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  4. Illinois Senate Passes Network Adequacy Bill, House Action Pending

On April 11, the Illinois State Senate, by an overwhelming majority, passed health plan network adequacy legislation, advocated by a multi-specialty coalition of medical societies, including the Illinois Society of Pathologists (ISP) and the CAP. The bill was opposed by the Illinois health insurance industry. The legislation now moves to the Illinois House for consideration. The legislation requires health plans to submit to the Illinois Department of Insurance information demonstrating that they have contracted with hospital-based physician specialists, including pathologists, radiologists, anesthesiologists, and emergency room physicians at in-network hospitals and facilities. The Illinois Department of Insurance currently conducts network adequacy assessments of health plans but does not scrutinize health plans for provision of in-network pathology/laboratory services, or for other on-site physician specialty services at hospitals and in-network facilities. The ISP, with the assistance of CAP, submitted a memorandum and provided testimony detailing support for the legislation.

On April 11, the Illinois State Senate, by an overwhelming majority, passed health plan network adequacy legislation, advocated by a multi-specialty coalition of medical societies, including the Illinois Society of Pathologists (ISP) and the CAP. The bill was opposed by the Illinois health insurance industry. The legislation now moves to the Illinois House for consideration.

The legislation requires health plans to submit to the Illinois Department of Insurance information demonstrating that they have contracted with hospital-based physician specialists, including pathologists, radiologists, anesthesiologists, and emergency room physicians at in-network hospitals and facilities. The Illinois Department of Insurance currently conducts network adequacy assessments of health plans but does not scrutinize health plans for provision of in-network pathology/laboratory services, or for other on-site physician specialty services at hospitals and in-network facilities.

The ISP, with the assistance of CAP, submitted a memorandum and provided testimony detailing support for the legislation.

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