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STATE GOVERNMENT

Lawmakers push insurance bill following Blue Cross, Springfield Clinic dispute

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SPRINGFIELD — An Illinois House committee is moving forward a bill that would crack down on insurance companies’ network adequacy requirements, following an emotional plea from state Rep. Sue Scherer during a hearing last week. 

House Bill 1463 passed out of the House State Government Administration Committee on Monday amid the ongoing dispute involving Blue Cross and Blue Shield of Illinois and Springfield Clinic. 

The bill was drafted by Scherer, D-Decatur, and state Sen. Doris Turner, D-Springfield, along with the Department of Insurance. 

“For my constituents, I have people with cancer who are dying. I have pregnant women who don't have doctors. And if everything was all OK, as the opposition has said, my patients wouldn't be without doctors,” Scherer said. 

Sue Scherer

Scherer

The Department of Insurance last month fined the parent company of Blue Cross Blue Shield of Illinois $339,000, finding that it violated state law when it did not properly file updated network adequacy filings following the termination of its contract with Springfield Clinic. 

Although Scherer and other proponents argued the bill isn’t targeted directly at Blue Cross, it does address reported concerns of long wait times and difficulty finding new in-network providers for former Springfield Clinic patients with Blue Cross coverage.  

The bill would allow the Department of Insurance to establish provider wait times and, in the case of excessive wait times, require insurers to cover the costs for patients to see out-of-network providers at in-network rate, among other provisions.  

Lawmakers have four more days to pass the bill in both chambers before session adjourns Friday.  

The bill, as written, would go into effect immediately after being signed into law. 

Proponents argued it would mostly codify protocol the Department of Insurance already follows, but opponents said it could introduce sweeping changes to the insurance industry and potentially increase insurance costs for some.  

“Bills like this, where we have not had the opportunity to share the impact or negotiate how we could reduce the impact, will only increase the cost to your small businesses and to your families when they're trying to have insurance coverage,” said Lori Reimers, a lobbyist for America’s Health Insurance Plans. 

But Scherer said some local patients need support now. 

“I know I sound like a broken record, but things are not working the way they are. People are paying premiums and don't have doctors. That means the system's broken and needs to be fixed,” she said. 

Following the committee’s vote, the bill will move to the House for second reading on Monday afternoon.  

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