September 1, 2010
New Law Guarantees Right to Review of Denied Health Insurance Claims
A NEW Illinois law guarantees your right to an external, independent review of denied health insurance claims.
THE HEALTH Carrier External Review Act (Public Act 96- 857), effective July 1, ensures that insurance company decisions to deny a recommended medical treatment are subject to review by a qualified, independent doctor.
PREVIOUSLY, ONLY Illinois consumers enrolled in a Health Maintenance Organization (HMO) had the right to an external, independent review when a claim was denied. The new law requires all health insurers and HMOs to provide the same opportunities for both internal appeals and external reviews of denied claims, extending this important right to millions of additional Illinois consumers.
“THE HEALTH Carrier External Review Act empowers and protects Illinois families and businesses who, after paying hard-earned premium dollars, are all too often denied needed medical treatment," said Michael T. McRaith, director of the Illinois Department of Insurance. "The act also requires greater transparency on the part of health insurance companies in Illinois, representing a significant early step towards reforming the State's health insurance marketplace."
THE NEW law allows consumers to request an external review within four months of receiving notice that a claim or treatment request was denied by the insurance company or HMO. Each case is reviewed by an unbiased doctor who is an expert in the relevant field and who is assigned by an Independent Review Organization approved by the Illinois Department of Insurance. The external review must be paid for entirely by the health insurance company and must be completed within 20 business days. In urgent cases, the review must be completed within 72 to 120 hours.
ADDITIONAL INFORMATION about the new external review process, including a list of approved Independent Review Organizations, is available on the Department' of Insurance’s website at http://insurance.illinois.gov.
Survey Success
UNDER SPONSORSHIP provided by the Chancellor, the Vice Chancellors, and the Executive Assistant Vice President for Business & Finance, APAC conducted a survey of Academic Professionals to capture matters of interest and concern to AP staff. The survey launched on Monday, July 12, and closed five weeks later on Monday, Aug. 9.
MORE THAN 1,200 employees completed the survey, which is approximately one-third of UIC’s Academic Professional staff. The goal of the survey is to create a reliable pool of information that can be used to inform campus decisionmakers on matters that impact Academic Professional staff. Further, the information will be used by APAC to shape future programs, events, and other related efforts.
RESULTS WILL be rolled out to the campus in the coming months, and APAC will provide additional details as they become available.
Profile: Laura Myers
LAURA MYERS is an Assistant Director in the Office of Career Services. The Office of Career Services provides personalized services that assist UIC students with career planning, among many other things.
HAVING WORKED at the office for nearly three years, Myers said, “I love working directly with students, whether it is during one-on-one career counseling appointments or through presentations and workshops.”
MYERS OFFICIALLY became a member of APAC in April 2010 after attending a few meetings. Like other Academic Professionals, she was looking for a way to become involved on campus. Furthermore, Myers wanted to “have a voice, not just for myself, but for my fellow Academic Professionals.” She currently serves as the Chair of the Building Community & Education Subcommittee.
WHILE NEW to APAC, she is proud to be a part of a committee with such “hard working and dedicated individuals,” she said. Myers noted that APAC has transformed in recent years, and added that it “is amazing that such a small group of people can accomplish such great things.”
THE BUILDING Community & Education Subcommittee has many exciting events planned, including educational events and professional development opportunities for APs. Myers indicated that she would like to see more APs become involved in APAC, whether by attending meetings or becoming involved in the subcommittees.
MYERS ENJOYS spending time with her 14-month-old son, Leo. In her free time, she loves catching a movie at a local theatre and going out to eat, which she said “I never take for granted any more now that I'm a mom.”
--Ivone De Jesus
The Continuing Crisis
Editor’s Note: “The Continuing Crisis” is a section of APAC News which links to news pertinent to the State budget crisis as it affects the University and Academic professionals. These news outlets are not affiliated with or endorsed by APAC.
NO RAISES for APs and faculty, according to the Daily Illini of Aug. 5. See here.
GOVERNOR QUINN cuts higher ed funding. See UIC News.
A UNIVERSITY of California-Berkeley law professor has proposed that cash-strapped states such as Illinois borrow from the U.S. Treasury. See Progress Illinois of July 9.
POLITICIANS’ INACTION only makes the budget crisis worse, said the State Journal-Register on July 11.
DELAY-AND-denial budget politics were decried by the Daily Herald on July 6. See http://www.dailyherald.com/story/?id=392061.
ILLINOIS IS in its worst financial position in history, the Chicago Sun-Times said on July 9.
STATE COMPTROLLER Dan Hynes issued a report on the State’s financial health, noting “Fiscal problems worsen significantly.” See http://www.comptroller.state.il.us/. Hynes also spoke about the state’s financial problems on CNN.
STATE, LOCAL governments could slash 400,000 jobs in the next year, says the Huffington Post of July 6.
THE ILLINOIS “dysfunctional political class refuses to pay the State’s bills and refuses to take the painful steps” to close the State’s deficit, the New York Times wrote on July 3.
LAWMAKERS HAVE left State universities in limbo, says the Chronicle of Higher Education of July 16.
ILLINOIS DEBT to reach $130 billion? See WHTI-TV 10 Terre Haute, IN, feature.
ILLINOIS ECONOMIC recovery “painfully slow,” says U of I prof. See Aug. 2 Pantagraph.com.
TIAA-CREF CEO calls retirement security a pressing national need. See July 29 Business Wire.
PROVOST BIDS farewell: the Chicago Flame did a two-part interview with retiring Provost
R. Michael Tanner. See Part I & Part 2.
ARE WE public sector employees the new “welfare queens? ” Some say we are. Jonathan Cohn of the New Republic on Aug. 8 argued as to why we’re not.
COMPELLING AP vacation use prior to termination? See July HR eNews (pdf).
TERRY SAVAGE, financial expert, says the State is actually $120.6 billion short. See Aug. 23 Chicago Sun-Times.
PRESIDENT HOGAN planning to shrink number of administrators? See Aug. 25 Daily Illini.
FOX NEWS Chicago brought together University of Illinois spokesperson
Tom Hardy and State Senator Martin Sandoval (D-12th) who talked about tuition, furloughs, and a hiring freeze. See here.
Q & A with President
Michael Hogan in the State Journal- Register.
DEMONIZING THE public sector harms the middle class overall, says the Aug. 26 The Hill’s Congress Blog.
Vol. 3, No. 7, September 2010
ISSN 1946-1860
Editor: William S. Bike
Writing Staff: Ivone De Jesus
Chair: Michael Moss
Vice Chair: Jennifer Rowan
Secretary: Jill Davis
Treasurer: Virginia Buglio
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