SENATE BILL No. 1259

May 11, 2000, Introduced by Senators SCHWARZ, YOUNG, BENNETT, EMERSON,

SHUGARS, HAMMERSTROM, GOSCHKA, BYRUM and DE BEAUSSAERT and

referred to the Committee on Health Policy.

A bill to amend 1978 PA 368, entitled

"Public health code,"

(MCL 333.1101 to 333.25211) by adding section 21052c.

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

1 SEC. 21052C. (1) A HEALTH MAINTENANCE ORGANIZATION SHALL

2 NOT ENCOURAGE OR DIRECT AN INSURED TO AN EMERGENCY HEALTH SERV-

3 ICES RESPONSE AND TRANSPORTATION SYSTEM THAT IS IN COMPETITION

4 WITH OR IS A SUBSTITUTION FOR THE 9-1-1 EMERGENCY HEALTH SERVICES

5 SYSTEM OR OTHER STATE OR LOCAL UNIT OF GOVERNMENT EMERGENCY

6 HEALTH SERVICES SYSTEM.

7 (2) SUBSECTION (1) DOES NOT PROHIBIT A HEALTH MAINTENANCE

8 ORGANIZATION FROM USING OR REQUIRING TRANSPORTATION OUTSIDE THE

9 9-1-1 EMERGENCY HEALTH SERVICES SYSTEM OR OTHER STATE OR LOCAL

10 UNIT OF GOVERNMENT EMERGENCY HEALTH SERVICES SYSTEM FOR

11 NONEMERGENCY HEALTH SERVICES.

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1 (3) A HEALTH MAINTENANCE ORGANIZATION SHALL NOT REQUIRE AN

2 ENROLLEE TO OBTAIN PRIOR AUTHORIZATION BEFORE ACCESSING THE 9-1-1

3 SYSTEM OR OTHER STATE OR LOCAL UNIT OF GOVERNMENT EMERGENCY

4 HEALTH SERVICES SYSTEM FOR EMERGENCY HEALTH SERVICES.

5 (4) A HEALTH MAINTENANCE ORGANIZATION SHALL NOT USE FALSE OR

6 MISLEADING LANGUAGE IN ANY MATERIALS PROVIDED TO ENROLLEES TO

7 DISCOURAGE OR PROHIBIT AN ENROLLEE FROM ACCESSING THE 9-1-1

8 SYSTEM FOR EMERGENCY HEALTH SERVICES.

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