summary
Introduced
01/31/2025
01/31/2025
In Committee
03/21/2025
03/21/2025
Crossed Over
Passed
Dead
Introduced Session
104th General Assembly
Bill Summary
Amends the Illinois Insurance Code. Provides that nothing in the provisions shall require an ambulance provider to bill a beneficiary, insured, enrollee, or health insurance issuer when prohibited by any other law, rule, ordinance, contract, or agreement. Limits home rule powers. Changes the definition of "emergency services" and "health care provider". Amends the Health Maintenance Organization Act. Removes language providing that upon reasonable demand by a provider of emergency transportation by ambulance, a health maintenance organization shall promptly pay to the provider, subject to coverage limitations stated in the contract or evidence of coverage, the charges for emergency transportation by ambulance provided to an enrollee in a health care plan arranged for by the health maintenance organization.
AI Summary
This bill amends the Illinois Insurance Code and Health Maintenance Organization Act to modify regulations around emergency medical services, particularly ambulance services. The bill expands the definition of "emergency services" to include ground ambulance transportation and clarifies billing requirements for emergency medical care provided by non-participating providers or facilities. Specifically, it ensures that patients receiving emergency services will not be charged more out-of-pocket costs than they would for in-network care, and it establishes a process for resolving payment disputes between health insurance issuers and non-participating providers through binding arbitration. The bill also limits home rule powers related to ambulance providers and removes previous language requiring health maintenance organizations to promptly pay emergency ambulance transportation providers. Key provisions include protecting patients from unexpected high medical bills during emergency situations, establishing clear guidelines for cost-sharing, and creating a structured mechanism for resolving billing conflicts between healthcare providers and insurance companies.
Committee Categories
Business and Industry
Sponsors (1)
Last Action
Rule 3-9(a) / Re-referred to Assignments (on 03/21/2025)
bill text
bill summary
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bill summary
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bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://www.ilga.gov/legislation/BillStatus.asp?DocNum=1471&GAID=18&DocTypeID=SB&SessionID=114&GA=104 |
| BillText | https://www.ilga.gov/legislation/104/SB/10400SB1471.htm |
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