(215 ILCS 130/2008) (from Ch. 73, par. 1502-8)
Sec. 2008.
Provider contracts.
(a) All contracts with providers or with
entities which subcontract for the provision of limited health services to
enrollees on a prepayment or other basis and any contract with any
subcontractor thereof shall contain the following hold-harmless clause:
"The provider agrees that in no event including, but not limited to,
nonpayment by the organization of amounts due the provider under this
contract, insolvency of the organization or any breach of this contract by
the organization, shall the provider or its assignees or subcontractors
have a right to seek any type of payment from, bill, charge, collect a
deposit from or have any recourse against the enrollee, persons acting on
the enrollee's behalf (other than the organization), the employer or group
contractholder for services provided pursuant to this contract except for
the payment of applicable copayments for services covered by the
organization or fees for services not covered by the organization. The
requirements of this clause shall survive any termination of this contract
for services rendered prior to such termination, regardless of the cause of
such termination. The organization's enrollees shall be third party
beneficiaries of this clause. This clause supersedes any oral or written
agreement now existing or hereafter entered into between the provider and
the enrollee or persons acting on the enrollee's behalf (other than the
organization).". To the extent that any provider or subcontractor's
contract, fails to incorporate such provisions, such provisions shall be
deemed incorporated into such contracts by operation of law.
(b) All provider and subcontractor contracts must contain provisions
whereby the provider or subcontractor shall provide, arrange for or
participate in the quality assessment programs mandated by this Act, unless
the Department of Insurance certifies that such programs will
be fully implemented without any participation or action from such
contracting provider.
(c) The Director may promulgate rules requiring that provider contracts
contain provisions concerning reasonable notices to be given between the
parties and for the organization to provide reasonable notice to its
enrollees and to the Director. Notice shall be given for such events as,
but not limited to, termination of insurance protection, quality assessment
or availability of medical area.
(Source: P.A. 86-600; 86-1408.)
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