{"data":{"id":"us-il/215-ilcs-220-10","jurisdiction":"us-il","citation":"215 ILCS 220/10","heading":"Applicability; scope.","body":"(This Section may contain text from a Public Act with a delayed effective date)\n(a) This Act applies to the following if they are issued, amended, delivered, or renewed on or after the effective date of this Act:\n(1) a policy or contract for health insurance coverage as defined in the Illinois Health Insurance Portability and Accountability Act;\n(2) State, employee, county, municipality, or school district group health plans; and\n(3) subject to federal law, rules, regulations, and guidance, policies issued or delivered in this State to the Department of Healthcare and Family Services and providing coverage to persons who are enrolled under Article V of the Illinois Public Aid Code or under the Children's Health Insurance Program Act. This Act does not diminish the ability of the Department of Healthcare and Family Services' Office of the Inspector General to prevent, detect, and eliminate fraud, waste, abuse, mismanagement, and misconduct.\nThis Act does not apply to employee or employer self-insured health benefit plans under the federal Employee Retirement Income Security Act of 1974 and health care provided pursuant to the Workers' Compensation Act or the Workers' Occupational Diseases Act, and excepted benefits, including stand-alone dental plans.\n(b) This Act shall not diminish a health care payor's duties and responsibilities under other federal or State law or the rules adopted thereunder.\n(c) This Act is not intended to alter or impede the provisions of any consent decree or judicial order to which the State or any of its agencies is a party.\n(d) The regulation of downcoding of medical claims in policies issued, amended, delivered, or renewed on or after January 1, 2028 is an exclusive power and function of the State. A home rule unit may not regulate downcoding of medical claims in policies issued, amended, delivered, or renewed on or after January 1, 2028. All home rule units must comply with this Act. This subsection is a denial and limitation of home rule powers and functions under subsection (h) of Section 6 of Article VII of the Illinois Constitution.","path":["CHAPTER 215 INSURANCE","Transparency in Downcoding Act."],"source_url":"https://www.ilga.gov/legislation/ILCS/details?ActID=4691\u0026ChapterID=22\u0026ChapAct=FullText\u0026Print=True","current_through":"at least Public Act 104-790","vintage":"","retrieved_at":"2026-09-15T04:46:30Z","sha256":"d86b3f99dba3fe657657633d942c874c3b4def1fe5a36d5019698b52c4fd8df5","source_id":"us-il","stale":false,"prev":"us-il/215-ilcs-220-5","next":"us-il/215-ilcs-220-15"},"notice":"GroundRules: Original legal text. Not legal advice."}