Illinois · 104th session
Amends the Illinois Insurance Code. Provides that, when a beneficiary, insured, or enrollee receives mental health services from a nonparticipating provider or a nonparticipating health care facility, the health insurance issuer shall ensure that the beneficiary, insured, or enrollee shall incur no greater out-of-pocket costs than the beneficiary, insured, or enrollee would have incurred with a participating provider or a participating health care facility. Requires any cost-sharing requirements to be applied as though the mental health services had been received from a participating provider or a participating health care facility. Provides that, if the cost sharing for the same item or service furnished by a participating provider would have been a flat-dollar copayment, that amount shall be the cost-sharing amount unless the provider has billed a lesser total amount. Provides that administrative requirements or limitations shall be no greater than those applicable to emergency services received from a participating provider or a participating health care facility. Permits a beneficiary, insured, or enrollee receiving ongoing mental health services from a nonparticipating…
Referred to Assignments (2025-02-07)