PocketLaw | Michigan Compiled Laws | Part 4 (550.1400...550.1439)

Part 4 (550.1400...550.1439)

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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Rates; Participation in Trade Practice Conference for Disability Insurers; Provider Class Plan Not Altered or Superseded; Probable Cause to Believe Provisions Violated; Notice; Disposition of Matter by Agreement of Parties; Action for Damages; Hearing; Issuance of Cease and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.