HOUSE BILL No. 5707


     May 2, 2000, Introduced by Reps. Baird, Lemmons, Schauer, Jacobs, Woodward, Dennis, Reeves, Neumann, Bogardus and
Martinez and referred to the Committee on Insurance and Financial Services.


        A bill to amend 1978 PA 368, entitled

   "Public health code,"

   by amending section 21003 (MCL 333.21003), as amended by 1982 PA

   354.

               THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

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           Sec. 21003.  (1) "Basic health services" means:

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           (a) Physician services including consultant and referral

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      services by a physician, but not including psychiatric services.

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           (b) Ambulatory services.

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           (c) Inpatient hospital services, other than those for the

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      treatment of mental illness.

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           (d) Emergency health services.

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           (e) Outpatient mental health services, not fewer than 20

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      visits per year.




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           (f) Intermediate and outpatient care for substance abuse

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      pursuant to the following:

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           (i)  In the case of  FOR group contracts, if the fees for a

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      group contract would be increased by 3% or more because of the

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      provision of services under this subdivision, the group sub-

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      scriber shall have the option to decline the services.  In the

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      case of  FOR individual contracts, if the total fees for all

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      individual contracts would be increased by 3% or more because of

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      the provision of the services required under this subdivision in

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      all of those contracts, the named subscriber of each such con-

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      tract shall have the option to decline the services required to

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      be provided under this subdivision.

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           (ii) Charges, terms, and conditions for the services

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      required to be provided under this subdivision shall not be less

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      favorable than the maximum prescribed for any other comparable

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      service.

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           (iii) The services required to be provided under this subdi-

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      vision shall not be reduced by terms or conditions  which  THAT

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      apply to other services in a contract, group or individual.  This

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      subparagraph shall not be construed to prohibit contracts that

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      provide for deductibles and copayment provisions for services for

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      intermediate and outpatient care for substance abuse.

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           (iv) The services required to be provided under this subdi-

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      vision shall, at a minimum, provide for up to $1,656.00 in serv-

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      ices for intermediate and outpatient care for substance abuse per

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      individual per year.  This minimum shall be adjusted annually by

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      March 31 each year in accordance with the annual average



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      percentage increase or decrease in the United States consumer

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      price index for the 12-month period ending the preceding December

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      31.

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           (v) As used in this subdivision, "intermediate care",

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      "outpatient care", and "substance abuse" have those meanings

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      ascribed to them in section 3425 of the insurance code of 1956,

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       Act No. 218 of the Public Acts of 1956, being section 500.3425

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      of the Michigan Compiled Laws  1956 PA 218, MCL 500.3425.

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           (g) Diagnostic laboratory and diagnostic and therapeutic

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      radiological services.

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           (h) Home health services.

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           (i) Preventive health services.

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           (J) OTHER HEALTH SERVICES IF CONSIDERED MEDICALLY NECESSARY

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      BY THE TREATING PHYSICIAN.

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           (2) "Commissioner" means the commissioner of insurance.



























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