Commercial Health Insurance/Managed CareManaged Care is one form of commercial health insurance in Illinois. The growth of managed care highlights the previous response of business to increasing health care costs. Although forms of managed care have existed for many years, the decade of the '90s demonstrated a dramatic increase in the number of lives covered by managed care organizations. Managed care is multi-faceted. In reality, different forms of managed care exist along a continuum ranging from tightly managed plans such as Health Maintenance Organizations (HMOs) to more loosely managed plans such as Preferred Provider Organizations (PPOs). In fact, some traditional fee-for-service plans have adopted aspects of managed care to review expenditures. Most recently, consumer driven health plans marketed from an indemnity platform have become the product of choice. Managed Care was originally a private payor phenomenon but it has expanded into the public sector in both the Medicare and Medicaid programs. State laws govern non-ERISA plans and federal laws govern ERISA plan administration.While State laws related to commercial health insurance may not cover all enrollees within Illinois, legislation still carries significant impact. You will find relevant information below regarding state laws and other issues regarding commercial health insurance. 2010 IWCC Medical Fees Will Go Down 1.48% Workers' Compensation Inpatient Fee Schedules FINAL Workers' Comp Outpatient/ASTC/Rehab Fee Schedules - Approved by State - To Be Implemented February 1, 2009 2009 Workers' Comp Inpatient Medical Fees Posted Workers' Compensation Outpatient/ASTC/Rehab Fee Schedules - Final Rules for JCAR Approval and February 1, 2009 Implementation Upcoming Behavioral Health Insurance Changes Workers' Compensation Update (password required) Summary of Workers' Comp Fee Schedules IHA Analysis of Lewin Group Report on Medicaid Managed Care (password required) Workers' Compensation Reform Insurance & Reimbursement Task Force Commercial Health Insurance and Managed Care Issues
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