Michigan Compiled Laws 350-1980-5 Part 5 (550.1501...550.1518)

• Section 550.1501 Contracts With Health Care Facilities.
  (1) A health care corporation subject to this act may enter into contracts with health care facilities in Michigan or health facilities in any...
• Section 550.1501a Special Participating Contracts With Health Care Providers For Provision Of Primary Health Care Benefits To Children Enrolled In Michigan Caring Program.
  A health care corporation may enter into special participating contracts with health care providers for the provision of primary health care benefits to children...
• Section 550.1501b Conduct On Behalf Of Or Information Provided To Subscriber By Health Care Provider; Prohibition Or Discouragement By Health Care Corporation.
  A health care corporation shall not prohibit or discourage a health care provider from advocating on behalf of a subscriber for appropriate medical treatment...
• Section 550.1501c Provider Network.
  Beginning January 1, 2014, a health care corporation shall establish and maintain a provider network that, at a minimum, satisfies any network adequacy requirements...
• Section 550.1502 Contracts For Reimbursement With Professional Health Care Providers; Private Provider-patient Relationship; Methods Of Diagnosis Or Treatment Not To Be Restricted; Refusal To Reimburse For Overutilized Services; List Of Providers; Recommendation Of Provider As Misdemeanor; Symbol Of Participation; Health Maintenance Organization Not Impeded; Contracts Subject To Mcl 550.1504 To 550.1518; Participation Of Freestanding Surgical Outpatient Facility; Optometry Services; Status Of License Or Registration; Chiropractic Service; Physical Therapist Or Physical Therapist Assistant Services.
  (1) A health care corporation may enter into participating contracts for reimbursement with professional health care providers practicing legally in this state for health...
• Section 550.1502a Prudent Purchaser Agreements; Group Contracts; Option; Group Contracts Under Which Financial Or Other Advantage Realized; Additional Option; Applicability Of Subsection (5); Individual Contracts; Rates; Contracts Subject To Mcl 550.1504 To 550.1518; Discrimination Against Class Of Health Care Providers; Provisions Inapplicable To Certain Contracts Or Renewals; Optometry, Chiropractic, And Physical Therapist Or Physical Therapist Assistant Services.
  (1) For the purpose of doing business as an organization under the prudent purchaser act, 1984 PA 233, MCL 550.51 to 550.63, a health...
• Section 550.1503 Uniform Reporting By Health Care Providers.
  In the course of developing and establishing provider class plans under this part, a health care corporation shall address the issue of uniform reporting...
• Section 550.1504 Reimbursement Arrangements; Goals; Definitions; Supplemental Efforts.
  (1) A health care corporation shall, with respect to providers, contract with or enter into a reimbursement arrangement to assure subscribers reasonable access to,...
• Section 550.1505 Provider Class Plan; Development, Modification, Implementation, Or Review; Procedures To Obtain Advice And Consultation.
  (1) A health care corporation shall establish and implement procedures to obtain advice and consultation from a provider class, either through individual providers of...
• Section 550.1506 Provider Class Plan; Transmitting To Commissioner; Examination; Determination; Notice; Placing Plan Into Effect; Retention Of Plan For Commissioner's Records.
  (1) A health care corporation shall transmit a copy of each provider class plan to the commissioner 45 days before the earliest effective date...
• Section 550.1507 Provider Class Plan; Inclusion And Transmittal Of Items Omitted.
  Within 15 days after receipt of the notification as provided in section 506(3), the health care corporation shall include the items omitted from the...
• Section 550.1508 Provider Class Plan; Modifications.
  (1) Except during the 6-month period provided in section 509(2), a provider class plan retained by the commissioner as provided in section 506(4) may...
• Section 550.1509 Achievement Of Goals And Objectives; Determinations By Commissioner.
  (1) The commissioner may determine if the health care corporation has substantially achieved the goals of a corporation as provided in section 504 and...
• Section 550.1510 Additional Determinations By Commissioner.
  (1) After considering the information and factors described in section 509(4), the goals of a health care corporation as provided in section 504, and...
• Section 550.1511 Provider Class Plan; Transmittal To Commissioner; Preparation By Commissioner.
  (1) Upon receipt of notice under section 510(2), the health care corporation, within 6 months or a period determined by the commissioner pursuant to...
• Section 550.1512 Extension Of 6-month Period Provided In Mcl 550.511(1); Determination.
  The commissioner may extend the 6-month period provided in section 511(1) once, for not more than 90 days, if the commissioner determines that a...
• Section 550.1513 Provider Class Plan; Examination; Automatic Retention; Placing Plan Into Effect; Preparation Of Plan By Commissioner; Notice.
  (1) Upon receipt of a provider class plan under section 511(1), the commissioner, after considering the information and factors described in section 509(4), within...
• Section 550.1514 Appeal; Selection And Qualifications Of Hearing Officer; Consolidation; Annual Report.
  (1) All appeals under this part shall be held before an independent hearing officer. The state court administrator shall compile and maintain a list...
• Section 550.1515 Appeal; Parties; Request; Time; Relief; Transmittal Of Provider Class Plan To Hearing Officer; Determinations.
  (1) An appeal may be brought from any action or determination of the commissioner under section 509(1), 510(1), or 513(1) or (2), by a...
• Section 550.1516 Provider Class Plan; Standards.
  (1) All provider class plans retained by the commissioner under section 513 or approved by the hearing officer shall maintain the following standards for...
• Section 550.1517 Annual Report.
  A health care corporation shall transmit an annual report for each provider class to the commissioner regarding the level of achievement of the goals...
• Section 550.1518 Considerations And Standards; Applicability; Appeal.
  The considerations set forth in section 509(4) and the standards set forth in section 516 shall only apply for purposes of this act and...

Last modified: October 10, 2016