Part 3: Increasing Health Insurer Accountability
ISMS members: Free
Non-ISMS members: $75.00
This three-part series focused on holding Illinois health insurers accountable for compliance with two state laws aimed at promoting fairness for patients and physicians. ISMS advocacy was instrumental in the passage of both laws. This program will discuss the formal complaint processes available to physicians who identify legal or regulatory violations by health insurance plans, including:
At the conclusion of this activity, learners will be able to:
- When and why to file a complaint
- Determining which state agency is responsible for addressing complaints
- Basics and timelines of the complaint submission, investigation and resolution process
ISMS members and their staffs
The recommendations contained in this resource are not intended to define conduct that is appropriate in every case, should not be considered as establishing any standard of care, and do not constitute legal advice. Physicians, clinicians and healthcare providers should take care to ensure that all care rendered reflects the best clinical judgment and complies with the laws and regulations of the state or location at which the care was provided.
Lila Valinoti is the Assistant Vice President of Health Policy Research and Education at the Illinois State Medical Society (ISMS) and has over 25 years’ experience in health policy development and helping physicians understand how legislative and regulatory changes may affect their practices.