Michigan · Statutes
Act Act-350-of-1980
145 sections
145 sections
- Mich. Comp. Laws § 550.1101Short title.
- Mich. Comp. Laws § 550.1102Legislative intent and policy.
- Mich. Comp. Laws § 550.1103Meanings of words and phrases.
- Mich. Comp. Laws § 550.1104Definitions; A to C.
- Mich. Comp. Laws § 550.1105Definitions; H.
- Mich. Comp. Laws § 550.1106Definitions; L to O.
- Mich. Comp. Laws § 550.1107Definitions; P.
- Mich. Comp. Laws § 550.1108Definitions; R, S.
- Mich. Comp. Laws § 550.1201Health care corporation; incorporation; number of persons; payment of cash or other material benefit to subscriber; applicable laws; charitable and benevolent institution; exemption from taxation; certificate of authority; health care benefits and certificates.
- Mich. Comp. Laws § 550.1201aFormation of health care corporation after January 1, 2014; prohibition.
- Mich. Comp. Laws § 550.1202Articles of incorporation; contents; number; forms; examination and certification by attorney general; fees.
- Mich. Comp. Laws § 550.1203Amendment or restatement of articles; review; approval.
- Mich. Comp. Laws § 550.1204Filing of statements and documents; examination; investigation; additional information; conditions; duties of commissioner.
- Mich. Comp. Laws § 550.1204aUnimpaired surplus.
- Mich. Comp. Laws § 550.1205aActuarial practices and accounting principles; financial report.
- Mich. Comp. Laws § 550.1206Funds, property, and business of health care corporation; investments; insurance; prepaid health care benefits.
- Mich. Comp. Laws § 550.1207Powers of health care corporation; interests of senior citizens; validity of corporate acts.
- Mich. Comp. Laws § 550.1208Action by member; complaint.
- Mich. Comp. Laws § 550.1209Action by member; discontinuance, compromise, or settlement; notice; expense.
- Mich. Comp. Laws § 550.1210Action by member; reasonable expenses; attorney's fees.
- Mich. Comp. Laws § 550.1211Administrative services only and cost-plus arrangements; service contracts; fees; administrative costs; marketing policy; notice; coverage, rights, and obligations under collective bargaining agreement; liability of individual; report; “noninsured benefit plan” defined.
- Mich. Comp. Laws § 550.1211aDefinitions; prohibited acts by corporation; processing claims for benefits on timely basis; claim form; notice to covered individuals; notice to corporation of complaint and proceedings contemplated; hearing; findings; order; violation of order; penalty; action and award of actual monetary damages; review; stay of enforcement.
- Mich. Comp. Laws § 550.1212Action without notice or lapse of time periods; waiver; attorney-in-fact.
- Mich. Comp. Laws § 550.1213Indemnification.
- Mich. Comp. Laws § 550.1214Rate of interest.
- Mich. Comp. Laws § 550.1215Health care corporation as shareholder in other nonprofit corporation; rights, powers, privileges, and liabilities.
- Mich. Comp. Laws § 550.1218Health care corporation; prohibited actions.
- Mich. Comp. Laws § 550.1219Provisions superseded.
- Mich. Comp. Laws § 550.1220Merger of health care corporation with nonprofit mutual disability insurer.
- Mich. Comp. Laws § 550.1301Board of directors; powers and duties generally; appointment, qualifications, and terms of members; vacancy; officer or employee as voting or nonvoting director; method of selection; definitions; prohibition.
- Mich. Comp. Laws § 550.1302Bylaws generally.
- Mich. Comp. Laws § 550.1303Meetings; required provisions in bylaws; notice; waiver; participation by conference telephone or similar communications equipment; quorum; action by board; actions requiring majority vote; record roll call vote; recording vote in minutes.
- Mich. Comp. Laws § 550.1304Books, records, and minutes; copy of minutes; disclosure, publication, and dissemination of minutes; compelling production of books or records.
- Mich. Comp. Laws § 550.1305Establishment and composition of corporate body; service of members on committees; membership on board of directors.
- Mich. Comp. Laws § 550.1306Effect of common directorship, officership, or interest on validity of contract or other transaction; burden of establishing validity of contract; exclusion of common or interested directors in determination of quorum; compensation of directors; bylaws regarding conflict of interest.
- Mich. Comp. Laws § 550.1307Advisory councils; committees of board of directors; bylaws regarding membership and emergency meetings and actions.
- Mich. Comp. Laws § 550.1308Committees of board of directors; powers and authority; prohibited activities; emergency actions.
- Mich. Comp. Laws § 550.1309Officers and assistants; selection; restriction; authority and duties; removal; contractual rights; bond; vacancies; compensation; pension.
- Mich. Comp. Laws § 550.1310Fiduciary duties; scope and manner of discharge; removal of director for breach of fiduciary duty; notice and hearing.
- Mich. Comp. Laws § 550.1311Liability for misapplication or misuse of corporate money or property.
- Mich. Comp. Laws § 550.1312Action for failure to perform duties; commencement.
- Mich. Comp. Laws § 550.1313False statement as misdemeanor; liability for false statement or report; commencement of action for civil liability.
- Mich. Comp. Laws § 550.1400Use of most favored nation clause in provider contract.
- Mich. Comp. Laws § 550.1401Offering 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.
- Mich. Comp. Laws § 550.1401aHealth care service rendered by dentist; benefits or reimbursement; “dentist” defined; certificates to which section applicable.
- Mich. Comp. Laws § 550.1401bCertificate providing benefits for mental health services; requirements.
- Mich. Comp. Laws § 550.1401cReplacement group certificate with preexisting condition limitation; elimination, reduction, or limitation of benefits; “disability coverage” defined.
- Mich. Comp. Laws § 550.1401dServices performed by physician's assistant; reimbursement; conditions; applicability of section; supervision by physician; definitions.
- Mich. Comp. Laws § 550.1401eGroup certificate issued by health care corporation; renewal or continuation; guaranteed renewal; discontinuing plan, product, or coverage in nongroup or group market; conditions.
- Mich. Comp. Laws § 550.1401fHealth care corporation; access to obstetrician-gynecologist.
- Mich. Comp. Laws § 550.1401gHealth care corporation; access to pediatric care services.
- Mich. Comp. Laws § 550.1401hHealth care corporation providing prescription drug coverage; formulary restrictions.
- Mich. Comp. Laws § 550.1401iPrescription drug coverage; pilot project; provisions; interim report; determination; evaluation.
- Mich. Comp. Laws § 550.1401jPrescription drug coverage; rate differentials; filing.
- Mich. Comp. Laws § 550.1401kTelemedicine services; provisions; definition; applicability.
- Mich. Comp. Laws § 550.1401mOffer of health care benefits to all residents regardless of health status.
- Mich. Comp. Laws § 550.1402Health 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.
- Mich. Comp. Laws § 550.1402aTerms and conditions of certificate; form; description; requested information; written request; “board certified” defined.
- Mich. Comp. Laws § 550.1402bPreexisting condition limitation or exclusion; prohibition; exception; “group” defined.
- Mich. Comp. Laws § 550.1402cTermination of participation between primary care physician and health care corporation; notice to member; effect of termination; definitions.
- Mich. Comp. Laws § 550.1402dApplicability of MCL 500.2212c to health care corporation.
- Mich. Comp. Laws § 550.1403Payment of benefits; interest; claim form; exception.
- Mich. Comp. Laws § 550.1403aBenefits paid by check or written instrument; escheat.
- Mich. Comp. Laws § 550.1403bAdvertising material prohibited.
- Mich. Comp. Laws § 550.1404Violation 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.
- Mich. Comp. Laws § 550.1405Single billing form; development; explanation of total bill for services.
- Mich. Comp. Laws § 550.1406Confidentiality 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.
- Mich. Comp. Laws § 550.1407Complaint system; procedures; response to complaint; access to complaints and responses; record of complaints; annual report; other legal remedies.
- Mich. Comp. Laws § 550.1408False, dishonest, or fraudulent claim for payment as misdemeanor; penalty; civil action; prosecution.
- Mich. Comp. Laws § 550.1409Civil action for negligence.
- Mich. Comp. Laws § 550.1409aCoverage 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.
- Mich. Comp. Laws § 550.1410Certificate providing coverage of dependent terminating at specified age; exceptions.
- Mich. Comp. Laws § 550.1410aProvisions of group certificate; electing coverage under group conversion certificate; notice of conversion privilege; requirements of group conversion certificate; premium; issuance; compliance.
- Mich. Comp. Laws § 550.1410bPremium for group conversion certificate after January 1, 2014; determination; rating factors.
- Mich. Comp. Laws § 550.1414aTreatment 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.
- Mich. Comp. Laws § 550.1414bOffer of wellness coverage by health care corporation.
- Mich. Comp. Laws § 550.1415Benefits for prosthetic devices.
- Mich. Comp. Laws § 550.1416Coverage 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.
- Mich. Comp. Laws § 550.1416aCoverage for drug used in antineoplastic therapy and cost of its administration; conditions.
- Mich. Comp. Laws § 550.1416bEstablishment of program to prevent onset of clinical diabetes required; report; coverages; “diabetes” defined.
- Mich. Comp. Laws § 550.1416cOff-label use of approved drug; coverage; conditions; compliance; use of copayment, deductible, sanction, or utilization control; limitation; definitions.
- Mich. Comp. Laws § 550.1416dCoverage for obstetrical and gynecological services by physician or nurse midwife.
- Mich. Comp. Laws § 550.1416eDiagnosis 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.
- Mich. Comp. Laws § 550.1417Hospice care; contracts with health care corporation; description of benefit.
- Mich. Comp. Laws § 550.1418Emergency health services; medical coverage required; “stabilization” defined.
- Mich. Comp. Laws § 550.1419Certificate offering dependent coverage to child; denial of enrollment on certain grounds prohibited.
- Mich. Comp. Laws § 550.1419aEligibility of parent for dependent coverage; health coverage of child through noncustodial parent; court or administrative order and notice required.
- Mich. Comp. Laws § 550.1419bIndividual eligible under title XIX of social security act; assignment of rights of subscriber to department of social services.
- Mich. Comp. Laws § 550.1435“Program” defined.
- Mich. Comp. Laws § 550.1436Michigan caring programs for children; creation; contribution requirements; rating methodologies; supersedure of inconsistent provisions.
- Mich. Comp. Laws § 550.1437Eligibility of child for enrollment in program.
- Mich. Comp. Laws § 550.1438Limitation of benefits; provision of other health care benefits.
- Mich. Comp. Laws § 550.1439Fees prohibited; exception; funding; enrollment of children.
- Mich. Comp. Laws § 550.1501Contracts with health care facilities.
- Mich. Comp. Laws § 550.1501aSpecial participating contracts with health care providers for provision of primary health care benefits to children enrolled in Michigan caring program.
- Mich. Comp. Laws § 550.1501bConduct on behalf of or information provided to subscriber by health care provider; prohibition or discouragement by health care corporation.
- Mich. Comp. Laws § 550.1501cProvider network.
- Mich. Comp. Laws § 550.1502Contracts for reimbursement with professional health care providers; private provider-patient relationship; methods of diagnosis or treatment not to be restricted; refusal to reimburse for overutilized services; list of providers; recommendation of provider as misdemeanor; symbol of participation; health maintenance organization not impeded; contracts subject to MCL 550.1504 to 550.1518; participation of freestanding surgical outpatient facility; optometry services; status of license or registration; chiropractic service; physical therapist or physical therapist assistant services.
- Mich. Comp. Laws § 550.1502aPrudent purchaser agreements; group contracts; option; group contracts under which financial or other advantage realized; additional option; applicability of subsection (5); individual contracts; rates; contracts subject to MCL 550.1504 to 550.1518; discrimination against class of health care providers; provisions inapplicable to certain contracts or renewals; optometry, chiropractic, and physical therapist or physical therapist assistant services.
- Mich. Comp. Laws § 550.1503Uniform reporting by health care providers.