Public Act 92-0770
HB4220 Enrolled LRB9211444JSpcA
AN ACT concerning insurance.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Managed Care Reform and Patient Rights
Act is amended by changing Section 30 as follows:
(215 ILCS 134/30)
Sec. 30. Prohibitions.
(a) No health care plan or its subcontractors may
prohibit or discourage health care providers by contract or
policy from discussing any health care services and health
care providers, utilization review and quality assurance
policies, terms and conditions of plans and plan policy with
enrollees, prospective enrollees, providers, or the public.
(b) No health care plan by contract, written policy, or
procedure may permit or allow an individual or entity to
dispense a different drug in place of the drug or brand of
drug ordered or prescribed without the express permission of
the person ordering or prescribing the drug, except as
provided under Section 3.14 of the Illinois Food, Drug and
(c) No health care plan or its subcontractors may by
contract, written policy, procedure, or otherwise mandate or
require an enrollee to substitute his or her participating
primary care physician under the plan during inpatient
hospitalization without the agreement of that enrollee's
participating primary care physician. "Participating primary
care physician" for health care plans and subcontractors that
do not require coordination of care by a primary care
physician means the participating physician treating the
patient. All health care plans shall inform enrollees of any
policies, recommendations, or guidelines concerning the
substitution of the enrollee's primary care physician when
hospitalization is necessary in the manner set forth in
subsections (d) and (e) of Section 15.
(c)Any violation of this Section shall be subject
to the penalties under this Act.
(Source: P.A. 91-617, eff. 1-1-00.)
Passed in the General Assembly May 29, 2002.
Approved August 06, 2002.