Michigan Compiled Laws
350-1980-5 - Part 5 (550.1501...550.1518)
Section 550.1506 - Provider Class Plan; Transmitting to Commissioner; Examination; Determination; Notice; Placing Plan Into Effect; Retention of Plan for Commissioner's Records.

Sec. 506.
(1) A health care corporation shall transmit a copy of each provider class plan to the commissioner 45 days before the earliest effective date of a provider contract or reimbursement arrangement for the appropriate provider class. The initial provider class plan for each class, which shall include provider contracts and reimbursement arrangements under which the corporation and a provider class are operating on the effective date of this act, shall be transmitted to the commissioner within 45 days after the effective date of this act, except where a provider class plan reimburses on a prospective basis, in which case the plan shall be transmitted within 1 year and 45 days after the effective date of this act.
(2) Upon receipt of a provider class plan, the commissioner shall examine the plan and shall determine only if the plan contains a reimbursement arrangement and objectives for each goal provided in section 504, and, for those providers with which a health care corporation contracts, provisions that are included in that contract. For purposes of making the determination required by this subsection only, the commissioner shall liberally construe the items contained in a provider class plan.
(3) If the commissioner determines that the plan does not contain a reimbursement arrangement, objectives for each goal provided in section 504, and, for those providers with which a health care corporation contracts, contract provisions, the commissioner, within 15 days after receipt of the plan, shall notify the corporation by certified or registered mail, along with a written statement of the items omitted.
(4) If the commissioner does not notify the health care corporation pursuant to subsection (3), the provider class plan shall be automatically placed into effect, and shall be retained for the commissioner's records. Provider class plans approved by the commissioner or an independent hearing officer under this part shall be considered retained for the commissioner's records under this subsection.
History: 1980, Act 350, Eff. Apr. 3, 1981 Popular Name: Blue Cross-Blue ShieldPopular Name: Act 350

Structure Michigan Compiled Laws

Michigan Compiled Laws

Chapter 550 - General Insurance Laws

Act 350 of 1980 - The Nonprofit Health Care Corporation Reform Act (550.1101 - 550.1704)

350-1980-5 - Part 5 (550.1501...550.1518)

Section 550.1501 - Contracts With Health Care Facilities.

Section 550.1501a - Special Participating Contracts With Health Care Providers for Provision of Primary Health Care Benefits to Children Enrolled in Michigan Caring Program.

Section 550.1501b - Conduct on Behalf of or Information Provided to Subscriber by Health Care Provider; Prohibition or Discouragement by Health Care Corporation.

Section 550.1501c - Provider Network.

Section 550.1502 - Contracts for Reimbursement With Professional Health Care Providers; Private Provider-Patient Relationship; Methods of Diagnosis or Treatment Not to Be Restricted; Refusal to Reimburse for Overutilized Services; List of Providers;...

Section 550.1502a - Prudent Purchaser Agreements; Group Contracts; Option; Group Contracts Under Which Financial or Other Advantage Realized; Additional Option; Applicability of Subsection (5); Individual Contracts; Rates; Contracts Subject to MCL 55...

Section 550.1503 - Uniform Reporting by Health Care Providers.

Section 550.1504 - Reimbursement Arrangements; Goals; Definitions; Supplemental Efforts.

Section 550.1505 - Provider Class Plan; Development, Modification, Implementation, or Review; Procedures to Obtain Advice and Consultation.

Section 550.1506 - Provider Class Plan; Transmitting to Commissioner; Examination; Determination; Notice; Placing Plan Into Effect; Retention of Plan for Commissioner's Records.

Section 550.1507 - Provider Class Plan; Inclusion and Transmittal of Items Omitted.

Section 550.1508 - Provider Class Plan; Modifications.

Section 550.1509 - Achievement of Goals and Objectives; Determinations by Commissioner.

Section 550.1510 - Additional Determinations by Commissioner.

Section 550.1511 - Provider Class Plan; Transmittal to Commissioner; Preparation by Commissioner.

Section 550.1512 - Extension of 6-Month Period Provided in MCL 550.511(1); Determination.

Section 550.1513 - Provider Class Plan; Examination; Automatic Retention; Placing Plan Into Effect; Preparation of Plan by Commissioner; Notice.

Section 550.1514 - Appeal; Selection and Qualifications of Hearing Officer; Consolidation; Annual Report.

Section 550.1515 - Appeal; Parties; Request; Time; Relief; Transmittal of Provider Class Plan to Hearing Officer; Determinations.

Section 550.1516 - Provider Class Plan; Standards.

Section 550.1517 - Annual Report.

Section 550.1518 - Considerations and Standards; Applicability; Appeal.