INSURANCE-REVIEW PROCEDURES House SponsorsRep. Mary E. Flowers-LaShawn K. Ford-Karen May-Lisa M. Dugan, Greg Harris, Kevin A. McCarthy, Fred Crespo, Esther Golar, Michael Tryon, Monique D. Davis and Al Riley Senate Sponsors(Sen. Jacqueline Y. Collins-Debbie DeFrancesco Halvorson-Iris Y. Martinez) 1/13/2009HouseSession Sine Die 5 ILCS 375/6.1155 ILCS 5/5-1069.365 ILCS 5/10-4-2.3105 ILCS 5/10-22.3f215 ILCS 5/356f.1 new215 ILCS 125/5-3from Ch. 111 1/2, par. 1411.2215 ILCS 130/4003from Ch. 73, par. 1504-3215 ILCS 165/10from Ch. 32, par. 604 Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Illinois Insurance Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, and the Voluntary Health Services Plans Act. Provides that a policy of accident or health insurance or managed care plan shall establish and maintain an appeals procedure related to the denial of health care benefits. Sets forth guidelines for maintaining an appeals procedure, including an expedited process for an enrollee with an ongoing course of treatment ordered by a health care provider, the denial of which could significantly increase the risk to an enrollee's health, or a treatment referral, service, procedure, or other health care service, the denial of which could significantly increase the risk to an enrollee's health. Provides that if an initial appeal is denied by the policy or plan, an enrollee is entitled to seek external independent review of the decision made by the policy or plan. Sets forth guidelines and requirements for the external independent review process. Provides that nothing in the provision shall be construed to require a policy or plan to pay for a health care service not covered under the enrollee's certificate of coverage or policy. Provides that the Office of Consumer Health Insurance of the Division of Insurance of the Department of Financial and Professional Regulation shall adopt rules for the enforcement of the provision. Makes other changes.House Amendment No. 1 Provides that there is no rulemaking authority under the amendatory Act, but that the Governor may suggest rules by filing them with the General Assembly and requesting that the General Assembly authorize such rulemaking by law, enact the suggested rules into law, or take other appropriate action in the General Assembly's discretion. 1/3/2008HouseFiled with the Clerk by Rep. Mary E. Flowers 1/4/2008HouseAdded Chief Co-Sponsor Rep. LaShawn K. Ford 1/4/2008HouseAdded Chief Co-Sponsor Rep. Karen May 1/7/2008HouseFirst Reading 1/7/2008HouseReferred to Rules Committee 2/13/2008HouseAssigned to Health Care Availability and Access Committee 2/20/2008HouseHouse Amendment No. 1 Filed with Clerk by Health Care Availability and Access Committee 2/20/2008HouseHouse Amendment No. 1 Adopted in Health Care Availability and Access Committee; by Voice Vote 2/20/2008HouseDo Pass as Amended / Short Debate Health Care Availability and Access Committee; 013-000-000 2/21/2008HousePlaced on Calendar 2nd Reading - Short Debate 2/25/2008HouseAdded Chief Co-Sponsor Rep. Lisa M. Dugan 2/25/2008HouseAdded Co-Sponsor Rep. Greg Harris 2/27/2008HouseAdded Co-Sponsor Rep. Kevin A. McCarthy 3/4/2008HouseHouse Amendment No. 2 Filed with Clerk by Rep. Mary E. Flowers 3/4/2008HouseHouse Amendment No. 2 Referred to Rules Committee 3/11/2008HouseHouse Amendment No. 2 Recommends Be Adopted Rules Committee; 004-000-000 3/13/2008HouseAdded Co-Sponsor Rep. Fred Crespo 3/13/2008HouseAdded Co-Sponsor Rep. Esther Golar 3/13/2008HouseAdded Co-Sponsor Rep. Michael Tryon 3/26/2008HouseHouse Amendment No. 3 Filed with Clerk by Rep. Mary E. Flowers 3/26/2008HouseHouse Amendment No. 3 Referred to Rules Committee 4/1/2008HouseHouse Amendment No. 3 Rules Refers to Health Care Availability and Access Committee 4/1/2008HouseHouse Amendment No. 3 Recommends Be Adopted Health Care Availability and Access Committee; 008-003-000 4/3/2008HouseSecond Reading - Short Debate 4/3/2008HouseHouse Amendment No. 2 Withdrawn by Rep. Mary E. Flowers 4/3/2008HouseHouse Amendment No. 3 Withdrawn by Rep. Mary E. Flowers 4/3/2008HousePlaced on Calendar Order of 3rd Reading - Short Debate 4/9/2008HouseAdded Co-Sponsor Rep. Monique D. Davis 4/9/2008HouseAdded Co-Sponsor Rep. Al Riley 4/9/2008HouseThird Reading - Short Debate - Passed 115-000-000 4/10/2008SenateArrive in Senate 4/10/2008SenatePlaced on Calendar Order of First Reading April 15, 2008 4/11/2008SenateChief Senate Sponsor Sen. Jacqueline Y. Collins 4/15/2008SenateAdded as Alternate Chief Co-Sponsor Sen. Debbie DeFrancesco Halvorson 4/16/2008SenateFirst Reading 4/16/2008SenateReferred to Rules 4/16/2008SenateAdded as Alternate Chief Co-Sponsor Sen. Iris Y. Martinez 5/15/2008SenateRule 2-10 Committee Deadline Established As May 22, 2008; Substantive House Bills Out of Committee 1/13/2009HouseSession Sine Die