IL SB0192

Department of Healthcare and Family Services must audit managed care organizations when the Governor declares a statewide disaster due to public health emergency and orders hospitals to cancel or suspend elective or nonemergent surgeries.

Each managed care organization must maintain a minimum medical loss ratio of 85% during the disaster period established by the gubernatorial proclamation.

Audit must be completed no later than 90 days after the proclaimed disaster expires.

Managed care organizations must submit all relevant data and information to the Department upon request to support the audit process.

Department shall recoup any overpayments made to managed care organizations that fail to maintain the 85% minimum medical loss ratio during the disaster period.