Chapter

HEALTH MAINTENANCE ORGANIZATIONS

Mich. Comp. Laws § 500.3501— Definitions
Mich. Comp. Laws § 500.3503— Applicability of provisions to health maintenance organization
Mich. Comp. Laws § 500.3505— Health maintenance contract; use of descriptive words; restrictions
Mich. Comp. Laws § 500.3507— Authorizing and regulating health maintenance organization; establishment of system by director
Mich. Comp. Laws § 500.3508— Quality assessment program; quality improvement program
Mich. Comp. Laws § 500.3509— Certificate of authority; application; form; limitation; change of service area
Mich. Comp. Laws § 500.3511— Governing body; election of enrollee board members; requirements; meetings
Mich. Comp. Laws § 500.3513— Health maintenance organization operations; regulation by director; incorporation as legal entity
Mich. Comp. Laws § 500.3515— Additional health services; deductibles; copayments; "preventive health care services" defined; partial payment from government or private person
Mich. Comp. Laws § 500.3517— Healthy lifestyle programs; emergency or out-of-area service; payment of expenses or fees
Mich. Comp. Laws § 500.3519— Contract and contract rates; fairness; rate differential; basic health services to large employers required
Mich. Comp. Laws § 500.3521— Prepayment rates; filing and approval of methodology; schedule
Mich. Comp. Laws § 500.3525— Proposal to revise contract or rate; approval of commissioner; approval with modifications; hearing; disposition; exception; notice
Mich. Comp. Laws § 500.3528— Health maintenance organization; credentialing verification; accreditation by nationally recognized accredited body
Mich. Comp. Laws § 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
Mich. Comp. Laws § 500.3530— Availability of covered services; assurance; establishment and maintenance of proximity
Mich. Comp. Laws § 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
Mich. Comp. Laws § 500.3533— Prudent purchaser contracts; reimbursement for unauthorized services or services by nonaffiliated providers
Mich. Comp. Laws § 500.3535— Solicitation or advertising
Mich. Comp. Laws § 500.3544— Noninsured benefit plan; processing and payment of claims
Mich. Comp. Laws § 500.3545— Acquisition of obligations from another managed care entity
Mich. Comp. Laws § 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
Mich. Comp. Laws § 500.3548— Maintenance of books, records, files, and financial records; funds and assets
Mich. Comp. Laws § 500.3551— Health maintenance organization; net worth
Mich. Comp. Laws § 500.3553— Certificate of authority; deposit requirements
Mich. Comp. Laws § 500.3555— Financial plan
Mich. Comp. Laws § 500.3557— Notice of changes in operations
Mich. Comp. Laws § 500.3559— Reinsurance contract or plan of self-insurance; purpose; filing; approval; coverage
Mich. Comp. Laws § 500.3561— Insolvency; continuation of benefits
Mich. Comp. Laws § 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
Mich. Comp. Laws § 500.3569— Assumption of financial risk
Mich. Comp. Laws § 500.3571— State or federal health programs
Mich. Comp. Laws § 500.3573— Operation of health care delivery system not meeting requirements of act; permitted conduct; limitations