A Big Win! New Rules for IL Health Insurance Companies

CHICAGO, Sept. 18 -- The Illinois State Medical Society issued the following news release:

Late Friday, Governor Bruce Rauner signed the Network Adequacy and Transparency Act - the NAT Act - ensuring important protections for Illinois patients who have struggled with the "narrowing" of physician networks in Illinois.

The NAT Act, initiated by the Illinois State Medical Society, creates important new protections for patients who purchase state-regulated private health plans. Increasingly, health insurers have been cost cutting by offering plans with extremely limited numbers of in-network physicians and hospitals. The rise of these "narrow network" plans has resulted in a dramatic reduction in access to health care in our state.

Here are the new protections now guaranteed in the law:

* Insurance companies must ensure their networks meet patients' needs. That means insurance plan networks must have enough health facilities and doctors, including specialists, in close proximity to where their policyholders live.

* Health plans must be more transparent. Insurers are now obligated to maintain updated provider directories. If a doctor or hospital is dropped from a network, the insurance company must notify patients in a timely fashion to help avoid surprise out-of-network charges. Doctors also face new patient notification requirements if they choose to leave a network.

* Patient care must not be disrupted due to changes in health insurance networks. A patient's doctor may be dropped from the network, but pregnant women and patients with complex conditions will be able to stay with their doctors long enough to make a smooth transition - without getting charged extra.

"The members of the Illinois State Medical Society are grateful to Gov. Rauner and the Illinois General Assembly for standing up for our patients," said ISMS President Nestor A. Ramirez, MD, MPH. "The NAT Act ensures Illinois patients have the information they need to make the right choice about the health insurance they're purchasing, and the relief of knowing they'll receive the coverage they're paying for."

Dr. Ramirez credited the bipartisan leadership of Representative Gregory Harris (D-Chicago), Representative Chad Hays (R-Catlin), Senator Linda Holmes (D-Aurora) and State Senator Sue Rezin (R-Morris) for sponsoring the legislation, then known as H.B. 311.

* AARP

* AIDS Foundation of Chicago

* American Academy of Dermatology Association

* American Diabetes Association

* American Society for Dermatologic Surgery Association

* American Cancer Society-Cancer Action Network

* American College of Obstetricians & Gynecologists

* Arthritis Foundation

* Bleeding Disorders Alliance of Illinois

* Chicago Hispanic Health Coalition

* Community Behavioral Healthcare Association of Illinois

* Cure Illinois

* Depression and Bipolar Support Alliance

* Epilepsy Foundation of Greater Chicago

* Equip for Equality

* Illinois Academy of Family Physicians

* Illinois Chiropractic Society

* Illinois College of Emergency Physicians

* Illinois Osteopathic Medical Society

* Illinois Psychiatric Society

* Illinois Psychological Association

* Illinois Public Health Association

* Illinois Society of Anesthesiologists

* International Pain Foundation

* March of Dimes

* Mental Health America of Illinois

* Mental Health Summit

* NAMI Chicago

* National Eczema Association

* National Multiple Sclerosis Society

* National Organization for Rare Disorders

* National Psoriasis Foundation

* Pediatric AIDS Foundation of Chicago

* Thresholds

* U.S. Pain Foundation