Illinois HB 3445: INS CD-RECOUPMENTS

Status: Rule 19(a) / Re-referred to Rules Committee (as of 2025-04-11)

State: Illinois · Session: 104th · Bill: HB 3445

Sponsors: Tracy Katz Muhl

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 Full Text of HB3445

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HB3445 EngrossedLRB104 10593 BAB 20669 b

1 AN ACT concerning regulation.

2 Be it enacted by the People of the State of Illinois, 

3represented in the General Assembly:

4 Section 5. The Illinois Insurance Code is amended by 

5changing Section 368d as follows:

6 (215 ILCS 5/368d)

7 Sec. 368d. Recoupments. 

8 (a) A health care professional or health care provider 

9shall be provided a remittance advice, which must include an 

10explanation of a recoupment or offset taken by an insurer, 

11health maintenance organization, independent practice 

12association, or physician hospital organization, if any. The 

13recoupment explanation shall, at a minimum, include the name 

14of the patient; the date of service; the service code or if no 

15service code is available a service description; the 

16recoupment amount; and the reason for the recoupment or 

17offset. In addition, an insurer, health maintenance 

18organization, independent practice association, or physician 

19hospital organization shall provide with the remittance 

20advice, or with any demand for recoupment or offset, a 

21telephone number or mailing address to initiate an appeal of 

22the recoupment or offset together with the deadline for 

23initiating an appeal. Such information shall be prominently 

HB3445 Engrossed- 2 -LRB104 10593 BAB 20669 b

1displayed on the remittance advice or written document 

2containing the demand for recoupment or offset. Any appeal of 

3a recoupment or offset by a health care professional or health 

4care provider must be made within 60 days after receipt of the 

5remittance advice. 

6 (b) It is not a recoupment when a health care professional 

7or health care provider is paid an amount prospe

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