FLOWERS-SAVIANO-SCHOENBERG-O'BRIEN-JOHNSON,TIM, MADIGAN,MJ, MCKEON, FEIGENHOLTZ, MCGUIRE, HAMOS, CURRY,JULIE, JONES,LOU, HOFFMAN, FOWLER, DAVIS,STEVE, RONEN, BOLAND, BRUNSVOLD, BUGIELSKI, BURKE, CAPPARELLI, CROTTY, DELGADO, FRANKS, FRITCHEY, GARRETT, GASH, GIGLIO, GRANBERG, HANNIG, HOLBROOK, HOWARD, JONES,SHIRLEY, KENNER, LOPEZ, MCCARTHY, MORROW, MURPHY, NOVAK, PUGH, REITZ, SILVA, SLONE, SMITH,MICHAEL, STROGER, TURNER,ART, WOOLARD, CURRIE, ACEVEDO, BRADLEY, DART, SHARP, HARTKE AND LANG. (BERMAN) New Act 5 ILCS 375/6.12 new 20 ILCS 1405/56.3 new 20 ILCS 1405/56.4 new 20 ILCS 1405/56.5 new 20 ILCS 1405/56.6 new 20 ILCS 1405/56.7 new 30 ILCS 105/5.490 new 30 ILCS 805/8.23 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 hearings, 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. 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. Amends the Civil Administrative Code of Illinois to establish the Office of Health Care Consumer Assistance, Advocacy, and Information within the Department of Insurance. Establishes a Managed Care Ombudsman Program to be a part of the Office of Health Care Consumer Assistance, Advocacy, and Information. Amends the State Finance Act to create the Managed Care Reform 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 January 1, 2000. FISCAL NOTE (Department of Central Management Services) HB 626 will increase HMO costs to the State by 5% to 15%, a fiscal impact of between $13 million and $39 million. HOUSE AMENDMENT NO. 1. Deletes reference to: 20 ILCS 1405/56.5 new 20 ILCS 1405/56.6 new 20 ILCS 1405/56.7 new Adds reference to: 215 ILCS 123/15 215 ILCS 123/20 Exempts employee or employer self-insured plans subject to ERISA. Requires the Department of Insurance to maintain records concerning complaints. Prohibits retaliation by managed care plans against health care providers. Imposes requirements for access to specialists and for transition of services. Sets forth requirements for emergency services. Provides for an Office of Consumer Health Insurance within the Department of Insurance. Removes provisions relating to the Managed Care Ombudsman Program. Amends the Health Care Purchasing Group Act to provide that a purchasing group may be formed by 2 or more employers having no more than 500 covered employees each rather than having an aggregate limit of 2,500 individuals. Authorizes the sponsorship of health care purchasing groups of up to 100,000, rather than 10,000, individuals. Effective immediately. FISCAL NOTE, H-AM 1 (Department of Public Health) Fiscal impact would be approximately $1.5 million GRF annually, not including costs that would be incurred by other State agencies. STATE MANDATES NOTE, H-AM 1 (Department of Commerce and Community Affairs) Creates a personnel mandate for which reimbursement of the in- creased costs to local gov't. would normally be required; exempts the State from reimbursement liability. No estimate of local gov't. costs is available. HOME RULE NOTE, H-AM 1 (Department of Commerce and Community Affairs) Preempts home rule and declares compliance is an exclusive power of the State and a denial and limitation of home rule powers. 99-02-04 H FILED WITH CLERK 99-02-05 H FIRST READING 99-02-05 H REFERRED TO HOUSE RULES COMMITTEE RULES 99-02-09 H ADDED AS A JOINT SPONSOR MCKEON 99-02-09 H ADDED AS A CO-SPONSOR SCOTT 99-02-09 H ADDED AS A CO-SPONSOR O'BRIEN 99-02-10 H ASSIGNED TO COMMITTEE HEALTH CARE 99-02-10 H JOINT-SPONSOR CHANGED TO FEIGENHOLTZ 99-02-10 H ADDED AS A CO-SPONSOR MCGUIRE 99-02-10 H ADDED AS A CO-SPONSOR HAMOS 99-02-10 H ADDED AS A CO-SPONSOR CURRY,JULIE 99-02-10 H ADDED AS A CO-SPONSOR DAVIS,MONIQUE 99-02-10 H ADDED AS A CO-SPONSOR JONES,LOU 99-02-11 H ADDED AS A CO-SPONSOR HOFFMAN 99-02-11 H ADDED AS A CO-SPONSOR FOWLER 99-02-18 H JOINT-SPONSOR CHANGED TO SAVIANO 99-02-18 H JOINT-SPONSOR CHANGED TO JOHNSON,TIM 99-02-18 H ADDED AS A CO-SPONSOR MCKEON 99-02-18 H ADDED AS A CO-SPONSOR FEIGENHOLTZ 99-02-18 H ADDED AS A CO-SPONSOR DAVIS,STEVE 99-02-18 H ADDED AS A CO-SPONSOR RONEN 99-02-19 H ADDED AS A CO-SPONSOR BOLAND 99-02-19 H ADDED AS A CO-SPONSOR BROSNAHAN 99-02-19 H ADDED AS A CO-SPONSOR BRUNSVOLD 99-02-19 H ADDED AS A CO-SPONSOR BUGIELSKI 99-02-19 H ADDED AS A CO-SPONSOR BURKE 99-02-19 H ADDED AS A CO-SPONSOR CAPPARELLI 99-02-19 H ADDED AS A CO-SPONSOR CROTTY 99-02-19 H ADDED AS A CO-SPONSOR DELGADO 99-02-19 H ADDED AS A CO-SPONSOR ERWIN 99-02-19 H ADDED AS A CO-SPONSOR FRANKS 99-02-19 H ADDED AS A CO-SPONSOR FRITCHEY 99-02-19 H ADDED AS A CO-SPONSOR GARRETT 99-02-19 H ADDED AS A CO-SPONSOR GASH 99-02-19 H ADDED AS A CO-SPONSOR GIGLIO 99-02-19 H ADDED AS A CO-SPONSOR GRANBERG 99-02-19 H ADDED AS A CO-SPONSOR HANNIG 99-02-19 H ADDED AS A CO-SPONSOR HARRIS 99-02-19 H ADDED AS A CO-SPONSOR HOLBROOK 99-02-19 H ADDED AS A CO-SPONSOR HOWARD 99-02-19 H ADDED AS A CO-SPONSOR JONES,SHIRLEY 99-02-19 H ADDED AS A CO-SPONSOR KENNER 99-02-19 H ADDED AS A CO-SPONSOR LOPEZ 99-02-19 H ADDED AS A CO-SPONSOR LYONS,JOSEPH 99-02-19 H ADDED AS A CO-SPONSOR MCCARTHY 99-02-19 H ADDED AS A CO-SPONSOR MORROW 99-02-19 H ADDED AS A CO-SPONSOR MURPHY 99-02-19 H ADDED AS A CO-SPONSOR NOVAK 99-02-19 H ADDED AS A CO-SPONSOR SCHOENBERG 99-02-19 H ADDED AS A CO-SPONSOR SCULLY 99-02-19 H ADDED AS A CO-SPONSOR SILVA 99-02-19 H ADDED AS A CO-SPONSOR SLONE 99-02-19 H ADDED AS A CO-SPONSOR SMITH,MICHAEL 99-02-19 H ADDED AS A CO-SPONSOR PUGH 99-02-19 H ADDED AS A CO-SPONSOR REITZ 99-02-19 H ADDED AS A CO-SPONSOR STROGER 99-02-19 H ADDED AS A CO-SPONSOR TURNER,ART 99-02-19 H ADDED AS A CO-SPONSOR WOOLARD 99-02-19 H ADDED AS A CO-SPONSOR YOUNGE 99-02-19 H ADDED AS A CO-SPONSOR MADIGAN,MJ 99-02-22 H FISCAL NOTE FILED 99-02-22 H COMMITTEE HEALTH CARE 99-02-24 H ADDED AS A CO-SPONSOR CURRIE 99-03-03 H AMENDMENT NO. 01-HTHCR-AVB-ACS H 99-03-03 H ADOPTED 010-006-000 99-03-03 H DO PASS AS AMENDED/STANDARD DEBATE 010-002-006 HCAA 99-03-03 H PLACED CAL 2ND READING-STANDARD DEBATE 99-03-04 H FISCAL NOTE REQUESTED AS AMENDED BLACK 99-03-04 H STATE MNDT FISCAL NOTE RQSTD AS AMENDED BLACK 99-03-04 H HOME RULE NOTE REQUESTED AS AMENDED BLACK 99-03-04 H CALENDAR ORDER 2ND READING-STANDARD DBT 99-03-04 H ADDED AS A CO-SPONSOR ACEVEDO 99-03-04 H ADDED AS A CO-SPONSOR BRADLEY 99-03-04 H ADDED AS A CO-SPONSOR DART 99-03-04 H ADDED AS A CO-SPONSOR SHARP 99-03-04 H ADDED AS A CO-SPONSOR HARTKE 99-03-04 H ADDED AS A CO-SPONSOR LANG 99-03-10 H FISCAL NOTE FILED AS AMENDED BY HOUSE AMEND #1 99-03-10 H CALENDAR ORDER 2ND READING-STANDARD DBT 99-03-11 H HOME RULE NOTE FILED AS AMENDED BY HOUSE AMEND #1 99-03-11 H STATE MNDT FISCAL NOTE FILED AS AMENDED BY HOUSE AMEND #1 99-03-11 H CALENDAR ORDER 2ND READING-STANDARD DBT 99-03-12 H SECOND READING-STANDARD DEBATE 99-03-12 H HELD CAL ORDER 2ND READING-STANDARD DBT 99-03-17 H PLCD CAL ORDER 3RD READING-STNDRD DEBATE 99-03-22 H JOINT-SPONSOR CHANGED TO SCHOENBERG 99-03-22 H ADDED AS A CO-SPONSOR SCOTT 99-03-24 H VERIFIED 99-03-24 H THIRD READING/STANDARD DEBATE/PASS 062-037-015 99-03-25 S ARRIVE IN SENATE 99-03-25 S PLACED CALENDAR ORDER OF FIRST READING 99-03-26 99-03-25 S CHIEF SPONSOR BERMAN 99-03-25 S FIRST READING 99-03-25 S REFERRED TO SENATE RULES COMMITTEE RULES 01-01-09 H SESSION SINE DIE END OF INQUIRY Full Text Bill Summary