There is a newer version of the Michigan Compiled Laws
2006 Michigan Compiled Laws - CHAPTER 35 HEALTH MAINTENANCE ORGANIZATIONS (500.3501...500.3580)
| Act 218 of 1956 HEALTH MAINTENANCE ORGANIZATIONS |
| Document | Description |
| Section 500.3501 | Definitions. |
| Section 500.3503 | Applicability of provisions to health maintenance organization. |
| Section 500.3505 | Certificate of authority; use of descriptive words; restrictions. |
| Section 500.3507 | Authorizing and regulating health maintenance organization; establishment of system by commissioner. |
| Section 500.3508 | Quality assessment program; quality improvement program. |
| Section 500.3509 | Certificate of authority; application; form; limitation; change of service area. |
| Section 500.3511 | Governing body; election of enrollee board members; terms; vacancy; meetings. |
| Section 500.3513 | Health delivery and business and financial operations; regulation by commissioner. |
| Section 500.3515 | Additional health maintenance services; copayments; limitation; report on increase of employer and employee numbers; "preventive health care services" defined; partial payment from government or private person. |
| Section 500.3517 | Healthy lifestyle programs; emergency or out-of-area service; payment of expenses or fees. |
| Section 500.3519 | Contract and contract rates; fairness; rate differential; basic health services required. |
| Section 500.3521 | Prepayment rates; filing and approval of methodology; schedule. |
| Section 500.3523 | Health maintenance contract; provisions. |
| Section 500.3525 | Proposal to revise contract; approval of commissioner; approval with modifications; hearing; disposition; exception; notice. |
| Section 500.3527 | Health maintenance contract; performance; violation of terms. |
| Section 500.3528 | Health maintenance organization; duties. |
| Section 500.3529 | Affiliated provider contracts; collection of payments from enrollees; contract provisions; waiver of requirement under subsection (2); contract format; evidence of sufficient number of providers. |
| Section 500.3530 | Availability of covered services; assurance; establishment and maintenance of proximity. |
| Section 500.3531 | Contracts with health care providers to become affiliated providers; requirements; standards; filing; duplicative standards; notice procedures; provider application period; approval or rejection as affiliated provider; termination of contract; providing information to insurer. |
| Section 500.3533 | Prudent purchaser contracts; reimbursement for unauthorized services or services by nonaffiliated providers; rate and operating requirements; maintenance of financial records by health maintenance organization. |
| Section 500.3535 | Solicitation or advertising. |
| Section 500.3537 | Open enrollment period; acceptance of group members; rating nongroup membership. |
| Section 500.3539 | Nongroup contract; exclusion or limitation; preexisting condition; renewal or continuation of nongroup contract or group contract; guaranteed renewal; healthy lifestyle program; "group" defined. |
| Section 500.3541 | Advocation by health professional. |
| Section 500.3542 | Inducement to health professional prohibited; exception. |
| Section 500.3543 | Third party administrator. |
| Section 500.3545 | Acquisition of obligations from another managed care entity. |
| Section 500.3547 | Health care service operations; visitation or examination by commissioner; consultation with enrollees; additional authority. |
| Section 500.3548 | Maintenance of books, records, and files; funds and assets. |
| Section 500.3549 | Disciplinary action; notice to board. |
| Section 500.3551 | Health maintenance organization; net worth. |
| Section 500.3553 | Minimum deposit requirements. |
| Section 500.3555 | Financial plan. |
| Section 500.3557 | Notice of changes in operations. |
| Section 500.3559 | Reinsurance contract or plan; purpose; filing; approval; coverage. |
| Section 500.3561 | Insolvency; continuation of benefits. |
| Section 500.3563 | Insolvency; allocation of group coverage to health maintenance organizations and insurers participating in enrollment process; allocation of group coverage to health maintenance organizations or insurers within service area; nongroup coverage; reassignment of enrollees of insolvent organization contracting with state funded health care program. |
| Section 500.3565 | Cancellation of contract by nongroup subscriber. |
| Section 500.3567 | Cancellation of contract with nongroup enrollee by health maintenance organization. |
| Section 500.3569 | Assumption of financial risk; "requiring an affiliated provider to assume financial risk" defined. |
| Section 500.3571 | State and federal health programs. |
| Section 500.3573 | Operation of health care delivery system not meeting requirements of act; permitted conduct; limitations. |
| Section 500.3580 | Consumer guide to health maintenance organizations; publication; contents; data; writing, presentation, promotion, and distribution of guide; access through internet. |
Disclaimer: These codes may not be the most recent version. Michigan may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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