103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB4025
 
Introduced 3/23/2023, 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
 

  
HB4025LRB103 31469 BMS 59243 b


  
1    AN ACT concerning regulation.
  
 
2    Be it enacted by the People of the State of Illinois,
 
3represented in the General Assembly:
  
 
 
4    Section 5. The Network Adequacy and Transparency Act is 
5amended  by changing Section 30 as follows:
 
6    (215 ILCS 124/30)

7    Sec. 30. Administration and enforcement.
 
8    (a) Insurers, as defined in this Act, have a continuing 
9obligation to comply with the requirements of this Act.  Other 
10than the duties specifically created in this Act, nothing in 
11this Act is intended to preclude, prevent, or require the 
12adoption, modification, or termination of any utilization 
13management, quality management, or claims processing 
14methodologies of an insurer.
15    (b) Nothing in this Act precludes, prevents, or requires 
16the adoption, modification, or termination of any network plan 
17term, benefit, coverage or eligibility provision, or payment 
18methodology.
19    (c) The Director shall enforce the provisions of this Act 
20pursuant to the enforcement powers granted to it by law.
21    (d) The Department shall adopt rules to enforce compliance 
22with this Act to the extent necessary.

23    (e)   The Department shall create a Network Adequacy Unit 
 
 
HB4025- 2 -LRB103 31469 BMS 59243 b

1within the Department for the purpose of investigating 
2insurers for compliance with this Act and enforcing its 
3provisions. The Director may hire and retain insurance 
4analysts, managers, actuaries, and any other staff necessary 
5to operate the Network Adequacy Unit.
6    (f)   The Director may, in the Director's sole discretion,  
7publicly acknowledge the existence of an ongoing network 
8adequacy market conduct examination before filing the 
9examination report, notwithstanding any provision of law to 
10the contrary. 
11(Source: P.A. 100-502, eff. 9-15-17.)
 
 
12    Section 99. Effective date. This Act takes effect July 1, 
132023.