May 5, 2015, Introduced by Senator KNOLLENBERG and referred to the Committee on Insurance.
A bill to amend 1956 PA 218, entitled
"The insurance code of 1956,"
by amending sections 3157 and 3610a (MCL 500.3157 and 500.3610a),
section 3610a as added by 1984 PA 65, and by adding section 3406t.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 3157. (1) A physician, hospital, clinic, or other person
or
institution that lawfully rendering renders treatment
to an
injured person for an accidental bodily injury covered by personal
protection
insurance, and or a person or institution providing that
provides
rehabilitative occupational training
following the such an
injury,
may charge must be
reimbursed a reasonable amount for the
products,
services, and or
accommodations rendered. The charge
shall
not exceed
(2) A person that renders treatment as described in subsection
(1) must not be reimbursed an amount that exceeds the amount the
person
or institution is customarily charges reimbursed for like
products,
services, and or
accommodations. in
cases not involving
insurance.
(3) A person that renders treatment as described in subsection
(1) shall not seek reimbursement in an amount that exceeds the
amount the person customarily is paid for rendering like treatment
to injured persons for similar bodily injuries that do not arise
from the ownership, operation, maintenance, or use of a motor
vehicle as a motor vehicle.
(4) If a person that renders treatment as described in
subsection (1) has previously received payment from an insurer,
health maintenance organization, third-party administrator, or
other similar person that provided health and accident coverage
that is coordinated under section 3109a for treatment rendered to
the injured person for the same injury arising from the ownership,
operation, maintenance, or use of a motor vehicle as a motor
vehicle and if the benefits under the other health and accident
coverage have been exhausted, the person shall not seek
reimbursement from the insurer providing the security required
under section 3101(1) in an amount that exceeds the amount the
person previously was paid for the same or similar treatment by the
other insurer, health maintenance organization, third-party
administrator, or other similar person.
(5) As used in this section, "person", as provided in section
114, includes an individual, including a physician, and also any
other legal entity, including a hospital, clinic, or other
institution.
Sec. 3406t. (1) An expense-incurred hospital, medical, or
surgical group or individual policy or certificate that is
delivered, issued for delivery, or renewed in this state and a
health maintenance organization group or individual contract must
not deny or limit health coverage to an insured or enrollee solely
because the insured or enrollee suffers accidental bodily injury
arising out of the ownership, operation, maintenance, or use of a
motor vehicle as a motor vehicle or is eligible for personal
protection insurance benefits under chapter 31.
(2) This section does not prevent the inclusion in a policy,
certificate, or contract listed in subsection (1) of a provision
stating that the policy, certificate, or contract is secondary to
an automobile insurance policy if the automobile insurance policy
is not coordinated as provided in section 3109a.
(3) This section does not apply to a policy, certificate, or
contract related to the provision of benefits under Medicare or
Medicaid.
(4) As used in this section:
(a) "Accidental bodily injury" means that term as described in
section 3105.
(b) "Automobile insurance" means that term as defined in
section 2102.
(c) "Bodily injury" means that term as described in section
3105.
(d) "Motor vehicle" means that term as defined in section
3101.
Sec. 3610a. (1) A Except as provided in section 3406t, a group
disability insurance policy may contain provisions for the
coordination of benefits otherwise payable under the policy with
benefits payable for the same loss under other group insurance;
automobile medical payments insurance; or coverage provided on a
group basis by hospital, medical, or dental service organizations,
by union welfare plans, or employee or employer benefit
organizations.
(2) If a group disability insurance policy contains a
coordination
of benefits provision, the benefits shall be are
payable pursuant to the coordination of benefits act.
Enacting section 1. (1) This amendatory act takes effect 90
days after the date it is enacted into law.
(2) This amendatory act applies to policies, certificates, and
contracts delivered, executed, issued, amended, adjusted, or
renewed in this state, or outside of this state if covering
residents of this state, beginning after the date this amendatory
act is enacted into law.