Part

Part 4

Mich. Comp. Laws § 550.1400— Use of most favored nation clause in provider contract
Mich. Comp. Laws § 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
Mich. Comp. Laws § 550.1401a— Health care service rendered by dentist; benefits or reimbursement; “dentist” defined; certificates to which section applicable
Mich. Comp. Laws § 550.1401b— Certificate providing benefits for mental health services; requirements
Mich. Comp. Laws § 550.1401c— Replacement group certificate with preexisting condition limitation; elimination, reduction, or limitation of benefits; “disability coverage” defined
Mich. Comp. Laws § 550.1401d— Services performed by physician's assistant; reimbursement; conditions; applicability of section; supervision by physician; definitions
Mich. Comp. Laws § 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
Mich. Comp. Laws § 550.1401f— Health care corporation; access to obstetrician-gynecologist
Mich. Comp. Laws § 550.1401g— Health care corporation; access to pediatric care services
Mich. Comp. Laws § 550.1401h— Health care corporation providing prescription drug coverage; formulary restrictions
Mich. Comp. Laws § 550.1401i— Prescription drug coverage; pilot project; provisions; interim report; determination; evaluation
Mich. Comp. Laws § 550.1401j— Prescription drug coverage; rate differentials; filing
Mich. Comp. Laws § 550.1401k— Telemedicine services; provisions; definition; applicability
Mich. Comp. Laws § 550.1401m— Offer of health care benefits to all residents regardless of health status
Mich. Comp. Laws § 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rates; participation in trade practice conference for disability insurers; provider class plan not altered or superseded; probable cause to believe provisions violated; notice; disposition of matter by agreement of parties; action for damages; hearing; issuance of cease and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
Mich. Comp. Laws § 550.1402a— Terms and conditions of certificate; form; description; requested information; written request; “board certified” defined
Mich. Comp. Laws § 550.1402b— Preexisting condition limitation or exclusion; prohibition; exception; “group” defined
Mich. Comp. Laws § 550.1402c— Termination of participation between primary care physician and health care corporation; notice to member; effect of termination; definitions
Mich. Comp. Laws § 550.1402d— Applicability of MCL 500.2212c to health care corporation
Mich. Comp. Laws § 550.1403— Payment of benefits; interest; claim form; exception
Mich. Comp. Laws § 550.1403a— Benefits paid by check or written instrument; escheat
Mich. Comp. Laws § 550.1403b— Advertising material prohibited
Mich. Comp. Laws § 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
Mich. Comp. Laws § 550.1405— Single billing form; development; explanation of total bill for services
Mich. Comp. Laws § 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
Mich. Comp. Laws § 550.1407— Complaint system; procedures; response to complaint; access to complaints and responses; record of complaints; annual report; other legal remedies
Mich. Comp. Laws § 550.1408— False, dishonest, or fraudulent claim for payment as misdemeanor; penalty; civil action; prosecution
Mich. Comp. Laws § 550.1409— Civil action for negligence
Mich. Comp. Laws § 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
Mich. Comp. Laws § 550.1410— Certificate providing coverage of dependent terminating at specified age; exceptions
Mich. Comp. Laws § 550.1410a— Provisions of group certificate; electing coverage under group conversion certificate; notice of conversion privilege; requirements of group conversion certificate; premium; issuance; compliance
Mich. Comp. Laws § 550.1410b— Premium for group conversion certificate after January 1, 2014; determination; rating factors
Mich. Comp. Laws § 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
Mich. Comp. Laws § 550.1414b— Offer of wellness coverage by health care corporation
Mich. Comp. Laws § 550.1415— Benefits for prosthetic devices
Mich. Comp. Laws § 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
Mich. Comp. Laws § 550.1416a— Coverage for drug used in antineoplastic therapy and cost of its administration; conditions
Mich. Comp. Laws § 550.1416b— Establishment of program to prevent onset of clinical diabetes required; report; coverages; “diabetes” defined
Mich. Comp. Laws § 550.1416c— Off-label use of approved drug; coverage; conditions; compliance; use of copayment, deductible, sanction, or utilization control; limitation; definitions
Mich. Comp. Laws § 550.1416d— Coverage for obstetrical and gynecological services by physician or nurse midwife
Mich. Comp. Laws § 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
Mich. Comp. Laws § 550.1417— Hospice care; contracts with health care corporation; description of benefit
Mich. Comp. Laws § 550.1418— Emergency health services; medical coverage required; “stabilization” defined
Mich. Comp. Laws § 550.1419— Certificate offering dependent coverage to child; denial of enrollment on certain grounds prohibited
Mich. Comp. Laws § 550.1419a— Eligibility of parent for dependent coverage; health coverage of child through noncustodial parent; court or administrative order and notice required
Mich. Comp. Laws § 550.1419b— Individual eligible under title XIX of social security act; assignment of rights of subscriber to department of social services
Mich. Comp. Laws § 550.1435— “Program” defined
Mich. Comp. Laws § 550.1436— Michigan caring programs for children; creation; contribution requirements; rating methodologies; supersedure of inconsistent provisions
Mich. Comp. Laws § 550.1437— Eligibility of child for enrollment in program
Mich. Comp. Laws § 550.1438— Limitation of benefits; provision of other health care benefits
Mich. Comp. Laws § 550.1439— Fees prohibited; exception; funding; enrollment of children