SB3778 Summary

• Amends the Illinois Insurance Code Section 356z.3a to expand the definition of "health care facility" for non-emergency services to include facilities or offices providing reproductive health care as defined in the Reproductive Health Act.

• Requires health insurance issuers to ensure patients receiving non-emergency reproductive health care services at participating facilities incur no greater out-of-pocket costs than they would with a participating provider.

• Applies cost-sharing requirements as though services were received from a participating provider, calculated based on the recognized amount (lesser of billed amount or qualifying payment amount).

• Prohibits balance billing of patients and requires direct payment from insurers to nonparticipating providers for covered services under the specified conditions.

• Establishes binding arbitration process through the Department of Insurance to resolve payment disputes between insurers and nonparticipating reproductive health care providers when negotiation fails within 30 days.