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Section 500.3501 - Definitions. - Sec. 3501. As used in this chapter: (a) "Affiliated provider"...
Section 500.3503 - Applicability of Provisions to Health Maintenance Organization. - Sec. 3503. (1) Unless specifically excluded, or otherwise specifically provided...
Section 500.3505 - Health Maintenance Contract; Use of Descriptive Words; Restrictions. - Sec. 3505. (1) A health maintenance organization shall not issue...
Section 500.3507 - Authorizing and Regulating Health Maintenance Organization; Establishment of System by Director. - Sec. 3507. The director shall establish a system of authorizing...
Section 500.3508 - Quality Assessment Program; Quality Improvement Program. - Sec. 3508. (1) A health maintenance organization shall develop and...
Section 500.3509 - Certificate of Authority; Application; Form; Limitation; Change of Service Area. - Sec. 3509. (1) An application to the director for a...
Section 500.3511 - Governing Body; Election of Enrollee Board Members; Requirements; Meetings. - Sec. 3511. (1) A health maintenance organization's governing body must...
Section 500.3513 - Health Maintenance Organization Operations; Regulation by Director; Incorporation as Legal Entity. - Sec. 3513. (1) The director shall regulate health delivery aspects...
Section 500.3515 - Additional Health Services; Deductibles; Copayments; "Preventive Health Care Services" Defined; Partial Payment From Government or Private Person. - Sec. 3515. (1) A health maintenance organization may provide additional...
Section 500.3517 - Healthy Lifestyle Programs; Emergency or Out-of-Area Service; Payment of Expenses or Fees. - Sec. 3517. (1) A health maintenance contract shall not provide...
Section 500.3519 - Contract and Contract Rates; Fairness; Rate Differential; Basic Health Services to Large Employers Required. - Sec. 3519. (1) A health maintenance organization contract and the...
Section 500.3521 - Prepayment Rates; Filing and Approval of Methodology; Schedule. - Sec. 3521. (1) The methodology used to determine prepayment rates...
Section 500.3523 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. - Compiler's Notes: The repealed section pertained to provisions included in...
Section 500.3525 - Proposal to Revise Contract or Rate; Approval of Commissioner; Approval With Modifications; Hearing; Disposition; Exception; Notice. - Sec. 3525. (1) Except as otherwise provided in subsection (2),...
Section 500.3527 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. - Compiler's Notes: The repealed section pertained to performance of obligations...
Section 500.3528 - Health Maintenance Organization; Credentialing Verification; Accreditation by Nationally Recognized Accredited Body. - Sec. 3528. (1) A health maintenance organization shall establish written...
Section 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. - Sec. 3529. (1) A health maintenance organization may contract with...
Section 500.3530 - Availability of Covered Services; Assurance; Establishment and Maintenance of Proximity. - Sec. 3530. (1) A health maintenance organization shall maintain contracts...
Section 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... - Sec. 3531. (1) This section applies if a health maintenance...
Section 500.3533 - Prudent Purchaser Contracts; Reimbursement for Unauthorized Services or Services by Nonaffiliated Providers. - Sec. 3533. Subject to section 3405, a health maintenance organization...
Section 500.3535 - Solicitation or Advertising. - Sec. 3535. Solicitation of enrollees or advertising of the services,...
Section 500.3537 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. - Compiler's Notes: The repealed section pertained to open enrollment period...
Section 500.3539 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. - Compiler's Notes: The repealed section pertained to exclusions and limitations...
Section 500.3541 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. - Compiler's Notes: The repealed section pertained to health professional advocating...
Section 500.3542 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. - Compiler's Notes: The repealed section pertained to prohibition against use...
Section 500.3543 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. - Compiler's Notes: The repealed section pertained to owning or investing...
Section 500.3544 - Noninsured Benefit Plan; Processing and Payment of Claims. - Sec. 3544. (1) A health maintenance organization may process and...
Section 500.3545 - Acquisition of Obligations From Another Managed Care Entity. - Sec. 3545. With the director's prior approval, a health maintenance...
Section 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. - Sec. 3547. (1) The director at any time may visit...
Section 500.3548 - Maintenance of Books, Records, Files, and Financial Records; Funds and Assets. - Sec. 3548. (1) A health maintenance organization shall keep all...
Section 500.3549 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. - Compiler's Notes: The repealed section pertained to notice to appropriate...
Section 500.3551 - Health Maintenance Organization; Net Worth. - Sec. 3551. (1) A health maintenance organization shall determine its...
Section 500.3553 - Certificate of Authority; Deposit Requirements. - Sec. 3553. (1) To obtain or maintain a certificate of...
Section 500.3555 - Financial Plan. - Sec. 3555. A health maintenance organization shall maintain a financial...
Section 500.3557 - Notice of Changes in Operations. - Sec. 3557. A health maintenance organization shall file notice with...
Section 500.3559 - Reinsurance Contract or Plan of Self-Insurance; Purpose; Filing; Approval; Coverage. - Sec. 3559. (1) Subject to subsection (2), a health maintenance...
Section 500.3561 - Insolvency; Continuation of Benefits. - Sec. 3561. A health maintenance organization shall have a plan...
Section 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... - Sec. 3563. (1) If a health maintenance organization becomes insolvent,...
Section 500.3565 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. - Compiler's Notes: The repealed section pertained to cancellation of contract...
Section 500.3567 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. - Compiler's Notes: The repealed section pertained to cancellation of contract...
Section 500.3569 - Assumption of Financial Risk. - Sec. 3569. (1) Except as provided in section 3515(2), a...
Section 500.3571 - State or Federal Health Programs. - Sec. 3571. A health maintenance organization that participates in a...
Section 500.3573 - Operation of Health Care Delivery System Not Meeting Requirements of Act; Permitted Conduct; Limitations. - Sec. 3573. (1) A person that proposes to operate a...
Section 500.3580 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. - Compiler's Notes: The repealed section pertained to consumer guide to...