Public Act 100-0063
HB2506 EnrolledLRB100 08314 MJP 18421 b

    AN ACT concerning health.
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
    Section 5. The Health Maintenance Organization Act is
amended by changing Section 2-2 as follows:
    (215 ILCS 125/2-2)  (from Ch. 111 1/2, par. 1404)
    Sec. 2-2. Determination by Director; Health Maintenance
Advisory Board.
    (a) Upon receipt of an application for issuance of a
certificate of authority, the Director shall transmit copies of
such application and accompanying documents to the Director of
the Illinois Department of Public Health. The Director of the
Department of Public Health shall then determine whether the
applicant for certificate of authority, with respect to health
care services to be furnished: (1) has demonstrated the
willingness and potential ability to assure that such health
care service will be provided in a manner to insure both
availability and accessibility of adequate personnel and
facilities and in a manner enhancing availability,
accessibility, and continuity of service; and (2) has
arrangements, established in accordance with regulations
promulgated by the Department of Public Health for an ongoing
quality of health care assurance program concerning health care
processes and outcomes. Upon investigation, the Director of the
Department of Public Health shall certify to the Director
whether the proposed Health Maintenance Organization meets the
requirements of this subsection (a). If the Director of the
Department of Public Health certifies that the Health
Maintenance Organization does not meet such requirements, he
shall specify in what respect it is deficient.
    There is created in the Department of Public Health a
Health Maintenance Advisory Board composed of 11 members. Nine
members shall have practiced in the health field, 4 of which
shall have been or are currently affiliated with a Health
Maintenance Organization. Two of the members shall be members
of the general public, one of whom is over 50 years of age.
Each member shall be appointed by the Director of the
Department of Public Health and serve at the pleasure of that
Director and shall receive no compensation for services
rendered other than reimbursement for expenses. Six members of
the Board shall constitute a quorum. A vacancy in the
membership of the Advisory Board shall not impair the right of
a quorum to exercise all rights and perform all duties of the
Board. The Health Maintenance Advisory Board has the power to
review and comment on proposed rules and regulations to be
promulgated by the Director of the Department of Public Health
within 30 days after those proposed rules and regulations have
been submitted to the Advisory Board.
    (b) Issuance of a certificate of authority shall be granted
if the following conditions are met:
        (1) the requirements of subsection (c) of Section 2-1
    have been fulfilled;
        (2) the persons responsible for the conduct of the
    affairs of the applicant are competent, trustworthy, and
    possess good reputations, and have had appropriate
    experience, training or education;
        (3) the Director of the Department of Public Health
    certifies that the Health Maintenance Organization's
    proposed plan of operation meets the requirements of this
        (4) the Health Care Plan furnishes basic health care
    services on a prepaid basis, through insurance or
    otherwise, except to the extent of reasonable requirements
    for co-payments or deductibles as authorized by this Act;
        (5) the Health Maintenance Organization is financially
    responsible and may reasonably be expected to meet its
    obligations to enrollees and prospective enrollees; in
    making this determination, the Director shall consider:
            (A) the financial soundness of the applicant's
        arrangements for health services and the minimum
        standard rates, co-payments and other patient charges
        used in connection therewith;
            (B) the adequacy of working capital, other sources
        of funding, and provisions for contingencies; and
            (C) that no certificate of authority shall be
        issued if the initial minimum net worth of the
        applicant is less than $2,000,000. The initial net
        worth shall be provided in cash and securities in
        combination and form acceptable to the Director;
        (6) the agreements with providers for the provision of
    health services contain the provisions required by Section
    2-8 of this Act; and
        (7) any deficiencies identified by the Director have
    been corrected.
(Source: P.A. 91-617, eff. 1-1-00.)
    Section 99. Effective date. This Act takes effect upon
becoming law.