Welcome to Gallagher Bassett's (GB) special Internet site designed to keep our clients updated on Illinois House Bill 1698, and the Preferred Provider Program (PPP).
In June 2011, Governor Quinn signed Illinois House Bill 1698, which included the creation of a Preferred Provider Program (PPP) for workers’ compensation (WC). As a GBCARE offering, Coventry Workers’ Compensation Services is approved as a WC PPP.
Illinois House Bill 1698
- Allowed the formation of networks known as Preferred Provider Programs or a PPP
- Allows for “Direction of Care” within a PPP with some limitations
- Allows for the use of Utilization Review
- Reduced the State Fee Schedule
- Consolidated the Geo Zips from 29 to 4 for physicians and to 14 for hospitals – expected effective 1/1/12
- Mandates E-Billing by 6-30-2012
- Carpal Tunnel Syndrome Reform
- Introduced AMA Guidelines for Impairment Ratings
- Permanent Disability Reform
Provider selection and opt out
- The main benefit of the PPP is to direct care to a workers’ compensation provider network, control medical costs, reduce multiple primary treating physician changes and to reduce the chain of medical referrals.
- Without a PPP, employees have free choice of medical providers limited to a maximum of 2 different choices along with any referrals from those two choices.
- With a PPP, Employees have 2 choices of medical providers from within the employer’s network.
- If the commission finds that the injured workers second choice of physician has NOT provided adequate care then the injured worker can choose a medical provider outside of the PPP.
- Employees may opt out of the program but must do so in writing. This constitutes a choice in physicians.
- If an injured worker chooses non-emergency care prior to the report of an injury that also constitutes a choice in physicians.
Should you need additional information regarding the IL PPP or programs and services offered by Gallagher Bassett, please contact your Account Executive.
DISCLAIMER. The content of this Web site is provided for informational purposes only, from a general insurance/risk management perspective, with the understanding that Gallagher Bassett Services, Inc. (GB) is not rendering legal, accounting or other professional advice on specific matters. Accordingly, GB assumes no liability whatsoever in connection with the use of such content. GB recommends that you consult your legal counsel or other professional advisor with respect to your individual situation.
The information provided throughout this Web site is provided from a general insurance/risk management perspective and is NOT legal advice. Gallagher Bassett Services, Inc. (GB) does not provide legal advice as it is not qualified to do so. GB recommends that you seek the advice of legal counsel in order to become fully apprised of the legal implications related to the information provided above as such implications are highly dependent on the unique facts and circumstances applicable to an individual situation.