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215 ILCS 200/ – An Act concerning regulation. | Midpage
Collections
Illinois Compiled Statutes
Regulation
Chapter 215
200
215 ILCS 200/
An Act concerning regulation.
1
Short title
10
Applicability; scope
15
Definitions
20
Disclosure and review of prior authorization requirements
25
Health insurance issuer's and its contracted utilization review organization's obligations with respect to prior authorizations in nonurgent circumstances
30
Health insurance issuer's and its contracted utilization review organization's obligations with respect to prior authorizations concerning urgent health care services
35
Personnel qualified to make adverse determinations of a prior authorization request
40
Requirements for adverse determination
45
Requirements applicable to the personnel who can review appeals
5
Purpose
50
Review of prior authorization requirements
55
Denial or penalty
60
Length of prior authorization approval
65
Length of prior authorization approval for treatment for chronic or long-term conditions
70
Continuity of care for enrollees
75
Health care services deemed authorized if a health insurance issuer or its contracted utilization review organization fails to comply with the requirements of this Act
77
Prior authorization for drug therapies for hereditary bleeding disorders
80
Severability
85
Administration and enforcement
900
215 Ilcs 200/900
905
215 Ilcs 200/905
910
215 Ilcs 200/910
999
Effective date