PocketLaw | Michigan Compiled Laws | Chapter 35 Health Maintenance

Chapter 35 Health Maintenance Organizations (500.3501...500.3580)

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Section
500.3501

Definitions.

Section
500.3503

Applicability of Provisions to Health Maintenance Organization.

Section
500.3505

Health Maintenance Contract; Use of Descriptive Words; Restrictions.

Section
500.3507

Authorizing and Regulating Health Maintenance Organization; Establishment of System by Director.

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; Requirements; Meetings.

Section
500.3513

Health Maintenance Organization Operations; Regulation by Director; Incorporation as Legal Entity.

Section
500.3515

Additional Health Services; Deductibles; Copayments; "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 to Large Employers Required.

Section
500.3521

Prepayment Rates; Filing and Approval of Methodology; Schedule.

Section
500.3523

Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.

Section
500.3525

Proposal to Revise Contract or Rate; Approval of Commissioner; Approval With Modifications; Hearing; Disposition; Exception; Notice.

Section
500.3527

Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.

Section
500.3528

Health Maintenance Organization; Credentialing Verification; Accreditation by Nationally Recognized Accredited Body.

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.

Section
500.3535

Solicitation or Advertising.

Section
500.3537

Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.

Section
500.3539

Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.

Section
500.3541

Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.

Section
500.3542

Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.

Section
500.3543

Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.

Section
500.3544

Noninsured Benefit Plan; Processing and Payment of Claims.

Section
500.3545

Acquisition of Obligations From Another Managed Care Entity.

Section
500.3547

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

Maintenance of Books, Records, Files, and Financial Records; Funds and Assets.

Section
500.3549

Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.

Section
500.3551

Health Maintenance Organization; Net Worth.

Section
500.3553

Certificate of Authority; Deposit Requirements.

Section
500.3555

Financial Plan.

Section
500.3557

Notice of Changes in Operations.

Section
500.3559

Reinsurance Contract or Plan of Self-Insurance; Purpose; Filing; Approval; Coverage.

Section
500.3561

Insolvency; Continuation of Benefits.

Section
500.3563

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

Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.

Section
500.3567

Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.

Section
500.3569

Assumption of Financial Risk.

Section
500.3571

State or Federal Health Programs.

Section
500.3573

Operation of Health Care Delivery System Not Meeting Requirements of Act; Permitted Conduct; Limitations.

Section
500.3580

Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.