reglab/housing_qa huggingface dataset:
MI Comp L § 550.1416a (2021)
2021 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 550.1416a - Coverage for Drug Used in Antineoplastic Therapy and Cost of Its Administration; Conditions.

550.1416a Coverage for drug used in antineoplastic therapy and cost of its administration; conditions. Sec. 416a.  A health care corporation shall provide coverage in each group and nongroup certificate for a federal food and drug administration approved drug used in antineoplastic therapy and the reasonable cost of its administration. Coverage shall be provided regardless of whether the specific neoplasm for which the drug is being used as treatment is the specific neoplasm for which the drug has received approval by the federal food and drug administration if all of the following conditions are met:  (a) The drug is ordered by a physician for the treatment of a specific type of neoplasm.  (b) The drug is approved by the federal food and drug administration for use in antineoplastic therapy.  (c) The drug is used as part of an antineoplastic drug regimen.  (d) Current medical literature substantiates its efficacy and recognized oncology organizations generally accept the treatment.  (e) The physician has obtained informed consent from the patient for the treatment regimen which includes federal food and drug administration approved drugs for off-label indications. History: Add. 1989, Act 57, Imd. Eff. June 16, 1989 Popular Name: Blue Cross-Blue ShieldPopular Name: Act 350
MI Comp L § 550.1416d (2021)
2021 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 550.1416d - Coverage for Obstetrical and Gynecological Services by Physician or Nurse Midwife.

550.1416d Coverage for obstetrical and gynecological services by physician or nurse midwife.Sec. 416d.  (1) As used in this section, "nurse midwife" means an individual licensed as a registered professional nurse under article 15 of the public health code, 1978 PA 368, MCL 333.16101 to 333.18838, who has been issued a specialty certification in the practice of nurse midwifery by the Michigan board of nursing under section 17210 of the public health code, 1978 PA 368, MCL 333.17210.  (2) Effective March 1, 2005, a group or nongroup certificate that provides coverage for obstetrical and gynecological services shall include coverage for obstetrical and gynecological services whether performed by a physician or a nurse midwife acting within the scope of his or her license or specialty certification or shall do 1 or both of the following:  (a) Offer to provide coverage for obstetrical and gynecological services whether performed by a physician or a nurse midwife acting within the scope of his or her license or specialty certification.  (b) Offer to provide coverage for maternity services and gynecological services rendered during pre- and post-natal care whether performed by a physician or a nurse midwife acting within the scope of his or her license or specialty certification. History: Add. 2004, Act 374, Imd. Eff. Oct. 11, 2004
MI Comp L § 550.1417 (2021)
2021 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 550.1417 - Hospice Care; Contracts With Health Care Corporation; Description of Benefit.

550.1417 Hospice care; contracts with health care corporation; description of benefit. Sec. 417.  (1) A health care corporation shall offer to include benefits for hospice care in each certificate that provides benefits for inpatient hospital care.  (2) A health care corporation may enter into contracts with health care providers for the rendering of hospice care. A contracting health care provider shall be a licensed hospice under article 17 of the public health code, Act No. 368 of the Public Acts of 1978, being sections 333.20101 to 333.22260 of the Michigan Compiled Laws, and shall meet the standards set by the corporation for contracting health care providers.  (3) If benefits for hospice care are provided, a description of the hospice benefit shall be included in communications sent to the individual or group purchaser of coverage. History: Add. 1984, Act 369, Eff. Jan. 1, 1986 ;-- Am. 1994, Act 235, Imd. Eff. June 30, 1994 Popular Name: Blue Cross-Blue ShieldPopular Name: Act 350
MI Comp L § 550.1418 (2021)
2021 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 550.1418 - Emergency Health Services; Medical Coverage Required; “Stabilization” Defined.

550.1418 Emergency health services; medical coverage required; “stabilization” defined. 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
MI Comp L § 550.1419 (2021)
2021 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 550.1419 - Certificate Offering Dependent Coverage to Child; Denial of Enrollment on Certain Grounds Prohibited.

550.1419 Certificate offering dependent coverage to child; denial of enrollment on certain grounds prohibited. Sec. 419.  A health care corporation certificate that offers dependent coverage shall not deny enrollment to a subscriber's child on any of the following grounds:  (a) The child was born out of wedlock.  (b) The child is not claimed as a dependent on the subscriber's federal income tax return.  (c) The child does not reside with the subscriber or in the health care corporation's service area. History: Add. 1995, Act 238, Eff. Mar. 28, 1996 Popular Name: Blue Cross-Blue ShieldPopular Name: Act 350
MI Comp L § 550.1419a (2021)
2021 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 550.1419a - Eligibility of Parent for Dependent Coverage; Health Coverage of Child Through Noncustodial Parent; Court or Administrative Order and Notice Required.

550.1419a Eligibility of parent for dependent coverage; health coverage of child through noncustodial parent; court or administrative order and notice required. Sec. 419a.  (1) If a parent is eligible for dependent coverage through a health care corporation, the health care corporation shall:  (a) Permit the parent to enroll, under the dependent coverage, a child who is otherwise eligible for coverage without regard to any enrollment season restrictions.  (b) If the parent is enrolled but fails to make application to obtain coverage for the child, enroll the child under dependent coverage upon application by the friend of the court or by the child's other parent through the friend of the court.  (c) Not eliminate the child's coverage unless premiums have not been paid as required by the certificate or the health care corporation is provided with satisfactory written evidence of either of the following:  (i) The court or administrative order is no longer in effect.  (ii) The child is or will be enrolled in comparable health coverage through another health care corporation, insurer, health maintenance organization, or self-funded health coverage plan that will take effect not later than the effective date of the cancellation of the existing coverage.  (2) If a child has health coverage through a health care corporation of a noncustodial parent, that health care corporation shall do all of the following:  (a) Provide the custodial parent with information necessary for the child to obtain benefits through that coverage.  (b) Permit the custodial parent or, with the custodial parent's approval, the provider to submit a claim for covered services without the noncustodial parent's approval.  (c) If applicable, reimburse or make payment on claims submitted by the custodial parent or medical provider for services obtained or provided under subdivision (b).  (3) This section applies only if a parent is required by a court or administrative order to provide health coverage for a child and the health care corporation is notified of that court or administrative order. History: Add. 1995, Act 238, Eff. Mar. 28, 1996 Popular Name: Blue Cross-Blue ShieldPopular Name: Act 350
MI Comp L § 550.1419b (2021)
2021 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 550.1419b - Individual Eligible Under Title XIX of Social Security Act; Assignment of Rights of Subscriber to Department of Social Services.

550.1419b Individual eligible under title XIX of social security act; assignment of rights of subscriber to department of social services. Sec. 419b.  (1) A health care corporation shall not consider whether an individual is eligible for or has available medical assistance under title XIX of the social security act, chapter 531, 49 Stat. 620, 42 U.S.C. 1396 to 1396g and 1396i to 1396v, in this or another state when considering eligibility for coverage or making payments under its plan for eligible subscribers.  (2) If a health care corporation has a legal liability to make payments, and payment for covered expenses for medical goods or services furnished to an individual has been made under the medical assistance program established under section 105 of the social welfare act, Act No. 280 of the Public Acts of 1939, being section 400.105 of the Michigan Compiled Laws, the department of social services has the rights of the individual to payment by the health care corporation to the extent payment was made by the department of social services's medical assistance program for those medical goods or services.  (3) If the department of social services has been assigned the rights of a subscriber who is eligible for medical assistance under section 105 of Act No. 280 of the Public Acts of 1939 and is covered by a health care corporation, the health care corporation shall not impose requirements on the department of social services that are different from requirements that apply to an agent or assignee of any other covered subscriber. History: Add. 1995, Act 238, Eff. Mar. 28, 1996 Popular Name: Blue Cross-Blue ShieldPopular Name: Act 350
MI Comp L § 550.1420-550.1430 (2021)
2021 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 550.1420-550.1430 - Repealed. 2006, Act 441, Imd. Eff. Oct. 19, 2006.

550.1420-550.1430 Repealed. 2006, Act 441, Imd. Eff. Oct. 19, 2006. Compiler's Notes: The repealed sections pertained to individual and group long-term care coverage.Popular Name: Act 218
MI Comp L § 550.1435 (2021)
2021 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 550.1435 - “Program” Defined.

550.1435 “Program” defined. Sec. 435.  As used in sections 436 to 439, "program" means the Michigan caring program created in section 436. History: Add. 1991, Act 60, Imd. Eff. June 27, 1991 Popular Name: Blue Cross-Blue ShieldPopular Name: Act 350
MI Comp L § 550.1436 (2021)
2021 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 550.1436 - Michigan Caring Programs for Children; Creation; Contribution Requirements; Rating Methodologies; Supersedure of Inconsistent Provisions.

550.1436 Michigan caring programs for children; creation; contribution requirements; rating methodologies; supersedure of inconsistent provisions. Sec. 436.  There may be created within each health care corporation a Michigan caring program for children. The program shall provide primary health care coverage for children as set forth in section 438 and shall be administered by the health care corporation. Each program shall be described in a certificate that sets forth the benefits provided. A certificate and the contribution to be charged shall be subject to the commissioner's approval. Contribution requirements shall be established in accordance with rating methodologies approved by the commissioner which, over time, shall not result in either gain or loss to the corporation. The rating methodology for a program shall not include any factors otherwise includable pursuant to other sections of this act that are intended to provide for subsidies, surcharges, or administrative costs. Any other provisions of this act that would otherwise apply to a program but which are inconsistent with the provisions of this section and sections 437 to 439 are superseded. History: Add. 1991, Act 60, Imd. Eff. June 27, 1991 Popular Name: Blue Cross-Blue ShieldPopular Name: Act 350
MI Comp L § 550.1437 (2021)
2021 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 550.1437 - Eligibility of Child for Enrollment in Program.

550.1437 Eligibility of child for enrollment in program. Sec. 437.  A child is eligible for enrollment in the program if the child meets all of the following:  (a) Is less than 19 years of age.  (b) Is unmarried.  (c) Resides in a household with income 185% or less of the federal poverty level.  (d) Is ineligible to receive health care through title XIX of the social security act, chapter 531, 49 Stat. 620, 42 U.S.C. 1396 to 1396d, 1396f to 1369g, and 1396i to 1396s.  (e) Is enrolled in the program with all other eligible siblings who have no other health care coverage available.  (f) Is a resident of this state.  (g) Has no other health care coverage available. History: Add. 1991, Act 60, Imd. Eff. June 27, 1991 Popular Name: Blue Cross-Blue ShieldPopular Name: Act 350
MI Comp L § 550.1438 (2021)
2021 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 550.1438 - Limitation of Benefits; Provision of Other Health Care Benefits.

550.1438 Limitation of benefits; provision of other health care benefits. Sec. 438.  (1) Notwithstanding any other provision of this act, a health care corporation may limit the benefits it will furnish to an eligible child enrolled in the program to the following primary health care benefits:  (a) Doctor office visits for a sick child.  (b) Medically necessary outpatient diagnostic tests.  (c) Emergency medical and accident care in a doctor's office or hospital's emergency room.  (d) Medically necessary outpatient surgery and anesthesia.  (e) Preventive care, including, but not limited to, immunizations and well-child visits to a doctor's office.  (f) Outpatient substance abuse care.  (2) With the commissioner's approval, a health care corporation may provide other health care benefits in addition to the primary health care benefits set forth in subsection (1). History: Add. 1991, Act 60, Imd. Eff. June 27, 1991 Popular Name: Blue Cross-Blue ShieldPopular Name: Act 350
MI Comp L § 550.1439 (2021)
2021 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 550.1439 - Fees Prohibited; Exception; Funding; Enrollment of Children.

550.1439 Fees prohibited; exception; funding; enrollment of children. Sec. 439.  The program shall not charge any fee to an enrolled eligible child or the child's parents or legal guardians except that if prescription drug benefits are offered a co-pay not to exceed $3.00 may be charged. The program shall be funded by private donations and private and public grants. The health care corporation may provide free of charge administrative services to the program as approved by its board of directors and subject to the commissioner's approval. A child shall be enrolled as follows:  (a) Dependent on funding on a first-come, first-served basis unless a named child is part of a group of 10 or more children who are fully sponsored by private donations.  (b) Without regard to health status. History: Add. 1991, Act 60, Imd. Eff. June 27, 1991 Popular Name: Blue Cross-Blue ShieldPopular Name: Act 350
MI Comp L § 550.1451-550.1499a (2021)
2021 Michigan Compiled Laws|Chapter 550 - General Insurance Laws|Act 350 of 1980 - The Nonprofit Health Care Corporation Reform Act (550.1101 - 550.1704)|350-1980-4A - Part 4a Medicare Supplement Certificates (550.1451...550.1499a)|Section 550.1451-550.1499a - Repealed. 2002, Act 559, Imd. Eff. Sept. 27, 2002;—2006, Act 462, Imd. Eff. Dec. 20, 2006.

550.1451-550.1499a Repealed. 2002, Act 559, Imd. Eff. Sept. 27, 2002;—2006, Act 462, Imd. Eff. Dec. 20, 2006. Popular Name: Blue Cross-Blue ShieldPopular Name: Act 350
MI Comp L § 550.1501 (2021)
2021 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.

550.1501 Contracts with health care facilities. Sec. 501.  (1) A health care corporation subject to this act may enter into contracts with health care facilities in Michigan or health facilities in any other jurisdiction. It is the intent of the legislature that contracts with health facilities outside of Michigan expand access to health care without reducing access to Michigan licensed health facilities.  (2) Contracts entered into under this section with health care facilities licensed in Michigan are subject to the provisions of sections 504 to 518. History: 1980, Act 350, Eff. Apr. 3, 1981 ;-- Am. 2003, Act 60, Imd. Eff. July 15, 2003 Popular Name: Blue Cross-Blue ShieldPopular Name: Act 350
MI Comp L § 550.1501a (2021)
2021 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 550.1501a - Special Participating Contracts With Health Care Providers for Provision of Primary Health Care Benefits to Children Enrolled in Michigan Caring Program.

550.1501a Special participating contracts with health care providers for provision of primary health care benefits to children enrolled in Michigan caring program. Sec. 501a.  A health care corporation may enter into special participating contracts with health care providers for the provision of primary health care benefits to children enrolled in a Michigan caring program created under section 436. Special participating contracts entered into under this section are not subject to sections 502 to 518. History: Add. 1991, Act 73, Imd. Eff. July 11, 1991 Popular Name: Blue Cross-Blue ShieldPopular Name: Act 350
MI Comp L § 550.1501b (2021)
2021 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 550.1501b - Conduct on Behalf of or Information Provided to Subscriber by Health Care Provider; Prohibition or Discouragement by Health Care Corporation.

550.1501b Conduct on behalf of or information provided to subscriber by health care provider; prohibition or discouragement by health care corporation. Sec. 501b.  A health care corporation shall not prohibit or discourage a health care provider from advocating on behalf of a subscriber for appropriate medical treatment options pursuant to the grievance procedure in section 404 or from discussing with a subscriber or provider any of the following:  (a) Health care treatments and services.  (b) Quality assurance plans required by law, if applicable.  (c) The financial relationships between the health care corporation and the health care provider including all of the following as applicable:  (i) Whether a fee-for-service arrangement exists, under which the provider is paid a specified amount for each covered service rendered to the participant.   (ii) Whether a capitation arrangement exists, under which a fixed amount is paid to the provider for all covered services that are or may be rendered to each covered individual or family.  (iii) Whether payments to providers are made based on standards relating to cost, quality, or patient satisfaction. History: Add. 1997, Act 68, Imd. Eff. July 15, 1997 Popular Name: Blue Cross-Blue ShieldPopular Name: Act 350
MI Comp L § 550.1501c (2021)
2021 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 550.1501c - Provider Network.

550.1501c Provider network.Sec. 501c.  Beginning January 1, 2014, a health care corporation shall establish and maintain a provider network that, at a minimum, satisfies any network adequacy requirements imposed by the commissioner pursuant to federal law. History: Add. 2013, Act 4, Imd. Eff. Mar. 18, 2013 Popular Name: Blue Cross-Blue ShieldPopular Name: Act 350
MI Comp L § 550.1503 (2021)
2021 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 550.1503 - Uniform Reporting by Health Care Providers.

550.1503 Uniform reporting by health care providers. Sec. 503.  In the course of developing and establishing provider class plans under this part, a health care corporation shall address the issue of uniform reporting by health care providers. History: 1980, Act 350, Eff. Apr. 3, 1981 Popular Name: Blue Cross-Blue ShieldPopular Name: Act 350