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.
A Big Win! New Rules for IL Health Insurance Companies
Gov. Rauner signs ISMS-initiated bill that makes insurance plans more
transparent and health care more accessible.
Chicago, IL – 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.
ISMS thanks the Illinois Health and Hospital Association and following organizations for supporting the NAT Act:
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
Bleeding Disorders Alliance of Illinois
Chicago Hispanic Health Coalition
Community Behavioral Healthcare Association of 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
National Eczema Association
National Multiple Sclerosis Society
National Organization for Rare Disorders National Psoriasis Foundation
Pediatric AIDS Foundation of Chicago
U.S. Pain Foundation