MI HB5107

Amends the Prudent Purchaser Act to add a new subsection (15) clarifying that coverage or reimbursement for chiropractic services is not required unless the service was included in the definition of chiropractic practice under MCL 333.16401 as of January 1, 2009.

Allows organizations to enter into prudent purchaser agreements with health care providers to control costs, ensure appropriate utilization, and maintain quality of care.

Requires organizations to offer comparable agreements to at least one health care provider within a reasonable distance if providers are available in the service area.

Mandates organizations provide all qualified providers in their geographic area an opportunity to apply for panel membership, with an initial 60-day application period and recurring 60-day periods at least every 4 years.

Requires written standards for provider selection based on quality maintenance, cost control, appropriate utilization, and reasonable access to services, with notification to applicants of acceptance or rejection within 90 days.