Bill > SB3181

This bill amends the Illinois Insurance Code to establish minimum reimbursement rates for physicians in Cook, DuPage, Lake, and Will Counties. Specifically, health insurance companies, which include entities like health maintenance organizations and preferred provider organizations that administer health insurance plans regulated in Illinois, must pay physicians at least 160% of the Medicare rate for covered health care services, defined as any service for which a Medicare rate has been established. If Medicare has multiple rates for a service, the reimbursement floor will be based on the rate that best matches the service's setting and type. The bill also states that any contract or agreement that sets reimbursement below this minimum is void and unenforceable. Furthermore, physicians are prohibited from waiving these minimum reimbursement protections, even as a condition for joining a health benefit plan. The Department of Insurance is empowered to enforce these provisions, create necessary rules, and impose penalties on health insurance companies that violate the law, including civil penalties of up to $15,000 per violation, restitution to the physician, and other authorized remedies.

https://www.ilga.gov/Legislation/BillStatus?DocNum=3181&GAID=18&DocTypeID=SB&SessionID=114&GA=104