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General Assembly Passes Bill to Protect Patients Who Purchase Health Insurance
Posted on: 7/5/2017

Illinois lawmakers cleared ISMS' top legislative priority: the Network Adequacy and Transparency Act (NAT Act)! The measure ( House Bill 311) will now be transmitted to Governor Bruce Rauner for signature.


This monumental endeavor began well over a year ago when ISMS heard from many of you who were concerned about health insurer network changes that were negatively affecting the physician-patient relationship. Commercial health insurers were increasingly on a trajectory of "downsizing" patient options by establishing narrow networks.

Late last month, Illinois lawmakers agreed with ISMS-backed legislation House Bill 311 to defend patients' rights. Patients must not have their care disrupted by being forced to abruptly switch doctors. Or receive a significantly higher bill because the care they received is no longer in-network. The NAT Act ensures this through several provisions

A BIG thanks to all ISMS members who helped to advocate for this important legislation!

Read News Release

House Bill 311 highlights:

1.     Insurance companies will have to make sure their networks meet patients' needs – that means enough health facilities and doctors, including specialists, in close proximity to where their policyholders live.

2.     Health plans must be more transparent; provider directories must be kept up-to-date. If a doctor or hospital is dropped from a network, the insurance company will have to notify patients in a timely fashion to help the patient avoid surprise out-of-network charges. Doctors will also have new notification requirements if they choose to leave a network.

3.     No disruption in patient care. If a patient's doctor is dropped from the network and the patient is pregnant or has a complex medical condition, that patient will be able to stay with his or her same doctor long enough to make a smooth transition – without getting charged extra.

ISMS will keep you informed of any developments concerning this legislation as we await the governor's action. 

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