holmes 041124SPRINGFIELD – State Senator Linda Holmes—a leader with a successful track record of passing pro-consumer health care legislation—advanced a measure through the Senate Wednesday that would require insurers to document whether they have enough physicians and specialists to diagnose and treat their patients.

“When people go to the doctor, they expect they’ll get the care and urgency their condition calls for, but they often have to wait weeks or months for a diagnosis and treatment when they live in smaller communities,” said Holmes (D-Aurora). “They might suffer needless anxiety or fear waiting on help, simply because the network is understaffed.”

 

Network adequacy means insurers have enough specialists in key roles practicing at the in-network facility to ensure plan members have reasonable and timely access to care. Illinoisans are more likely to find staffing shortages in rural areas that lack the number of specialists typically found in city health care networks.

 

Under Holmes’ bill, insurers would be required to provide the Department of Insurance with documentation on whether each of their in-network hospitals and facilities have a sufficient number of these specialists.

“Families are in a dreadful waiting game; they need diagnostic results to identify what stage a disease is in, but waiting for a diagnosis can delay treatment decisions,” Holmes said. “Health insurance consumers rightfully expect their insurers’ coverage to be what they signed up and paid for.”

SB 2641 passed the Senate Thursday, and moves to the House for their consideration.