90th General Assembly
Summary of SB0505
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Senate Sponsors:
COLLINS.

Short description: 
INS POINT OF SERVICE OPTION                                                

Synopsis of Bill as introduced:
        Amends  the   Illinois   Insurance   Code,   Health   Maintenance      
   Organization   Act,  Limited  Health  Service  Organization  Act,  and      
   Voluntary Health Services Plans  Act.   Provides  that  if  a  covered      
   individual  is  a  student  attending  a  college  or  university at a      
   location outside of the service  area  of  a  health  care  plan,  the      
   student may obtain services from a provider at the college location at      
   no  greater  cost  than  the  service  would  cost  from  a designated      
   provider. Provides that managed  care  plans  under  those  Acts  must      
   contain  a  point-of-service  option  allowing covered individuals the      
   option of obtaining service from providers not included in the  health      
   care  plan panel of providers. Establishes requirements for disclosure      
   of terms and conditions of health care  plans.  Provides  that  health      
   care plans operated under those Acts must cover emergency medical care      
   provided by non-designated providers when designated providers are not      
   reasonably  available  or  accessible.  Establishes utilization review      
   appeal requirements for  patients  and  providers.   Requires  private      
   review agents to provide for dispute resolution.  Prohibits an adverse      
   decision with respect to treatment unless the claim has been evaluated      
   by  a  physician  practicing  in  the same field as the provider whose      
   decision is the subject of the review.   Requires  the  Department  of      
   Insurance to issue rules regulating grievance procedures.                   
 
Last action on Bill: SESSION SINE DIE

   Last action date: 99-01-12

           Location: Senate

 Amendments to Bill: AMENDMENTS ADOPTED: HOUSE -   0     SENATE -   0


   END OF INQUIRY 



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