SENATE BILL NO. 1084


   April 23, 1998, Introduced by Senator STILLE and referred to the
        Committee on Health Policy and Senior Citizens.



        A bill to amend 1984 PA 218, entitled

   "Third party administrator act,"

   (MCL 550.901 to 550.962) by adding section 33.

               THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 1         SEC. 33.  A TPA SHALL NOT ENTER INTO A SERVICE CONTRACT TO

 2    ADMINISTER A PLAN THAT REQUIRES A COVERED INDIVIDUAL TO DESIGNATE

 3    A PARTICIPATING PRIMARY CARE PROVIDER AND PROVIDES FOR ANNUAL

 4    WELL-WOMAN EXAMINATIONS AND ROUTINE OBSTETRICAL AND GYNECOLOGIC

 5    SERVICES UNLESS THE PLAN:

 6         (A) PERMITS A FEMALE COVERED INDIVIDUAL TO ACCESS AN

 7    OBSTETRICIAN-GYNECOLOGIST FOR ANNUAL WELL-WOMAN EXAMINATIONS AND

 8    ROUTINE OBSTETRICAL AND GYNECOLOGIC SERVICES.

 9         (B) DOES NOT REQUIRE PRIOR AUTHORIZATION OR REFERRAL FOR

10    ACCESS TO AN OBSTETRICIAN-GYNECOLOGIST WHO PARTICIPATES WITH THE

11    PLAN.  THIS SUBDIVISION DOES NOT PROHIBIT A PLAN FROM REQUIRING


   06257'98                                                 DKH
           
                                   2

 1    AUTHORIZATION OR REFERRAL FOR ACCESS TO A NONPARTICIPATING

 2    OBSTETRICIAN-GYNECOLOGIST.

 3         Enacting section 1.  This amendatory act takes effect

 4    October 1, 1998.
















































   06257'98          Final page.                            DKH