Illinois SB 2405: LOCAL GOVERNMENT-TECH

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104TH GENERAL ASSEMBLY 
State of Illinois 
2025 and 2026
SB2405

Introduced 2/7/2025, by Sen. Ram Villivalam 

SYNOPSIS AS INTRODUCED:

215 ILCS 5/356z.3a

215 ILCS 5/370g from Ch. 73, par. 982g

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

815 ILCS 505/2HHHH new

 Amends the Illinois Insurance Code to create the Consumer Protection from Surprise Health Care Billing Act. Provides that, on or after July 1, 2025, notwithstanding any other applicable provision, when a beneficiary, insured, or enrollee receives services from a nonparticipating ground ambulance service provider, the health insurance issuer shall ensure that the beneficiary, insured, or enrollee shall incur no greater out-of-pocket costs than the beneficiary, insured, or enrollee would have incurred with a participating ground ambulance service provider. Provides that any cost-sharing requirements shall be applied as though the services provided by the nonparticipating ground ambulance service provider had been provided by a participating ground ambulance service provider. Sets forth provisions concerning payment for ground ambulance services; calculating the recognized amount; limitations for the cost sharing amount for any occurrence in which a ground ambulance service is provided to a beneficiary; appeals for payments made by health insurance issuers; the maximum allowable payment amounts, by individual service types, for nonparticipating ground ambulance service providers owned, operated, or controlled by a private organization; and payments to nonparticipating ground ambulance service providers owned, operated, or controll