HB 6562 Illinois House · 99th Regular Session

NETWORK ADEQUACY TRANSPARENCY

Summary
Creates the Network Adequacy and Transparency Act. Provides that administrators and insurers, prior to going to market, must file with the Department of Insurance for review and approval a description of the services to be offered through a health care network plan with certain criteria included in the description. Provides that the health care network plan shall demonstrate to the Department, prior to approval, a minimum ratio of full-time equivalent providers to plan beneficiaries and maximum travel and distance burdens for plan beneficiaries based in the maximum minutes or miles to be traveled by a plan beneficiary for each county type as defined under the Act. Provides that the Department shall conduct periodic audits of health care network plan to verify compliance with network adequacy standards. Establishes certain notice requirements. Provides that a health care network plan shall provide for continuity of care for its beneficiaries based on certain circumstances. Provides that a health care network plan shall post electronically a current and accurate provider directory and make available in print, upon request, a provider directory each subject to the provision's specifications. Provides that the provisions of the Act are deemed incorporated into the health care providers service contracts entered into on or before the effective date of the Act. Provides that the Department is granted specific authority to issue a cease and desist order against, fine, or otherwise penalize any insurer or administrator for violations of any provision of the Act. Effective January 1, 2017.
Bill status failed 1 of 4 stages cleared
Introduction
Apr 2016
Committee Review
Floor Vote
Governor
Introduced Apr 21, 2016 Last action Jan 10, 2017
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Full legislative history

Actions timeline

Total actions
28
Key actions
0
Committee
1
Apr 21, 2016
Committee
Referred to Rules Committee
lower
0 primary · 1 co-sponsor

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