MEDICAL RETAINER AGREEMENTS                                                                  S.B. 1033:

                                                                                  SUMMARY OF INTRODUCED BILL

                                                                                                         IN COMMITTEE

 

 

 

 

 

 

 

 

 

Senate Bill 1033 (as introduced 9-9-14)

Sponsor:  Senator Patrick J. Colbeck

Committee:  Insurance

 

Date Completed:  9-23-14

 

CONTENT

 

The bill would amend the Insurance Code to do the following:

 

--    Specify that a medical retainer agreement would not be insurance, entering into such an agreement would not be the business of insurance, and neither would be subject to the Code.

--    Specify that a health care provider, or the agent of a health care provider, would not be required to have a certificate of authority or license under the Code to market, sell, or offer to sell a medical retainer agreement.

--    Prescribe the requirements for an agreement to be considered a medical retainer agreement.

 

The bill would define "medical retainer agreement" as "a contract between a health care provider and an individual patient or his or her legal representative in which the health care provider agrees to provide routine health care services to the individual patient for an agreed-upon fee and period of time".

 

To be considered a medical retainer agreement for the purposes of the bill, the agreement would have to be in writing and be signed by the health care provider or agent of the health care provider and the individual patient or his or her legal representative. The agreement also would have to do the following: a) allow either party to terminate the agreement on written notice to the other party, b) describe the specific routine health care services that were included in the agreement, c) specify the fee for the agreement, d) specify the period of time under the agreement, e) prominently state in writing that the agreement was not health insurance, and f) prohibit the health care provider, but not the patient, from billing an insurer or other third party payer for the services provided under the agreement.

 

"Health care provider" would mean an individual or other legal entity that is licensed, registered, or otherwise authorized to provide a health care service in this State under the Public Health Code. A health care provider would include an individual or other legal entity alone or with others professionally associated with the individual or other legal entity.

 

"Routine health care service" would include the following:

 

 --    Screening, assessment, diagnosis, and treatment for the purpose of promoting health or detecting and managing disease or injury.

 --    Medical supplies and prescription drugs dispensed in a health care provider's office or facility site.

 --    Laboratory work.

 

Laboratory work would include routine blood screening or routine pathology screening performed by a laboratory that either was associated with the health care provider that was a party to the medical retainer agreement, or had entered into an agreement with the health care provider to provide the laboratory work without charging a fee to the patient for the work.

 

Proposed MCL 500.129                                                      Legislative Analyst:  Jeff Mann

 

FISCAL IMPACT

 

To the extent that entities chose to provide health care coverage through a medical retainer agreement instead of more traditional insurance, the State would see a reduction in Health Insurance Claims Assessment (HICA) revenue. The HICA rate is currently 0.75%, so each $1.0 million in coverage shifted from traditional insurance to a medical retainer agreement would result in a reduction in State revenue of $7,500. While HICA revenue is Restricted, it is used to offset GF/GP revenue in the Medicaid program, so the net impact for each $1.0 million shifted would be an increase in GF/GP costs of $7,500.

 

                                                                                    Fiscal Analyst:  Steve Angelotti

 

This analysis was prepared by nonpartisan Senate staff for use by the Senate in its deliberations and does not constitute an official statement of legislative intent.