State of Illinois
91st General Assembly
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Public Act 91-0788

SB1511 Enrolled                                LRB9111306JSpc

    AN ACT relating to payment for certain 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 changing Section 6.12 as follows:

    (5 ILCS 375/6.12)
    Sec. 6.12.  Payment for services.  The program of  health
benefits  is subject to the provisions of Section 368a, 356z,
356y of the Illinois Insurance Code.
(Source: P.A. 91-605, eff. 12-14-99; revised 10-18-99.)

    Section 10.  The Illinois Insurance Code  is  amended  by
renumbering  Section 356y, as added by Public Act 91-605, and
changing Section 370a as follows:

    (215 ILCS 5/356y)
    Sec. 368a. 356y. 356z.  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.
(Source: P.A. 91-605, eff. 12-14-99; revised 10-18-99.)

    (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  368a,  356z,  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. 91-605, eff. 12-14-99; revised 10-18-99.)

    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,  356z,  367i,  368a,  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 IIA, 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.  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; 91-357, eff.  7-29-99;  91-406,
eff.  1-1-00;  91-549,  eff.  8-14-99; 91-605, eff. 12-14-99;
revised 10-18-99.)

    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, 368a, 356z, 356y,
401, 401.1, 402, 403, 403A, 408, 408.2, 409,  412,  444,  and
444.1  and  Articles  IIA, 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;  91-549,  eff.  8-14-99;  91-605,  eff.
12-14-99; revised 10-18-99.)

    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 Articles IIA and XII 1/2 and Sections 3.1, 133,
140,  143,  143c,  149,  354,  355.2, 356r, 356t, 356u, 356v,
356w, 356x, 356y, 356z, 367.2, 368a, 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. 90-7, eff. 6-10-97; 90-25, eff. 1-1-98; 90-655,
eff. 7-30-98;  90-741,  eff.  1-1-99;  91-406,  eff.  1-1-00;
91-549,   eff.   8-14-99;   91-605,  eff.  12-14-99;  revised
10-18-99.)

    Section 99.  Effective date.  This Act takes effect  upon
becoming law.

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