Sec. 66k.
(1) A county that establishes a patient care management system shall establish an office to which inquiries may be directed by health care providers under the system concerning the eligibility of patients and past admissions.
(2) An office created pursuant to subsection (1) shall be notified by health care providers of a patient's status and shall give or deny authorization for treatment on a timely basis. The office also shall review or provide for the review of utilization of services by patients and by health care providers under the patient care management system. An office may contract for the performance of its duties, subject to supervision of the contractor by the office.
(3) An office created pursuant to subsection (1) may do any of the following:
(a) Deny reimbursement to a health care provider for services determined by the office to be medically unnecessary for the treatment of a patient.
(b) Establish and publish medical protocols that permit either or both of the following:
(i) The denial of reimbursement to a health care provider if the services needed by an individual may be provided at another facility under the patient care management system at a lower cost and the patient is physically able to be transferred to that facility.
(ii) Reimbursement of the health care provider for the services rendered at the rate of reimbursement for that service at a facility which provides that service at a lower cost.
(4) An office created pursuant to subsection (1) shall implement an appeals procedure for providers of health care who are denied reimbursement, or who receive a lower rate of reimbursement, pursuant to subsection (3).
(5) An office created pursuant to subsection (1) shall develop and implement an appeals procedure for recipients of medical services under a patient care management system, by which a person can appeal the denial to him or her of any or all medical services provided under a patient care management system.
History: Add. 1987, Act 266, Imd. Eff. Dec. 28, 1987 Popular Name: Act 280
Structure Michigan Compiled Laws
Act 280 of 1939 - The Social Welfare Act (400.1 - 400.122)
Section 400.48 - Organization of Counties Into Single Administrative Unit; Appointment of Director.
Section 400.50 - County Employee; Unauthorized Transfer of Public Relief Recipient, Misdemeanor.
Section 400.53 - County Board; Cooperation With State Department.
Section 400.55 - Administration of Public Welfare Program by County Department.
Section 400.55b - Repealed. 1983, Act 213, Imd. Eff. Nov. 11, 1983.
Section 400.55c - Repealed. 1995, Act 223, Eff. Mar. 28, 1996.
Section 400.56 - Repealed. 1995, Act 223, Eff. Mar. 28, 1996.
Section 400.56a, 400.56b - Repealed. 1964, Act 3, Imd. Eff. Mar. 13, 1964.
Section 400.56c-400.56g - Repealed. 1995, Act 223, Eff. Mar. 28, 1996.
Section 400.57c - Application for Assistance by Minor Parent; Duties of Department.
Section 400.57h - Repealed. 2011, Act 131, Eff. Oct. 1, 2011.
Section 400.57k - Repealed. 2011, Act 131, Eff. Oct. 1, 2011.
Section 400.57l - Feasibility of Substance Abuse Testing Program; Report.
Section 400.57o - Repealed. 2011, Act 131, Eff. Oct. 1, 2011.
Section 400.57p - Counting Certain Months Toward Cumulative Total of 48 Months; Exclusion.
Section 400.57q - Earned Income Disregard.
Section 400.57r - Family Independence Program Assistance; Limitation.
Section 400.57s - Repealed. 2015, Act 58, Eff. Oct. 1, 2015.
Section 400.57t - Repealed. 2011, Act 131, Eff. Oct. 1, 2011.
Section 400.58a - County Medical Care Facility; Admittance.
Section 400.58c - County Medical Care Facility; Patients With Contagious Disease, Isolation.
Section 400.59b - Notification of County of Residence; Denial of Settlement, Notice.
Section 400.59c - Domicile and Legal Settlement Cases; Appeal, Determination by State Department.
Section 400.59d - Domicile and Legal Settlement Cases; Appeal; Insufficient Evidence.
Section 400.60a - Program of Computer Data Matching; Development and Implementation; Report.
Section 400.61 - Violations; Penalties; Cessation of Payments During Imprisonment.
Section 400.62 - Relief or Assistance; Effect of Amendment or Repeal; No Claim for Compensation.
Section 400.63a - Contract Awards to Specific Organizations.
Section 400.65 - Hearings Within County Department; Rules for Procedure; Review by Board.
Section 400.66 - Finality of Decision as to Relief or Medical Care; Investigation by Department.
Section 400.66c - Hospitalization; Reimbursement of County Expense.
Section 400.66d - Finality of Determination of Ineligibility for Hospitalization.
Section 400.66f - Repealed. 1971, Act 146, Imd. Eff. Nov. 12, 1971.
Section 400.66h - Hospitalization; Consent to Surgical Operation, Medical Treatment; First Aid.
Section 400.66k - Office; Creation; Purpose; Duties; Powers; Appeals Procedure.
Section 400.66m - Invoices for Reimbursement.
Section 400.66n - Appropriations.
Section 400.68 - Application by County Board for State and Federal Moneys.
Section 400.70 - Appropriation for Expenses by County Board of Supervisors.
Section 400.71 - Distinction Between Township, City, and County Poor; Abolition.
Section 400.72 - Repealed. 1968, Act 117, Imd. Eff. June 11, 1968.
Section 400.73 - Repealed. 1975, Act 237, Eff. Jan. 1, 1976.
Section 400.74 - Child Care and Social Welfare Funds; Disbursement; Bond; Purchases Made Locally.
Section 400.75 - County Board of Auditors; Authority.
Section 400.77b - Repealed. 1973, Act 189, Imd. Eff. Jan. 8, 1974.
Section 400.79 - Prosecuting Attorney; Duty to Give Counsel to Board or Director.
Section 400.80 - County Social Welfare Board; Reports to State Department.
Section 400.86 - County Departments; Powers and Duties Transferred.
Section 400.87 - Veterans' Relief Act Not Repealed.
Section 400.88 - Repealed. 1957, Act 95, Eff. July 1, 1957.
Section 400.90 - Political Activity or Use of Position by Officers and Employes Prohibited; Penalty.
Section 400.103 - Agreements as to Eligibility for Supplementary Benefits and Medical Assistance.
Section 400.105e - Appropriations.
Section 400.105f - Michigan Health Care Cost and Quality Advisory Committee.
Section 400.105g - Remote Patient Monitoring Services; Definition.
Section 400.105h - Telemedicine; Eligibility; Definitions.
Section 400.107 - Medically Indigent; Financial Eligibility; Income.
Section 400.107a - Workforce Engagement Requirements; Definitions.
Section 400.109b - Modification of Formula for Indigent Care Volume Price Adjustor.
Section 400.109d - Services Relating to Performing Abortions; Prohibitions.
Section 400.109i - Locally or Regionally Based Single Point of Entry Agencies for Long-Term Care.
Section 400.109j - Designation of Single Point of Entry Agencies; Limitation.
Section 400.110 - Medical Services for Residents Absent From State.
Section 400.110a - Funding; Rural Hospital Access Pool; Limitations; Definitions.
Section 400.111b - Requirements as Condition of Participation by Provider.
Section 400.111c - Duties of Director in Carrying Out Authority Conferred by MCL 400.111a(7)(d).
Section 400.111e - Grounds for Action by Director.
Section 400.111h - Applicability of MCL 400.111a to 400.111g.
Section 400.111k - Lead Screening on Children Enrolled in Medicaid.
Section 400.111l - Children Participants in Wic Program; Lead Testing Required.
Section 400.111n - Effective Date of Policy Changes Affecting Medicaid Cost Reports.
Section 400.112 - Medical Services; Contract With Private Agencies as Fiscal Agents.
Section 400.112b - Definitions.
Section 400.112d - Repealed. 2006, Act 674, Imd. Eff. Jan. 10, 2007.
Section 400.112e[1] - Payments Not Required; Amounts Constituting Payment in Full.
Section 400.112h - "Estate" and "Property" Defined.
Section 400.112j - Rules; Report.
Section 400.112k - Applicability of Program to Certain Medical Assistance Recipients.
Section 400.113 - “Executive Director” and “Office” Defined.
Section 400.115 - Services to Children and Youth.
Section 400.115a - Office of Children and Youth Services; Duties Generally.
Section 400.115f - Definitions.
Section 400.115k - Appeal of Determination; Notice of Rights of Appeal.
Section 400.115n - Escape of Juvenile From Facility or Residence; Notification; Definitions.
Section 400.115s - Interstate Compacts; Authorization; Force and Effect; Contents.
Section 400.117 - Repealed. 1972, Act 301, Eff. Jan. 1, 1973.
Section 400.117b - Office of Children and Youth Services; Powers Generally.
Section 400.117d - Repealed. 2018, Act 21, Eff. May 15, 2018.
Section 400.117f - Joint Program for Providing Juvenile Justice Services.
Section 400.117g - County Block Grant; Calculation; Adjustment; Deduction.
Section 400.119 - Youth Advisory Commission; Duties.
Section 400.119a - Departments and Agencies of Executive Branch of Government; Duties.
Section 400.120, 400.121 - Repealed. 1988, Act 75, Eff. June 1, 1991.
Section 400.122 - Repealed. 1978, Act 87, Eff. Apr. 1, 1978.