Illinois Compiled Statutes 215 Insurance: Article -

• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 1
  Short title. This Act may be cited as the Managed Care Reform and Patient Rights Act. (Source: P.A. 91-617, eff. 1-1-00.)
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 5
  Health care patient rights. (a) The General Assembly finds that: (1) A patient has the right to care consistent with professional standards of practice...
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 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...
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 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...
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 20
  Notice of nonrenewal or termination. A health care plan must give at least 60 days notice of nonrenewal or termination of a health care...
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 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...
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 30
  Prohibitions. (a) No health care plan or its subcontractors may prohibit or discourage health care providers by contract or policy from discussing any health care...
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 35
  Medically appropriate health care protection. (a) No health care plan or its subcontractors shall retaliate against a physician or other health care provider who...
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 40
  Access to specialists. (a) All health care plans that require each enrollee to select a health care provider for any purpose including coordination of care...
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 43
  Utilization of health care facilities. (a) A health care plan must provide its enrollees with a description of their rights and responsibilities in obtaining...
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 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...
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 45.1
  Medical exceptions procedures required. (a) Every health carrier that offers a qualified health plan, as defined in the federal Patient Protection and Affordable Care Act...
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 45.2
  Prior authorization form; prescription benefits. (a) Notwithstanding any other provision of law, on and after January 1, 2015, a health insurer that provides prescription drug...
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 50
  Administrative complaints and Departmental review. (a) Administrative complaint process. (1) A health care plan shall accept and review appeals of its determinations and complaints...
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 55
  Record of complaints. (a) The Department shall maintain records concerning the complaints filed against health care plans. To that end, the Department shall require...
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 60
  Choosing a physician. (a) A health care plan may also offer other arrangements under which enrollees may access health care services from contracted providers...
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 65
  Emergency services prior to stabilization. (a) A health care plan that provides or that is required by law to provide coverage for emergency services...
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 70
  Post-stabilization medical services. (a) If prior authorization for covered post-stabilization services is required by the health care plan, the plan shall provide access 24...
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 72
  Pharmacy providers. (a) Before entering into an agreement with pharmacy providers, a health care plan must establish terms and conditions that must be met...
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 75
  Consumer advisory committee. (a) A health care plan shall establish a consumer advisory committee. The consumer advisory committee shall have the authority to identify...
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 80
  Quality assessment program. (a) A health care plan shall develop and implement a quality assessment and improvement strategy designed to identify and evaluate accessibility,...
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 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...
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 90
  Office of Consumer Health Insurance. (a) The Director of Insurance shall establish the Office of Consumer Health Insurance within the Department of Insurance to...
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 95
  Prohibited activity. No health care plan or its subcontractors by contract, written policy, or procedure shall contain any clause attempting to transfer or transferring...
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 100
  Prohibition of waiver of rights. No health care plan or contract shall contain any provision, policy, or procedure that limits, restricts, or waives any...
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 105
  Administration and enforcement. The Director of Insurance may adopt rules necessary to implement the Department's responsibilities under this Act. To enforce the provisions of...
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 110
  Applicability and scope. This Act applies to policies and contracts amended, delivered, issued, or renewed on or after the effective date of this Act....
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 115
  Effect on benefits under Workers' Compensation Act and Workers' Occupational Diseases Act. Nothing in this Act shall be construed to expand, modify, or restrict...
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 120
  Severability. The provisions of this Act are severable under Section 1.31 of the Statute on Statutes. (Source: P.A. 91-617, eff. 1-1-00.)
• Illinois Insurance: Article -
  Amendatory provisions; text omitted
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 200
  (Amendatory provisions; text omitted). (Source: P.A. 91-617, eff. 8-19-99; text omitted.)
• Illinois Insurance: Article -
  Amendatory provisions; text omitted
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 205
  (Amendatory provisions; text omitted). (Source: P.A. 91-617, eff. 1-1-00; text omitted.)
• Illinois Insurance: Article -
  Amendatory provisions; text omitted
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 210
  (Amendatory provisions; text omitted). (Source: P.A. 91-617, eff. 1-1-00; text omitted.)
• Illinois Insurance: Article -
  Amendatory provisions, text omitted
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 215
  (Amendatory provisions, text omitted). (Source: P.A. 91-617, eff. 1-1-00; text omitted.)
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 220
  (Amendatory provisions; text omitted.) (Source: P.A. 91-617, eff. 1-1-00; text omitted.)
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 225
  (Amendatory provisions; text omitted.) (Source: P.A. 91-617, eff. 1-1-00; text omitted.)
• Illinois Insurance: Article -
  Amendatory provisions; text omitted
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 230
  (Amendatory provisions; text omitted). (Source: P.A. 91-617, eff. 1-1-00; text omitted.)
• Illinois Insurance: Article -
  Amendatory provisions; text omitted
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 235
  (Amendatory provisions; text omitted). (Source: P.A. 91-617, eff. 1-1-00; text omitted.)
• Illinois Insurance: Article -
  Amendatory provisions; text omitted
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 240
  (Amendatory provisions; text omitted). (Source: P.A. 91-617, eff. 1-1-00; text omitted.)
• Illinois Insurance: Article -
  Amendatory provisions; text omitted
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 245
  (Amendatory provisions; text omitted). (Source: P.A. 91-617, eff. 1-1-00; text omitted.)
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 250
  (Amendatory provisions; text omitted.) (Source: P.A. 91-617, eff. 1-1-00; text omitted.)
• Illinois Managed Care Reform and Patient Rights Act. - 215 ILCS 134, Section 299
  Effective date. This Section and Section 200 of this Act take effect upon becoming law; Sections 25 and 85 take effect July 1, 2000;...

Last modified: February 18, 2015