Entities Contracting With State or Local Government for Costs of Health Care Services Under Self-Funded Plan; Duties.

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Sec. 2.

(1) An entity that contracts with a state or local unit of government to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services provided under a self-funded plan established or maintained by that state or local unit of government for its employees shall do all of the following:

(a) Establish procedures and make available to persons covered by the plan internal reviews as though the entity were an insurer subject to section 2213 of the insurance code of 1956, 1956 PA 218, MCL 500.2213.

(b) Establish procedures and make available to persons covered by the plan external reviews in the same manner and subject to all the obligations, conditions, and consequences as though the entity were a health carrier under the patient's right to independent review act, 2000 PA 251, MCL 550.1901 to 550.1929.

(2) The commissioner of the office of financial and insurance services shall provide external reviews under subsection (1)(b) to a person covered by the plan as though that person were a covered person under the patient's right to independent review act, 2000 PA 251, MCL 550.1901 to 550.1929.

History: 2006, Act 495, Imd. Eff. Dec. 29, 2006


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