HB1577sam002 97TH GENERAL ASSEMBLY

Sen. William R. Haine

Filed: 5/25/2011

09700HB1577sam002 LRB097 09798 RPM 56231 a

AMENDMENT TO HOUSE BILL 1577

AMENDMENT NO. ______. Amend House Bill 1577 by replacing everything after the enacting clause with the following:

"Section 5. "An Act concerning insurance", approved February 14, 2011, Public Act 96-1523, is amended by adding Section 99 as follows:

(P.A. 96-1523, Sec. 99 new)

Sec. 99. Effective date. This Act takes effect January 1, 2012.

Section 10. The Department of Insurance Law of the Civil Administrative Code of Illinois is amended by adding Section 1405-40 as follows:

(20 ILCS 1405/1405-40 new)

Sec. 1405-40. Study of out-of-network facility-based physician and provider claims.

(a) The Department shall study the issue of insurance claims for medical services submitted by nonparticipating facility-based physicians and providers addressed in Section 356z.3a of the Illinois Insurance Code as added by Public Act 96-1523. The Department shall have the authority to request insurers, health plans, and applicable nonparticipating facility-based physician and provider trade associations to assemble and submit information needed for the purposes of this study.

(b) The Department shall report its findings and recommendations to the General Assembly no later than November 1, 2011.

Section 15. The Illinois Insurance Code is amended by adding Section 356z.3b as follows:

(215 ILCS 5/356z.3b new)

Sec. 356z.3b. Facility-based physicians and providers; reimbursement rate. From June 1, 2011 to December 31, 2011, facility-based physicians and providers shall be reimbursed at the highest participating provider reimbursement rate for the same services in the same geographic area by all insurers and health plans for claims for medical services submitted for the services addressed in Section 356z.3a of the Illinois Insurance Code as added by Public Act 96-1523.

Section 99. Effective date. This Act takes effect upon becoming law.".