HOUSE BILL No. 4484


     April 15, 1999, Introduced by Reps. Birkholz, Ehardt, Howell, DeRossett, Caul, Woronchak, Richardville, Shackleton, Gilbert, Julian, Faunce, Bisbee, Kowall, Hager, Van Woerkom and Scranton and referred to the Committee on Health Policy.


        A bill to amend 1978 PA 368, entitled

   "Public health code,"

   (MCL 333.1101 to 333.25211) by adding section 21053e.

               THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 1         SEC. 21053E.  (1) A HEALTH MAINTENANCE ORGANIZATION CONTRACT

 2    THAT REQUIRES AN ENROLLEE TO DESIGNATE AN AFFILIATED PRIMARY CARE

 3    PROVIDER AND PROVIDES FOR DEPENDENT CARE COVERAGE SHALL PERMIT A

 4    DEPENDENT MINOR ENROLLEE TO ACCESS A PEDIATRICIAN FOR PEDIATRIC

 5    CARE SERVICES.

 6         (2) A HEALTH MAINTENANCE ORGANIZATION SHALL NOT REQUIRE

 7    PRIOR AUTHORIZATION OR REFERRAL FOR ACCESS UNDER SUBSECTION (1)

 8    TO A PEDIATRICIAN WHO IS AFFILIATED WITH THE HEALTH MAINTENANCE

 9    ORGANIZATION.  A HEALTH MAINTENANCE ORGANIZATION MAY REQUIRE

10    PRIOR AUTHORIZATION OR REFERRAL FOR ACCESS TO A NONAFFILIATED

11    PEDIATRICIAN.


   02731'99                                                 DKH