98-03-26 H ADDED AS A CO-SPONSOR KENNER 98-03-26 H ADDED AS A CO-SPONSOR LANG 98-03-26 H ADDED AS A CO-SPONSOR LOPEZ 98-03-26 H ADDED AS A CO-SPONSOR LYONS,JOSEPH 98-03-26 H ADDED AS A CO-SPONSOR MCCARTHY 98-03-26 H ADDED AS A CO-SPONSOR MORROW 98-03-26 H ADDED AS A CO-SPONSOR MURPHY 98-03-26 H ADDED AS A CO-SPONSOR NOVAK 98-03-26 H ADDED AS A CO-SPONSOR SMITH,MICHAEL 98-03-26 H ADDED AS A CO-SPONSOR STROGER 98-03-26 H ADDED AS A CO-SPONSOR TURNER,ART 98-03-26 H ADDED AS A CO-SPONSOR YOUNGE 98-03-30 H AMENDMENT NO. 04-FLOWERS 98-03-30 H AMENDMENT REFERRED TO HRUL 98-03-30 H HELD CAL ORDER 2ND READING-STANDARD DBT 98-03-30 H ADDED AS A CO-SPONSOR GRANBERG 98-03-31 H AMENDMENT NO. 04-FLOWERS 98-03-31 H BE APPROVED FOR CONSIDERATION HRUL 98-03-31 H HELD CAL ORDER 2ND READING-STANDARD DBT 98-03-31 H ADDED AS A CO-SPONSOR MCGUIRE 98-03-31 H ADDED AS A CO-SPONSOR MOORE,EUGENE 98-04-02 H STATE MNDT FISCAL NOTE FILED AS AMENDED BY AMEND 1 & 2 98-04-02 H 3RD READING 98-04-02 H DEADLINE EXTENDED 98-04-02 H TO APRIL 30, 1998 98-04-02 H HELD CAL ORDER 2ND READING-STANDARD DBT 98-04-30 H 3RD READING 98-04-30 H DEADLINE EXTENDED 98-04-30 H TO MAY 22, 1998 98-04-30 H HELD CAL ORDER 2ND READING-STANDARD DBT 98-05-22 H RE-REFERRED TO RULES COMM/RULE 19(A) RULES HRUL 99-01-12 H SESSION SINE DIE END OF INQUIRY Full Text Bill Summary