HOUSE BILL No. 4479


     April 15, 1999, Introduced by Reps. Woronchak, Howell, Ehardt, DeRossett, Birkholz, Caul, Richardville, Shackleton, Gilbert, Julian, Faunce, Bisbee, Kowall, Hager, Van Woerkom and Scranton and referred to the Committee on Health Policy.


        A bill to amend 1980 PA 350, entitled

   "The nonprofit health care corporation reform act,"

   (MCL 550.1101 to 550.1704) by adding section 401h.

               THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 1         SEC. 401H.  A HEALTH CARE CORPORATION THAT PROVIDES COVERAGE

 2    FOR PRESCRIPTION DRUGS AND LIMITS THOSE BENEFITS TO DRUGS

 3    INCLUDED IN A FORMULARY SHALL DO ALL OF THE FOLLOWING:

 4         (A) ENSURE PARTICIPATION OF PARTICIPATING PHYSICIANS AND

 5    PHARMACISTS IN THE DEVELOPMENT OF THE FORMULARY.

 6         (B) DISCLOSE TO HEALTH CARE PROVIDERS AND UPON REQUEST TO

 7    MEMBERS THE NATURE OF THE FORMULARY RESTRICTIONS.

 8         (C) PROVIDE FOR EXCEPTIONS FROM THE FORMULARY LIMITATION

 9    WHEN A NONFORMULARY ALTERNATIVE IS MEDICALLY INDICATED.  THIS

10    SUBDIVISION DOES NOT PREVENT A HEALTH CARE CORPORATION FROM

11    ESTABLISHING HIGHER COST-SHARING FOR NONFORMULARY ALTERNATIVES.


   03046'99                                                 DKH