Bill Text: IL HB2506 | 2017-2018 | 100th General Assembly | Engrossed

Bill Title: Amends the Health Maintenance Organization Act. Abolishes the Health Maintenance Advisory Board and makes a corresponding change. Effective immediately.

Spectrum: Bipartisan Bill

Status: (Engrossed) 2017-04-20 - Referred to Assignments [HB2506 Detail]

Download: Illinois-2017-HB2506-Engrossed.html

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1 AN ACT concerning health.
2 Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4 Section 5. The Health Maintenance Organization Act is
5amended by changing Section 2-2 as follows:
6 (215 ILCS 125/2-2) (from Ch. 111 1/2, par. 1404)
7 Sec. 2-2. Determination by Director; Health Maintenance
8Advisory Board.
9 (a) Upon receipt of an application for issuance of a
10certificate of authority, the Director shall transmit copies of
11such application and accompanying documents to the Director of
12the Illinois Department of Public Health. The Director of the
13Department of Public Health shall then determine whether the
14applicant for certificate of authority, with respect to health
15care services to be furnished: (1) has demonstrated the
16willingness and potential ability to assure that such health
17care service will be provided in a manner to insure both
18availability and accessibility of adequate personnel and
19facilities and in a manner enhancing availability,
20accessibility, and continuity of service; and (2) has
21arrangements, established in accordance with regulations
22promulgated by the Department of Public Health for an ongoing
23quality of health care assurance program concerning health care

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1processes and outcomes. Upon investigation, the Director of the
2Department of Public Health shall certify to the Director
3whether the proposed Health Maintenance Organization meets the
4requirements of this subsection (a). If the Director of the
5Department of Public Health certifies that the Health
6Maintenance Organization does not meet such requirements, he
7shall specify in what respect it is deficient.
8 There is created in the Department of Public Health a
9Health Maintenance Advisory Board composed of 11 members. Nine
10members shall have practiced in the health field, 4 of which
11shall have been or are currently affiliated with a Health
12Maintenance Organization. Two of the members shall be members
13of the general public, one of whom is over 50 years of age.
14Each member shall be appointed by the Director of the
15Department of Public Health and serve at the pleasure of that
16Director and shall receive no compensation for services
17rendered other than reimbursement for expenses. Six members of
18the Board shall constitute a quorum. A vacancy in the
19membership of the Advisory Board shall not impair the right of
20a quorum to exercise all rights and perform all duties of the
21Board. The Health Maintenance Advisory Board has the power to
22review and comment on proposed rules and regulations to be
23promulgated by the Director of the Department of Public Health
24within 30 days after those proposed rules and regulations have
25been submitted to the Advisory Board.
26 (b) Issuance of a certificate of authority shall be granted

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1if the following conditions are met:
2 (1) the requirements of subsection (c) of Section 2-1
3 have been fulfilled;
4 (2) the persons responsible for the conduct of the
5 affairs of the applicant are competent, trustworthy, and
6 possess good reputations, and have had appropriate
7 experience, training or education;
8 (3) the Director of the Department of Public Health
9 certifies that the Health Maintenance Organization's
10 proposed plan of operation meets the requirements of this
11 Act;
12 (4) the Health Care Plan furnishes basic health care
13 services on a prepaid basis, through insurance or
14 otherwise, except to the extent of reasonable requirements
15 for co-payments or deductibles as authorized by this Act;
16 (5) the Health Maintenance Organization is financially
17 responsible and may reasonably be expected to meet its
18 obligations to enrollees and prospective enrollees; in
19 making this determination, the Director shall consider:
20 (A) the financial soundness of the applicant's
21 arrangements for health services and the minimum
22 standard rates, co-payments and other patient charges
23 used in connection therewith;
24 (B) the adequacy of working capital, other sources
25 of funding, and provisions for contingencies; and
26 (C) that no certificate of authority shall be

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1 issued if the initial minimum net worth of the
2 applicant is less than $2,000,000. The initial net
3 worth shall be provided in cash and securities in
4 combination and form acceptable to the Director;
5 (6) the agreements with providers for the provision of
6 health services contain the provisions required by Section
7 2-8 of this Act; and
8 (7) any deficiencies identified by the Director have
9 been corrected.
10(Source: P.A. 91-617, eff. 1-1-00.)
11 Section 99. Effective date. This Act takes effect upon
12becoming law.