IL HB4703

Amends Illinois Insurance Code Section 356z.3 to require insurers to disclose that nonparticipating providers may bill patients for amounts exceeding plan payments, with exceptions for certain services at participating health care facilities under Section 356z.3a.

Creates comprehensive Section 356z.3a establishing protections for emergency services and certain non-emergency services at participating facilities: patients cannot be billed more than they would pay in-network, cost-sharing is calculated based on recognized amounts, and no referral requirements can deny coverage.

Requires binding arbitration for payment disputes between insurers and nonparticipating providers when negotiation fails within 30 days, with decisions issued within 45 days and arbitrator selection through a vetoing process.

Extends Section 356z.3a protections to Health Maintenance Organizations, point-of-service contracts, and health services plans, and prohibits prior authorization requirements for post-stabilization services that constitute emergency services.

Effective July 1, 2022, except changes to disclosure requirements take effect January 1, 2023.