Lawmakers reject bill written in response to Blue Cross-Springfield Clinic controversy

The Illinois House of Representatives rejected a measure Wednesday night designed to provide protection to consumers in the case of a contract dispute between an insurance company and a health care provider.

“My bill was called to bring transparency and accountability to big insurance companies,” said the bill's chief sponsor Rep. Sue Scherer, D-Decatur, in a statement after the bill failed. “I care deeply about providing affordable, accessible health care to the residents of my district and I will continue to work towards that goal and fight for my constituents as always.”

The bill, HB 1463, was rejected by the House on a vote of 40-21-7, with 50 of the House's 118 members not voting on the measure. It needed 60 votes to pass.

In a fiery speech before the ill-fated vote, Scherer threatened to use a vote against the measure against other lawmakers.

"Tomorrow, if I want to answer who's owned by the insurance companies, guess what? I'm handing them a roll call and you try to explain it," said Scherer.

"If you just don't care, why are you even here?" she added.

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The bill was a series of updates to the Network Adequacy and Transparency Act of 2017. It would have explicitly laid out a fine structure for violating the original law. Currently, the Department of Insurance has leeway to set the fine at any level. The bill also would have introduced new requirements for doctors to update insurance companies when they stop accepting new patients or change location.

The proposal was an effort to reduce what Scherer called "ghost networks," where insurance companies list health care providers that are either not accepting new patients or who are otherwise unavailable.

The subject of ghost networks came up in a legislative hearing last week in which Scherer and other lawmakers questioned executives from Blue Cross Blue Shield of Illinois and Springfield Clinic.

In that hearing, Springfield Clinic Chief Medical Officer Ken Sagins said that when he checked Blue Cross' latest listings for available radiation oncologists in Springfield, they listed four. Of those four, Sagins said two were from Springfield Clinic and one lived in Chicago.

The relationship between those Blue Cross and Springfield Clinic has been the subject of intense scrutiny in recent weeks.

Ever since the two ended their contract, thousands of patients have been forced to find new doctors. The insurer estimated 55,000 patients were affected, Springfield Clinic has said the true number is closer to 110,000.

More: 'I need answers': lawmakers grill Blue Cross Blue Shield, Springfield Clinic in hearing

Because of the change, the Department of Insurance fined Blue Cross $339,000 in March. It was the first fine under the powers of the Network Adequacy and Transparency Act.

The bill was sponsored by a bipartisan group of lawmakers, including two from Springfield: Republican Representatives Tim Butler and Sandy Hamilton.

Despite the bipartisan support for its creation, lawmakers of both parties criticized the bill during the debate Wednesday night.

Rep. Thaddeus Jones, D-Calumet City, chair of the House Insurance Committee said the "bill is not only overkill, this bill doesn't solve the problem," said Jones.

Jones also criticized the process Scherer used to craft the bill, saying she didn't have adequate input from insurance trade groups or the state's medical association. Scherer rejected the accusation.

On the other side of the aisle, some criticized the bill's aim. The bill would have given the Department of Insurance the ability to implement emergency rules, which require less legislative oversight.

"We're talking about making major changes to an act that hasn't been enacted yet and that this has major holes about how the enforcement of these provisions actually take effect," said Rep. Tom Demmer, R-Dixon.

Contact Andrew Adams: aadams1@gannett.com; (312)-291-1417; twitter.com/drewjayadams.

This article originally appeared on State Journal-Register: IL lawmakers reject bill aimed at Blue Cross, Springfield Clinic rift