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Section 550.1205 Repealed. 2003, Act 59, Eff.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.