Part 4520 - MANAGED CARE REFORM & PATIENT RIGHTS

  1. § 4520.10 - Purpose
  2. § 4520.20 - Applicability and Scope
  3. § 4520.30 - Definitions
  4. § 4520.40 - Provision of Information
  5. § 4520.50 - Notice of Nonrenewal or Termination
  6. § 4520.60 - Transition of Services
  7. § 4520.70 - Health Care Services, Appeals, Complaints and External Independent Reviews
  8. § 4520.80 - Joint Resolution of Complaints - Department of Insurance and Department of Public Health - Notification and Resolution Process
  9. § 4520.90 - Record of Complaints
  10. § 4520.100 - Access and Quality of Care from Providers Without Primary Care Physician Referral or Authorization
  11. § 4520.110 - Emergency Services
  12. § 4520.120 - Post Stabilization Services
  13. § 4520.130 - Registration of Utilization Review Organizations
  14. § 4520.140 - Operational Requirements
  15. Exhibit A - Complaint Record and Column Descriptions, version 28
  16. Exhibit B - Application for Registration of a Utilization Review Organization, version 14
  17. Exhibit C - Utilization Review Organization Officers and Directors Biographical Affidavit (Repealed), version 9
  18. Exhibit D - NAIC Utilization Review Organization Officers and Directors Biographical Affidavit (Repealed), version 6

Current through Register Vol. 46, No. 15, April 8, 2022

Notes

Adopted at 24 ill. reg. 3374, effective february 10, 2000; amended at 24 ill. reg. 9429, effective july 1, 2000; transferred from the department of insurance to the department of financial and professional regulation pursuant to executive order 2004-6 on july 1, 2004; amended at 28 ill. reg. 13711, effective september 28, 2004; amended at 30 ill. reg. 6368, effective march 29, 2006; amended at 34 ill. reg. 6879, effective april 29, 2010; amended at 38 ill. reg. 2253, effective january 2, 2014; amended at 38 ill. reg. 23431, effective november 25, 2014; transferred from the department of financial and professional regulation to the department of insurance pursuant to executive order 2009-4 Recodified from 50 Ill. Adm. Code 5420 to 50 Ill. Adm. Code 4520 at 41 Ill. Reg. 4982. Amended at 42 Ill. Reg. 20417, effective 11/1/2018. Amended at 43 Ill. Reg. 11479, effective 9/24/2019.

AUTHORITY: Implementing the Managed Care Reform and Patient Rights Act [215 ILCS 134] and authorized by Section 401 of the Illinois Insurance Code [215 ILCS 5/401], 42 USC 300gg-22, and 45 CFR 150.101(b)(2) and 150.201.

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