PATIENT'S RIGHT TO INDEPENDENT REVIEW ACT
Act 251 of 2000
AN ACT to provide review of certain health care coverage adverse determinations made by health carriers; to prescribe eligibility, powers, and duties of certain independent review organizations; to prescribe the powers and duties of certain health carriers; to prescribe the powers and duties of certain persons; to prescribe the powers and duties of certain state officials; to provide for the reporting of certain information; to provide fees; and to provide penalties for violations of this act.
History: 2000, Act 251, Eff. Oct. 1, 2000
© 2009 Legislative Council, State of Michigan
The People of the State of Michigan enact:
| Section 550.1901 | Section | Short title. |
| Section 550.1903 | Section | Definitions. |
| Section 550.1905 | Section | Scope. |
| Section 550.1907 | Section | Right to request external review for adverse determination; written notice. |
| Section 550.1909 | Section | Written request to commissioner. |
| Section 550.1911 | Section | Request for external review; commencement; preliminary review; notice of acceptance; duties of commissioner; incomplete request; nonacceptance; assignment of independent review organization; duty of health carrier to provide documents; reconsideration by health carrier of its adverse determination; recommendation; considerations; review by commissioner; notice of decision. |
| Section 550.1913 | Section | Expedited external review. |
| Section 550.1915 | Section | Decision as final administrative remedy; other remedies. |
| Section 550.1917 | Section | Approved independent review organizations; application; form; fee; expiration; termination; updated list. |
| Section 550.1919 | Section | Approved independent review organizations; requirements. |
| Section 550.1921 | Section | Independent review organization; liability for damages. |
| Section 550.1923 | Section | Maintenance of records; report to commissioner. |
| Section 550.1925 | Section | Description of internal grievance and external review procedures; inclusion with materials provided to covered persons. |
| Section 550.1927 | Section | Rules. |
| Section 550.1929 | Section | Cease and desist order; additional orders; fines; hearing; injunction; creation of cancer clinical trials; disposition of funds. |