Bill Title: Amends the Illinois Insurance Code. Makes changes to the provision concerning disclosure of limited benefits. Provides that when a beneficiary, insured, or enrollee utilizes a participating network hospital or a participating network ambulatory surgery center and, due to any reason, in network services for radiology, anesthesiology, pathology, emergency physician, or neonatology are unavailable and are provided by a nonparticipating facility-based physician or provider, the insurer or health plan shall ensure that the beneficiary, insured, or enrollee shall incur no greater out-of-pocket costs than the beneficiary, insured, or enrollee would have incurred with a participating physician or provider for covered services. Sets forth provisions concerning written explanation of benefits, billing, assignment, negotiated reimbursement, arbitration, prudent laypersons, failure to make an offer of payment, and noncovered services.

Spectrum: Slight Partisan Bill (Democrat 10-5)

Status: (Passed) 2011-11-18 - Public Act . . . . . . . . . 97-0621 [SB0072 Detail]

Text: Latest bill text (Chaptered) [HTML]

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