SPRINGFIELD, Ill. (WAND) — The Illinois Senate unanimously passed a bill Thursday to ban insurance companies from automatically coding a health service lower than what is actually provided to patients.

This proposal states that all downcoding determinations must be made or reviewed by a real person, and insurance companies would be required to notify doctors if a service is downcoded.

The plan also bans insurers from downcoding in a discriminatory manner against doctors who routinely treat patients with complex health conditions.

"Downcoding, quite frankly, is just an unfair system," said Sen. Dave Koehler (D-Peoria). "There was some discussion about also trying to limit upcoding, but upcoding is primarily illegal."

Insurance companies would be required to provide health care professionals a clear process to dispute downcoded claims within 90 days.

The Illinois Life & Health Insurance Council initially opposed the legislation, but the organization shifted its position to neutral after negotiating changes that preserved the insurers' ability to use automation while ensuring a process exists for providers to dispute downcoded claims.

"We appreciate the collaborative working relationship with the bill's chief sponsors, Senators Dave Koehler and Julie Morrison, and the Illinois State Medical Society," said ILHIC President Laura Minzer.

Senate Bill 3114 now moves to the House for further consideration. 

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