90th General Assembly
Summary of SB1484
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Senate Sponsors:
BERMAN-KEHOE AND HALVORSON.

Short description: 
MANAGED CARE REFORM ACT                                                    

Synopsis of Bill as introduced:
        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.                                                     
 
Last action on Bill: SESSION SINE DIE

   Last action date: 99-01-12

           Location: Senate

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


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