Sec. 418.
(1) A health care corporation certificate that provides coverage for emergency health services shall provide coverage for medically necessary services provided to a member for the sudden onset of a medical condition that manifests itself by signs and symptoms of sufficient severity, including severe pain, such that the absence of immediate medical attention could reasonably be expected to result in serious jeopardy to the individual's health or to a pregnancy in the case of a pregnant woman, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part. A health care corporation shall not require a physician to transfer a patient before the physician determines that the patient has reached the point of stabilization. A health care corporation shall not deny payment for emergency health services up to the point of stabilization provided to a member under this subsection because of either of the following:
(a) The final diagnosis.
(b) Prior authorization was not given by the health care corporation before emergency health services were provided.
(2) As used in this section, "stabilization" means the point at which no material deterioration of a condition is likely, within reasonable medical probability, to result from or occur during transfer of the patient.
History: Add. 1998, Act 124, Imd. Eff. June 10, 1998 ;-- Am. 2004, Act 8, Imd. Eff. Feb. 20, 2004 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.