Michigan Compiled Laws
350-1980-5 - Part 5 (550.1501...550.1518)
Section 550.1510 - Additional Determinations by Commissioner.

Sec. 510.
(1) After considering the information and factors described in section 509(4), the goals of a health care corporation as provided in section 504, and the objectives contained in the provider class plan, the commissioner shall determined 1 of the following:
(a) That the provider class plan achieves the goals of the corporation as provided in section 504.
(b) That although the provider class plan does not substantially achieve 1 or more of the goals of the corporation, a change in the provider class plan is not required because there has been competent, material, and substantial information obtained or submitted to support a determination that the failure to achieve 1 or more of the goals was reasonable due to factors listed in section 509(4).
(c) That a provider class plan does not substantially achieve 1 or more of the goals of the corporation as provided in section 504.
(2) The commissioner shall notify the health care corporation, and each person who has requested a copy of such notice, of a determination under subsection (1) by certified or registered mail. Determinations made pursuant to subsection (1)(b) or (c) shall include a concise written statement of specific findings supporting that determination.
(3) An existing provider contract or reimbursement arrangement shall remain in effect until a new provider class plan has been retained and placed into effect as provided in section 506(4). A provider class plan shall not be subject to further review until the expiration of the time period provided in section 509(1).
(4) A provider class plan with respect to which a determination was made under subsection (1)(a) or (b) shall not be subject to further review until the expiration of 2 years following the determination.
History: 1980, Act 350, Eff. Apr. 3, 1981 Compiler's Notes: Near the end of subsection (1), “determined” evidently should read “determine.”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.