IL HB4820

Requires remittance advice for insurance recoupments to reject Current Procedural Terminology codes only with clear explanation of reasons and must provide payment for all services provided, including multiple procedures performed in one day.

Reduces the time limit for insurers, HMOs, IPAs, and physician hospital organizations to request or withhold recoupments or offsets from 18 months to 60 days after original payment, with exceptions for fraud findings, Comprehensive Health Insurance Plan administration, or when provider was already paid in full by other payers.

Requires remittance advice and recoupment demands to include a prominently displayed telephone number or mailing address for appealing recoupments, with a 60-day deadline for providers to file appeals after receipt.

Permits the Department of Healthcare and Family Services to recover improperly paid, erroneously paid, or overpaid amounts under the Illinois Public Aid Code only within 60 days of any payment through setoff, credit against future billings, or direct repayment.