Prior Authorization Reform Act

Sections covered

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