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Michigan Legislature
Michigan Compiled Laws Complete Through PA 255 of 2017
House: Adjourned until Tuesday, January 23, 2018 6:00:00 PM
Senate: Adjourned until Tuesday, January 23, 2018 10:00:00 AM

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NOTE: Dates reflect any modification to item, not necessarily a change in law.

218-1956-35 - CHAPTER 35 HEALTH MAINTENANCE ORGANIZATIONS (500.3501...500.3580)
Section 500.3501 ‑ Definitions.
Section 500.3503 ‑ Applicability of provisions to health maintenance organization.
Section 500.3505 ‑ Health maintenance contract; use of descriptive words; restrictions.
Section 500.3507 ‑ Authorizing and regulating health maintenance organization; establishment of system by director.
Section 500.3508 ‑ Quality assessment program; quality improvement program.
Section 500.3509 ‑ Certificate of authority; application; form; limitation; change of service area.
Section 500.3511 ‑ Governing body; election of enrollee board members; requirements; meetings.
Section 500.3513 ‑ Health maintenance organization operations; regulation by director; incorporation as legal entity.
Section 500.3515 ‑ Additional health services; deductibles; copayments; "preventive health care services" defined; partial payment from government or private person.
Section 500.3517 ‑ Healthy lifestyle programs; emergency or out-of-area service; payment of expenses or fees.
Section 500.3519 ‑ Contract and contract rates; fairness; rate differential; basic health services to large employers required.
Section 500.3521 ‑ Prepayment rates; filing and approval of methodology; schedule.
Section 500.3523 ‑ Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3525 ‑ Proposal to revise contract or rate; approval of commissioner; approval with modifications; hearing; disposition; exception; notice.
Section 500.3527 ‑ Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3528 ‑ Health maintenance organization; credentialing verification; accreditation by nationally recognized accredited body.
Section 500.3529 ‑ Affiliated provider contracts; collection of payments from enrollees; contract provisions; waiver of requirement under subsection (2); contract format; evidence of sufficient number of providers.
Section 500.3530 ‑ Availability of covered services; assurance; establishment and maintenance of proximity.
Section 500.3531 ‑ Contracts with health care providers to become affiliated providers; requirements; standards; filing; duplicative standards; notice procedures; provider application period; approval or rejection as affiliated provider; termination of contract; providing information to insurer.
Section 500.3533 ‑ Prudent purchaser contracts; reimbursement for unauthorized services or services by nonaffiliated providers.
Section 500.3535 ‑ Solicitation or advertising.
Section 500.3537 ‑ Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3539 ‑ Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3541 ‑ Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3542 ‑ Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3543 ‑ Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3544 ‑ Noninsured benefit plan; processing and payment of claims.
Section 500.3545 ‑ Acquisition of obligations from another managed care entity.
Section 500.3547 ‑ Health care service operations; visitation or examination by director; consultation with enrollees; authority; access to information relating to delivery of services; submission of information regarding proposed contract.
Section 500.3548 ‑ Maintenance of books, records, files, and financial records; funds and assets.
Section 500.3549 ‑ Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3551 ‑ Health maintenance organization; net worth.
Section 500.3553 ‑ Certificate of authority; deposit requirements.
Section 500.3555 ‑ Financial plan.
Section 500.3557 ‑ Notice of changes in operations.
Section 500.3559 ‑ Reinsurance contract or plan of self-insurance; purpose; filing; approval; coverage.
Section 500.3561 ‑ Insolvency; continuation of benefits.
Section 500.3563 ‑ Insolvency; offer of enrollment by health insurers participating in enrollment process; allocation of group coverage to health maintenance organizations or insurers within service area; nongroup coverage; reassignment of enrollees of insolvent organization contracting with state funded health care program; substitute coverage under American health benefit exchange.
Section 500.3565 ‑ Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3567 ‑ Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3569 ‑ Assumption of financial risk.
Section 500.3571 ‑ State or federal health programs.
Section 500.3573 ‑ Operation of health care delivery system not meeting requirements of act; permitted conduct; limitations.
Section 500.3580 ‑ Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.

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