Illinois HB 3796: INSURANCE-PROVIDER PANELS

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 Full Text of HB3796

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HB3796 EnrolledLRB104 09757 BAB 19823 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 Network Adequacy and Transparency Act is 

5amended by changing Section 20 as follows:

6 (215 ILCS 124/20)

7 Sec. 20. Transition of services.

8 (a) A network plan shall provide for continuity of care 

9for its beneficiaries as follows:

10 (1) If a beneficiary's provider leaves the network 

11 plan's network of providers for reasons other than 

12 termination of a contract in situations involving imminent 

13 harm to a patient or a final disciplinary action by a State 

14 licensing board and the provider remains within the 

15 network plan's service area, if benefits provided under 

16 such network plan with respect to such provider or 

17 facility are terminated because of a change in the terms 

18 of the participation of such provider or facility in such 

19 plan, or if a contract between a group health plan and a 

20 health insurance issuer offering a network plan in 

21 connection with the group health plan is terminated and 

22 results in a loss of benefits provided under such plan 

23 with respect to such provider, then the network plan shall 

HB3796 Enrolled- 2 -LRB104 09757 BAB 19823 b

1 permit the beneficiary to continue an ongoing course of 

2 treatment with that provider during a transitional period 

3 for the following duration:

4 (A) 90 days from the date of the notice to the 

5 beneficiary of the provider's disaffiliation from the 

6 network plan