House Sponsors: ERWIN-ZICKUS-LANG-MULLIGAN-FEIGENHOLTZ, JOHNSON,TIM, BELLOCK, CROTTY, MCGUIRE, BROSNAHAN, SHARP, LYONS,EILEEN, KLINGLER, LINDNER, GASH AND BRADLEY. Senate Sponsors: CULLERTON-MYERS,J Short description: MEDICAL NEED EXTERNAL APPEAL Synopsis of Bill as introduced: Amends the Health Maintenance Organization Act. Adds an Article to provide for an external appeal process for adverse determinations of health care treatment decisions. Authorizes the Director of Insurance to certify external appeal agents. Establishes standards for certification. Establishes the procedures for the appeal of adverse determinations of health care treatment decisions. Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Illinois Insurance Code, and the Voluntary Health Services Plans Act to require that health care determinations be made subject to the external appeals process. Amends the State Mandates Act to provide an exemption from that Act for costs of implementing the external appeals process. FISCAL NOTE (Department of Insurance) Fiscal impact to the Dpt. could exceed $200,000 for personnel and equipment, and more for assigning and investigating exter- nal appeal agents. STATE MANDATES NOTE (Dept. of Commerce and Community Affairs) Creates a personnel mandate for which State reimbursement of increased costs to local gov't. is normally required; however, the State Mandates Act is amended to exempt the State from reimbursement liability. HOME RULE NOTE (Department of Commerce and Community Affairs) Preempts home rule authority. Last action on Bill: SESSION SINE DIE Last action date: 01-01-09 Location: House Amendments to Bill: AMENDMENTS ADOPTED: HOUSE - 0 SENATE - 0 END OF INQUIRY Full Text Bill Status