ILL. HEALTH MAINTENANCE ORG. v. SHAPO

Nos. 1-02-0264, 1-02-0409 to 1-02-0412, 1-02-0686, 1-02-1149 to 1-02-1162, 1-02-1437 to 1-02-1440, 1-02-1443, 1-02-2220, 1-02-2222 to 1-02-2233.

826 N.E.2d 1135 (2005)

357 Ill. App.3d 122

292 Ill.Dec. 699

ILLINOIS HEALTH MAINTENANCE ORGANIZATION GUARANTY ASSOCIATION, Plaintiff-Appellant and Cross-Appellee, v. Nathaniel S. SHAPO, the Director of Insurance of the State of Illinois, the Department of Insurance, Michael B. Nash, Royal B. Martin, Oak Park Hospital, Paul T. Atkenson, EHS Hospitals-South Chicago Community Hospital, Hartgrove Hospital, EHS Hospitals-Christ Hospital, Ravenswood Hospital and Medical Center, Little Company of Mary Hospital, Children's Memorial Hospital, Loyola Medical Practice Plan, Thorek Hospital and Medical Center, EHS Hospitals-Bethany Hospital, SSM Regional Health Services, d/b/a St. Francis Hospital and Health Center, University of Chicago Physicians Group, South Suburban Hospital, Rush-Presbyterian-St. Luke's Hospital, St. James Hospital-Chicago Heights, Westside Community Hospital, d/b/a Sacred Heart Hospital, Westlake Community Hospital, University of Chicago Hospitals, County of Cook on behalf of John H. Stroger, Jr. Hospital of Cook County, St. Bernard Hospital, Loyola University Medical Center, West Suburban Hospital, and Grant Hospital, Defendants-Appellees (EHS Hospitals—Bethany Hospital, EHS Hospitals—Christ Hospital, and EHS Hospitals—South Chicago Community Hospital Defendants-Appellees and Cross-Appellants). Little Company of Mary Hospital, County of Cook on behalf of John H. Stroger, Jr. Hospital of Cook County, Oak Park Hospital, Grant Hospital, Loyola Medical Practice Plan, University of Chicago Physicians Group, Westlake Community Hospital, Rush-Presbyterian-St. Luke's Medical Center, University of Chicago Hospitals, Loyola University Medical Center, EHS Hospitals-South Chicago Community Hospital, EHS Hospitals-Christ Hospital, EHS Hospitals-Bethany Hospital, and SSM Regional Health Services D/B/A St. Francis Hospital and Health Center, Plaintiffs, v. Illinois Health Maintenance Organization Guaranty Association, Defendant.

Appellate Court of Illinois, First District, Sixth Division.

March 31, 2005.


Attorney(s) appearing for the Case

Foley & Lardner, Chicago (Wm. Carlisle Herbert, Mary Kay Martire, Andrew L. Reisman and Tiffany C. Woodie, of counsel), for Plaintiff-Appellant/Cross-Appellee Illinois Health Maintenance Organization Guaranty Association.

Bell, Boyd & Lloyd, LLC, Chicago (William F. Dolan and Daniel J. Lawler, of counsel), for Defendants-Appellees/Cross-Appellants EHS Hospitals — Bethany Hospital, EHS Hospitals — Christ Hospital, and EHS Hospitals — South Chicago Community Hospital and Defendants-Appellees Loyola University Medical Center, University of Chicago Hospitals, EHS Hospitals — Bethany Hospital, EHS Hospitals — Christ Hospital and EHS Hospitals — South Chicago Community Hospital.

Mayer, Brown, Rowe & Maw, Chicago (Alan J. Martin, Marc E. Rosenthal and Robert M. Dow, Jr., of counsel), for Defendants-Appellees Nathaniel S. Shapo, Director of the Illinois Department of Insurance, and the Illinois Department of Insurance.


Justice FROSSARD delivered the opinion of the court:

Plaintiff-appellant, the Illinois Health Maintenance Organization Guaranty Association ("plaintiff" or "Association"), filed 24 complaints for administrative review in the trial court seeking review of decisions issued by Nathaniel Shapo, the Director of the Illinois Department of Insurance (Department). In those decisions Director Shapo (the Director) found plaintiff liable to health care providers for services...

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