In poor health. Gov. Pritzker Signs Consumer Protection Bills for Health Insurance Coverage – InsuranceNewsNet


CHICAGO, Illinois, May 27 — Gov. JB Pritzker, D-Illinois, issued the next news release on May 26, 2022:

Governor Pritzker today signed HB4703, SB3910, and HB0836 into law to extend protections and access for Illinois medical health insurance consumers. These bills help implement fair and transparent billing practices and supply higher access to details about enrollment options.

Specifically, HB4703 addresses surprise medical billing, which is one of the vital common reasons people file medical health insurance complaints. The brand new law grants the Illinois Department of Insurance (IDOI) additional authority to help consumers facing astronomical bills because they unknowingly or mistakenly received care from hospitals or doctors that were out-of-network.

“Healthcare is a right-not a privilege, and surprise medical billing further deters Illinoisans from getting the care they need,” said Governor JB Pritzker. “Since day one, my administration has worked to expand access to quality, inexpensive healthcare. We capped the value of insulin, reduced the Medicaid backlog, and enacted the Health Care Affordability Act. I’m proud to sign these bills into law to further that crucial work and ensure consumers are protected within the medical billing process.”

The signed bills include:

* HB4703 – Amends the Illinois Insurance Code and addresses surprise medical billing by constructing on the federal No Surprises Act. The brand new law grants the Illinois Department of Insurance additional authority to help consumers who were billed at out-of-network rates after unknowingly or mistakenly receiving care from hospitals, doctors and other providers that they believed were in-network.

* SB3910 – Creates a disclosure requirement on medical health insurance and HMO member ID cards that easily identifies the regulatory entity that holds authority over the plan, any deductible or out-of-pocket maximum applicable to the plan, in addition to a phone number or website a cardholder may go to for extra plan information. The bill also allows the Department of Insurance to implement the ID card transparency requirements that the federal No Surprises Act added to Section 2799A-1(e) of the Public Health Service Act.

* HB0836 – Creates the Health Insurance Coverage Premium Misalignment Study Act. The Department of Insurance will oversee a study to explore rate setting approaches that will yield a misalignment of premiums across different tiers of coverage in Illinois’ individual medical health insurance market. The study will produce cost estimates for Illinois residents, together with the impact of the policy on medical health insurance affordability and access. It’s going to examine the uninsured rates for low-income and middle-income residents with break-out data by geography, race, ethnicity, and income level.

“Research shows that greater than 137 million people on this country recently experienced financial hardship due to medical bills, a few of them unexpected,” said Lt. Governor Juliana Stratton. “This must change, and we’re committed to creating the pathways to achieve this. These latest laws will help countless families in Illinois by protecting consumer rights in the case of medical health insurance and providing pathways to more accessible and transparent coverage.”

“Consumers who’re already affected by illnesses or injuries mustn’t be further burdened with higher costs because they’re unable to search out an in-network provider for emergency care, or because an insurer doesn’t have enough in-network providers available in a selected coverage area,” said IDOI Director Dana Popish Severinghaus. “We sit up for intervening on behalf of more Illinois insurance consumers to fight surprise medical billing.”

“I’m dedicated to finding ways to make sure medical health insurance is transparent and user friendly for consumers. Requiring your insurance card to offer mandatory information will ensure consumers know where to show to for help after they have issues with their insurance,” said State Senator Laura Effective (D-Glenview). “As well as, with the passage of the speed study, the Department can take the mandatory steps to ensure consumers are getting the bottom possible rates for his or her health care.”

“Surprise medical bills are a growing problem for people all over the place,” said State Representative Bob Morgan (D-Deerfield). “Particularly during health emergencies when individuals are most vulnerable. It’s unthinkable which you can seek treatment, only to search out out later that the provider is out-of-network and also you’re now accountable for paying a much higher than anticipated medical bill. We passed this essential laws to present DOI expanded powers to guard consumers beyond what the federal No Surprises Act provides. Moreover, the Premium Misalignment Study Act will allow legislators and regulators to get a clearer picture of the ways insurance rates are set and look for methods to guard consumers from unnecessarily high premiums.”

“It’s shameful that somebody receiving medical care would experience financial hardship in consequence of surprise medical billing,” said State Senator Ann Gillespie (D-Arlington Heights). “This latest law will provide much more protection for consumers from exorbitant out-of-pocket healthcare costs, especially at a time when many families are struggling to pay other household bills.”

“The Shriver Center on Poverty Law commends the Governor, the Department of Insurance, and the General Assembly for passing this consumer-focused laws making health care more transparent and protecting Illinois consumers from high and unexpected medical costs,” said Stephani Becker, Associate Director of Healthcare Justice of the Shriver Center on Poverty Law. “The Shriver Center supports the Department of Insurance of their commitment to check whether premiums are misaligned across different tiers of coverage within the state’s medical health insurance marketplace. The findings of this study will make medical health insurance cheaper for low- to middle-income Illinois residents and have a big impact on over 300,000 Illinoisans who obtain coverage through the Marketplace.”


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