093_SB1774sam001
LRB093 03725 JLS 12983 a
1 AMENDMENT TO SENATE BILL 1774
2 AMENDMENT NO. . Amend Senate Bill 1774 by replacing
3 the title with the following:
4 "AN ACT concerning insurance."; and
5 by replacing everything after the enacting clause with the
6 following:
7 "Section 5. The Illinois Insurance Code is amended by
8 adding Section 368d as follows:
9 (215 ILCS 5/368d new)
10 Sec. 368d. Fairness in contracting procedures.
11 (a) A health care professional or health care provider
12 offered a contract for signature after the effective date of
13 this amendatory Act of the 93rd General Assembly shall be
14 provided with a complete copy of any proposed professional
15 services contract. Upon request, a health care professional
16 or health care provider, paid on a service by service basis,
17 shall be given the opportunity to review the relevant medical
18 policies, fee schedules, and claims submission and payment
19 procedures related to the covered services. If the health
20 care professional or health care provider is not paid on a
21 service by service basis, the amounts payable and terms of
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1 payment under that alternative payment system shall be
2 provided upon request. The health care professional or health
3 care provider shall be allowed at least 30 days to review the
4 complete contract before signing.
5 (b) An insurer, health maintenance organization,
6 independent practice association, or physician hospital
7 organization shall notify a health care professional or
8 health care provider within 35 days of the effective date of
9 any material changes to the payment rates. This notice may be
10 provided by mail, e-mail, newsletter, website listing, or
11 other reasonable method.
12 (c) Upon termination of a contract with an insurer,
13 health maintenance organization, independent practice
14 association, or physician hospital organization, a health
15 care professional or health care provider shall, at the
16 request of a patient, transfer copies of medical records.
17 Section 99. Effective date. This Act takes effect on
18 December 1, 2003.".