Bill Text: IL SB0904 | 2017-2018 | 100th General Assembly | Enrolled
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Amends the Illinois Insurance Code. Creates an advisory council within the Department of Insurance to review and make recommendations to the Department regarding rules to be adopted by the Department concerning continuing education courses, course materials, curriculum, and credentials of instructors. Provides that the members shall be appointed by the Director of Insurance. Provides criteria for membership, length of terms, term limits, and quorum. Provides that a member of the advisory council or a designee of the Director shall be permitted access to any classroom or any educational offering while instruction is in progress to monitor the instruction for any class that has been submitted to the Department for continuing education credit under the provisions of the Code. Effective immediately.
Spectrum: Partisan Bill (Democrat 55-0)
Status: (Passed) 2018-11-29 - Public Act . . . . . . . . . 100-1117 [SB0904 Detail]
Download: Illinois-2017-SB0904-Enrolled.html
Bill Title: Amends the Illinois Insurance Code. Creates an advisory council within the Department of Insurance to review and make recommendations to the Department regarding rules to be adopted by the Department concerning continuing education courses, course materials, curriculum, and credentials of instructors. Provides that the members shall be appointed by the Director of Insurance. Provides criteria for membership, length of terms, term limits, and quorum. Provides that a member of the advisory council or a designee of the Director shall be permitted access to any classroom or any educational offering while instruction is in progress to monitor the instruction for any class that has been submitted to the Department for continuing education credit under the provisions of the Code. Effective immediately.
Spectrum: Partisan Bill (Democrat 55-0)
Status: (Passed) 2018-11-29 - Public Act . . . . . . . . . 100-1117 [SB0904 Detail]
Download: Illinois-2017-SB0904-Enrolled.html
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1 | AN ACT concerning regulation.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 5. The Workers' Compensation Act is amended by | ||||||
5 | changing Sections 8.2 and 8.2a as follows:
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6 | (820 ILCS 305/8.2)
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7 | Sec. 8.2. Fee schedule.
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8 | (a) Except as provided for in subsection (c), for | ||||||
9 | procedures, treatments, or services covered under this Act and | ||||||
10 | rendered or to be rendered on and after February 1, 2006, the | ||||||
11 | maximum allowable payment shall be 90% of the 80th percentile | ||||||
12 | of charges and fees as determined by the Commission utilizing | ||||||
13 | information provided by employers' and insurers' national | ||||||
14 | databases, with a minimum of 12,000,000 Illinois line item | ||||||
15 | charges and fees comprised of health care provider and hospital | ||||||
16 | charges and fees as of August 1, 2004 but not earlier than | ||||||
17 | August 1, 2002. These charges and fees are provider billed | ||||||
18 | amounts and shall not include discounted charges. The 80th | ||||||
19 | percentile is the point on an ordered data set from low to high | ||||||
20 | such that 80% of the cases are below or equal to that point and | ||||||
21 | at most 20% are above or equal to that point. The Commission | ||||||
22 | shall adjust these historical charges and fees as of August 1, | ||||||
23 | 2004 by the Consumer Price Index-U for the period August 1, |
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1 | 2004 through September 30, 2005. The Commission shall establish | ||||||
2 | fee schedules for procedures, treatments, or services for | ||||||
3 | hospital inpatient, hospital outpatient, emergency room and | ||||||
4 | trauma, ambulatory surgical treatment centers, and | ||||||
5 | professional services. These charges and fees shall be | ||||||
6 | designated by geozip or any smaller geographic unit. The data | ||||||
7 | shall in no way identify or tend to identify any patient, | ||||||
8 | employer, or health care provider. As used in this Section, | ||||||
9 | "geozip" means a three-digit zip code based on data | ||||||
10 | similarities, geographical similarities, and frequencies. A | ||||||
11 | geozip does not cross state boundaries. As used in this | ||||||
12 | Section, "three-digit zip code" means a geographic area in | ||||||
13 | which all zip codes have the same first 3 digits. If a geozip | ||||||
14 | does not have the necessary number of charges and fees to | ||||||
15 | calculate a valid percentile for a specific procedure, | ||||||
16 | treatment, or service, the Commission may combine data from the | ||||||
17 | geozip with up to 4 other geozips that are demographically and | ||||||
18 | economically similar and exhibit similarities in data and | ||||||
19 | frequencies until the Commission reaches 9 charges or fees for | ||||||
20 | that specific procedure, treatment, or service. In cases where | ||||||
21 | the compiled data contains less than 9 charges or fees for a | ||||||
22 | procedure, treatment, or service, reimbursement shall occur at | ||||||
23 | 76% of charges and fees as determined by the Commission in a | ||||||
24 | manner consistent with the provisions of this paragraph. | ||||||
25 | Providers of out-of-state procedures, treatments, services, | ||||||
26 | products, or supplies shall be reimbursed at the lesser of that |
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1 | state's fee schedule amount or the fee schedule amount for the | ||||||
2 | region in which the employee resides. If no fee schedule exists | ||||||
3 | in that state, the provider shall be reimbursed at the lesser | ||||||
4 | of the actual charge or the fee schedule amount for the region | ||||||
5 | in which the employee resides. Not later than September 30 in | ||||||
6 | 2006 and each year thereafter, the Commission shall | ||||||
7 | automatically increase or decrease the maximum allowable | ||||||
8 | payment for a procedure, treatment, or service established and | ||||||
9 | in effect on January 1 of that year by the percentage change in | ||||||
10 | the Consumer Price Index-U for the 12 month period ending | ||||||
11 | August 31 of that year. The increase or decrease shall become | ||||||
12 | effective on January 1 of the following year. As used in this | ||||||
13 | Section, "Consumer Price Index-U" means the index published by | ||||||
14 | the Bureau of Labor Statistics of the U.S. Department of Labor, | ||||||
15 | that measures the average change in prices of all goods and | ||||||
16 | services purchased by all urban consumers, U.S. city average, | ||||||
17 | all items, 1982-84=100. | ||||||
18 | (a-1) Notwithstanding the provisions of subsection (a) and | ||||||
19 | unless otherwise indicated, the following provisions shall | ||||||
20 | apply to the medical fee schedule starting on September 1, | ||||||
21 | 2011: | ||||||
22 | (1) The Commission shall establish and maintain fee | ||||||
23 | schedules for procedures, treatments, products, services, | ||||||
24 | or supplies for hospital inpatient, hospital outpatient, | ||||||
25 | emergency room, ambulatory surgical treatment centers, | ||||||
26 | accredited ambulatory surgical treatment facilities, |
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1 | prescriptions filled and dispensed outside of a licensed | ||||||
2 | pharmacy, dental services, and professional services. This | ||||||
3 | fee schedule shall be based on the fee schedule amounts | ||||||
4 | already established by the Commission pursuant to | ||||||
5 | subsection (a) of this Section. However, starting on | ||||||
6 | January 1, 2012, these fee schedule amounts shall be | ||||||
7 | grouped into geographic regions in the following manner: | ||||||
8 | (A) Four regions for non-hospital fee schedule | ||||||
9 | amounts shall be utilized: | ||||||
10 | (i) Cook County; | ||||||
11 | (ii) DuPage, Kane, Lake, and Will Counties; | ||||||
12 | (iii) Bond, Calhoun, Clinton, Jersey, | ||||||
13 | Macoupin, Madison, Monroe, Montgomery, Randolph, | ||||||
14 | St. Clair, and Washington Counties; and | ||||||
15 | (iv) All other counties of the State. | ||||||
16 | (B) Fourteen regions for hospital fee schedule | ||||||
17 | amounts shall be utilized: | ||||||
18 | (i) Cook, DuPage, Will, Kane, McHenry, DeKalb, | ||||||
19 | Kendall, and Grundy Counties; | ||||||
20 | (ii) Kankakee County; | ||||||
21 | (iii) Madison, St. Clair, Macoupin, Clinton, | ||||||
22 | Monroe, Jersey, Bond, and Calhoun Counties; | ||||||
23 | (iv) Winnebago and Boone Counties; | ||||||
24 | (v) Peoria, Tazewell, Woodford, Marshall, and | ||||||
25 | Stark Counties; | ||||||
26 | (vi) Champaign, Piatt, and Ford Counties; |
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1 | (vii) Rock Island, Henry, and Mercer Counties; | ||||||
2 | (viii) Sangamon and Menard Counties; | ||||||
3 | (ix) McLean County; | ||||||
4 | (x) Lake County; | ||||||
5 | (xi) Macon County; | ||||||
6 | (xii) Vermilion County; | ||||||
7 | (xiii) Alexander County; and | ||||||
8 | (xiv) All other counties of the State. | ||||||
9 | (2) If a geozip, as defined in subsection (a) of this | ||||||
10 | Section, overlaps into one or more of the regions set forth | ||||||
11 | in this Section, then the Commission shall average or | ||||||
12 | repeat the charges and fees in a geozip in order to | ||||||
13 | designate charges and fees for each region. | ||||||
14 | (3) In cases where the compiled data contains less than | ||||||
15 | 9 charges or fees for a procedure, treatment, product, | ||||||
16 | supply, or service or where the fee schedule amount cannot | ||||||
17 | be determined by the non-discounted charge data, | ||||||
18 | non-Medicare relative values and conversion factors | ||||||
19 | derived from established fee schedule amounts, coding | ||||||
20 | crosswalks, or other data as determined by the Commission, | ||||||
21 | reimbursement shall occur at 76% of charges and fees until | ||||||
22 | September 1, 2011 and 53.2% of charges and fees thereafter | ||||||
23 | as determined by the Commission in a manner consistent with | ||||||
24 | the provisions of this paragraph. | ||||||
25 | (4) To establish additional fee schedule amounts, the | ||||||
26 | Commission shall utilize provider non-discounted charge |
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1 | data, non-Medicare relative values and conversion factors | ||||||
2 | derived from established fee schedule amounts, and coding | ||||||
3 | crosswalks. The Commission may establish additional fee | ||||||
4 | schedule amounts based on either the charge or cost of the | ||||||
5 | procedure, treatment, product, supply, or service. | ||||||
6 | (5) Implants shall be reimbursed at 25% above the net | ||||||
7 | manufacturer's invoice price less rebates, plus actual | ||||||
8 | reasonable and customary shipping charges whether or not | ||||||
9 | the implant charge is submitted by a provider in | ||||||
10 | conjunction with a bill for all other services associated | ||||||
11 | with the implant, submitted by a provider on a separate | ||||||
12 | claim form, submitted by a distributor, or submitted by the | ||||||
13 | manufacturer of the implant. "Implants" include the | ||||||
14 | following codes or any substantially similar updated code | ||||||
15 | as determined by the Commission: 0274 | ||||||
16 | (prosthetics/orthotics); 0275 (pacemaker); 0276 (lens | ||||||
17 | implant); 0278 (implants); 0540 and 0545 (ambulance); 0624 | ||||||
18 | (investigational devices); and 0636 (drugs requiring | ||||||
19 | detailed coding). Non-implantable devices or supplies | ||||||
20 | within these codes shall be reimbursed at 65% of actual | ||||||
21 | charge, which is the provider's normal rates under its | ||||||
22 | standard chargemaster. A standard chargemaster is the | ||||||
23 | provider's list of charges for procedures, treatments, | ||||||
24 | products, supplies, or services used to bill payers in a | ||||||
25 | consistent manner. | ||||||
26 | (6) The Commission shall automatically update all |
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1 | codes and associated rules with the version of the codes | ||||||
2 | and rules valid on January 1 of that year. | ||||||
3 | (a-2) For procedures, treatments, services, or supplies | ||||||
4 | covered under this Act and rendered or to be rendered on or | ||||||
5 | after September 1, 2011, the maximum allowable payment shall be | ||||||
6 | 70% of the fee schedule amounts, which shall be adjusted yearly | ||||||
7 | by the Consumer Price Index-U, as described in subsection (a) | ||||||
8 | of this Section. | ||||||
9 | (a-3) Prescriptions filled and dispensed outside of a | ||||||
10 | licensed pharmacy shall be subject to a fee schedule that shall | ||||||
11 | not exceed the Average Wholesale Price (AWP) plus a dispensing | ||||||
12 | fee of $4.18. AWP or its equivalent as registered by the | ||||||
13 | National Drug Code shall be set forth for that drug on that | ||||||
14 | date as published in Medispan. | ||||||
15 | (b) Notwithstanding the provisions of subsection (a), if
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16 | the Commission finds that there is a significant limitation on
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17 | access to quality health care in either a specific field of
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18 | health care services or a specific geographic limitation on
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19 | access to health care, it may change the Consumer Price Index-U
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20 | increase or decrease for that specific field or specific
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21 | geographic limitation on access to health care to address that
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22 | limitation. | ||||||
23 | (c) The Commission shall establish by rule a process to | ||||||
24 | review those medical cases or outliers that involve | ||||||
25 | extra-ordinary treatment to determine whether to make an | ||||||
26 | additional adjustment to the maximum payment within a fee |
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1 | schedule for a procedure, treatment, or service. | ||||||
2 | (d) When a patient notifies a provider that the treatment, | ||||||
3 | procedure, or service being sought is for a work-related | ||||||
4 | illness or injury and furnishes the provider the name and | ||||||
5 | address of the responsible employer, the provider shall bill | ||||||
6 | the employer or its designee directly. The employer or its | ||||||
7 | designee shall make payment for treatment in accordance with | ||||||
8 | the provisions of this Section directly to the provider, except | ||||||
9 | that, if a provider has designated a third-party billing entity | ||||||
10 | to bill on its behalf, payment shall be made directly to the | ||||||
11 | billing entity. Providers and providers shall submit bills and | ||||||
12 | records in accordance with the provisions of this Section. | ||||||
13 | (1) All payments to providers for treatment provided | ||||||
14 | pursuant to this Act shall be made within 30 days of | ||||||
15 | receipt of the bills as long as the bill claim contains | ||||||
16 | substantially all the required data elements necessary to | ||||||
17 | adjudicate the bill bills . | ||||||
18 | (2) If the bill claim does not contain substantially | ||||||
19 | all the required data elements necessary to adjudicate the | ||||||
20 | bill, or the claim is denied for any other reason, in whole | ||||||
21 | or in part, the employer or insurer shall provide written | ||||||
22 | notification to the provider in the form of an explanation | ||||||
23 | of benefits , explaining the basis for the denial and | ||||||
24 | describing any additional necessary data elements , to the | ||||||
25 | provider within 30 days of receipt of the bill. The | ||||||
26 | Commission, with assistance from the Medical Fee Advisory |
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1 | Board, shall adopt rules detailing the requirements for the | ||||||
2 | explanation of benefits required under this subsection. | ||||||
3 | (3) In the case (i) of nonpayment to a provider within | ||||||
4 | 30 days of receipt of the bill which contained | ||||||
5 | substantially all of the required data elements necessary | ||||||
6 | to adjudicate the bill , (ii) of or nonpayment to a provider | ||||||
7 | of a portion of such a bill , or (iii) where the provider | ||||||
8 | has not been issued an explanation of benefits for a bill | ||||||
9 | up to the lesser of the actual charge or the payment level | ||||||
10 | set by the Commission in the fee schedule established in | ||||||
11 | this Section , the bill, or portion of the bill up to the | ||||||
12 | lesser of the actual charge or the payment level set by the | ||||||
13 | Commission in the fee schedule established in this Section , | ||||||
14 | shall incur interest at a rate of 1% per month payable by | ||||||
15 | the employer to the provider. Any required interest | ||||||
16 | payments shall be made by the employer or its insurer to | ||||||
17 | the provider not later than within 30 days after payment of | ||||||
18 | the bill . | ||||||
19 | (4) If the employer or its insurer fails to pay | ||||||
20 | interest required pursuant to this subsection (d), the | ||||||
21 | provider may bring an action in circuit court to enforce | ||||||
22 | the provisions of this subsection (d) against the employer | ||||||
23 | or its insurer responsible for insuring the employer's | ||||||
24 | liability pursuant to item (3) of subsection (a) of Section | ||||||
25 | 4. Interest under this subsection (d) is only payable to | ||||||
26 | the provider. An employee is not responsible for the |
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1 | payment of interest under this Section. The right to | ||||||
2 | interest under this subsection (d) shall not delay, | ||||||
3 | diminish, restrict, or alter in any way the benefits to | ||||||
4 | which the employee or his or her dependents are entitled | ||||||
5 | under this Act. | ||||||
6 | The changes made to this subsection (d) by this amendatory | ||||||
7 | Act of the 100th General Assembly apply to procedures, | ||||||
8 | treatments, and services rendered on and after the effective | ||||||
9 | date of this amendatory Act of the 100th General Assembly. | ||||||
10 | (e) Except as provided in subsections (e-5), (e-10), and | ||||||
11 | (e-15), a provider shall not hold an employee liable for costs | ||||||
12 | related to a non-disputed procedure, treatment, or service | ||||||
13 | rendered in connection with a compensable injury. The | ||||||
14 | provisions of subsections (e-5), (e-10), (e-15), and (e-20) | ||||||
15 | shall not apply if an employee provides information to the | ||||||
16 | provider regarding participation in a group health plan. If the | ||||||
17 | employee participates in a group health plan, the provider may | ||||||
18 | submit a claim for services to the group health plan. If the | ||||||
19 | claim for service is covered by the group health plan, the | ||||||
20 | employee's responsibility shall be limited to applicable | ||||||
21 | deductibles, co-payments, or co-insurance. Except as provided | ||||||
22 | under subsections (e-5), (e-10), (e-15), and (e-20), a provider | ||||||
23 | shall not bill or otherwise attempt to recover from the | ||||||
24 | employee the difference between the provider's charge and the | ||||||
25 | amount paid by the employer or the insurer on a compensable | ||||||
26 | injury, or for medical services or treatment determined by the |
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1 | Commission to be excessive or unnecessary. | ||||||
2 | (e-5) If an employer notifies a provider that the employer | ||||||
3 | does not consider the illness or injury to be compensable under | ||||||
4 | this Act, the provider may seek payment of the provider's | ||||||
5 | actual charges from the employee for any procedure, treatment, | ||||||
6 | or service rendered. Once an employee informs the provider that | ||||||
7 | there is an application filed with the Commission to resolve a | ||||||
8 | dispute over payment of such charges, the provider shall cease | ||||||
9 | any and all efforts to collect payment for the services that | ||||||
10 | are the subject of the dispute. Any statute of limitations or | ||||||
11 | statute of repose applicable to the provider's efforts to | ||||||
12 | collect payment from the employee shall be tolled from the date | ||||||
13 | that the employee files the application with the Commission | ||||||
14 | until the date that the provider is permitted to resume | ||||||
15 | collection efforts under the provisions of this Section. | ||||||
16 | (e-10) If an employer notifies a provider that the employer | ||||||
17 | will pay only a portion of a bill for any procedure, treatment, | ||||||
18 | or service rendered in connection with a compensable illness or | ||||||
19 | disease, the provider may seek payment from the employee for | ||||||
20 | the remainder of the amount of the bill up to the lesser of the | ||||||
21 | actual charge, negotiated rate, if applicable, or the payment | ||||||
22 | level set by the Commission in the fee schedule established in | ||||||
23 | this Section. Once an employee informs the provider that there | ||||||
24 | is an application filed with the Commission to resolve a | ||||||
25 | dispute over payment of such charges, the provider shall cease | ||||||
26 | any and all efforts to collect payment for the services that |
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1 | are the subject of the dispute. Any statute of limitations or | ||||||
2 | statute of repose applicable to the provider's efforts to | ||||||
3 | collect payment from the employee shall be tolled from the date | ||||||
4 | that the employee files the application with the Commission | ||||||
5 | until the date that the provider is permitted to resume | ||||||
6 | collection efforts under the provisions of this Section. | ||||||
7 | (e-15) When there is a dispute over the compensability of | ||||||
8 | or amount of payment for a procedure, treatment, or service, | ||||||
9 | and a case is pending or proceeding before an Arbitrator or the | ||||||
10 | Commission, the provider may mail the employee reminders that | ||||||
11 | the employee will be responsible for payment of any procedure, | ||||||
12 | treatment or service rendered by the provider. The reminders | ||||||
13 | must state that they are not bills, to the extent practicable | ||||||
14 | include itemized information, and state that the employee need | ||||||
15 | not pay until such time as the provider is permitted to resume | ||||||
16 | collection efforts under this Section. The reminders shall not | ||||||
17 | be provided to any credit rating agency. The reminders may | ||||||
18 | request that the employee furnish the provider with information | ||||||
19 | about the proceeding under this Act, such as the file number, | ||||||
20 | names of parties, and status of the case. If an employee fails | ||||||
21 | to respond to such request for information or fails to furnish | ||||||
22 | the information requested within 90 days of the date of the | ||||||
23 | reminder, the provider is entitled to resume any and all | ||||||
24 | efforts to collect payment from the employee for the services | ||||||
25 | rendered to the employee and the employee shall be responsible | ||||||
26 | for payment of any outstanding bills for a procedure, |
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1 | treatment, or service rendered by a provider. | ||||||
2 | (e-20) Upon a final award or judgment by an Arbitrator or | ||||||
3 | the Commission, or a settlement agreed to by the employer and | ||||||
4 | the employee, a provider may resume any and all efforts to | ||||||
5 | collect payment from the employee for the services rendered to | ||||||
6 | the employee and the employee shall be responsible for payment | ||||||
7 | of any outstanding bills for a procedure, treatment, or service | ||||||
8 | rendered by a provider as well as the interest awarded under | ||||||
9 | subsection (d) of this Section. In the case of a procedure, | ||||||
10 | treatment, or service deemed compensable, the provider shall | ||||||
11 | not require a payment rate, excluding the interest provisions | ||||||
12 | under subsection (d), greater than the lesser of the actual | ||||||
13 | charge or the payment level set by the Commission in the fee | ||||||
14 | schedule established in this Section. Payment for services | ||||||
15 | deemed not covered or not compensable under this Act is the | ||||||
16 | responsibility of the employee unless a provider and employee | ||||||
17 | have agreed otherwise in writing. Services not covered or not | ||||||
18 | compensable under this Act are not subject to the fee schedule | ||||||
19 | in this Section. | ||||||
20 | (f) Nothing in this Act shall prohibit an employer or
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21 | insurer from contracting with a health care provider or group
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22 | of health care providers for reimbursement levels for benefits | ||||||
23 | under this Act different
from those provided in this Section. | ||||||
24 | (g) On or before January 1, 2010 the Commission shall | ||||||
25 | provide to the Governor and General Assembly a report regarding | ||||||
26 | the implementation of the medical fee schedule and the index |
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1 | used for annual adjustment to that schedule as described in | ||||||
2 | this Section.
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3 | (Source: P.A. 97-18, eff. 6-28-11.)
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4 | (820 ILCS 305/8.2a) | ||||||
5 | Sec. 8.2a. Electronic claims. | ||||||
6 | (a) The Director of Insurance shall adopt rules to do all | ||||||
7 | of the following: | ||||||
8 | (1) Ensure that all health care providers and | ||||||
9 | facilities submit medical bills for payment on | ||||||
10 | standardized forms. | ||||||
11 | (2) Require acceptance by employers and insurers of | ||||||
12 | electronic claims for payment of medical services. | ||||||
13 | (3) Ensure confidentiality of medical information | ||||||
14 | submitted on electronic claims for payment of medical | ||||||
15 | services. | ||||||
16 | (4) Ensure that health care providers have an | ||||||
17 | opportunity to comply with requests for records by | ||||||
18 | employers and insurers for the authorization of the payment | ||||||
19 | of workers' compensation claims. | ||||||
20 | (5) Ensure that health care providers are responsible | ||||||
21 | for supplying only those medical records pertaining to the | ||||||
22 | provider's own claims that are minimally necessary under | ||||||
23 | the federal Health Insurance Portability and | ||||||
24 | Accountability Act of 1996. | ||||||
25 | (6) Provide that any electronically submitted bill |
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1 | determined to be complete but not paid or objected to | ||||||
2 | within 30 days shall be subject to interest pursuant to | ||||||
3 | item (3) of subsection (d) of Section 8.2. | ||||||
4 | (7) Provide that the Department of Insurance shall | ||||||
5 | impose an administrative fine if it determines that an | ||||||
6 | employer or insurer has failed to comply with the | ||||||
7 | electronic claims acceptance and response process. The | ||||||
8 | amount of the administrative fine shall be no greater than | ||||||
9 | $1,000 per each violation, but shall not exceed $10,000 for | ||||||
10 | identical violations during a calendar year. | ||||||
11 | (b) To the extent feasible, standards adopted pursuant to | ||||||
12 | subdivision (a) shall be consistent with existing standards | ||||||
13 | under the federal Health Insurance Portability and | ||||||
14 | Accountability Act of 1996 and standards adopted under the | ||||||
15 | Illinois Health Information Exchange and Technology Act. | ||||||
16 | (c) The rules requiring employers and insurers to accept | ||||||
17 | electronic claims for payment of medical services shall be | ||||||
18 | proposed on or before January 1, 2012, and shall require all | ||||||
19 | employers and insurers to accept electronic claims for payment | ||||||
20 | of medical services on or before June 30, 2012. The Director of | ||||||
21 | Insurance shall adopt rules by January 1, 2019 to implement the | ||||||
22 | changes to this Section made by this amendatory Act of the | ||||||
23 | 100th General Assembly. The Commission, with assistance from | ||||||
24 | the Department and the Medical Fee Advisory Board, shall | ||||||
25 | publish on its Internet website a companion guide to assist | ||||||
26 | with compliance with electronic claims rules. The Medical Fee |
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1 | Advisory Board shall periodically review the companion guide. | ||||||
2 | (d) The Director of Insurance shall by rule establish | ||||||
3 | criteria for granting exceptions to employers, insurance | ||||||
4 | carriers, and health care providers who are unable to submit or | ||||||
5 | accept medical bills electronically.
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6 | (Source: P.A. 97-18, eff. 6-28-11.)
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7 | Section 99. Effective date. This Act takes effect upon | ||||||
8 | becoming law.
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