IL SB1974

Reduces the timeframe for insurers to request recoupments or offsets from health care providers from 18 months to 12 months after the original payment is made.

Requires insurers, health maintenance organizations, independent practice associations, and physician hospital organizations to provide remittance advice that includes the patient name, date of service, service code or description, recoupment amount, and reason for recoupment.

Mandates that appeal contact information and deadline (60 days from receipt) be prominently displayed on remittance advice or recoupment demand documents.

Adds a new exception allowing recoupments beyond the 12-month period when an insurer contracted with the Department of Healthcare and Family Services is required by that department to recoup or offset payments due to federal Medicaid requirements.

Effective date: January 1, 2022.