Bill > SB1925

This bill: 1. Amends the Illinois Insurance Code to require health insurance issuers to ensure that individuals receiving emergency services from non-participating providers or non-participating emergency facilities incur no greater out-of-pocket costs than they would have with a participating provider or facility. It also applies similar requirements for ancillary services provided by non-participating providers at participating health care facilities. 2. Provides a process for non-participating providers and facilities to bill and negotiate reimbursement with health insurance issuers, including the ability to initiate binding arbitration if necessary. 3. Removes a provision in the Health Maintenance Organization Act that previously required health maintenance organizations to promptly pay charges for emergency transportation by ambulance to the provider upon reasonable demand. 4. Prohibits home rule units from regulating ambulance providers in a manner inconsistent with the provisions of the bill. 5. Clarifies that nothing in the bill requires an ambulance provider to bill a beneficiary, insured, enrollee, or health insurance issuer when prohibited by any other law, rule, ordinance, contract, or agreement.