(Chicago, IL) — January 5, 2010. Governor Pat Quinn yesterday signed legislation that ensures that all Illinois residents denied health insurance claims can soon be reviewed by a qualified, independent doctor.
“This new law guarantees the right to an independent review of denied claims for everyone with health insurance in Illinois,” said Quinn.
Under current law, only consumers who are enrolled in a Health Maintenance Organization (HMO) have the right to an independent, external review when claims are denied. However, millions of Illinois residents, with other types of health insurance coverage, lack this right.
The new law, sponsored by State Rep. Greg Harris (D-Chicago) and State Senator Heather Steans (D-Chicago), will allow Illinois residents to submit their health insurance claim for an external review after it is denied by their insurer. The review must be completed within 20 business days. In certain urgent cases the review must be completed within 72 to 120 hours.
Also under the new law, insurance providers that cover small businesses must accept a standard insurance application by January 1, 2011. This new requirement means small businesses can avoid long and often complex applications that differ from one insurer to another.
The standard application will be developed by a committee of consumers, small business owners, insurance agents and insurance company representatives. The committee will work with the Illinois Department of Insurance.
Additionally, House Bill 3923 requires health insurers operating in Illinois to provide the state with how much they receive in premiums and how much of those premiums are spent on paying claims and healthcare costs versus covering administration costs. The Department of Insurance will post this information online.
“This new law represents the most important insurance reform in the last decade and gives Illinois consumers essential protections to assure that care is provided,” said Michael McRaith, Director of the Department of Insurance.
The importance of this law new can not be underestimated. Insurers are now on notice.
Harris and Steans deserve the lion’s share of the credit for the successful effort to move this bill through the legislature and put it on Quinn’s desk. Moving insurance bills require Herculean skill and patience in equal measure. Most land in the rabbit hole. This one didn’t.
Harris and Steans are responsible–in spades—for its success.
Job well done.