Illinois House Bill 2730 (Prior Session Legislation)

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Spectrum: Partisan Bill (Democrat 4-0)
Status: Introduced on February 14 2019 - 25% progression, died in committee
Action: 2019-05-08 - Added Co-Sponsor Rep. Rita Mayfield
Pending: House Rules Committee
Text: Latest bill text (Introduced) [HTML]

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that a provider who has exhausted the written internal appeals process of a managed care organization (MCO) shall be entitled to an external independent third-party review of the MCO's final decision that denies, in whole or in part, a health care service to an enrollee or a claim for reimbursement to a provider for a health care service rendered to an enrollee of the Medicaid managed care organization. Requires an MCO's final decision letter to a provider to include: (i) a statement that the provider's internal appeal rights within the MCO have been exhausted; (ii) a statement that the provider is entitled to an external independent third-party review; (iii) the time period granted to request an external independent third-party review; and (iv) the mailing address to initiate an external independent third-party review. Provides that a party shall be entitled to appeal a final decision of the external independent third-party review within 30 days after the date upon which the appealing party receives the external independent third-party review. Provides that a final decision by the Director of Healthcare and Family Services shall be final and reviewable under the Administrative Review Law. Contains provisions concerning fees to help defray the cost of the administrative hearings; the specific claims of services that are appealable; and the Department's rulemaking authority. Effective immediately.

MEDICAID-MANAGED CARE APPEALS

Rep. Bob Morgan [D]

Rep. Kelly Cassidy [D]

Sen. Karina Villa [D]

Rep. Rita Mayfield [D]

Date	Chamber	Action
2019-05-08	House	Added Co-Sponsor Rep. Rita Mayfield
2019-03-29	House	Added Co-Sponsor Rep. Karina Villa
2019-03-29	House	Rule 19(a) / Re-referred to Rules Committee
2019-03-06	House	To Medicaid Subcommittee
2019-02-26	House	Assigned to Human Services Committee
2019-02-21	House	Added Co-Sponsor Rep. Kelly M. Cassidy
2019-02-14	House	Referred to Rules Committee
2019-02-14	House	First Reading
2019-02-14	House	Filed with the Clerk by Rep. Bob Morgan

Chapter	Article	Section	Citation Type	Statute Text
305	5	5-30.1	Amended Code	Citation Text

Type	Source
Summary	https://www.ilga.gov/legislation/BillStatus.asp?DocNum=2730&GAID=15&DocTypeID=HB&SessionID=108&GA=101
Text	https://www.ilga.gov/legislation/101/HB/10100HB2730.htm