Legislative Update

****LEGISLATIVE UPDATE ****

SB904: PROVIDING MEDICAL PROVIDERS A PRIVATE CAUSE OF ACTION FOR SECTION 8.2 INTEREST

By: Adam J. Cox

 

            Following the Senate’s override by a vote of 55-1-1 on November 14, 2018, the Illinois House followed suit, overriding the Governor’s amendatory veto of SB 904 on November 27, 2018.  Since the overrides overwhelmingly met the requisite majority, SB 904 is now law.  Below is a link to the full bill history and the bill itself.

http://ilga.gov/legislation/billstatus.asp?DocNum=904&GAID=14&GA=100&DocTypeID=SB&LegID=103034&SessionID=91#actions

            The changes to the current law are as follows:

·         Authorizes medical providers to bring an action in circuit court against the employer to seek payment of 1% per month statutory interest, for unpaid charges outstanding longer than 30 days. The employee is not responsible for payment of the interest

·         Establishes new regulations concerning submission of electronic claims, including the imposition of penalties on employers and insurers that fail to accept electronic submission of medical bills.

·         Requires medical providers to directly bill an employer or its designee.

·         Requires that the employer or the insurer who denies charges to provide an explanation of benefits to the billing medical provider.

·         Requires the Director of Insurance to create rules for medical providers to respond to medical records requests by employers and insurers.

The situation is not exactly settled. There are two pending items in the legislature (amendment to HB 200 and HB 3452), which address some of the laws recently enacted in SB 904.  Stay tuned for further updates.  Feel free to contact me with any questions.

 

Special thanks to Jay Shattuck and my Associate, Joseph Gregorio, for their information and contributions to this article.

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