Defined terms related to dental preauthorization, and requires a dental carrier to not automatically enroll provider in leased network without giving them an opt-out option.
Notification does not require certified notification, gives additional notification choices.
Bill provisions provide guidance re denial of claims after initial preauthorizations.
Dental carrier will not deny any claim subsequently submitted for procedures specifically included in a prior authorization except if denied under certain instances.
A dental carrier also cannot recoup a claim solely due to loss of coverage of a patient or ineligibility, if the dental carrier has erroneously confirmed coverage and eligibility.
Legislative History
On Feb. 6, 2024, bill introduced in House; on May 25, 2024, bill was passed in House.
On Apr. 17, 2024, bill delivered to Senate; on May 16, 2024, bill was passed in Senate.
On May 25, 2024, House concurred with amendments; bill passed both chambers.
Effectiveness
If approved, bill becomes effective as of Jan. 1, 2025.
Aug. 2024 ILL LEG Governor Approval
On Aug. 9, 2024, ILL LEG reported governor signed bill into law, assigned PA 103-0832
