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<title>Illinois General Assembly - Bill Status for HB 5313         </title>
<shortdesc>INS-NETWORK ADEQUACY-DIRECTORY</shortdesc>
<sponsor>
<sponsorhead1>House Sponsors</sponsorhead1><sponsors>Rep. Margaret Croke-Lindsey LaPointe-Maurice A. West, II-William E Hauter-Camille Y. Lilly, Bob Morgan, Terra Costa Howard, Gregg Johnson, Kelly M. Cassidy, Daniel Didech, Ann M. Williams, Sue Scherer, Emanuel "Chris" Welch, Dagmara Avelar, Yolonda Morris, Jaime M. Andrade, Jr. and Stephanie A. Kifowit</sponsors>
<sponsorhead2>Senate Sponsors</sponsorhead2><altsponsors>(Sen. Cristina Castro, Christopher Belt and Lakesia Collins)</altsponsors>
</sponsor>
<lastaction>
<statusdate>1/7/2025</statusdate><chamber>House</chamber><action>Session Sine Die</action>
</lastaction>
<synopsis>
<synopsistitle></synopsistitle>
<reference>215 ILCS 124/25</reference><aliasreference></aliasreference><reference>215 ILCS 124/35 new</reference><aliasreference></aliasreference><SynopsisText>     Amends the Network Adequacy and Transparency Act. Provides that a network plan shall, at least annually, audit (instead of audit periodically) at least 25% of its provider directories for accuracy, make any corrections necessary, and retain documentation of the audit. Provides that the network plan shall submit the audit to the Department of Insurance (instead of to the Director of Insurance upon request). Provides that the Department shall make the audit publicly available. Provides that a network plan shall include in the print format provider directory (i) a detailed description of the process to dispute charges for out-of-network providers or facilities that were incorrectly listed as in-network prior to the provision of care and (ii) a telephone number and email address to dispute those charges. Makes changes to the information that must be provided in a network plan's electronic and print directory. Requires the Director to conduct random audits of the accuracy of provider directories for at least 10% of plans each year. Provides that a consumer who incurs a cost for inappropriate out-of-network charges for a provider, facility, or hospital that was listed as in-network prior to the provision of services may file a verified complaint with the Department, and the Department shall conduct an investigation of the verified complaint and determine whether the complaint is sufficient. Provides that, upon a finding of sufficiency, the Director shall have the authority to levy a fine for not less than the cost incurred by the consumer for inappropriate out-of-network charges for a provider, facility, or hospital that was listed in-network. Provides that the fines collected by the Director shall be remitted to the consumer.</SynopsisText></synopsis>
<actions>
<statusdate>2/9/2024</statusdate><chamber>House</chamber><action>Filed with the Clerk by Rep. Margaret Croke</action>
<statusdate>2/9/2024</statusdate><chamber>House</chamber><action>First Reading</action>
<statusdate>2/9/2024</statusdate><chamber>House</chamber><action>Referred to Rules Committee</action>
<statusdate>2/21/2024</statusdate><chamber>House</chamber><action>Added Chief Co-Sponsor Rep. Lindsey LaPointe</action>
<statusdate>2/26/2024</statusdate><chamber>House</chamber><action>Added Chief Co-Sponsor Rep. Maurice A. West, II</action>
<statusdate>2/28/2024</statusdate><chamber>House</chamber><action>Assigned to Mental Health &amp; Addiction Committee</action>
<statusdate>3/13/2024</statusdate><chamber>House</chamber><action>House Committee Amendment No. 1 Filed with Clerk by Rep. Margaret Croke</action>
<statusdate>3/13/2024</statusdate><chamber>House</chamber><action>House Committee Amendment No. 1 Referred to Rules Committee</action>
<statusdate>3/13/2024</statusdate><chamber>House</chamber><action>Added Co-Sponsor Rep. Bob Morgan</action>
<statusdate>3/14/2024</statusdate><chamber>House</chamber><action>Added Co-Sponsor Rep. Terra Costa Howard</action>
<statusdate>3/14/2024</statusdate><chamber>House</chamber><action>Do Pass / Short Debate Mental Health &amp; Addiction Committee;  021-000-000</action>
<statusdate>3/14/2024</statusdate><chamber>House</chamber><action>House Committee Amendment No. 1 Tabled</action>
<statusdate>3/14/2024</statusdate><chamber>House</chamber><action>Placed on Calendar 2nd Reading - Short Debate</action>
<statusdate>3/14/2024</statusdate><chamber>House</chamber><action>Added Co-Sponsor Rep. Gregg Johnson</action>
<statusdate>3/20/2024</statusdate><chamber>House</chamber><action>Added Co-Sponsor Rep. Kelly M. Cassidy</action>
<statusdate>3/21/2024</statusdate><chamber>House</chamber><action>Added Chief Co-Sponsor Rep. William E Hauter</action>
<statusdate>3/21/2024</statusdate><chamber>House</chamber><action>Added Co-Sponsor Rep. Daniel Didech</action>
<statusdate>3/21/2024</statusdate><chamber>House</chamber><action>Added Co-Sponsor Rep. Ann M. Williams</action>
<statusdate>3/22/2024</statusdate><chamber>House</chamber><action>Added Co-Sponsor Rep. Camille Y. Lilly</action>
<statusdate>3/22/2024</statusdate><chamber>House</chamber><action>Removed Co-Sponsor Rep. Camille Y. Lilly</action>
<statusdate>4/1/2024</statusdate><chamber>House</chamber><action>Added Co-Sponsor Rep. Sue Scherer</action>
<statusdate>4/1/2024</statusdate><chamber>House</chamber><action>Added Co-Sponsor Rep. Emanuel "Chris" Welch</action>
<statusdate>4/12/2024</statusdate><chamber>House</chamber><action>House Floor Amendment No. 2 Filed with Clerk by Rep. Margaret Croke</action>
<statusdate>4/12/2024</statusdate><chamber>House</chamber><action>House Floor Amendment No. 2 Referred to Rules Committee</action>
<statusdate>4/12/2024</statusdate><chamber>House</chamber><action>Second Reading - Short Debate</action>
<statusdate>4/12/2024</statusdate><chamber>House</chamber><action>Placed on Calendar Order of 3rd Reading - Short Debate</action>
<statusdate>4/15/2024</statusdate><chamber>House</chamber><action>House Floor Amendment No. 2 Rules Refers to Mental Health &amp; Addiction Committee</action>
<statusdate>4/17/2024</statusdate><chamber>House</chamber><action>House Floor Amendment No. 2 Motion Filed to Table Rep. Margaret Croke</action>
<statusdate>4/17/2024</statusdate><chamber>House</chamber><action>Third Reading - Short Debate - Passed 107-005-000</action>
<statusdate>4/17/2024</statusdate><chamber>House</chamber><action>House Floor Amendment No. 2 Tabled</action>
<statusdate>4/17/2024</statusdate><chamber>House</chamber><action>Added Co-Sponsor Rep. Dagmara Avelar</action>
<statusdate>4/17/2024</statusdate><chamber>House</chamber><action>Added Co-Sponsor Rep. Yolonda Morris</action>
<statusdate>4/17/2024</statusdate><chamber>House</chamber><action>Added Co-Sponsor Rep. Jaime M. Andrade, Jr.</action>
<statusdate>4/17/2024</statusdate><chamber>House</chamber><action>Added Co-Sponsor Rep. Stephanie A. Kifowit</action>
<statusdate>4/17/2024</statusdate><chamber>House</chamber><action>Added Chief Co-Sponsor Rep. Camille Y. Lilly</action>
<statusdate>4/17/2024</statusdate><chamber>House</chamber><action>Chief Co-Sponsor Changed to Rep. Camille Y. Lilly</action>
<statusdate>4/18/2024</statusdate><chamber>Senate</chamber><action>Arrive in Senate</action>
<statusdate>4/18/2024</statusdate><chamber>Senate</chamber><action>Placed on Calendar Order of First Reading</action>
<statusdate>4/18/2024</statusdate><chamber>Senate</chamber><action>Chief Senate Sponsor Sen. Cristina Castro</action>
<statusdate>4/18/2024</statusdate><chamber>Senate</chamber><action>First Reading</action>
<statusdate>4/18/2024</statusdate><chamber>Senate</chamber><action>Referred to Assignments</action>
<statusdate>4/24/2024</statusdate><chamber>Senate</chamber><action>Assigned to Insurance</action>
<statusdate>4/30/2024</statusdate><chamber>Senate</chamber><action>Postponed - Insurance</action>
<statusdate>4/30/2024</statusdate><chamber>Senate</chamber><action>Rule 2-10 Committee Deadline Established As May 10, 2024</action>
<statusdate>5/10/2024</statusdate><chamber>Senate</chamber><action>Rule 2-10 Committee Deadline Established As May 17, 2024</action>
<statusdate>5/14/2024</statusdate><chamber>Senate</chamber><action>Added as Alternate Co-Sponsor Sen. Christopher Belt</action>
<statusdate>5/16/2024</statusdate><chamber>Senate</chamber><action>Added as Alternate Co-Sponsor Sen. Lakesia Collins</action>
<statusdate>5/17/2024</statusdate><chamber>Senate</chamber><action>Rule 3-9(a) / Re-referred to Assignments</action>
<statusdate>1/7/2025</statusdate><chamber>House</chamber><action>Session Sine Die</action>
</actions>
</xml>

