State of Illinois
91st General Assembly
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Public Act 91-0605

HB2713 Enrolled                                LRB9103967SMpr

    AN ACT concerning payment for medical services,  amending
named Acts.

    Be  it  enacted  by  the People of the State of Illinois,
represented in the General Assembly:

    Section 5.  The State Employees Group  Insurance  Act  of
1971 is amended by adding Section 6.12 as follows:

    (5 ILCS 375/6-12 new)
    Sec.  6.12.  Payment for services.  The program of health
benefits is subject to the provisions of Section 356y of  the
Illinois Insurance Code.

    Section  10.  The  Illinois  Insurance Code is amended by
adding Section 356y and changing Sections 357.9 and  370a  as
follows:

    (215 ILCS 5/356y new)
    Sec. 356y.  Timely payment for health care services.
    (a)  This Section applies to insurers, health maintenance
organizations,   managed   care  plans,  health  care  plans,
preferred provider organizations, third party administrators,
independent  practice  associations,  and  physician-hospital
organizations (hereinafter  referred  to  as  "payors")  that
provide periodic payments, which are payments not requiring a
claim,   bill,   capitation  encounter  data,  or  capitation
reconciliation  reports,  such  as   prospective   capitation
payments,  to  health  care  professionals  and  health  care
facilities  to  provide  medical  or health care services for
insureds or enrollees.
         (1)  A  payor  shall  make  periodic   payments   in
    accordance  with  item  (3).   Failure  to  make periodic
    payments  within the period of time specified in item (3)
    shall entitle the health care professional or health care
    facility to interest at the rate of 9% per year from  the
    date  payment  was required to be made to the date of the
    late payment, provided that interest  amounting  to  less
    than $1 need not be paid.  Any required interest payments
    shall be made within 30 days after the payment.
         (2)  When  a  payor  requires  selection of a health
    care professional or health care facility, the  selection
    shall  be  completed  by the insured or enrollee no later
    than 30 days after enrollment.  The payor  shall  provide
    written  notice  of  this requirement to all insureds and
    enrollees. Nothing in this Section shall be construed  to
    require  a  payor to select a health care professional or
    health care facility for an insured or enrollee.
         (3)  A  payor  shall   provide   the   health   care
    professional  or  health care facility with notice of the
    selection as a health care professional  or  health  care
    facility by an insured or enrollee and the effective date
    of  the  selection  within  60  calendar  days  after the
    selection.  No later than the 60th day following the date
    an  insured  or  enrollee  has  selected  a  health  care
    professional or health care facility  or  the  date  that
    selection  becomes  effective,  whichever is later, or in
    cases of retrospective enrollment  only,  30  days  after
    notice  by  an  employer to the payor of the selection, a
    payor  shall  begin  periodic  payment  of  the  required
    amounts  to  the  insured's  or  enrollee's  health  care
    professional or health care facility, or the designee  of
    either, calculated from the date of selection or the date
    the  selection becomes effective, whichever is later. All
    subsequent payments shall be made in  accordance  with  a
    monthly periodic cycle.
    (b)  Notwithstanding any other provision of this Section,
independent   practice  associations  and  physician-hospital
organizations shall begin  making  periodic  payment  of  the
required  amounts within 60 days after an insured or enrollee
has selected  a  health  care  professional  or  health  care
facility  or  the  date  that  selection  becomes  effective,
whichever  is  later.  Before  January  1,  2001,  subsequent
periodic  payments  shall be made in accordance with a 60-day
periodic schedule, and after December  31,  2000,  subsequent
periodic  payments shall be made in accordance with a monthly
periodic schedule.
    Notwithstanding any  other  provision  of  this  Section,
independent   practice  associations  and  physician-hospital
organizations  shall  make  all  other  payments  for  health
services within 60 days after receipt of due  proof  of  loss
received  before  January  1,  2001  and within 30 days after
receipt of due proof of  loss  received  after  December  31,
2000.       Independent     practice     associations     and
physician-hospital organizations shall  notify  the  insured,
insured's  assignee, health care professional, or health care
facility of any failure to provide  sufficient  documentation
for  a  due proof of loss within 30 days after receipt of the
claim for health services.
    Failure to pay within  the  required  time  period  shall
entitle the payee to interest at the rate of 9% per year from
the  date the payment is due to the date of the late payment,
provided that interest amounting to less that $1 need not  be
paid.  Any required interest payments shall be made within 30
days after the payment.
    (c)  All   insurers,  health  maintenance  organizations,
managed care plans, health  care  plans,  preferred  provider
organizations,  and  third  party administrators shall ensure
that  all  claims  and  indemnities  concerning  health  care
services other than for any periodic payment  shall  be  paid
within  30  days  after  receipt of due written proof of such
loss.   An   insured,   insured's   assignee,   health   care
professional, or health care facility shall  be  notified  of
any  known  failure to provide sufficient documentation for a
due proof of loss within 30 days after receipt of  the  claim
for  health care services.  Failure to pay within such period
shall entitle the payee to interest at the  rate  of  9%  per
year from the 30th day after receipt of such proof of loss to
the date of late payment, provided that interest amounting to
less than one dollar need not be paid.  Any required interest
payments shall be made within 30 days after the payment.
    (d)  The  Department shall enforce the provisions of this
Section pursuant to the enforcement powers granted to  it  by
law.
    (e)  The  Department is hereby granted specific authority
to issue  a  cease  and  desist  order,  fine,  or  otherwise
penalize     independent     practice     associations    and
physician-hospital organizations that violate  this  Section.
The  Department  shall  adopt  reasonable  rules  to  enforce
compliance   with   this   Section  by  independent  practice
associations and physician-hospital organizations.

    (215 ILCS 5/357.9) (from Ch. 73, par. 969.9)
    Sec. 357.9.  "TIME  OF  PAYMENT  OF  CLAIMS:  Indemnities
payable  under  this  policy for any loss other than loss for
which this policy provides any periodic payment will be  paid
immediately  upon  receipt of due written proof of such loss.
Subject to due written proof of loss, all accrued indemnities
for loss for which this policy provides periodic payment will
be paid .... (insert period for payment  which  must  not  be
less  frequently  than  monthly)  and  any  balance remaining
unpaid upon  the  termination  of  liability,  will  be  paid
immediately upon receipt of due written proof."
    All  claims  and indemnities payable under the terms of a
policy of accident and health insurance shall be paid  within
30  days  following  receipt  by  the insurer of due proof of
loss. Failure to pay within such  period  shall  entitle  the
insured  to interest at the rate of 9 per cent per annum from
the 30th day after receipt of such proof of loss to the  date
of  late  payment,  provided  that interest amounting to less
than one dollar need not be paid. An insured or an  insured's
assignee shall be notified by the insurer, health maintenance
organization,  managed care plan, health care plan, preferred
provider organization, or third party  administrator  of  any
known  failure  to provide sufficient documentation for a due
proof of loss within 30 days after receipt of the claim.  Any
required interest payments shall be made within 30 days after
the payment.
    The requirements of  this  Section  shall  apply  to  any
policy of accident and health insurance delivered, issued for
delivery,  renewed  or amended on or after 180 days following
the effective date  of  this  amendatory  Act  of  1985.  The
requirements of this Section also shall specifically apply to
any  group policy of dental insurance only, delivered, issued
for delivery,  renewed  or  amended  on  or  after  180  days
following the effective date of this amendatory Act of 1987.
(Source: P.A. 85-395.)

    (215 ILCS 5/370a) (from Ch. 73, par. 982a)
    Sec.   370a.   Assignability   of   Accident  and  Health
Insurance.
    No provision of the Illinois Insurance Code, or any other
law, prohibits an insured under any policy  of  accident  and
health  insurance or any other person who may be the owner of
any rights under such policy from making an assignment of all
or any part of his rights and  privileges  under  the  policy
including  but  not  limited  to  the  right  to  designate a
beneficiary and  to  have  an  individual  policy  issued  in
accordance with its terms. Subject to the terms of the policy
or any contract relating thereto, an assignment by an insured
or by any other owner of rights under the policy, made before
or after the effective date of this amendatory Act of 1969 is
valid  for  the  purpose  of  vesting  in  the  assignee,  in
accordance  with  any  provisions  included therein as to the
time at which it is effective, all rights and  privileges  so
assigned.  However,  such  assignment is without prejudice to
the company on account of any payment it makes or  individual
policy  it issues before receipt of notice of the assignment.
This  amendatory  Act  of  1969  acknowledges,  declares  and
codifies the existing right of assignment of interests  under
accident  and  health  insurance  policies. If an enrollee or
insured  of  an  insurer,  health  maintenance  organization,
managed care  plan,  health  care  plan,  preferred  provider
organization, or third party administrator assigns a claim to
a  health  care  professional  or  health care facility, then
payment  shall  be  made  directly   to   the   health   care
professional  or  health care facility including any interest
required under Section 356y of this Code for failure  to  pay
claims  within  30  days  after receipt by the insurer of due
proof of loss.  Nothing in this Section shall be construed to
prevent any parties from reconciling duplicate payments.
(Source: P. A. 76-1709.)

    Section 15.  The Health Maintenance Organization  Act  is
amended by changing Section 5-3 as follows:

    (215 ILCS 125/5-3) (from Ch. 111 1/2, par. 1411.2)
    Sec. 5-3.  Insurance Code provisions.
    (a)  Health Maintenance Organizations shall be subject to
the  provisions of Sections 133, 134, 137, 140, 141.1, 141.2,
141.3, 143, 143c, 147, 148, 149, 151, 152, 153,  154,  154.5,
154.6,  154.7,  154.8, 155.04, 355.2, 356m, 356v, 356w, 356x,
356y, 367i, 401, 401.1, 402, 403, 403A, 408, 408.2, 409, 412,
444, and 444.1, paragraph (c) of subsection  (2)  of  Section
367,  and  Articles  VIII  1/2, XII, XII 1/2, XIII, XIII 1/2,
XXV, and XXVI of the Illinois Insurance Code.
    (b)  For purposes of the Illinois Insurance Code,  except
for  Sections  444  and 444.1 and Articles XIII and XIII 1/2,
Health Maintenance Organizations in the following  categories
are deemed to be "domestic companies":
         (1)  a   corporation  authorized  under  the  Dental
    Service Plan Act or the Voluntary Health  Services  Plans
    Act;
         (2)  a  corporation organized under the laws of this
    State; or
         (3)  a  corporation  organized  under  the  laws  of
    another state, 30% or more of the enrollees of which  are
    residents  of this State, except a corporation subject to
    substantially the  same  requirements  in  its  state  of
    organization  as  is  a  "domestic company" under Article
    VIII 1/2 of the Illinois Insurance Code.
    (c)  In considering the merger, consolidation,  or  other
acquisition  of  control of a Health Maintenance Organization
pursuant to Article VIII 1/2 of the Illinois Insurance Code,
         (1)  the Director shall give  primary  consideration
    to  the  continuation  of  benefits  to enrollees and the
    financial conditions of the acquired  Health  Maintenance
    Organization  after  the  merger, consolidation, or other
    acquisition of control takes effect;
         (2)(i)  the criteria specified in subsection  (1)(b)
    of Section 131.8 of the Illinois Insurance Code shall not
    apply  and (ii) the Director, in making his determination
    with respect  to  the  merger,  consolidation,  or  other
    acquisition  of  control,  need not take into account the
    effect on competition of the  merger,  consolidation,  or
    other acquisition of control;
         (3)  the  Director  shall  have the power to require
    the following information:
              (A)  certification by an independent actuary of
         the  adequacy  of  the  reserves   of   the   Health
         Maintenance Organization sought to be acquired;
              (B)  pro  forma financial statements reflecting
         the combined balance sheets of the acquiring company
         and the Health Maintenance Organization sought to be
         acquired as of the end of the preceding year and  as
         of  a date 90 days prior to the acquisition, as well
         as  pro  forma   financial   statements   reflecting
         projected  combined  operation  for  a  period  of 2
         years;
              (C)  a pro forma  business  plan  detailing  an
         acquiring   party's   plans   with  respect  to  the
         operation of  the  Health  Maintenance  Organization
         sought  to be acquired for a period of not less than
         3 years; and
              (D)  such other  information  as  the  Director
         shall require.
    (d)  The  provisions  of Article VIII 1/2 of the Illinois
Insurance Code and this Section 5-3 shall apply to  the  sale
by any health maintenance organization of greater than 10% of
its  enrollee  population  (including  without limitation the
health maintenance organization's right, title, and  interest
in and to its health care certificates).
    (e)  In  considering  any  management contract or service
agreement subject to Section 141.1 of the Illinois  Insurance
Code,  the  Director  (i)  shall, in addition to the criteria
specified in Section 141.2 of the  Illinois  Insurance  Code,
take  into  account  the effect of the management contract or
service  agreement  on  the  continuation  of   benefits   to
enrollees   and   the   financial  condition  of  the  health
maintenance organization to be managed or serviced, and  (ii)
need  not  take  into  account  the  effect of the management
contract or service agreement on competition.
    (f)  Except for small employer groups as defined  in  the
Small  Employer  Rating,  Renewability and Portability Health
Insurance Act and except for medicare supplement policies  as
defined  in  Section  363  of  the Illinois Insurance Code, a
Health Maintenance Organization may by contract agree with  a
group  or  other  enrollment unit to effect refunds or charge
additional premiums under the following terms and conditions:
         (i)  the amount of, and other terms  and  conditions
    with respect to, the refund or additional premium are set
    forth  in the group or enrollment unit contract agreed in
    advance of the period for which a refund is to be paid or
    additional premium is to be charged (which  period  shall
    not be less than one year); and
         (ii)  the amount of the refund or additional premium
    shall   not   exceed   20%   of  the  Health  Maintenance
    Organization's profitable or unprofitable experience with
    respect to the group or other  enrollment  unit  for  the
    period  (and,  for  purposes  of  a  refund or additional
    premium, the profitable or unprofitable experience  shall
    be calculated taking into account a pro rata share of the
    Health   Maintenance  Organization's  administrative  and
    marketing expenses, but shall not include any  refund  to
    be made or additional premium to be paid pursuant to this
    subsection (f)).  The Health Maintenance Organization and
    the   group   or  enrollment  unit  may  agree  that  the
    profitable or unprofitable experience may  be  calculated
    taking into account the refund period and the immediately
    preceding 2 plan years.
    The  Health  Maintenance  Organization  shall  include  a
statement in the evidence of coverage issued to each enrollee
describing the possibility of a refund or additional premium,
and  upon request of any group or enrollment unit, provide to
the group or enrollment unit a description of the method used
to  calculate  (1)  the  Health  Maintenance   Organization's
profitable experience with respect to the group or enrollment
unit and the resulting refund to the group or enrollment unit
or  (2)  the  Health  Maintenance Organization's unprofitable
experience with respect to the group or enrollment  unit  and
the  resulting  additional premium to be paid by the group or
enrollment unit.
    In  no  event  shall  the  Illinois  Health   Maintenance
Organization  Guaranty  Association  be  liable  to  pay  any
contractual  obligation  of  an insolvent organization to pay
any refund authorized under this Section.
(Source: P.A.  89-90,  eff.  6-30-95;  90-25,  eff.   1-1-98;
90-177,  eff.  7-23-97;  90-372,  eff.  7-1-98;  90-583, eff.
5-29-98; 90-655, eff. 7-30-98; 90-741, eff.  1-1-99;  revised
9-8-98.)

    Section  20.  The Limited Health Service Organization Act
is amended by changing Section 4003 as follows:

    (215 ILCS 130/4003) (from Ch. 73, par. 1504-3)
    Sec. 4003.  Illinois Insurance Code provisions.   Limited
health   service   organizations  shall  be  subject  to  the
provisions of Sections 133,  134,  137,  140,  141.1,  141.2,
141.3,  143,  143c, 147, 148, 149, 151, 152, 153, 154, 154.5,
154.6, 154.7, 154.8, 155.04, 355.2, 356v, 356y,  401,  401.1,
402,  403,  403A,  408,  408.2,  409, 412, 444, and 444.1 and
Articles VIII 1/2, XII, XII 1/2, XIII,  XIII  1/2,  XXV,  and
XXVI  of  the  Illinois  Insurance Code.  For purposes of the
Illinois Insurance Code, except for Sections  444  and  444.1
and  Articles  XIII  and  XIII  1/2,  limited  health service
organizations in the following categories are  deemed  to  be
domestic companies:
         (1)  a corporation under the laws of this State; or
         (2)  a  corporation  organized  under  the  laws  of
    another  state, 30% of more of the enrollees of which are
    residents of this State, except a corporation subject  to
    substantially  the  same  requirements  in  its  state of
    organization as is a domestic company under Article  VIII
    1/2 of the Illinois Insurance Code.
(Source: P.A.  90-25,  eff.  1-1-98;  90-583,  eff.  5-29-98;
90-655, eff. 7-30-98.)

    Section  25.   The Voluntary Health Services Plans Act is
amended by changing Section 10 as follows:

    (215 ILCS 165/10) (from Ch. 32, par. 604)
    Sec.  10.  Application  of  Insurance  Code   provisions.
Health  services plan corporations and all persons interested
therein  or  dealing  therewith  shall  be  subject  to   the
provisions  of  Article  XII  1/2 and Sections 3.1, 133, 140,
143, 143c, 149, 354, 355.2, 356r,  356t,  356u,  356v,  356w,
356x,  356y,  367.2,  401, 401.1, 402, 403, 403A, 408, 408.2,
and 412, and paragraphs (7) and (15) of Section  367  of  the
Illinois Insurance Code.
(Source: P.A.  89-514,  eff.  7-17-96;  90-7,  eff.  6-10-97;
90-25,  eff.  1-1-98;  90-655,  eff.  7-30-98;  90-741,  eff.
1-1-99.)

    Section  99.   Effective date.  This Act takes effect 120
days after becoming law.

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