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MI HB4935
Bill
Status
7/13/2016
Primary Sponsor
Thomas Leonard
Click for details
AI Summary
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Comprehensively amends Michigan's Insurance Code of 1956 to revise health insurance regulations, including modifications to policy requirements, coverage mandates, and insurer conduct standards.
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Adds new provisions requiring health insurers to cover telemedicine services, autism spectrum disorder treatment (with specified annual benefit limits by age), and substance use disorder intermediate and outpatient care.
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Establishes enhanced consumer protections including grievance procedures, internal review processes, physician continuity of care during network terminations, and prohibition of most favored nation clauses in provider contracts.
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Modifies regulatory oversight by clarifying examination procedures, financial solvency requirements, and the director's authority to evaluate insurer financial condition using specified standards and risk-based capital requirements.
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Repeals outdated sections and adds new definitions and provisions governing group disability insurance, blanket disability insurance, family expense insurance, and health maintenance organizations to align with federal requirements and modern insurance practices.
Legislative Description
Insurance; health insurers; insurance code; provide for general amendments relating to health insurance. Amends secs. 106, 116, 120, 221, 222, 250, 402, 436, 436a, 454, 460, 462, 606, 632, 1001, 2003, 2006, 2059, 2212a, 2212b, 2213, 2213a, 2213b, 2214, 2236, 2237, 2242, 3400, 3402, 3403, 3404, 3405, 3405a, 3406a, 3406c, 3406d, 3406e, 3406j, 3406k, 3406l, 3406m, 3406n, 3406o, 3406p, 3406q, 3406r, 3406s, 3407, 3407b, 3408, 3409, 3411, 3412, 3413, 3414, 3416, 3418, 3420, 3422, 3424, 3425, 3426, 3428, 3432, 3438, 3440, 3452, 3472, 3475, 3476, 3501, 3503, 3505, 3507, 3508, 3509, 3511, 3513, 3515, 3517, 3519, 3528, 3533, 3535, 3545, 3547, 3548, 3551, 3553, 3555, 3557, 3559, 3561, 3563, 3569, 3571, 3573, 3701, 3703, 3705, 3711, 3723, 4601, 4701, 6428, 7060 & 7705 of 1956 PA 218 (MCL 500.106 et seq.); adds secs. 607, 608, 3401a, 3402a, 3402b, 3402c, 3402d, 3402e, 3402f, 3402g, 3402h, 3477 & 3544 & repeals secs. 3401, 3406f, 3406g, 3439, 3523, 3527, 3537, 3539, 3541, 3542, 3543, 3549, 3565, 3567, 3580 & 3706 & ch. 36 of 1956 PA 218 (MCL 500.3401 et seq.). TIE BAR WITH: HB 4933'15, HB 4934'15
State agencies (existing): insurance and financial services
Last Action
Assigned Pa 276'16 With Immediate Effect
7/13/2016