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IL SB3739
Bill
AI Summary
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Amends the Network Adequacy and Transparency Act to align Illinois health insurance network standards with federal Federally-Facilitated Exchange standards, ensuring minimum provider ratios are no less stringent and maximum travel/distance and appointment wait time standards are no greater than federal requirements.
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Authorizes the Department of Insurance to adopt emergency rules implementing federal network adequacy standards that are more stringent than existing state standards, with the emergency authorization repealing one year after enactment.
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Expands network adequacy requirements for mental health and substance use disorder treatment, establishing specific time and distance standards (30 minutes/miles in Cook County area; 60 minutes/miles elsewhere) and appointment wait times (10 business days for initial appointments, 20 business days for follow-up).
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Establishes penalties for issuer noncompliance including $5,000 monthly fines for failure to update provider directories, $1,000 daily fines for late network adequacy filing submissions, and $1,000 per policy civil penalties for issuing plans that fail to meet adequacy standards.
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Requires provider directories to include digital contact information, telehealth/telemedicine offerings, appointment availability, and whether providers accept new patients; mandates 90-day audit cycles of all provider directories and 2-business-day updates upon provider notification of changes.
Legislative Description
NETWORK ADEQUACY-STANDARDS
Last Action
Session Sine Die
1/7/2025