Bill Text: IL HB4025 | 2023-2024 | 103rd General Assembly | Introduced

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Bill Title: Amends the Network Adequacy and Transparency Act. Provides that the Department of Insurance shall create a Network Adequacy Unit within the Department for the purpose of investigating insurers for compliance with the Act and enforcing its provisions. Provides that the Director of Insurance may hire and retain insurance analysts, managers, actuaries, and any other staff necessary to operate the Network Adequacy Unit. Provides that the Director may, in the Director's sole discretion, publicly acknowledge the existence of an ongoing network adequacy market conduct examination before filing the examination report. Effective July 1, 2023.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced) 2023-03-23 - Referred to Rules Committee [HB4025 Detail]

Download: Illinois-2023-HB4025-Introduced.html

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103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB4025 Introduced , by Rep. Sue Scherer SYNOPSIS AS INTRODUCED:
215 ILCS 124/30
Amends the Network Adequacy and Transparency Act. Provides that the Department of Insurance shall create a Network Adequacy Unit within the Department for the purpose of investigating insurers for compliance with the Act and enforcing its provisions. Provides that the Director of Insurance may hire and retain insurance analysts, managers, actuaries, and any other staff necessary to operate the Network Adequacy Unit. Provides that the Director may, in the Director's sole discretion, publicly acknowledge the existence of an ongoing network adequacy market conduct examination before filing the examination report. Effective July 1, 2023.
LRB103 31469 BMS 59243 b
A BILL FOR
HB4025 LRB103 31469 BMS 59243 b
AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Network Adequacy and Transparency Act is
amended by changing Section 30 as follows:
(215 ILCS 124/30)
Sec. 30. Administration and enforcement.
(a) Insurers, as defined in this Act, have a continuing
obligation to comply with the requirements of this Act. Other
than the duties specifically created in this Act, nothing in
this Act is intended to preclude, prevent, or require the
adoption, modification, or termination of any utilization
management, quality management, or claims processing
methodologies of an insurer.
(b) Nothing in this Act precludes, prevents, or requires
the adoption, modification, or termination of any network plan
term, benefit, coverage or eligibility provision, or payment
methodology.
(c) The Director shall enforce the provisions of this Act
pursuant to the enforcement powers granted to it by law.
(d) The Department shall adopt rules to enforce compliance
with this Act to the extent necessary.
(e) The Department shall create a Network Adequacy Unit

HB4025 - 2 - LRB103 31469 BMS 59243 b
within the Department for the purpose of investigating
insurers for compliance with this Act and enforcing its
provisions. The Director may hire and retain insurance
analysts, managers, actuaries, and any other staff necessary
to operate the Network Adequacy Unit.
(f) The Director may, in the Director's sole discretion,
publicly acknowledge the existence of an ongoing network
adequacy market conduct examination before filing the
examination report, notwithstanding any provision of law to
the contrary.
(Source: P.A. 100-502, eff. 9-15-17.)
Section 99. Effective date. This Act takes effect July 1,
2023.