Bill Text: IL SB2256 | 2011-2012 | 97th General Assembly | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Amends the Illinois Insurance Code. Provides that no insurer shall implement any change to a provider contract that may adversely impact reimbursement unless, prior to the effective date of the change, the insurer gives the health care provider with whom the insurer has directly contracted and who is impacted by the change at least 60 days written notice of the change. Sets forth provisions concerning notice.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Failed) 2013-01-08 - Session Sine Die [SB2256 Detail]

Download: Illinois-2011-SB2256-Introduced.html

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97TH GENERAL ASSEMBLY State of Illinois 2011 and 2012 SB2256 Introduced 2/15/2011, by Sen. William R. Haine SYNOPSIS AS INTRODUCED:
215 ILCS 5/368g new
Amends the Illinois Insurance Code. Provides that no insurer shall implement any change to a provider contract that may adversely impact reimbursement unless, prior to the effective date of the change, the insurer gives the health care provider with whom the insurer has directly contracted and who is impacted by the change at least 60 days written notice of the change. Sets forth provisions concerning notice.
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A BILL FOR
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AN ACT concerning insurance.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Illinois Insurance Code is amended by adding
Section 368g as follows:
(215 ILCS 5/368g new)
Sec. 368g. Provider contract changes.
(a) No insurer shall implement a change to a provider
contract or modify policies and procedures that have been
incorporated or incorporated by reference into that contract
that may adversely impact reimbursement unless, prior to the
effective date of the change, the insurer gives the health care
provider with whom the insurer has directly contracted and who
is impacted by the change at least 60 days written notice of
the change.
(b) If the contracting health care provider objects to the
change that is the subject of the notice from the insurer, then
the health care provider may, within 30 days after the date of
the notice, give written notice to the insurer to terminate the
contract with the insurer effective upon the implementation
date of the adverse reimbursement change.
(c) The notice provisions required by this Section shall
not apply where:

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(1) such change is otherwise required by law,
regulation or applicable regulatory authority, or as a
result of changes in fee schedules, reimbursement
methodology, or payment policies established by a
government agency or by the American Medical Association's
current procedural terminology codes, reporting
guidelines, and conventions; or
(2) such change is expressly provided for under the
terms of the contract by the inclusion of or reference to a
specific fee or fee schedule, reimbursement methodology,
or payment policy indexing mechanism.