MCL - 218-1956-35
Act 218 of 1956
HEALTH MAINTENANCE ORGANIZATIONS
| Document | Type | Description |
|---|---|---|
| Section 500.3501 | Section | Definitions. |
| Section 500.3503 | Section | Applicability of provisions to health maintenance organization. |
| Section 500.3505 | Section | Health maintenance contract; use of descriptive words; restrictions. |
| Section 500.3507 | Section | Authorizing and regulating health maintenance organization; establishment of system by director. |
| Section 500.3508 | Section | Quality assessment program; quality improvement program. |
| Section 500.3509 | Section | Certificate of authority; application; form; limitation; change of service area. |
| Section 500.3511 | Section | Governing body; election of enrollee board members; requirements; meetings. |
| Section 500.3513 | Section | Health maintenance organization operations; regulation by director; incorporation as legal entity. |
| Section 500.3515 | Section | Additional health services; deductibles; copayments; "preventive health care services" defined; partial payment from government or private person. |
| Section 500.3517 | Section | Healthy lifestyle programs; emergency or out-of-area service; payment of expenses or fees. |
| Section 500.3519 | Section | Contract and contract rates; fairness; rate differential; basic health services to large employers required. |
| Section 500.3521 | Section | Prepayment rates; filing and approval of methodology; schedule. |
| Section 500.3523 | Section | Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. |
| Section 500.3525 | Section | Proposal to revise contract or rate; approval of commissioner; approval with modifications; hearing; disposition; exception; notice. |
| Section 500.3527 | Section | Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. |
| Section 500.3528 | Section | Health maintenance organization; credentialing verification; accreditation by nationally recognized accredited body. |
| Section 500.3529 | Section | 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 | Section | Availability of covered services; assurance; establishment and maintenance of proximity. |
| Section 500.3531 | Section | 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 | Section | Prudent purchaser contracts; reimbursement for unauthorized services or services by nonaffiliated providers. |
| Section 500.3535 | Section | Solicitation or advertising. |
| Section 500.3537 | Section | Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. |
| Section 500.3539 | Section | Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. |
| Section 500.3541 | Section | Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. |
| Section 500.3542 | Section | Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. |
| Section 500.3543 | Section | Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. |
| Section 500.3544 | Section | Noninsured benefit plan; processing and payment of claims. |
| Section 500.3545 | Section | Acquisition of obligations from another managed care entity. |
| Section 500.3547 | Section | Health care service operations; visitation or examination by director; consultation with enrollees; authority; access to information relating to delivery of services; submission of information regarding proposed contract. |
| Section 500.3548 | Section | Maintenance of books, records, files, and financial records; funds and assets. |
| Section 500.3549 | Section | Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. |
| Section 500.3551 | Section | Health maintenance organization; net worth. |
| Section 500.3553 | Section | Certificate of authority; deposit requirements. |
| Section 500.3555 | Section | Financial plan. |
| Section 500.3557 | Section | Notice of changes in operations. |
| Section 500.3559 | Section | Reinsurance contract or plan of self-insurance; purpose; filing; approval; coverage. |
| Section 500.3561 | Section | Insolvency; continuation of benefits. |
| Section 500.3563 | Section | Insolvency; offer of enrollment by health 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; substitute coverage under American health benefit exchange. |
| Section 500.3565 | Section | Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. |
| Section 500.3567 | Section | Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. |
| Section 500.3569 | Section | Assumption of financial risk. |
| Section 500.3571 | Section | State or federal health programs. |
| Section 500.3573 | Section | Operation of health care delivery system not meeting requirements of act; permitted conduct; limitations. |
| Section 500.3580 | Section | Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. |