Illinois General Assembly - Illinois Compiled Statutes

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215 ILCS 125/4-15

(215 ILCS 125/4-15) (from Ch. 111 1/2, par. 1409.8)

Sec. 4-15.

(a) No contract or evidence of coverage for basic health
care services delivered, issued for delivery, renewed or amended by a
Health Maintenance Organization shall exclude coverage for emergency
transportation by
ambulance.
For the purposes of this Section, the term "emergency" means a need for
immediate medical attention resulting from a life threatening condition or
situation or a need for immediate medical attention as otherwise reasonably
determined by a physician, public safety official or other emergency
medical personnel.

(b) Upon reasonable demand by a provider of emergency transportation
by ambulance, a Health Maintenance Organization shall promptly pay to the
provider, subject to
coverage limitations stated in the contract or evidence of coverage,
the
charges for emergency transportation by ambulance provided to an enrollee in a health care
plan arranged for by the Health Maintenance
Organization.  By
accepting any such payment from the Health Maintenance Organization, the
provider of emergency transportation by ambulance agrees not to seek any
payment from the enrollee for services provided to the enrollee.

(Source: P.A. 86-833; 86-1028.)