INS CD-HEALTH-EMERGENCY SERVIC Senate SponsorsSen. William R. Haine House Sponsors(Rep. Frank J. Mautino-Barbara Flynn Currie) 1/24/2013SenatePublic Act . . . . . . . . . 97-1148 20 ILCS 1405/1405-40 new215 ILCS 5/356z.3aAmends the Department of Insurance Law of the Civil Administrative Code of Illinois. Provides that the Department of Insurance shall study the frequency and economic impact of nonparticipating facility-based physician and provider claims concerning the issue of when a beneficiary, insured, or enrollee utilizes a participating network hospital or a participating network ambulatory surgery center and, due to any reason, in-network services for radiology, anesthesiology, pathology, emergency physician, or neonatology are unavailable and are provided by a nonparticipating facility-based physician or provider and the insurer's or health plan's responsibility to ensure that the beneficiary, insured, or enrollee incurs no greater out-of-pocket costs than the beneficiary, insured, or enrollee would have incurred with a participating physician or provider for covered services. Provides that the Department shall report its findings and recommendations to the General Assembly no later than October 1, 2012. Amends the Illinois Insurance Code to provide that nothing in the provision concerning nonparticipating facility-based physicians and providers shall be interpreted to change the prudent layperson provisions with respect to emergency services under the Managed Care Reform and Patient Rights Act. Effective immediately.Senate Committee Amendment No. 1 Deletes reference to:20 ILCS 1405/1405-40 newReplaces everything after the enacting clause with the introduced bill with the following change. Deletes the provision amending the Department of Insurance Law of the Civil Administrative Code of Illinois concerning the study of out-of-network facility-based physician and provider claims. Effective immediately.House Committee Amendment No. 1 Deletes reference to:215 ILCS 5/356z.3aAdds reference to:215 ILCS 125/1-2from Ch. 111 1/2, par. 1402215 ILCS 125/4-14from Ch. 111 1/2, par. 1409.7215 ILCS 125/4-20 newReplaces everything after the enacting clause. Amends the Health Maintenance Organization Act. Makes changes to the definitions of "basic health care services" and "health care plan". Makes changes to the provision concerning evidence of coverage. Provides that a Health Maintenance Organization may require deductibles and copayments of enrollees as a condition for the receipt of specific health care services, including basic health care services. Provides that deductibles and copayments shall be the only allowable charge, other than premiums, assessed enrollees. Provides that deductibles and copayments shall be for specific dollar amounts or for specific percentages of the cost of the health care services. Provides that no deductible and copayment paid for the receipt of basic health care services may exceed the annual out-of-pocket expenses as defined in the federal Internal Revenue Code. Provides that no combination of deductibles and copayments for basic health care services may exceed the annual maximums as specified by the federal Affordable Care Act. Provides that deductibles and copayments applicable to supplemental health care services, catastrophic-only plans as defined under the federal Affordable Care Act, or pre-existing conditions are not subject to the annual limitations described in the provision concerning deductibles and copayments. Effective immediately.House Floor Amendment No. 2 Provides that the provision concerning deductibles and copayments applies to enrollees and does not limit the health care plan payment for services provided by non-participating providers.House Floor Amendment No. 3 Deletes language that provides that no deductible and copayment paid for the receipt of basic health care services may exceed the annual out-of-pocket expenses as defined in the federal Internal Revenue Code and that no combination of deductibles and copayments for basic health care services may exceed the annual maximums as specified by the federal Affordable Care Act. Provides instead that no combination of deductibles and copayments paid for the receipt of basic health care services may exceed the annual maximum out-of-pocket expenses of a high deductible health plan as defined in the provision of the United States Code concerning health savings accounts. Provides that the provision concerning deductibles and copayments applies to enrollees and does not limit the health care plan payment for services provided by non-participating providers. 2/1/2012SenateFiled with Secretary by Sen. William R. Haine 2/1/2012SenateFirst Reading 2/1/2012SenateReferred to Assignments 2/7/2012SenateAssigned to Insurance 2/24/2012SenatePostponed - Insurance 3/1/2012SenatePostponed - Insurance 3/2/2012SenateSenate Committee Amendment No. 1 Filed with Secretary by Sen. William R. Haine 3/2/2012SenateSenate Committee Amendment No. 1 Referred to Assignments 3/6/2012SenateSenate Committee Amendment No. 1 Assignments Refers to Insurance 3/7/2012SenateSenate Committee Amendment No. 1 Adopted 3/8/2012SenateDo Pass as Amended Insurance; 009-000-000 3/8/2012SenatePlaced on Calendar Order of 2nd Reading March 21, 2012 3/21/2012SenateSecond Reading 3/21/2012SenatePlaced on Calendar Order of 3rd Reading March 22, 2012 3/22/2012SenateThird Reading - Passed; 052-000-000 3/22/2012HouseArrived in House 3/22/2012HousePlaced on Calendar Order of First Reading 3/22/2012HouseChief House Sponsor Rep. Frank J. Mautino 3/23/2012HouseFirst Reading 3/23/2012HouseReferred to Rules Committee 11/9/2012HouseFinal Action Deadline Extended-9(b) January 8, 2013 11/9/2012HouseAssigned to Executive Committee 11/26/2012HouseHouse Committee Amendment No. 1 Filed with Clerk by Rep. Frank J. Mautino 11/26/2012HouseHouse Committee Amendment No. 1 Referred to Rules Committee 11/26/2012HouseHouse Committee Amendment No. 1 Rules Refers to Executive Committee 11/27/2012HouseHouse Committee Amendment No. 1 Adopted in Executive Committee; by Voice Vote 11/27/2012HouseDo Pass as Amended / Short Debate Executive Committee; 011-000-000 11/27/2012HousePlaced on Calendar 2nd Reading - Short Debate 11/27/2012HouseSecond Reading - Short Debate 11/27/2012HouseHeld on Calendar Order of Second Reading - Short Debate 11/28/2012HouseHouse Floor Amendment No. 2 Filed with Clerk by Rep. Frank J. Mautino 11/28/2012HouseHouse Floor Amendment No. 2 Referred to Rules Committee 12/3/2012HouseAdded Alternate Chief Co-Sponsor Rep. Barbara Flynn Currie 12/3/2012HouseHouse Floor Amendment No. 2 Recommends Be Adopted Rules Committee; 004-000-000 12/4/2012HouseHouse Floor Amendment No. 3 Filed with Clerk by Rep. Frank J. Mautino 12/4/2012HouseHouse Floor Amendment No. 3 Referred to Rules Committee 12/5/2012HouseHouse Floor Amendment No. 3 Recommends Be Adopted Rules Committee; 005-000-000 12/5/2012HouseHouse Floor Amendment No. 2 Adopted by Voice Vote 12/5/2012HouseHouse Floor Amendment No. 3 Adopted by Voice Vote 12/5/2012HousePlaced on Calendar Order of 3rd Reading - Short Debate 12/5/2012House3/5 Vote Required 12/5/2012HouseThird Reading - Short Debate - Passed 084-027-000 12/5/2012SenateSecretary's Desk - Concurrence House Amendment(s) 1, 2, 3 12/5/2012SenatePlaced on Calendar Order of Concurrence House Amendment(s) 2, 1, 3 - January 2, 2013 12/5/2012SenateHouse Committee Amendment No. 1 Motion to Concur Filed with Secretary Sen. William R. Haine 12/5/2012SenateHouse Committee Amendment No. 1 Motion to Concur Referred to Assignments 12/5/2012SenateHouse Floor Amendment No. 2 Motion to Concur Filed with Secretary Sen. William R. Haine 12/5/2012SenateHouse Floor Amendment No. 2 Motion to Concur Referred to Assignments 12/5/2012SenateHouse Floor Amendment No. 3 Motion to Concur Filed with Secretary Sen. William R. Haine 12/5/2012SenateHouse Floor Amendment No. 3 Motion to Concur Referred to Assignments 1/2/2013SenateHouse Committee Amendment No. 1 Motion to Concur Assignments Referred to Insurance 1/2/2013SenateHouse Floor Amendment No. 2 Motion to Concur Assignments Referred to Insurance 1/2/2013SenateHouse Floor Amendment No. 3 Motion to Concur Assignments Referred to Insurance 1/3/2013SenateHouse Committee Amendment No. 1 Motion To Concur Recommended Do Adopt Insurance; 008-000-000 1/3/2013SenateHouse Floor Amendment No. 2 Motion To Concur Recommended Do Adopt Insurance; 008-000-000 1/3/2013SenateHouse Floor Amendment No. 3 Motion To Concur Recommended Do Adopt Insurance; 008-000-000 1/3/2013SenateHouse Committee Amendment No. 1 Senate Concurs 051-000-001 1/3/2013SenateHouse Floor Amendment No. 2 Senate Concurs 051-000-001 1/3/2013SenateHouse Floor Amendment No. 3 Senate Concurs 051-000-001 1/3/2013SenatePassed Both Houses 1/15/2013SenateSent to the Governor 1/24/2013SenateGovernor Approved 1/24/2013SenateEffective Date January 24, 2013 1/24/2013SenatePublic Act . . . . . . . . . 97-1148