Legislation to Create Network Adequacy and Transparency Act Sails through House

Lawmakers in Springfield today approved landmark legislation that will improve adequacy and transparency of health insurance coverage for all Illinoisans.

According the State Representative Chad Hays (R-Catlin), who serves as a Chief Co-Sponsor of HB 311, the bill offers significant protections and remedies to the serious problems that are caused by the increasing use of narrow preferred provider networks in Illinois. “As a legislator from the central part of the state, I can tell you that the health insurance issues we face here are very real,” said Hays. “I hear all too often from constituents who believe they are scheduling appointments with ‘in-network’ physicians and specialists, only to learn when they arrive at an appointment that the professional is no longer on their insurance plan. In central Illinois it is not unusual for patients to drive an hour or longer to an appointment, and the provisions in HB 311 will go far in establishing new standards to protect consumers in these instances.”

Specifically, HB 311 seeks to protect Illinois patients in the following ways:
  • Insurance companies will have to make sure their networks meet patients’ needs. That means insurance plan networks must have enough doctors, including specialists, in close proximity to where their polcyholders live.
  • It will bring transparency. Patients will know which doctors are in-network. If a doctor is dropped from the network, the insurance company will have to notify patients in a timely fashion and offer an option for patients to switch plans to stay with a preferred doctor.
  • Patient care will not be disrupted due to changes in health insurance networks. A patient’s doctor may be dropped from the network, but pregnant women or anyone with certain complex conditions will be able to stay with their doctor long enough to make a smooth transition – without getting charged extra.
“This bill does a lot to protect the doctor-patient relationship, which is, in my opinion, one of the most sacred relationships that exists between a consumer and a professional,” Hays said. “I was pleased to see wide, bipartisan support on this bill, because we need to put a stop to situations where patients are forced to make abrupt changes in the doctors and specialists they see.”

The bill will now move to the Senate for consideration.

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