MCL - 350-1980-4

Download Division | View Division Index
Chapter 550
Act 350 of 1980
Previous Division
Next Division
THE NONPROFIT HEALTH CARE CORPORATION REFORM ACT (EXCERPT)
Act 350 of 1980
Part 4

Document Type Description
Section 550.1400 Section Use of most favored nation clause in provider contract.
Section 550.1401 Section Offering of health care benefits; limiting benefits; division of benefits into classes or kinds; prohibited conduct; grounds for denial of coverage; coordination of benefits, subrogation, and nonduplication of benefits; health care corporation as party in interest; limiting or denying coverage or participation status; requirements for participation and reimbursement; determination by commissioner; definitions.
Section 550.1401a Section Health care service rendered by dentist; benefits or reimbursement; “dentist” defined; certificates to which section applicable.
Section 550.1401b Section Certificate providing benefits for mental health services; requirements.
Section 550.1401c Section Replacement group certificate with preexisting condition limitation; elimination, reduction, or limitation of benefits; “disability coverage” defined.
Section 550.1401d Section Services performed by physician's assistant; reimbursement; conditions; applicability of section; supervision by physician; definitions.
Section 550.1401e Section Group certificate issued by health care corporation; renewal or continuation; guaranteed renewal; discontinuing plan, product, or coverage in nongroup or group market; conditions.
Section 550.1401f Section Health care corporation; access to obstetrician-gynecologist.
Section 550.1401g Section Health care corporation; access to pediatric care services.
Section 550.1401h Section Health care corporation providing prescription drug coverage; formulary restrictions.
Section 550.1401i Section Prescription drug coverage; pilot project; provisions; interim report; determination; evaluation.
Section 550.1401j Section Prescription drug coverage; rate differentials; filing.
Section 550.1401k Section Telemedicine services; provisions; definition; applicability.
Section 550.1401m Section Offer of health care benefits to all residents regardless of health status.
Section 550.1402 Section Health care corporation; prohibited conduct; commission or compensation; new preexisting condition limitation waiting period; readjusting rates; participation in trade practice conference for disability insurers; provider class plan not altered or superseded; probable cause to believe provisions violated; notice; disposition of matter by agreement of parties; action for damages; hearing; issuance of cease and desist order; violation of cease and desist order; civil fine; action for actual monetary damage; attorneys' fees.
Section 550.1402a Section Terms and conditions of certificate; form; description; requested information; written request; “board certified” defined.
Section 550.1402b Section Preexisting condition limitation or exclusion; prohibition; exception; “group” defined.
Section 550.1402c Section Termination of participation between primary care physician and health care corporation; notice to member; effect of termination; definitions.
Section 550.1402d Section Applicability of MCL 500.2212c to health care corporation.
Section 550.1403 Section Payment of benefits; interest; claim form; exception.
Section 550.1403a Section Benefits paid by check or written instrument; escheat.
Section 550.1403b Section Advertising material prohibited.
Section 550.1404 Section Violation of MCL 550.1402 or MCL 550.1403; private informal managerial-level conference; review by commissioner; internal procedures; determination by commissioner; expedited grievance procedure; procedural rules; hearing matter as contested case; authorization to act on behalf of member.
Section 550.1405 Section Single billing form; development; explanation of total bill for services.
Section 550.1406 Section Confidentiality of records; disclosures; consent; policy regarding protection of privacy and confidentiality of personal data; violation as misdemeanor; penalty; civil action for damages; effect of section on governmental agencies; compliance with federal law and regulations; "health care operations" defined.
Section 550.1407 Section Complaint system; procedures; response to complaint; access to complaints and responses; record of complaints; annual report; other legal remedies.
Section 550.1408 Section False, dishonest, or fraudulent claim for payment as misdemeanor; penalty; civil action; prosecution.
Section 550.1409 Section Civil action for negligence.
Section 550.1409a Section Coverage for children who are full-time or part-time students; continuing coverage if dependent student takes leave of absence due to illness or injury; eligibility; requirements.
Section 550.1410 Section Certificate providing coverage of dependent terminating at specified age; exceptions.
Section 550.1410a Section Provisions of group certificate; electing coverage under group conversion certificate; notice of conversion privilege; requirements of group conversion certificate; premium; issuance; compliance.
Section 550.1410b Section Premium for group conversion certificate after January 1, 2014; determination; rating factors.
Section 550.1411-550.1413a Section Repealed. 1994, Act 40, Imd. Eff. Mar. 14, 1994.
Section 550.1414 Section Expired. 1980, Act 430, Eff. Jan. 1, 1982.
Section 550.1414a Section Treatment of substance abuse; contracts; qualifications of provider; coverage for intermediate and outpatient care for substance abuse required; demonstration projects; substance abuse advisory committee; report; contracts based on final report; reimbursement; group and nongroup certificates; exceptions; option to decline coverage; charges, terms, and conditions; reduction of coverage; deductibles and copayment provision; minimum coverage; adjustment; definitions; effective date of section.
Section 550.1414b Section Offer of wellness coverage by health care corporation.
Section 550.1415 Section Benefits for prosthetic devices.
Section 550.1416 Section Coverage for breast cancer diagnostic services, breast cancer outpatient services, and breast cancer rehabilitative services; coverage for breast cancer screening mammography; definitions; effective date of section.
Section 550.1416a Section Coverage for drug used in antineoplastic therapy and cost of its administration; conditions.
Section 550.1416b Section Establishment of program to prevent onset of clinical diabetes required; report; coverages; “diabetes” defined.
Section 550.1416c Section Off-label use of approved drug; coverage; conditions; compliance; use of copayment, deductible, sanction, or utilization control; limitation; definitions.
Section 550.1416d Section Coverage for obstetrical and gynecological services by physician or nurse midwife.
Section 550.1416e Section Diagnosis and treatment of autism spectrum disorders; coverage; prohibition; availability of other benefits; conditions; qualified health plan offered through American health benefit exchange pursuant to federal law; prescription drug plan; coordinated benefits; definitions.
Section 550.1417 Section Hospice care; contracts with health care corporation; description of benefit.
Section 550.1418 Section Emergency health services; medical coverage required; “stabilization” defined.
Section 550.1419 Section Certificate offering dependent coverage to child; denial of enrollment on certain grounds prohibited.
Section 550.1419a Section Eligibility of parent for dependent coverage; health coverage of child through noncustodial parent; court or administrative order and notice required.
Section 550.1419b Section Individual eligible under title XIX of social security act; assignment of rights of subscriber to department of social services.
Section 550.1420-550.1430 Section Repealed. 2006, Act 441, Imd. Eff. Oct. 19, 2006.
Section 550.1435 Section “Program” defined.
Section 550.1436 Section Michigan caring programs for children; creation; contribution requirements; rating methodologies; supersedure of inconsistent provisions.
Section 550.1437 Section Eligibility of child for enrollment in program.
Section 550.1438 Section Limitation of benefits; provision of other health care benefits.
Section 550.1439 Section Fees prohibited; exception; funding; enrollment of children.