MCL - Index of Act 350 of 1980
NOTE: Dates reflect any modification to item, not necessarily a change in law.
Title | Subject |
---|---|
Act 350 of 1980 | THE NONPROFIT HEALTH CARE CORPORATION REFORM ACT (550.1101 - 550.1704) |
350-1980-1 | PART 1 (550.1101...550.1108) |
Section 550.1101 | Short title. |
Section 550.1102 | Legislative intent and policy. |
Section 550.1103 | Meanings of words and phrases. |
Section 550.1104 | Definitions; A to C. |
Section 550.1105 | Definitions; H. |
Section 550.1106 | Definitions; L to O. |
Section 550.1107 | Definitions; P. |
Section 550.1108 | Definitions; R, S. |
350-1980-2 | PART 2 (550.1201...550.1220) |
Section 550.1201 | Health 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. |
Section 550.1201a | Formation of health care corporation after January 1, 2014; prohibition. |
Section 550.1202 | Articles of incorporation; contents; number; forms; examination and certification by attorney general; fees. |
Section 550.1203 | Amendment or restatement of articles; review; approval. |
Section 550.1204 | Filing of statements and documents; examination; investigation; additional information; conditions; duties of commissioner. |
Section 550.1204a | Unimpaired surplus. |
Section 550.1205 | Repealed. 2003, Act 59, Eff. July 23, 2003. |
Section 550.1205a | Actuarial practices and accounting principles; financial report. |
Section 550.1206 | Funds, property, and business of health care corporation; investments; insurance; prepaid health care benefits. |
Section 550.1207 | Powers of health care corporation; interests of senior citizens; validity of corporate acts. |
Section 550.1208 | Action by member; complaint. |
Section 550.1209 | Action by member; discontinuance, compromise, or settlement; notice; expense. |
Section 550.1210 | Action by member; reasonable expenses; attorney's fees. |
Section 550.1211 | Administrative 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. |
Section 550.1211a | Definitions; 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. |
Section 550.1212 | Action without notice or lapse of time periods; waiver; attorney-in-fact. |
Section 550.1213 | Indemnification. |
Section 550.1214 | Rate of interest. |
Section 550.1215 | Health care corporation as shareholder in other nonprofit corporation; rights, powers, privileges, and liabilities. |
Section 550.1216, 550.1217 | Repealed. 2002, Act 559, Imd. Eff. Sept. 27, 2002. |
Section 550.1218 | Health care corporation; prohibited actions. |
Section 550.1219 | Provisions superseded. |
Section 550.1220 | Merger of health care corporation with nonprofit mutual disability insurer. |
350-1980-3 | PART 3 (550.1301...550.1313) |
Section 550.1301 | Board 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. |
Section 550.1302 | Bylaws generally. |
Section 550.1303 | Meetings; 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. |
Section 550.1304 | Books, records, and minutes; copy of minutes; disclosure, publication, and dissemination of minutes; compelling production of books or records. |
Section 550.1305 | Establishment and composition of corporate body; service of members on committees; membership on board of directors. |
Section 550.1306 | Effect 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. |
Section 550.1307 | Advisory councils; committees of board of directors; bylaws regarding membership and emergency meetings and actions. |
Section 550.1308 | Committees of board of directors; powers and authority; prohibited activities; emergency actions. |
Section 550.1309 | Officers and assistants; selection; restriction; authority and duties; removal; contractual rights; bond; vacancies; compensation; pension. |
Section 550.1310 | Fiduciary duties; scope and manner of discharge; removal of director for breach of fiduciary duty; notice and hearing. |
Section 550.1311 | Liability for misapplication or misuse of corporate money or property. |
Section 550.1312 | Action for failure to perform duties; commencement. |
Section 550.1313 | False statement as misdemeanor; liability for false statement or report; commencement of action for civil liability. |
350-1980-4 | PART 4 (550.1400...550.1439) |
Section 550.1400 | Use of most favored nation clause in provider contract. |
Section 550.1401 | Offering 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. |
Section 550.1401a | Health care service rendered by dentist; benefits or reimbursement; “dentist” defined; certificates to which section applicable. |
Section 550.1401b | Certificate providing benefits for mental health services; requirements. |
Section 550.1401c | Replacement group certificate with preexisting condition limitation; elimination, reduction, or limitation of benefits; “disability coverage” defined. |
Section 550.1401d | Services performed by physician's assistant; reimbursement; conditions; applicability of section; supervision by physician; definitions. |
Section 550.1401e | Group certificate issued by health care corporation; renewal or continuation; guaranteed renewal; discontinuing plan, product, or coverage in nongroup or group market; conditions. |
Section 550.1401f | Health care corporation; access to obstetrician-gynecologist. |
Section 550.1401g | Health care corporation; access to pediatric care services. |
Section 550.1401h | Health care corporation providing prescription drug coverage; formulary restrictions. |
Section 550.1401i | Prescription drug coverage; pilot project; provisions; interim report; determination; evaluation. |
Section 550.1401j | Prescription drug coverage; rate differentials; filing. |
Section 550.1401k | Telemedicine services; provisions; definition; applicability. |
Section 550.1401m | Offer of health care benefits to all residents regardless of health status. |
Section 550.1402 | Health 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. |
Section 550.1402a | Terms and conditions of certificate; form; description; requested information; written request; “board certified” defined. |
Section 550.1402b | Preexisting condition limitation or exclusion; prohibition; exception; “group” defined. |
Section 550.1402c | Termination of participation between primary care physician and health care corporation; notice to member; effect of termination; definitions. |
Section 550.1402d | Applicability of MCL 500.2212c to health care corporation. |
Section 550.1403 | Payment of benefits; interest; claim form; exception. |
Section 550.1403a | Benefits paid by check or written instrument; escheat. |
Section 550.1403b | Advertising material prohibited. |
Section 550.1404 | Violation 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. |
Section 550.1405 | Single billing form; development; explanation of total bill for services. |
Section 550.1406 | Confidentiality 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. |
Section 550.1407 | Complaint system; procedures; response to complaint; access to complaints and responses; record of complaints; annual report; other legal remedies. |
Section 550.1408 | False, dishonest, or fraudulent claim for payment as misdemeanor; penalty; civil action; prosecution. |
Section 550.1409 | Civil action for negligence. |
Section 550.1409a | Coverage 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. |
Section 550.1410 | Certificate providing coverage of dependent terminating at specified age; exceptions. |
Section 550.1410a | Provisions of group certificate; electing coverage under group conversion certificate; notice of conversion privilege; requirements of group conversion certificate; premium; issuance; compliance. |
Section 550.1410b | Premium for group conversion certificate after January 1, 2014; determination; rating factors. |
Section 550.1411-550.1413a | Repealed. 1994, Act 40, Imd. Eff. Mar. 14, 1994. |
Section 550.1414 | Expired. 1980, Act 430, Eff. Jan. 1, 1982. |
Section 550.1414a | Treatment 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. |
Section 550.1414b | Offer of wellness coverage by health care corporation. |
Section 550.1415 | Benefits for prosthetic devices. |
Section 550.1416 | Coverage 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. |
Section 550.1416a | Coverage for drug used in antineoplastic therapy and cost of its administration; conditions. |
Section 550.1416b | Establishment of program to prevent onset of clinical diabetes required; report; coverages; “diabetes” defined. |
Section 550.1416c | Off-label use of approved drug; coverage; conditions; compliance; use of copayment, deductible, sanction, or utilization control; limitation; definitions. |
Section 550.1416d | Coverage for obstetrical and gynecological services by physician or nurse midwife. |
Section 550.1416e | Diagnosis 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. |
Section 550.1417 | Hospice care; contracts with health care corporation; description of benefit. |
Section 550.1418 | Emergency health services; medical coverage required; “stabilization” defined. |
Section 550.1419 | Certificate offering dependent coverage to child; denial of enrollment on certain grounds prohibited. |
Section 550.1419a | Eligibility of parent for dependent coverage; health coverage of child through noncustodial parent; court or administrative order and notice required. |
Section 550.1419b | Individual eligible under title XIX of social security act; assignment of rights of subscriber to department of social services. |
Section 550.1420-550.1430 | Repealed. 2006, Act 441, Imd. Eff. Oct. 19, 2006. |
Section 550.1435 | “Program” defined. |
Section 550.1436 | Michigan caring programs for children; creation; contribution requirements; rating methodologies; supersedure of inconsistent provisions. |
Section 550.1437 | Eligibility of child for enrollment in program. |
Section 550.1438 | Limitation of benefits; provision of other health care benefits. |
Section 550.1439 | Fees prohibited; exception; funding; enrollment of children. |
350-1980-4A | PART 4A MEDICARE SUPPLEMENT CERTIFICATES (550.1451...550.1499a) |
Section 550.1451-550.1499a | Repealed. 2002, Act 559, Imd. Eff. Sept. 27, 2002;—2006, Act 462, Imd. Eff. Dec. 20, 2006. |
350-1980-5 | PART 5 (550.1501...550.1518) |
Section 550.1501 | Contracts with health care facilities. |
Section 550.1501a | Special participating contracts with health care providers for provision of primary health care benefits to children enrolled in Michigan caring program. |
Section 550.1501b | Conduct on behalf of or information provided to subscriber by health care provider; prohibition or discouragement by health care corporation. |
Section 550.1501c | Provider network. |
Section 550.1502 | Contracts 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. |
Section 550.1502a | Prudent 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. |
Section 550.1503 | Uniform reporting by health care providers. |
Section 550.1504 | Reimbursement arrangements; goals; definitions; supplemental efforts. |
Section 550.1505 | Provider class plan; development, modification, implementation, or review; procedures to obtain advice and consultation. |
Section 550.1506 | Provider class plan; transmitting to commissioner; examination; determination; notice; placing plan into effect; retention of plan for commissioner's records. |
Section 550.1507 | Provider class plan; inclusion and transmittal of items omitted. |
Section 550.1508 | Provider class plan; modifications. |
Section 550.1509 | Achievement of goals and objectives; determinations by commissioner. |
Section 550.1510 | Additional determinations by commissioner. |
Section 550.1511 | Provider class plan; transmittal to commissioner; preparation by commissioner. |
Section 550.1512 | Extension of 6-month period provided in MCL 550.511(1); determination. |
Section 550.1513 | Provider class plan; examination; automatic retention; placing plan into effect; preparation of plan by commissioner; notice. |
Section 550.1514 | Appeal; selection and qualifications of hearing officer; consolidation; annual report. |
Section 550.1515 | Appeal; parties; request; time; relief; transmittal of provider class plan to hearing officer; determinations. |
Section 550.1516 | Provider class plan; standards. |
Section 550.1517 | Annual report. |
Section 550.1518 | Considerations and standards; applicability; appeal. |
350-1980-6 | PART 6 (550.1601...550.1620) |
Section 550.1601 | Regulation and supervision of health care corporation; delegation of authority. |
Section 550.1602 | Statement of condition; statistical, financial, and other reports. |
Section 550.1603 | Visitation and examination; access to books, papers, and documents; witnesses; expenses; disclosure of information; reporting violation; action by attorney general; ex parte order directing compliance. |
Section 550.1603a | Health care corporation subject to MCL 500.224 and 500.225; costs and expenses. |
Section 550.1604 | Confidentiality; violation as misdemeanor; penalty. |
Section 550.1605 | Certificate of authority; suspension or limitation; circumstances; order; hearing; notice. |
Section 550.1606 | Authority of commissioner regarding officers and directors; authority as to dissolution, taking over, or liquidation of corporations; insolvency defined. |
Section 550.1607 | Submission of new or revised certificate and applicable proposed rates; approval or disapproval; exemption; circumstances and conditions; notice; implementation of certificates and rates. |
Section 550.1608 | Rates charged to nongroup subscribers for certificate; methodology and definitions of rating system, formula, component, and factor used to calculate rates for group subscribers for certificate; filing; approval, disapproval, or modification; standard; burden of proof; effective date of proposed rate; rate adjustments; implementation prior to approval; examination of financial arrangement; formulae, and factors. |
Section 550.1609 | Excessive rate; administrative expense budget; equitable rate; adequate rate; line of business to be self-sustaining; cost transfers for benefit of senior citizens and group conversion subscribers. |
Section 550.1610 | Filing of information and materials relative to proposed rate; notice; approval, approval with modifications, or disapproval; additional information and materials; determination; notice; visitation and examination; expenses; order; effect of inability to approve 1 or more rating classes of business within line of business; information in support of nongroup rate filing; public inspection of information; forms and instructions for filing proposed rates. |
Section 550.1611 | Legislative intent. |
Section 550.1612 | Notice of rate filing; contents of request for hearing; advertisements; limitation on fee for copy of rate filing; waiver or reduction of fee; calculation of costs. |
Section 550.1613 | Request for hearing; standing of person; access to filing; confidentiality; penalty; appointment and qualifications of independent hearing officer; commencement of hearing; discovery; conducting hearing; burden of proving compliance; factors in rendering proposal for decision; order rendering decision; withdrawal of order. |
Section 550.1614 | Interim rates; petition; determination; granting interim rate; final rate determination; refunds or adjustments; limitation on order establishing interim rate adjustment; rates to which section applicable. |
Section 550.1615 | Review of final order or decision. |
Section 550.1616 | Endorsing, filing, and indexing documents; notice of refusal to file; judicial review; certificate of correction; persons adversely affected by correction; documents to which section inapplicable. |
Section 550.1617 | Rules. |
Section 550.1618 | Compliance with new procedures, benefits, or contracts. |
Section 550.1619 | Injunction; declaratory and equitable relief; enforcement of act or rules. |
Section 550.1620 | Certificate subject to policy and certificate issuance and rate filing requirements; establishment of reasonable open enrollment periods; frequency and duration; denial, condition, or discrimination. |
350-1980-6A | PART 6A HEALTH ENDOWMENT FUND CORPORATIONS (550.1651...550.1655) |
Section 550.1651 | Definitions. |
Section 550.1652 | Health endowment fund corporation; incorporation; conflict of interest; appointment of board members; vacancy; terms; quorum; vote; business open to public; notice; meeting in closed session; minutes; compensation. |
Section 550.1653 | Charitable purpose nonprofit corporation; receipt and administration of funds; articles of incorporation; grants; conflict with other provisions of law; social mission contributions; fund as private, nonprofit corporation. |
Section 550.1654 | Executive director. |
Section 550.1655 | Disbursement, expenditure, and investment of money by fund; system of financial accounting, controls, audits, and reports; appointment of audit committee; duties of executive director; requirement to keep accurate accounting; cooperation with investigation. |
350-1980-7 | PART 7 (550.1701...550.1704) |
Section 550.1701 | Formal reorganization not required; duties of health care corporation; amendments to articles and bylaws; description of board restructuring; review; certification; statement of reasons for disapproval; judicial remedies; effect of noncompliance; extension of corporate existence; powers undiminished. |
Section 550.1702 | Discontinuation of certain rules; continuation of certain orders and approvals. |
Section 550.1703 | Repeal of MCL 550.301 to 550.316 and 550.501 to 550.517. |
Section 550.1704 | Effective date. |