WALSH,T-KLEMM-SULLIVAN-RADOGNO-NOLAND, MYERS,J, LUECHTEFELD, BOMKE AND CRONIN. (SCHOENBERG-KRAUSE-KENNER-FEIGENHOLTZ-CROSS) New Act 5 ILCS 375/6.12 new 30 ILCS 805/8.23 new 55 ILCS 5/5-1069.8 new 65 ILCS 5/10-4-2.8 new 215 ILCS 5/155.36 new 215 ILCS 5/370g from Ch. 73, par. 982g 215 ILCS 5/370s new 215 ILCS 5/511.118 new 215 ILCS 105/8.6 new 215 ILCS 123/15 215 ILCS 123/20 215 ILCS 125/2-2 from Ch. 111 1/2, par. 1404 215 ILCS 125/5-3.6 new 215 ILCS 125/6-7 from Ch. 111 1/2, par. 1418.7 215 ILCS 130/4002.6 new 215 ILCS 165/15.30 new 305 ILCS 5/5-16.12 new Creates the Managed Care Patient Rights Act. Enumerates certain information and quality of care standards to which a patient is entitled. Requires health care plans to disclose to enrollees and prospective enrollees specific information concerning benefits and coverages, emergency services, out-of-area coverages, service area covered, access to specialists, and grievance procedures. Sets forth requirements for continuity of care. Prohibits restraints on communications between health care providers and enrollees and others regarding care alternatives, quality, and utilization review issues. Establishes requirements for access to specialists and the mechanisms for second opinions. Requires health care plans to have a consumer advisory committee made up of enrollees and to establish a quality assessment program. Provides for the registration of utilization review programs. Amends the Health Care Purchasing Group Act to provide that the 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 covered individuals. Authorizes the sponsorship of health care purchasing groups with up to 100,000 rather than 10,000 covered individuals. Amends the State Employees Group Insurance Plan of 1971, the Counties Code, the Illinois Municipal Code, the Comprehensive Health Insurance Plan Act, the Health Maintenance Organization Act, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code to require that health care coverage under those Acts comply with Managed Care Patient Rights Act. Amends the Illinois Insurance Code to require compliance with provisions of the Managed Care Patient Rights Act concerning utilization review and complaint procedures. Amends the State Mandates Act to provide reimbursement by the State is not required. Effective January 1, 2000. SENATE AMENDMENT NO. 2. Provides that certain patient information may be shared for quality assessment purposes. Provides that the term "physician" means any physician licensed under the Medical Practice Act of 1987. Removes provision prohibiting health care plans from imposing restrictions on physicians or health care providers as to recommended health care services. Provides that coverage for emergency services may not be retrospectively denied. Provides that a health care plan may not dele- gate the ultimate responsibility for coverage and payment decisions. Excludes independent practice associations and physician-hospital organizations from the scope of the bill. Delays the effective date with respect to utilization review requirements to July 1, 2000. 99-02-24 S FIRST READING 99-02-24 S REFERRED TO SENATE RULES COMMITTEE RULES 99-02-24 S ASSIGNED TO COMMITTEE INS & PENS. 99-03-04 S ADDED AS A CHIEF CO-SPONSOR KLEMM 99-03-09 S ADDED AS A CO-SPONSOR MYERS,J 99-03-09 S ADDED AS A CHIEF CO-SPONSOR SULLIVAN 99-03-09 S ADDED AS A CHIEF CO-SPONSOR RADOGNO 99-03-09 S ADDED AS A CO-SPONSOR DONAHUE 99-03-09 S ADDED AS A CO-SPONSOR LUECHTEFELD 99-03-09 S ADDED AS A CO-SPONSOR BOMKE 99-03-10 S DO PASS 006-000-003 SINS 99-03-10 S PLACED ON CALENDAR ORDER OF 2ND READING 99-03-11 99-03-10 S ADDED AS A CHIEF CO-SPONSOR NOLAND 99-03-11 S SECOND READING 99-03-11 S PLACED ON CALENDAR ORDER OF 3RD READING 99-03-16 99-03-12 S ADDED AS A CO-SPONSOR CRONIN 99-03-24 S FILED WITH SECRETARY 99-03-24 S AMENDMENT NO. 01-WALSH,T 99-03-24 S AMENDMENT REFERRED TO SRUL 99-03-24 S AMENDMENT NO. 01-WALSH,T 99-03-24 S RULES REFERS TO SINS 99-03-24 S AMENDMENT NO. 01-WALSH,T 99-03-24 S HELD IN COMMITTEE SINS 99-03-25 S FILED WITH SECRETARY 99-03-25 S AMENDMENT NO. 02-WALSH,T 99-03-25 S AMENDMENT REFERRED TO SRUL 99-03-25 S AMENDMENT NO. 02-WALSH,T 99-03-25 S RULES REFERS TO SINS 99-03-25 S AMENDMENT NO. 02-WALSH,T 99-03-25 S BE ADOPTED SINS/010-000-000 99-03-25 S RECALLED TO SECOND READING 99-03-25 S AMENDMENT NO. 02-WALSH,T 99-03-25 S ADOPTED 99-03-25 S PLACED ON CALENDAR ORDER OF 3RD READING 99-03-25 S THIRD READING - PASSED 036-003-019 99-03-25 S TABLED PURSUANT TO RULE 5-4(A) SA 01 99-03-25 S THIRD READING - PASSED 036-003-019 99-03-26 H ARRIVE IN HOUSE 99-03-26 H HOUSE SPONSOR FLOWERS 99-03-26 H FIRST READING 99-03-26 H REFERRED TO HOUSE RULES COMMITTEE RULES 99-04-14 H ASSIGNED TO COMMITTEE HEALTH CARE 99-04-29 H COMMITTEE AND 3RD 99-04-29 H READING DEADLINE 99-04-29 H EXTENDED - 5/21/99 99-04-29 H COMMITTEE HEALTH CARE 99-04-30 H ALTERNATE PRIMARY SPONSOR CHANGED TO SCHOENBERG 99-05-05 H ADDED AS A JOINT SPONSOR KRAUSE 99-05-05 H ADDED AS A JOINT SPONSOR KENNER 99-05-05 H ADDED AS A JOINT SPONSOR FEIGENHOLTZ 99-05-05 H ADDED AS A JOINT SPONSOR CROSS 99-05-21 H COMMITTEE AND 3RD 99-05-21 H READING DEADLINE 99-05-21 H EXTENDED - 5/31/99 99-05-21 H COMMITTEE HEALTH CARE 99-05-31 H RE-REFERRED TO RULES COMM/RULE 19(A) RULES HRUL 01-01-09 S SESSION SINE DIE END OF INQUIRY Full Text Bill Summary