Sec. 400.
(1) Notwithstanding any provision of this act to the contrary, this section applies to the use of a most favored nation clause in a provider contract on and after February 1, 2013.
(2) Subject to subsection (3), beginning February 1, 2013, a health care corporation shall not use a most favored nation clause in any provider contract, including a provider contract in effect on February 1, 2013, unless the most favored nation clause has been filed with and approved by the commissioner. Subject to subsection (3), beginning February 1, 2013, a health care corporation shall not enforce a most favored nation clause in any provider contract without the prior approval of the commissioner.
(3) Beginning January 1, 2014, a health care corporation shall not use a most favored nation clause in any provider contract, including a provider contract in effect on January 1, 2014.
(4) As used in this section, "most favored nation clause" means a clause that does any of the following:
(a) Prohibits, or grants a contracting health care corporation an option to prohibit, a provider from contracting with another party to provide health care services at a lower rate than the payment or reimbursement rate specified in the contract with the health care corporation.
(b) Requires, or grants a contracting health care corporation an option to require, a provider to accept a lower payment or reimbursement rate if the provider agrees to provide health care services to any other party at a lower rate than the payment or reimbursement rate specified in the contract with the health care corporation.
(c) Requires, or grants a contracting health care corporation an option to require, termination or renegotiation of an existing provider contract if a provider agrees to provide health care services to any other party at a lower rate than the payment or reimbursement rate specified in the contract with the health care corporation.
(d) Requires a provider to disclose, to the health care corporation or its designee, the provider's contractual payment or reimbursement rates with other parties.
History: Add. 2013, Act 4, Imd. Eff. Mar. 18, 2013 Popular Name: Blue Cross-Blue ShieldPopular Name: Act 350
Structure Michigan Compiled Laws
Chapter 550 - General Insurance Laws
Act 350 of 1980 - The Nonprofit Health Care Corporation Reform Act (550.1101 - 550.1704)
350-1980-4 - Part 4 (550.1400...550.1439)
Section 550.1400 - Use of Most Favored Nation Clause in Provider Contract.
Section 550.1401b - Certificate Providing Benefits for Mental Health Services; Requirements.
Section 550.1401f - Health Care Corporation; Access to Obstetrician-Gynecologist.
Section 550.1401g - Health Care Corporation; Access to Pediatric Care Services.
Section 550.1401j - Prescription Drug Coverage; Rate Differentials; Filing.
Section 550.1401k - Telemedicine Services; Provisions; Definition; Applicability.
Section 550.1401m - Offer of Health Care Benefits to All Residents Regardless of Health Status.
Section 550.1402d - Applicability of MCL 500.2212c to Health Care Corporation.
Section 550.1403 - Payment of Benefits; Interest; Claim Form; Exception.
Section 550.1403a - Benefits Paid by Check or Written Instrument; Escheat.
Section 550.1403b - Advertising Material Prohibited.
Section 550.1405 - Single Billing Form; Development; Explanation of Total Bill for Services.
Section 550.1409 - Civil Action for Negligence.
Section 550.1411-550.1413a - Repealed. 1994, Act 40, Imd. Eff. Mar. 14, 1994.
Section 550.1414 - Expired. 1980, Act 430, Eff. Jan. 1, 1982.
Section 550.1414b - Offer of Wellness Coverage by Health Care Corporation.
Section 550.1415 - Benefits for Prosthetic Devices.
Section 550.1417 - Hospice Care; Contracts With Health Care Corporation; Description of Benefit.
Section 550.1418 - Emergency Health Services; Medical Coverage Required; “Stabilization” Defined.
Section 550.1420-550.1430 - Repealed. 2006, Act 441, Imd. Eff. Oct. 19, 2006.
Section 550.1435 - “Program” Defined.
Section 550.1437 - Eligibility of Child for Enrollment in Program.
Section 550.1438 - Limitation of Benefits; Provision of Other Health Care Benefits.
Section 550.1439 - Fees Prohibited; Exception; Funding; Enrollment of Children.