(215 ILCS 134/10) (Text of Section from P.A. 103-426) Sec. 10. Definitions. "Adverse determination" means a determination by a health care plan under Section 45 or by a utilization review program under Section 85 that a health care service is not medically necessary. "Clinical peer" means a health care professional who is in the same profession and the same or similar specialty as the health care provider who typically manages the medical condition, procedures, or treatment under review. "Department" means the Department of Insurance. "Emergency medical condition" means a medical condition manifesting itself by acute symptoms of sufficient severity, regardless of the final diagnosis given, such that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate medical attention to result in: (1) placing the health of the individual (or, with |
| respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy;
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|
(2) serious impairment to bodily functions;
(3) serious dysfunction of any bodily organ or part;
(4) inadequately controlled pain; or
(5) with respect to a pregnant woman who is having
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(A) inadequate time to complete a safe transfer
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| to another hospital before delivery; or
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|
(B) a transfer to another hospital may pose a
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| threat to the health or safety of the woman or unborn child.
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|
"Emergency medical screening examination" means a medical screening examination and evaluation by a physician licensed to practice medicine in all its branches, or to the extent permitted by applicable laws, by other appropriately licensed personnel under the supervision of or in collaboration with a physician licensed to practice medicine in all its branches to determine whether the need for emergency services exists.
"Emergency services" means, with respect to an enrollee of a health care plan, transportation services, including but not limited to ambulance services, and covered inpatient and outpatient hospital services furnished by a provider qualified to furnish those services that are needed to evaluate or stabilize an emergency medical condition. "Emergency services" does not refer to post-stabilization medical services.
"Enrollee" means any person and his or her dependents enrolled in or covered by a health care plan.
"Health care plan" means a plan, including, but not limited to, a health maintenance organization, a managed care community network as defined in the Illinois Public Aid Code, or an accountable care entity as defined in the Illinois Public Aid Code that receives capitated payments to cover medical services from the Department of Healthcare and Family Services, that establishes, operates, or maintains a network of health care providers that has entered into an agreement with the plan to provide health care services to enrollees to whom the plan has the ultimate obligation to arrange for the provision of or payment for services through organizational arrangements for ongoing quality assurance, utilization review programs, or dispute resolution. Nothing in this definition shall be construed to mean that an independent practice association or a physician hospital organization that subcontracts with a health care plan is, for purposes of that subcontract, a health care plan.
For purposes of this definition, "health care plan" shall not include the following:
(1) indemnity health insurance policies including
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| those using a contracted provider network;
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|
(2) health care plans that offer only dental or only
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|
(3) preferred provider administrators, as defined in
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| Section 370g(g) of the Illinois Insurance Code;
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(4) employee or employer self-insured health benefit
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| plans under the federal Employee Retirement Income Security Act of 1974;
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(5) health care provided pursuant to the Workers'
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| Compensation Act or the Workers' Occupational Diseases Act; and
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(6) except with respect to subsections (a) and (b) of
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| Section 65 and subsection (a-5) of Section 70, not-for-profit voluntary health services plans with health maintenance organization authority in existence as of January 1, 1999 that are affiliated with a union and that only extend coverage to union members and their dependents.
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"Health care professional" means a physician, a registered professional nurse, or other individual appropriately licensed or registered to provide health care services.
"Health care provider" means any physician, hospital facility, facility licensed under the Nursing Home Care Act, long-term care facility as defined in Section 1-113 of the Nursing Home Care Act, or other person that is licensed or otherwise authorized to deliver health care services. Nothing in this Act shall be construed to define Independent Practice Associations or Physician-Hospital Organizations as health care providers.
"Health care services" means any services included in the furnishing to any individual of medical care, or the hospitalization incident to the furnishing of such care, as well as the furnishing to any person of any and all other services for the purpose of preventing, alleviating, curing, or healing human illness or injury including behavioral health, mental health, home health, and pharmaceutical services and products.
"Medical director" means a physician licensed in any state to practice medicine in all its branches appointed by a health care plan.
"Person" means a corporation, association, partnership, limited liability company, sole proprietorship, or any other legal entity.
"Physician" means a person licensed under the Medical Practice Act of 1987.
"Post-stabilization medical services" means health care services provided to an enrollee that are furnished in a licensed hospital by a provider that is qualified to furnish such services, and determined to be medically necessary and directly related to the emergency medical condition following stabilization.
"Stabilization" means, with respect to an emergency medical condition, to provide such medical treatment of the condition as may be necessary to assure, within reasonable medical probability, that no material deterioration of the condition is likely to result.
"Utilization review" means the evaluation of the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities.
"Utilization review program" means a program established by a person to perform utilization review.
(Source: P.A. 102-409, eff. 1-1-22; 103-426, eff. 8-4-23.)
(Text of Section from P.A. 103-650)
Sec. 10. Definitions. In this Act:
"Adverse determination" means a determination by a health care plan under Section 45 or by a utilization review program under Section 85 that a health care service is not medically necessary.
"Clinical peer" means a health care professional who is in the same profession and the same or similar specialty as the health care provider who typically manages the medical condition, procedures, or treatment under review.
"Department" means the Department of Insurance.
"Emergency medical condition" means a medical condition manifesting itself by acute symptoms of sufficient severity, regardless of the final diagnosis given, such that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate medical attention to result in:
(1) placing the health of the individual (or, with
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| respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy;
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|
(2) serious impairment to bodily functions;
(3) serious dysfunction of any bodily organ or part;
(4) inadequately controlled pain; or
(5) with respect to a pregnant woman who is having
|
|
(A) inadequate time to complete a safe transfer
|
| to another hospital before delivery; or
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|
(B) a transfer to another hospital may pose a
|
| threat to the health or safety of the woman or unborn child.
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|
"Emergency medical screening examination" means a medical screening examination and evaluation by a physician licensed to practice medicine in all its branches, or to the extent permitted by applicable laws, by other appropriately licensed personnel under the supervision of or in collaboration with a physician licensed to practice medicine in all its branches to determine whether the need for emergency services exists.
"Emergency services" means, with respect to an enrollee of a health care plan, transportation services, including but not limited to ambulance services, and covered inpatient and outpatient hospital services furnished by a provider qualified to furnish those services that are needed to evaluate or stabilize an emergency medical condition. "Emergency services" does not refer to post-stabilization medical services.
"Enrollee" means any person and his or her dependents enrolled in or covered by a health care plan.
"Generally accepted standards of care" means standards of care and clinical practice that are generally recognized by health care providers practicing in relevant clinical specialties for the illness, injury, or condition or its symptoms and comorbidities. Valid, evidence-based sources reflecting generally accepted standards of care include peer-reviewed scientific studies and medical literature, recommendations of nonprofit health care provider professional associations and specialty societies, including, but not limited to, patient placement criteria and clinical practice guidelines, recommendations of federal government agencies, and drug labeling approved by the United States Food and Drug Administration.
"Health care plan" means a plan, including, but not limited to, a health maintenance organization, a managed care community network as defined in the Illinois Public Aid Code, or an accountable care entity as defined in the Illinois Public Aid Code that receives capitated payments to cover medical services from the Department of Healthcare and Family Services, that establishes, operates, or maintains a network of health care providers that has entered into an agreement with the plan to provide health care services to enrollees to whom the plan has the ultimate obligation to arrange for the provision of or payment for services through organizational arrangements for ongoing quality assurance, utilization review programs, or dispute resolution. Nothing in this definition shall be construed to mean that an independent practice association or a physician hospital organization that subcontracts with a health care plan is, for purposes of that subcontract, a health care plan.
For purposes of this definition, "health care plan" shall not include the following:
(1) indemnity health insurance policies including
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| those using a contracted provider network;
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|
(2) health care plans that offer only dental or only
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|
(3) preferred provider administrators, as defined in
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| Section 370g(g) of the Illinois Insurance Code;
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|
(4) employee or employer self-insured health benefit
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| plans under the federal Employee Retirement Income Security Act of 1974;
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|
(5) health care provided pursuant to the Workers'
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| Compensation Act or the Workers' Occupational Diseases Act; and
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|
(6) except with respect to subsections (a) and (b) of
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| Section 65 and subsection (a-5) of Section 70, not-for-profit voluntary health services plans with health maintenance organization authority in existence as of January 1, 1999 that are affiliated with a union and that only extend coverage to union members and their dependents.
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"Health care professional" means a physician, a registered professional nurse, or other individual appropriately licensed or registered to provide health care services.
"Health care provider" means any physician, hospital facility, facility licensed under the Nursing Home Care Act, long-term care facility as defined in Section 1-113 of the Nursing Home Care Act, or other person that is licensed or otherwise authorized to deliver health care services. Nothing in this Act shall be construed to define Independent Practice Associations or Physician-Hospital Organizations as health care providers.
"Health care services" means any services included in the furnishing to any individual of medical care, or the hospitalization incident to the furnishing of such care, as well as the furnishing to any person of any and all other services for the purpose of preventing, alleviating, curing, or healing human illness or injury including behavioral health, mental health, home health, and pharmaceutical services and products.
"Medical director" means a physician licensed in any state to practice medicine in all its branches appointed by a health care plan.
"Medically necessary" means that a service or product addresses the specific needs of a patient for the purpose of screening, preventing, diagnosing, managing, or treating an illness, injury, or condition or its symptoms and comorbidities, including minimizing the progression of an illness, injury, or condition or its symptoms and comorbidities, in a manner that is all of the following:
(1) in accordance with generally accepted standards
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(2) clinically appropriate in terms of type,
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| frequency, extent, site, and duration; and
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(3) not primarily for the economic benefit of the
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| health care plan, purchaser, or utilization review organization, or for the convenience of the patient, treating physician, or other health care provider.
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"Person" means a corporation, association, partnership, limited liability company, sole proprietorship, or any other legal entity.
"Physician" means a person licensed under the Medical Practice Act of 1987.
"Post-stabilization medical services" means health care services provided to an enrollee that are furnished in a licensed hospital by a provider that is qualified to furnish such services, and determined to be medically necessary and directly related to the emergency medical condition following stabilization.
"Stabilization" means, with respect to an emergency medical condition, to provide such medical treatment of the condition as may be necessary to assure, within reasonable medical probability, that no material deterioration of the condition is likely to result.
"Step therapy requirement" means a utilization review or formulary requirement that specifies, as a condition of coverage under a health care plan, the order in which certain health care services must be used to treat or manage an enrollee's health condition.
"Step therapy requirement" does not include:
(1) utilization review to identify when a treatment
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| or health care service is contraindicated or clinically appropriate or to limit quantity or dosage for an enrollee based on utilization review criteria consistent with generally accepted standards of care developed in accordance with Section 87 of this Act;
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(2) the removal of a drug from a formulary or
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| changing the drug's preferred or cost-sharing tier to higher cost sharing;
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(3) use of the medical exceptions process under
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| Section 45.1 of this Act; any decision during a medical exceptions process based on cost is step therapy and prohibited;
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(4) a requirement to obtain prior authorization for
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| the requested treatment; or
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(5) for health care plans operated or overseen by the
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| Department of Healthcare and Family Services, including Medicaid managed care plans, any utilization controls mandated by 42 CFR 456.703 or a preferred drug list as described in Section 5-30.14 of the Illinois Public Aid Code.
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"Utilization review" means the evaluation of the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities.
"Utilization review" includes either of the following:
(1) prospectively, retrospectively, or concurrently
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| reviewing and approving, modifying, delaying, or denying, based, in whole or in part, on medical necessity, requests by health care providers, enrollees, or their authorized representatives for coverage of health care services before, retrospectively, or concurrently with the provision of health care services to enrollees; or
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(2) evaluating the medical necessity,
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| appropriateness, level of care, service intensity, efficacy, or efficiency of health care services, benefits, procedures, or settings, under any circumstances, to determine whether a health care service or benefit subject to a medical necessity coverage requirement in a health care plan is covered as medically necessary for an enrollee.
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"Utilization review criteria" means criteria, standards, protocols, or guidelines used by a utilization review program to conduct utilization review to ensure that a patient's care is aligned with generally accepted standards of care and consistent with State law.
"Utilization review program" means a program established by a person to perform utilization review.
(Source: P.A. 102-409, eff. 1-1-22; 103-426, eff. 8-4-23; 103-650, eff. 1-1-25.)
(Text of Section from P.A. 103-656)
Sec. 10. Definitions. In this Act:
For a health care plan under Section 45 or for a utilization review program under Section 85, "adverse determination" has the meaning given to that term in Section 10 of the Health Carrier External Review Act.
"Clinical peer" means a health care professional who is in the same profession and the same or similar specialty as the health care provider who typically manages the medical condition, procedures, or treatment under review.
"Department" means the Department of Insurance.
"Emergency medical condition" means a medical condition manifesting itself by acute symptoms of sufficient severity, regardless of the final diagnosis given, such that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate medical attention to result in:
(1) placing the health of the individual (or, with
|
| respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy;
|
|
(2) serious impairment to bodily functions;
(3) serious dysfunction of any bodily organ or part;
(4) inadequately controlled pain; or
(5) with respect to a pregnant woman who is having
|
|
(A) inadequate time to complete a safe transfer
|
| to another hospital before delivery; or
|
|
(B) a transfer to another hospital may pose a
|
| threat to the health or safety of the woman or unborn child.
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|
"Emergency medical screening examination" means a medical screening examination and evaluation by a physician licensed to practice medicine in all its branches, or to the extent permitted by applicable laws, by other appropriately licensed personnel under the supervision of or in collaboration with a physician licensed to practice medicine in all its branches to determine whether the need for emergency services exists.
"Emergency services" means, with respect to an enrollee of a health care plan, transportation services, including but not limited to ambulance services, and covered inpatient and outpatient hospital services furnished by a provider qualified to furnish those services that are needed to evaluate or stabilize an emergency medical condition. "Emergency services" does not refer to post-stabilization medical services.
"Enrollee" means any person and his or her dependents enrolled in or covered by a health care plan.
"Health care plan" means a plan, including, but not limited to, a health maintenance organization, a managed care community network as defined in the Illinois Public Aid Code, or an accountable care entity as defined in the Illinois Public Aid Code that receives capitated payments to cover medical services from the Department of Healthcare and Family Services, that establishes, operates, or maintains a network of health care providers that has entered into an agreement with the plan to provide health care services to enrollees to whom the plan has the ultimate obligation to arrange for the provision of or payment for services through organizational arrangements for ongoing quality assurance, utilization review programs, or dispute resolution. Nothing in this definition shall be construed to mean that an independent practice association or a physician hospital organization that subcontracts with a health care plan is, for purposes of that subcontract, a health care plan.
For purposes of this definition, "health care plan" shall not include the following:
(1) indemnity health insurance policies including
|
| those using a contracted provider network;
|
|
(2) health care plans that offer only dental or only
|
|
(3) preferred provider administrators, as defined in
|
| Section 370g(g) of the Illinois Insurance Code;
|
|
(4) employee or employer self-insured health benefit
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| plans under the federal Employee Retirement Income Security Act of 1974;
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|
(5) health care provided pursuant to the Workers'
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| Compensation Act or the Workers' Occupational Diseases Act; and
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|
(6) except with respect to subsections (a) and (b) of
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| Section 65 and subsection (a-5) of Section 70, not-for-profit voluntary health services plans with health maintenance organization authority in existence as of January 1, 1999 that are affiliated with a union and that only extend coverage to union members and their dependents.
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|
"Health care professional" means a physician, a registered professional nurse, or other individual appropriately licensed or registered to provide health care services.
"Health care provider" means any physician, hospital facility, facility licensed under the Nursing Home Care Act, long-term care facility as defined in Section 1-113 of the Nursing Home Care Act, or other person that is licensed or otherwise authorized to deliver health care services. Nothing in this Act shall be construed to define Independent Practice Associations or Physician-Hospital Organizations as health care providers.
"Health care services" means any services included in the furnishing to any individual of medical care, or the hospitalization incident to the furnishing of such care, as well as the furnishing to any person of any and all other services for the purpose of preventing, alleviating, curing, or healing human illness or injury including behavioral health, mental health, home health, and pharmaceutical services and products.
"Medical director" means a physician licensed in any state to practice medicine in all its branches appointed by a health care plan.
"Person" means a corporation, association, partnership, limited liability company, sole proprietorship, or any other legal entity.
"Physician" means a person licensed under the Medical Practice Act of 1987.
"Post-stabilization medical services" means health care services provided to an enrollee that are furnished in a licensed hospital by a provider that is qualified to furnish such services, and determined to be medically necessary and directly related to the emergency medical condition following stabilization.
"Stabilization" means, with respect to an emergency medical condition, to provide such medical treatment of the condition as may be necessary to assure, within reasonable medical probability, that no material deterioration of the condition is likely to result.
"Utilization review" means the evaluation, including any evaluation based on an algorithmic automated process, of the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities.
"Utilization review program" means a program established by a person to perform utilization review.
(Source: P.A. 102-409, eff. 1-1-22; 103-426, eff. 8-4-23; 103-656, eff. 1-1-25.)
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(215 ILCS 134/15)
Sec. 15. Provision of information.
(a) A health care plan shall provide annually to enrollees and prospective
enrollees, upon request, a complete list of participating health care providers
in the
health care plan's service area and a description of the following terms of
coverage:
(1) the service area;
(2) the covered benefits and services with all |
| exclusions, exceptions, and limitations;
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(3) the pre-certification and other utilization
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| review procedures and requirements;
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(4) a description of the process for the selection of
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| a primary care physician, any limitation on access to specialists, and the plan's standing referral policy;
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(5) the emergency coverage and benefits, including
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| any restrictions on emergency care services;
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(6) the out-of-area coverage and benefits, if any;
(7) the enrollee's financial responsibility for
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| copayments, deductibles, premiums, and any other out-of-pocket expenses;
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(8) the provisions for continuity of treatment in the
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| event a health care provider's participation terminates during the course of an enrollee's treatment by that provider;
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(9) the appeals process, forms, and time frames for
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| health care services appeals, complaints, and external independent reviews, administrative complaints, and utilization review complaints, including a phone number to call to receive more information from the health care plan concerning the appeals process; and
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(10) a statement of all basic health care services
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| and all specific benefits and services mandated to be provided to enrollees by any State law or administrative rule.
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(a-5) Without limiting the generality of subsection (a) of this Section, no qualified health plans shall be offered for sale directly to consumers through the health insurance marketplace operating in the State in accordance with Sections 1311 and
1321 of the federal Patient Protection and Affordable Care Act (Public Law 111-148), as amended by the federal Health Care and Education Reconciliation Act of 2010 (Public Law 111-152), and any amendments thereto, or regulations or guidance issued thereunder (collectively, "the Federal Act"), unless, in addition to the information required under subsection (a) of this Section, the following information is available to the consumer at the time he or she is comparing health care plans and their premiums:
(1) With respect to prescription drug benefits, the
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| most recently published formulary where a consumer can view in one location covered prescription drugs; information on tiering and the cost-sharing structure for each tier; and information about how a consumer can obtain specific copayment amounts or coinsurance percentages for a specific qualified health plan before enrolling in that plan. This information shall clearly identify the qualified health plan to which it applies.
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(2) The most recently published provider directory
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| where a consumer can view the provider network that applies to each qualified health plan and information about each provider, including location, contact information, specialty, medical group, if any, any institutional affiliation, and whether the provider is accepting new patients. The information shall clearly identify the qualified health plan to which it applies.
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In the event of an inconsistency between any separate written disclosure
statement and the enrollee contract or certificate, the terms of the enrollee
contract or certificate shall control.
(b) Upon written request, a health care plan shall provide to enrollees a
description of the financial relationships between the health care plan and any
health care provider
and, if requested, the percentage
of copayments, deductibles, and total premiums spent on healthcare related
expenses and the percentage of
copayments, deductibles, and total premiums spent on other expenses, including
administrative expenses,
except that no health care plan shall be required to disclose specific provider
reimbursement.
(c) A participating health care provider shall provide all of the
following, where applicable, to enrollees upon request:
(1) Information related to the health care provider's
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| educational background, experience, training, specialty, and board certification, if applicable.
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(2) The names of licensed facilities on the provider
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| panel where the health care provider presently has privileges for the treatment, illness, or procedure that is the subject of the request.
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(3) Information regarding the health care provider's
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| participation in continuing education programs and compliance with any licensure, certification, or registration requirements, if applicable.
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(d) A health care plan shall provide the information required to be
disclosed under this Act upon enrollment and annually thereafter in a legible
and understandable format. The Department
shall promulgate rules to establish the format based, to the extent
practical,
on
the standards developed for supplemental insurance coverage under Title XVIII
of
the federal Social Security Act as a guide, so that a person can compare the
attributes of the various health care plans.
(e) The written disclosure requirements of this Section may be met by
disclosure to one enrollee in a household.
(f) Each issuer of qualified health plans for sale directly to consumers through the health insurance marketplace operating in the State shall make the information described in subsection (a) of this Section, for each qualified health plan that it offers, available and accessible to the general public on the company's Internet website and through other means for individuals without access to the Internet.
(g) The Department shall ensure that State-operated Internet websites, in addition to the Internet website for the health insurance marketplace established in this State in accordance with the Federal Act and its implementing regulations, prominently provide links to Internet-based materials and tools to help consumers be informed purchasers of health care plans.
(h) Nothing in this Section shall be interpreted or implemented in a manner not consistent with the Federal Act. This Section shall apply to all qualified health plans offered for sale directly to consumers through the health insurance marketplace operating in this State for any coverage year beginning on or after January 1, 2015.
(Source: P.A. 103-154, eff. 6-30-23.)
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(215 ILCS 134/25)
(Text of Section before amendment by P.A. 103-650 )
Sec. 25. Transition of services.
(a) A health care plan shall provide for continuity of care for its
enrollees as follows:
(1) If an enrollee's physician leaves the health care |
| plan's network of health care providers for reasons other than termination of a contract in situations involving imminent harm to a patient or a final disciplinary action by a State licensing board and the physician remains within the health care plan's service area, the health care plan shall permit the enrollee to continue an ongoing course of treatment with that physician during a transitional period:
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(A) of 90 days from the date of the notice of
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| physician's termination from the health care plan to the enrollee of the physician's disaffiliation from the health care plan if the enrollee has an ongoing course of treatment; or
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(B) if the enrollee has entered the third
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| trimester of pregnancy at the time of the physician's disaffiliation, that includes the provision of post-partum care directly related to the delivery.
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(2) Notwithstanding the provisions in item (1) of
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| this subsection, such care shall be authorized by the health care plan during the transitional period only if the physician agrees:
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(A) to continue to accept reimbursement from the
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| health care plan at the rates applicable prior to the start of the transitional period;
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(B) to adhere to the health care plan's quality
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| assurance requirements and to provide to the health care plan necessary medical information related to such care; and
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(C) to otherwise adhere to the health care plan's
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| policies and procedures, including but not limited to procedures regarding referrals and obtaining preauthorizations for treatment.
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(3) During an enrollee's plan year, a health care
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| plan shall not remove a drug from its formulary or negatively change its preferred or cost-tier sharing unless, at least 60 days before making the formulary change, the health care plan:
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(A) provides general notification of the change
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| in its formulary to current and prospective enrollees;
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(B) directly notifies enrollees currently
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| receiving coverage for the drug, including information on the specific drugs involved and the steps they may take to request coverage determinations and exceptions, including a statement that a certification of medical necessity by the enrollee's prescribing provider will result in continuation of coverage at the existing level; and
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(C) directly notifies by first class mail and
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| through an electronic transmission, if available, the prescribing provider of all health care plan enrollees currently prescribed the drug affected by the proposed change; the notice shall include a one-page form by which the prescribing provider can notify the health care plan by first class mail that coverage of the drug for the enrollee is medically necessary.
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The notification in paragraph (C) may direct the
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| prescribing provider to an electronic portal through which the prescribing provider may electronically file a certification to the health care plan that coverage of the drug for the enrollee is medically necessary. The prescribing provider may make a secure electronic signature beside the words "certification of medical necessity", and this certification shall authorize continuation of coverage for the drug.
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If the prescribing provider certifies to the health
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| care plan either in writing or electronically that the drug is medically necessary for the enrollee as provided in paragraph (C), a health care plan shall authorize coverage for the drug prescribed based solely on the prescribing provider's assertion that coverage is medically necessary, and the health care plan is prohibited from making modifications to the coverage related to the covered drug, including, but not limited to:
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(i) increasing the out-of-pocket costs for the
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(ii) moving the covered drug to a more
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(iii) denying an enrollee coverage of the drug
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| for which the enrollee has been previously approved for coverage by the health care plan.
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Nothing in this item (3) prevents a health care plan
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| from removing a drug from its formulary or denying an enrollee coverage if the United States Food and Drug Administration has issued a statement about the drug that calls into question the clinical safety of the drug, the drug manufacturer has notified the United States Food and Drug Administration of a manufacturing discontinuance or potential discontinuance of the drug as required by Section 506C of the Federal Food, Drug, and Cosmetic Act, as codified in 21 U.S.C. 356c, or the drug manufacturer has removed the drug from the market.
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Nothing in this item (3) prohibits a health care
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| plan, by contract, written policy or procedure, or any other agreement or course of conduct, from requiring a pharmacist to effect substitutions of prescription drugs consistent with Section 19.5 of the Pharmacy Practice Act, under which a pharmacist may substitute an interchangeable biologic for a prescribed biologic product, and Section 25 of the Pharmacy Practice Act, under which a pharmacist may select a generic drug determined to be therapeutically equivalent by the United States Food and Drug Administration and in accordance with the Illinois Food, Drug and Cosmetic Act.
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This item (3) applies to a policy or contract that is
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| amended, delivered, issued, or renewed on or after January 1, 2019. This item (3) does not apply to a health plan as defined in the State Employees Group Insurance Act of 1971 or medical assistance under Article V of the Illinois Public Aid Code.
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(b) A health care plan shall provide for continuity of care for new
enrollees as follows:
(1) If a new enrollee whose physician is not a member
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| of the health care plan's provider network, but is within the health care plan's service area, enrolls in the health care plan, the health care plan shall permit the enrollee to continue an ongoing course of treatment with the enrollee's current physician during a transitional period:
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(A) of 90 days from the effective date of
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| enrollment if the enrollee has an ongoing course of treatment; or
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|
(B) if the enrollee has entered the third
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| trimester of pregnancy at the effective date of enrollment, that includes the provision of post-partum care directly related to the delivery.
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(2) If an enrollee elects to continue to receive care
|
| from such physician pursuant to item (1) of this subsection, such care shall be authorized by the health care plan for the transitional period only if the physician agrees:
|
|
(A) to accept reimbursement from the health care
|
| plan at rates established by the health care plan; such rates shall be the level of reimbursement applicable to similar physicians within the health care plan for such services;
|
|
(B) to adhere to the health care plan's quality
|
| assurance requirements and to provide to the health care plan necessary medical information related to such care; and
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|
(C) to otherwise adhere to the health care plan's
|
| policies and procedures including, but not limited to procedures regarding referrals and obtaining preauthorization for treatment.
|
|
(c) In no event shall this Section be construed to require a health care
plan
to
provide coverage for benefits not otherwise covered or to diminish or
impair preexisting condition limitations contained in the enrollee's
contract. In no event shall this Section be construed to prohibit the addition of prescription drugs to a health care plan's list of covered drugs during the coverage year.
(Source: P.A. 100-1052, eff. 8-24-18.)
(Text of Section after amendment by P.A. 103-650 )
Sec. 25. Transition of services.
(a) A health care plan shall provide for continuity of care for its enrollees as follows:
(1) If an enrollee's health care provider leaves the
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| health care plan's network of health care providers for reasons other than termination of a contract in situations involving imminent harm to a patient or a final disciplinary action by a State licensing board and the provider remains within the health care plan's service area, or if benefits provided under such health care plan with respect to such provider are terminated because of a change in the terms of the participation of such provider in such plan, or if a contract between a group health plan, as defined in Section 5 of the Illinois Health Insurance Portability and Accountability Act, and a health care plan offered in connection with the group health plan is terminated and results in a loss of benefits provided under such plan with respect to such provider, the health care plan shall permit the enrollee to continue an ongoing course of treatment with that provider during a transitional period:
|
|
(A) of 90 days from the date of the notice of
|
| provider's termination from the health care plan to the enrollee of the provider's disaffiliation from the health care plan if the enrollee has an ongoing course of treatment; or
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|
(B) if the enrollee has entered the third
|
| trimester of pregnancy at the time of the provider's disaffiliation, that includes the provision of post-partum care directly related to the delivery.
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|
(2) Notwithstanding the provisions in item (1) of
|
| this subsection, such care shall be authorized by the health care plan during the transitional period only if the provider agrees:
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|
(A) to continue to accept reimbursement from the
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| health care plan at the rates applicable prior to the start of the transitional period;
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|
(B) to adhere to the health care plan's quality
|
| assurance requirements and to provide to the health care plan necessary medical information related to such care; and
|
|
(C) to otherwise adhere to the health care plan's
|
| policies and procedures, including but not limited to procedures regarding referrals and obtaining preauthorizations for treatment.
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|
(3) During an enrollee's plan year, a health care
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| plan shall not remove a drug from its formulary or negatively change its preferred or cost-tier sharing unless, at least 60 days before making the formulary change, the health care plan:
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|
(A) provides general notification of the change
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| in its formulary to current and prospective enrollees;
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|
(B) directly notifies enrollees currently
|
| receiving coverage for the drug, including information on the specific drugs involved and the steps they may take to request coverage determinations and exceptions, including a statement that a certification of medical necessity by the enrollee's prescribing provider will result in continuation of coverage at the existing level; and
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|
(C) directly notifies in writing through an
|
| electronic transmission the prescribing provider of all health care plan enrollees currently prescribed the drug affected by the proposed change; the notice shall include a one-page form by which the prescribing provider can notify the health care plan in writing or electronically that coverage of the drug for the enrollee is medically necessary.
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|
The notification in paragraph (C) may direct the
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| prescribing provider to an electronic portal through which the prescribing provider may electronically file a certification to the health care plan that coverage of the drug for the enrollee is medically necessary. The prescribing provider may make a secure electronic signature beside the words "certification of medical necessity", and this certification shall authorize continuation of coverage for the drug.
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|
If the prescribing provider certifies to the health
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| care plan either in writing or electronically that the drug is medically necessary for the enrollee as provided in paragraph (C), a health care plan shall authorize coverage for the drug prescribed based solely on the prescribing provider's assertion that coverage is medically necessary, and the health care plan is prohibited from making modifications to the coverage related to the covered drug, including, but not limited to:
|
|
(i) increasing the out-of-pocket costs for the
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|
(ii) moving the covered drug to a more
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|
(iii) denying an enrollee coverage of the drug
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| for which the enrollee has been previously approved for coverage by the health care plan.
|
|
Nothing in this item (3) prevents a health care plan
|
| from removing a drug from its formulary or denying an enrollee coverage if the United States Food and Drug Administration has issued a statement about the drug that calls into question the clinical safety of the drug, the drug manufacturer has notified the United States Food and Drug Administration of a manufacturing discontinuance or potential discontinuance of the drug as required by Section 506C of the Federal Food, Drug, and Cosmetic Act, as codified in 21 U.S.C. 356c, or the drug manufacturer has removed the drug from the market.
|
|
Nothing in this item (3) prohibits a health care
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| plan, by contract, written policy or procedure, or any other agreement or course of conduct, from requiring a pharmacist to effect substitutions of prescription drugs consistent with Section 19.5 of the Pharmacy Practice Act, under which a pharmacist may substitute an interchangeable biologic for a prescribed biologic product, and Section 25 of the Pharmacy Practice Act, under which a pharmacist may select a generic drug determined to be therapeutically equivalent by the United States Food and Drug Administration and in accordance with the Illinois Food, Drug and Cosmetic Act.
|
|
This item (3) applies to a policy or contract that is
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| amended, delivered, issued, or renewed on or after January 1, 2019. This item (3) does not apply to a health plan as defined in the State Employees Group Insurance Act of 1971 or medical assistance under Article V of the Illinois Public Aid Code.
|
|
(b) A health care plan shall provide for continuity of care for new enrollees as follows:
(1) If a new enrollee whose physician is not a member
|
| of the health care plan's provider network, but is within the health care plan's service area, enrolls in the health care plan, the health care plan shall permit the enrollee to continue an ongoing course of treatment with the enrollee's current physician during a transitional period:
|
|
(A) of 90 days from the effective date of
|
| enrollment if the enrollee has an ongoing course of treatment; or
|
|
(B) if the enrollee has entered the third
|
| trimester of pregnancy at the effective date of enrollment, that includes the provision of post-partum care directly related to the delivery.
|
|
(2) If an enrollee elects to continue to receive care
|
| from such physician pursuant to item (1) of this subsection, such care shall be authorized by the health care plan for the transitional period only if the physician agrees:
|
|
(A) to accept reimbursement from the health care
|
| plan at rates established by the health care plan; such rates shall be the level of reimbursement applicable to similar physicians within the health care plan for such services;
|
|
(B) to adhere to the health care plan's quality
|
| assurance requirements and to provide to the health care plan necessary medical information related to such care; and
|
|
(C) to otherwise adhere to the health care plan's
|
| policies and procedures including, but not limited to procedures regarding referrals and obtaining preauthorization for treatment.
|
|
(c) In no event shall this Section be construed to require a health care plan to provide coverage for benefits not otherwise covered or to diminish or impair preexisting condition limitations contained in the enrollee's contract. In no event shall this Section be construed to prohibit the addition of prescription drugs to a health care plan's list of covered drugs during the coverage year.
(d) In this Section, "ongoing course of treatment" has the meaning ascribed to that term in Section 5 of the Network Adequacy and Transparency Act.
(Source: P.A. 103-650, eff. 1-1-25.)
|
(215 ILCS 134/45) (Text of Section before amendment by P.A. 103-656 )
Sec. 45. Health care services appeals,
complaints, and
external independent reviews.
(a) A health care plan shall establish and maintain an appeals procedure as
outlined in this Act. Compliance with this Act's appeals procedures shall
satisfy a health care plan's obligation to provide appeal procedures under any
other State law or rules.
All appeals of a health care plan's administrative determinations and
complaints regarding its administrative decisions shall be handled as required
under Section 50.
(b) When an appeal concerns a decision or action by a health care plan,
its
employees, or its subcontractors that relates to (i) health care services,
including, but not limited to, procedures or
treatments,
for an enrollee with an ongoing course of treatment ordered
by a health care provider,
the denial of which could significantly
increase the risk to an
enrollee's health,
or (ii) a treatment referral, service,
procedure, or other health care service,
the denial of which could significantly
increase the risk to an
enrollee's health,
the health care plan must allow for the filing of an appeal
either orally or in writing. Upon submission of the appeal, a health care plan
must notify the party filing the appeal, as soon as possible, but in no event
more than 24 hours after the submission of the appeal, of all information
that the plan requires to evaluate the appeal.
The health care plan shall render a decision on the appeal within
24 hours after receipt of the required information. The health care plan shall
notify the party filing the
appeal and the enrollee, enrollee's primary care physician, and any health care
provider who recommended the health care service involved in the appeal of its
decision orally
followed-up by a written notice of the determination.
(c) For all appeals related to health care services including, but not
limited to, procedures or treatments for an enrollee and not covered by
subsection (b) above, the health care
plan shall establish a procedure for the filing of such appeals. Upon
submission of an appeal under this subsection, a health care plan must notify
the party filing an appeal, within 3 business days, of all information that the
plan requires to evaluate the appeal.
The health care plan shall render a decision on the appeal within 15 business
days after receipt of the required information. The health care plan shall
notify the party filing the appeal,
the enrollee, the enrollee's primary care physician, and any health care
provider
who recommended the health care service involved in the appeal orally of its
decision followed-up by a written notice of the determination.
(d) An appeal under subsection (b) or (c) may be filed by the
enrollee, the enrollee's designee or guardian, the enrollee's primary care
physician, or the enrollee's health care provider. A health care plan shall
designate a clinical peer to review
appeals, because these appeals pertain to medical or clinical matters
and such an appeal must be reviewed by an appropriate
health care professional. No one reviewing an appeal may have had any
involvement
in the initial determination that is the subject of the appeal. The written
notice of determination required under subsections (b) and (c) shall
include (i) clear and detailed reasons for the determination, (ii)
the medical or
clinical criteria for the determination, which shall be based upon sound
clinical evidence and reviewed on a periodic basis, and (iii) in the case of an
adverse determination, the
procedures for requesting an external independent review as provided by the Illinois Health Carrier External Review Act.
(e) If an appeal filed under subsection (b) or (c) is denied for a reason
including, but not limited to, the
service, procedure, or treatment is not viewed as medically necessary,
denial of specific tests or procedures, denial of referral
to specialist physicians or denial of hospitalization requests or length of
stay requests, any involved party may request an external independent review as provided by the Illinois Health Carrier External Review Act.
(f) Until July 1, 2013, if an external independent review decision made pursuant to the Illinois Health Carrier External Review Act upholds a determination adverse to the covered person, the covered person has the right to appeal the final decision to the Department; if the external review decision is found by the Director to have been arbitrary and capricious, then the Director, with consultation from a licensed medical professional, may overturn the external review decision and require the health carrier to pay for the health care service
or treatment; such decision, if any, shall be made solely on
the legal or medical merits of the claim. If an external review decision is overturned by the Director pursuant to this Section and the health carrier so requests, then the Director shall assign a new independent review organization to reconsider the overturned decision. The new independent review organization shall follow subsection (d) of Section 40 of the Health Carrier External Review Act in rendering a decision.
(g) Future contractual or employment action by the health care plan
regarding the
patient's physician or other health care provider shall not be based solely on
the physician's or other
health care provider's participation in health care services appeals,
complaints, or
external independent reviews under the Illinois Health Carrier External Review Act.
(h) Nothing in this Section shall be construed to require a health care
plan to pay for a health care service not covered under the enrollee's
certificate of coverage or policy.
(Source: P.A. 96-857, eff. 7-1-10 .)
(Text of Section after amendment by P.A. 103-656 ) Sec. 45. Health care services appeals, complaints, and external independent reviews. (a) A health care plan shall establish and maintain an appeals procedure as outlined in this Act. Compliance with this Act's appeals procedures shall satisfy a health care plan's obligation to provide appeal procedures under any other State law or rules. All appeals of a health care plan's administrative determinations and complaints regarding its administrative decisions shall be handled as required under Section 50. (b) When an appeal concerns a decision or action by a health care plan, its employees, or its subcontractors that relates to (i) health care services, including, but not limited to, procedures or treatments, for an enrollee with an ongoing course of treatment ordered by a health care provider, the denial of which could significantly increase the risk to an enrollee's health, or (ii) a treatment referral, service, procedure, or other health care service, the denial of which could significantly increase the risk to an enrollee's health, the health care plan must allow for the filing of an appeal either orally or in writing. Upon submission of the appeal, a health care plan must notify the party filing the appeal, as soon as possible, but in no event more than 24 hours after the submission of the appeal, of all information that the plan requires to evaluate the appeal. The health care plan shall render a decision on the appeal within 24 hours after receipt of the required information. The health care plan shall notify the party filing the appeal and the enrollee, enrollee's primary care physician, and any health care provider who recommended the health care service involved in the appeal of its decision orally followed-up by a written notice of the determination. (c) For all appeals related to health care services including, but not limited to, procedures or treatments for an enrollee and not covered by subsection (b) above, the health care plan shall establish a procedure for the filing of such appeals. Upon submission of an appeal under this subsection, a health care plan must notify the party filing an appeal, within 3 business days, of all information that the plan requires to evaluate the appeal. The health care plan shall render a decision on the appeal within 15 business days after receipt of the required information. The health care plan shall notify the party filing the appeal, the enrollee, the enrollee's primary care physician, and any health care provider who recommended the health care service involved in the appeal orally of its decision followed-up by a written notice of the determination. (d) An appeal under subsection (b) or (c) may be filed by the enrollee, the enrollee's designee or guardian, the enrollee's primary care physician, or the enrollee's health care provider. A health care plan shall designate a clinical peer to review appeals, because these appeals pertain to medical or clinical matters and such an appeal must be reviewed by an appropriate health care professional. No one reviewing an appeal may have had any involvement in the initial determination that is the subject of the appeal. The written notice of determination required under subsections (b) and (c) shall include (i) clear and detailed reasons for the determination, (ii) the medical or clinical criteria for the determination, which shall be based upon sound clinical evidence and reviewed on a periodic basis, and (iii) in the case of an adverse determination, the procedures for requesting an external independent review as provided by the Illinois Health Carrier External Review Act. (e) If an appeal filed under subsection (b) or (c) is denied for a reason including, but not limited to, the service, procedure, or treatment is not viewed as medically necessary, denial of specific tests or procedures, denial of referral to specialist physicians or denial of hospitalization requests or length of stay requests, any involved party may request an external independent review as provided by the Illinois Health Carrier External Review Act. (f) Until July 1, 2013, if an external independent review decision made pursuant to the Illinois Health Carrier External Review Act upholds a determination adverse to the covered person, the covered person has the right to appeal the final decision to the Department; if the external review decision is found by the Director to have been arbitrary and capricious, then the Director, with consultation from a licensed medical professional, may overturn the external review decision and require the health carrier to pay for the health care service or treatment; such decision, if any, shall be made solely on the legal or medical merits of the claim. If an external review decision is overturned by the Director pursuant to this Section and the health carrier so requests, then the Director shall assign a new independent review organization to reconsider the overturned decision. The new independent review organization shall follow subsection (d) of Section 40 of the Health Carrier External Review Act in rendering a decision. (g) Future contractual or employment action by the health care plan regarding the patient's physician or other health care provider shall not be based solely on the physician's or other health care provider's participation in health care services appeals, complaints, or external independent reviews under the Illinois Health Carrier External Review Act. (h) Nothing in this Section shall be construed to require a health care plan to pay for a health care service not covered under the enrollee's certificate of coverage or policy. (i) Even if a health care plan or other utilization review program uses an algorithmic automated process in the course of utilization review for medical necessity, the health care plan or other utilization review program shall ensure that only a clinical peer makes any adverse determination based on medical necessity and that any subsequent appeal is processed as required by this Section, including the restriction that only a clinical peer may review an appeal. A health care plan or other utilization review program using an automated process shall have the accreditation and the policies and procedures required by subsection (b-10) of Section 85 of this Act. (Source: P.A. 103-656, eff. 1-1-25.)
|
(215 ILCS 134/45.1) (Text of Section before amendment by P.A. 103-650 ) Sec. 45.1. Medical exceptions procedures required. (a) Notwithstanding any other provision of law, on or after
January 1, 2018 (the effective date of Public Act 99-761), every insurer licensed in this State to sell a policy
of group or individual accident and health insurance or a
health benefits plan shall establish and maintain a medical exceptions process that allows covered persons or their authorized representatives to request any clinically appropriate prescription drug when (1) the drug is not covered based on the health benefit plan's formulary; (2) the health benefit plan is discontinuing coverage of the drug on the plan's formulary for reasons other than safety or other than because the prescription drug has been withdrawn from the market by the drug's manufacturer; (3) the prescription drug alternatives required to be used in accordance with a step therapy requirement (A) has been ineffective in the treatment of the enrollee's disease or medical condition or, based on both sound clinical evidence and medical and scientific evidence, the known relevant physical or mental characteristics of the enrollee, and the known characteristics of the drug regimen, is likely to be ineffective or adversely affect the drug's effectiveness or patient compliance or (B) has caused or, based on sound medical evidence, is likely to cause an adverse reaction or harm to the enrollee; or (4) the number of doses available under a dose restriction for the prescription drug (A) has been ineffective in the treatment of the enrollee's disease or medical condition or (B) based on both sound clinical evidence and medical and scientific evidence, the known relevant physical and mental characteristics of the enrollee, and known characteristics of the drug regimen, is likely to be ineffective or adversely affect the drug's effective or patient compliance. (b) The health carrier's established medical exceptions procedures must require, at a minimum, the following: (1) Any request for approval of coverage made |
| verbally or in writing (regardless of whether made using a paper or electronic form or some other writing) at any time shall be reviewed by appropriate health care professionals.
|
|
(2) The health carrier must, within 72 hours after
|
| receipt of a request made under subsection (a) of this Section, either approve or deny the request. In the case of a denial, the health carrier shall provide the covered person or the covered person's authorized representative and the covered person's prescribing provider with the reason for the denial, an alternative covered medication, if applicable, and information regarding the procedure for submitting an appeal to the denial.
|
|
(3) In the case of an expedited coverage
|
| determination, the health carrier must either approve or deny the request within 24 hours after receipt of the request. In the case of a denial, the health carrier shall provide the covered person or the covered person's authorized representative and the covered person's prescribing provider with the reason for the denial, an alternative covered medication, if applicable, and information regarding the procedure for submitting an appeal to the denial.
|
|
(c) A step therapy requirement exception request shall be
approved if:
(1) the required prescription drug is contraindicated;
(2) the patient has tried the required prescription
|
| drug while under the patient's current or previous health insurance or health benefit plan and the prescribing provider submits evidence of failure or intolerance; or
|
|
(3) the patient is stable on a prescription drug
|
| selected by his or her health care provider for the medical condition under consideration while on a current or previous health insurance or health benefit plan.
|
|
(d) Upon the granting of an exception request, the insurer,
health plan, utilization review organization, or other entity
shall authorize the coverage for the drug
prescribed by the enrollee's treating health care provider,
to the extent the prescribed drug is a covered drug under the policy or contract up to the quantity covered.
(e) Any approval of a medical exception request made pursuant to this Section shall be honored for 12 months following the date of the approval or until renewal of the plan.
(f) Notwithstanding any other provision of this Section, nothing in this Section shall be interpreted or implemented in a manner not consistent with the federal Patient Protection and Affordable Care Act (Public Law 111-148), as amended by the federal Health Care and Education Reconciliation Act of 2010 (Public Law 111-152), and any amendments thereto, or regulations or guidance issued under those Acts.
(g) Nothing in this Section shall require or authorize the State agency responsible for the administration of the medical assistance program established under the Illinois Public Aid Code to approve, supply, or cover prescription drugs pursuant to the procedure established in this Section.
(Source: P.A. 103-154, eff. 6-30-23.)
(Text of Section after amendment by P.A. 103-650 )
Sec. 45.1. Medical exceptions procedures required.
(a) Notwithstanding any other provision of law, on or after January 1, 2018 (the effective date of Public Act 99-761), every insurer licensed in this State to sell a policy of group or individual accident and health insurance or a health benefits plan shall establish and maintain a medical exceptions process that allows covered persons or their authorized representatives to request any clinically appropriate prescription drug when (1) the drug is not covered based on the health benefit plan's formulary; (2) the health benefit plan is discontinuing coverage of the drug on the plan's formulary for reasons other than safety or other than because the prescription drug has been withdrawn from the market by the drug's manufacturer; (3) (blank); or (4) the number of doses available under a dose restriction for the prescription drug (A) has been ineffective in the treatment of the enrollee's disease or medical condition or (B) based on both sound clinical evidence and medical and scientific evidence, the known relevant physical and mental characteristics of the enrollee, and known characteristics of the drug regimen, is likely to be ineffective or adversely affect the drug's effective or patient compliance.
(b) The health carrier's established medical exceptions procedures must require, at a minimum, the following:
(1) Any request for approval of coverage made
|
| verbally or in writing (regardless of whether made using a paper or electronic form or some other writing) at any time shall be reviewed by appropriate health care professionals.
|
|
(2) The health carrier must, within 72 hours after
|
| receipt of a request made under subsection (a) of this Section, either approve or deny the request. In the case of a denial, the health carrier shall provide the covered person or the covered person's authorized representative and the covered person's prescribing provider with the reason for the denial, an alternative covered medication, if applicable, and information regarding the procedure for submitting an appeal to the denial. A health carrier shall not use the authorization of alternative covered medications under this Section in a manner that effectively creates a step therapy requirement.
|
|
(3) In the case of an expedited coverage
|
| determination, the health carrier must either approve or deny the request within 24 hours after receipt of the request. In the case of a denial, the health carrier shall provide the covered person or the covered person's authorized representative and the covered person's prescribing provider with the reason for the denial, an alternative covered medication, if applicable, and information regarding the procedure for submitting an appeal to the denial.
|
|
(c) An off-formulary exception request shall not be denied if:
(1) the formulary prescription drug is
|
|
(2) the patient has tried the formulary prescription
|
| drug while under the patient's current or previous health insurance or health benefit plan and the prescribing provider submits evidence of failure or intolerance; or
|
|
(3) the patient is stable on a prescription drug
|
| selected by his or her health care provider for the medical condition under consideration while on a current or previous health insurance or health benefit plan.
|
|
(d) Upon the granting of an exception request, the insurer, health plan, utilization review organization, or other entity shall authorize the coverage for the drug prescribed by the enrollee's treating health care provider, to the extent the prescribed drug is a covered drug under the policy or contract up to the quantity covered.
(e) Any approval of a medical exception request made pursuant to this Section shall be honored for 12 months following the date of the approval or until renewal of the plan.
(f) Notwithstanding any other provision of this Section, nothing in this Section shall be interpreted or implemented in a manner not consistent with the federal Patient Protection and Affordable Care Act (Public Law 111-148), as amended by the federal Health Care and Education Reconciliation Act of 2010 (Public Law 111-152), and any amendments thereto, or regulations or guidance issued under those Acts.
(g) Nothing in this Section shall require or authorize the State agency responsible for the administration of the medical assistance program established under the Illinois Public Aid Code to approve, supply, or cover prescription drugs pursuant to the procedure established in this Section.
(Source: P.A. 103-154, eff. 6-30-23; 103-650, eff. 1-1-26.)
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(215 ILCS 134/85) (Text of Section before amendment by P.A. 103-650 and 103-656 ) Sec. 85. Utilization review program registration. (a) No person may conduct a utilization review program in this State unless once every 2 years the person registers the utilization review program with the Department and certifies compliance with the Health Utilization Management Standards of the American Accreditation Healthcare Commission (URAC) sufficient to achieve American Accreditation Healthcare Commission (URAC) accreditation or submits evidence of accreditation by the American Accreditation Healthcare Commission (URAC) for its Health Utilization Management Standards. Nothing in this Act shall be construed to require a health care plan or its subcontractors to become American Accreditation Healthcare Commission (URAC) accredited. (b) In addition, the Director of the Department, in consultation with the Director of the Department of Public Health, may certify alternative utilization review standards of national accreditation organizations or entities in order for plans to comply with this Section. Any alternative utilization review standards shall meet or exceed those standards required under subsection (a). (b-5) The Department shall recognize the Accreditation Association for Ambulatory Health Care among the list of accreditors from which utilization organizations may receive accreditation and qualify for reduced registration and renewal fees. (c) The provisions of this Section do not apply to: (1) persons providing utilization review program |
| services only to the federal government;
|
|
(2) self-insured health plans under the federal
|
| Employee Retirement Income Security Act of 1974, however, this Section does apply to persons conducting a utilization review program on behalf of these health plans;
|
|
(3) hospitals and medical groups performing
|
| utilization review activities for internal purposes unless the utilization review program is conducted for another person.
|
|
Nothing in this Act prohibits a health care plan or other entity from contractually requiring an entity designated in item (3) of this subsection to adhere to the utilization review program requirements of this Act.
(d) This registration shall include submission of all of the following information regarding utilization review program activities:
(1) The name, address, and telephone number of the
|
| utilization review programs.
|
|
(2) The organization and governing structure of the
|
| utilization review programs.
|
|
(3) The number of lives for which utilization review
|
| is conducted by each utilization review program.
|
|
(4) Hours of operation of each utilization review
|
|
(5) Description of the grievance process for each
|
| utilization review program.
|
|
(6) Number of covered lives for which utilization
|
| review was conducted for the previous calendar year for each utilization review program.
|
|
(7) Written policies and procedures for protecting
|
| confidential information according to applicable State and federal laws for each utilization review program.
|
|
(e) (1) A utilization review program shall have written procedures for assuring that patient-specific information obtained during the process of utilization review will be:
(A) kept confidential in accordance with applicable
|
| State and federal laws; and
|
|
(B) shared only with the enrollee, the enrollee's
|
| designee, the enrollee's health care provider, and those who are authorized by law to receive the information.
|
|
Summary data shall not be considered confidential if it does not provide information to allow identification of individual patients or health care providers.
(2) Only a health care professional may make determinations regarding the medical necessity of health care services during the course of utilization review.
(3) When making retrospective reviews, utilization review programs shall base reviews solely on the medical information available to the attending physician or ordering provider at the time the health care services were provided.
(4) When making prospective, concurrent, and retrospective determinations, utilization review programs shall collect only information that is necessary to make the determination and shall not routinely require health care providers to numerically code diagnoses or procedures to be considered for certification, unless required under State or federal Medicare or Medicaid rules or regulations, but may request such code if available, or routinely request copies of medical records of all enrollees reviewed. During prospective or concurrent review, copies of medical records shall only be required when necessary to verify that the health care services subject to review are medically necessary. In these cases, only the necessary or relevant sections of the medical record shall be required.
(f) If the Department finds that a utilization review program is not in compliance with this Section, the Department shall issue a corrective action plan and allow a reasonable amount of time for compliance with the plan. If the utilization review program does not come into compliance, the Department may issue a cease and desist order. Before issuing a cease and desist order under this Section, the Department shall provide the utilization review program with a written notice of the reasons for the order and allow a reasonable amount of time to supply additional information demonstrating compliance with requirements of this Section and to request a hearing. The hearing notice shall be sent by certified mail, return receipt requested, and the hearing shall be conducted in accordance with the Illinois Administrative Procedure Act.
(g) A utilization review program subject to a corrective action may continue to conduct business until a final decision has been issued by the Department.
(h) Any adverse determination made by a health care plan or its subcontractors may be appealed in accordance with subsection (f) of Section 45.
(i) The Director may by rule establish a registration fee for each person conducting a utilization review program. All fees paid to and collected by the Director under this Section shall be deposited into the Insurance Producer Administration Fund.
(Source: P.A. 99-111, eff. 1-1-16 .)
(Text of Section after amendment by P.A. 103-650 and 103-656 )
Sec. 85. Utilization review program registration.
(a) No person may conduct a utilization review program in this State unless once every 2 years the person registers the utilization review program with the Department and provides proof of current accreditation for itself and its subcontractors with the Health Utilization Management Standards of the Utilization Review Accreditation Commission, the National Committee for Quality Assurance, or another accreditation entity authorized under this Section.
(b) In addition, the Director of the Department, in consultation with the Director of the Department of Public Health, may certify alternative utilization review standards of national accreditation organizations or entities in order for plans to comply with this Section. Any alternative utilization review standards shall meet or exceed those standards required under subsection (a).
(b-5) The Department shall recognize the Accreditation Association for Ambulatory Health Care among the list of accreditors from which utilization organizations may receive accreditation and qualify for reduced registration and renewal fees.
(b-10) Utilization review programs that use algorithmic automated processes to decide whether to render adverse determinations based on medical necessity in the course of utilization review shall use objective, evidence-based criteria compliant with the accreditation requirements of the Health Utilization Management Standards of the Utilization Review Accreditation Commission or the National Committee for Quality Assurance (NCQA) and shall provide proof of such compliance to the Department with the registration required under subsection (a), including any renewal registrations. Nothing in this subsection supersedes paragraph (2) of subsection (e). The utilization review program shall include, with its registration materials, attachments that contain policies and procedures:
(1) to ensure that licensed physicians with relevant
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| board certifications establish all criteria that the algorithmic automated process uses for utilization review; and
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(2) for a program integrity system that, both before
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| new or revised criteria are used for utilization review and when implementation errors in the algorithmic automated process are identified after new or revised criteria go into effect, requires licensed physicians with relevant board certifications to verify that the algorithmic automated process and corrections to it yield results consistent with the criteria for their certified field.
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(c) The provisions of this Section do not apply to:
(1) persons providing utilization review program
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| services only to the federal government;
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(2) self-insured health plans under the federal
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| Employee Retirement Income Security Act of 1974, however, this Section does apply to persons conducting a utilization review program on behalf of these health plans;
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(3) hospitals and medical groups performing
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| utilization review activities for internal purposes unless the utilization review program is conducted for another person.
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Nothing in this Act prohibits a health care plan or other entity from contractually requiring an entity designated in item (3) of this subsection to adhere to the utilization review program requirements of this Act.
(d) This registration shall include submission of all of the following information regarding utilization review program activities:
(1) The name, address, and telephone number of the
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| utilization review programs.
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(2) The organization and governing structure of the
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| utilization review programs.
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(3) The number of lives for which utilization review
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| is conducted by each utilization review program.
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(4) Hours of operation of each utilization review
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(5) Description of the grievance process for each
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| utilization review program.
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(6) Number of covered lives for which utilization
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| review was conducted for the previous calendar year for each utilization review program.
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(7) Written policies and procedures for protecting
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| confidential information according to applicable State and federal laws for each utilization review program.
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(e) (1) A utilization review program shall have written procedures for assuring that patient-specific information obtained during the process of utilization review will be:
(A) kept confidential in accordance with applicable
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| State and federal laws; and
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(B) shared only with the enrollee, the enrollee's
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| designee, the enrollee's health care provider, and those who are authorized by law to receive the information.
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Summary data shall not be considered confidential if it does not provide information to allow identification of individual patients or health care providers.
(2) Only a clinical peer may make adverse determinations regarding the medical necessity of health care services during the course of utilization review. Either a health care professional or an accredited algorithmic automated process, or both in combination, may certify the medical necessity of a health care service in accordance with accreditation standards. Nothing in this subsection prohibits an accredited algorithmic automated process from being used to refer a case to a clinical peer for a potential adverse determination.
(3) When making retrospective reviews, utilization review programs shall base reviews solely on the medical information available to the attending physician or ordering provider at the time the health care services were provided. This paragraph includes billing records and diagnosis or procedure codes that substantively contain the same medical information to an equal or lesser degree of specificity as the records the attending physician or ordering provider directly consulted at the time health care services were provided.
(4) When making prospective, concurrent, and retrospective determinations, utilization review programs shall collect only information that is necessary to make the determination and shall not routinely require health care providers to numerically code diagnoses or procedures to be considered for certification, unless required under State or federal Medicare or Medicaid rules or regulations, but may request such code if available, or routinely request copies of medical records of all enrollees reviewed. During prospective or concurrent review, copies of medical records shall only be required when necessary to verify that the health care services subject to review are medically necessary. In these cases, only the necessary or relevant sections of the medical record shall be required.
(f) If the Department finds that a utilization review program is not in compliance with this Section, the Department shall issue a corrective action plan and allow a reasonable amount of time for compliance with the plan. If the utilization review program does not come into compliance, the Department may issue a cease and desist order. Before issuing a cease and desist order under this Section, the Department shall provide the utilization review program with a written notice of the reasons for the order and allow a reasonable amount of time to supply additional information demonstrating compliance with requirements of this Section and to request a hearing. The hearing notice shall be sent by certified mail, return receipt requested, and the hearing shall be conducted in accordance with the Illinois Administrative Procedure Act.
(g) A utilization review program subject to a corrective action may continue to conduct business until a final decision has been issued by the Department.
(h) Any adverse determination made by a health care plan or its subcontractors may be appealed in accordance with subsection (f) of Section 45.
(i) The Director may by rule establish a registration fee for each person conducting a utilization review program. All fees paid to and collected by the Director under this Section shall be deposited into the Insurance Producer Administration Fund.
(Source: P.A. 103-650, eff. 1-1-25; 103-656, eff. 1-1-25.)
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(215 ILCS 134/87) (This Section may contain text from a Public Act with a delayed effective date ) Sec. 87. General standards for use of utilization review criteria. (a) Beginning January 1, 2026, all utilization review programs shall make medical necessity determinations in accordance with the requirements of this Section. No policy, contract, certificate, formulary, or evidence of coverage issued to any enrollee may contain terms or conditions to the contrary. (b) All utilization review programs shall determine medical necessity by using the most recent treatment criteria developed by: (1) an unaffiliated, nonprofit professional |
| association for the relevant clinical specialty;
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(2) a third-party entity that develops treatment
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| criteria that: (i) are updated annually; (ii) are not paid for clinical care decision outcomes; (iii) do not offer different treatment criteria for the same health care service unless otherwise required by State or federal law; and (iv) are consistent with current generally accepted standards of care; or
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(3) the Department of Healthcare and Family Services
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| if the criteria are consistent with current generally accepted standards of care.
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(c) For all level of care placement decisions, the utilization review program shall authorize placement at the level of care at or above the level ordered by the provider using the relevant treatment criteria as specified in subsection (b). If there is a disagreement between the health care plan and the provider or patient, the health care plan or utilization review program shall provide its complete assessment to the provider and the patient.
(d) If a utilization review program purchases or licenses utilization review criteria pursuant to this Section, the utilization review program shall, before using the criteria, verify and document that the criteria were developed in accordance with subsection (b).
(e) All health care plans and utilization review programs must:
(1) make an educational program on the chosen
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| treatment criteria available to all staff and contracted entities performing utilization review;
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(2) provide, at no cost, the treatment criteria and
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| any related training material to providers and enrollees upon request; enrollees and treating providers shall be able to access treatment criteria at any point in time, including before an initial request for authorization;
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(3) track, identify, and analyze how the treatment
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| criteria are used to certify care, deny care, and support the appeals process;
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(4) conduct interrater reliability testing to ensure
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| consistency in utilization review decision-making; this testing shall cover all aspects of utilization review criteria as defined in Section 10;
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(5) achieve interrater reliability pass rates of at
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| least 90% and, if this threshold is not met, initiate remediation of poor interrater reliability within 3 business days after the finding and conduct interrater reliability testing for all new staff before they can conduct utilization review supervision; and
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(6) maintain documentation of interrater reliability
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| testing and any remediation and submit to the Department of Insurance, or, in the case of Medicaid managed care organizations, the Department of Healthcare and Family Services, the testing results de-identified of patient or employee personal information and a summary of remedial actions.
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(f) Beginning January 1, 2026, no utilization review program or any policy, contract, certificate, evidence of coverage, or formulary shall impose step therapy requirements. Nothing in this subsection prohibits a health care plan, by contract, written policy, procedure, or any other agreement or course of conduct, from requiring a pharmacist to effect substitutions of prescription drugs consistent with Section 19.5 of the Pharmacy Practice Act, under which a pharmacist may substitute an interchangeable biologic for a prescribed biologic product, and Section 25 of the Pharmacy Practice Act, under which a pharmacist may select a generic drug determined to be therapeutically equivalent by the United States Food and Drug Administration and in accordance with the Illinois Food, Drug and Cosmetic Act. For health care plans operated or overseen by the Department of Healthcare and Family Services, including Medicaid managed care plans, the prohibition in this subsection does not apply to step therapy requirements for drugs that do not appear on the most recent Preferred Drug List published by the Department of Healthcare and Family Services.
(g) Except for subsection (f), this Section does not apply to utilization review concerning diagnosis, prevention, and treatment of mental, emotional, nervous, or substance use disorders or conditions, which shall be governed by Section 370c of the Illinois Insurance Code.
(h) Nothing in this Section supersedes or waives requirements provided under any other State or federal law or federal regulation that any coverage subject to this Section comply with specific utilization review criteria for a specific illness, level of care placement, injury, or condition or its symptoms and comorbidities.
(Source: P.A. 103-650, eff. 1-1-25.)
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