SENATE BILL No. 17

January 30, 2001, Introduced by Senator BYRUM and referred to the Committee on Health

Policy.

A bill to amend 1986 PA 268, entitled

"Legislative council act,"

(MCL 4.1101 to 4.1901) by amending the title, as amended by 1988

PA 100, and by adding chapter 8A.

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

1 TITLE

2 An act to create the legislative council; to prescribe its

3 membership, powers, and duties; to create a legislative service

4 bureau to provide staff services to the legislature and the coun-

5 cil; to provide for operation of legislative parking facilities;

6 to create funds; to provide for the expenditure of appropriated

7 funds by legislative council agencies; to authorize the sale of

8 access to certain computerized data bases DATABASES; to

9 establish fees; to create the Michigan commission on uniform

10 state laws; to create a law revision commission; to create a

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1 senate fiscal agency and a house fiscal agency; to create a

2 Michigan capitol committee; to create a commission on intergov-

3 ernmental relations; TO CREATE THE MANAGED CARE OMBUDSMAN'S

4 OFFICE; to prescribe the powers and duties of certain state agen-

5 cies and departments; AND to repeal certain acts and parts of

6 acts. ; and to repeal certain parts of this act on specific

7 dates.

8 CHAPTER 8A.

9 MANAGED CARE OMBUDSMAN.

10 SEC. 851. AS USED IN THIS CHAPTER:

11 (A) "CONSUMER" MEANS A RESIDENT OF THIS STATE WHO IS UNDER

12 MANAGED CARE.

13 (B) "MANAGED CARE PLAN" MEANS A POLICY, CERTIFICATE, OR CON-

14 TRACT OFFERED BY A HEALTH INSURER, HEALTH MAINTENANCE ORGANIZA-

15 TION, OR HEALTH CARE CORPORATION UNDER WHICH COVERED INDIVIDUALS

16 ELECT TO OBTAIN HEALTH CARE SERVICES FROM AFFILIATED PROVIDERS OR

17 FROM HEALTH CARE PROVIDERS WHO HAVE ENTERED INTO PRUDENT PUR-

18 CHASER AGREEMENTS.

19 (C) "OMBUDSMAN" MEANS THE LEGISLATIVE MANAGED CARE

20 OMBUDSMAN.

21 SEC. 852. (1) THE MANAGED CARE OMBUDSMAN'S OFFICE IS CRE-

22 ATED WITHIN THE LEGISLATIVE COUNCIL.

23 (2) THE PRINCIPAL EXECUTIVE OFFICER OF THE OFFICE IS THE

24 MANAGED CARE OMBUDSMAN WHO SHALL BE APPOINTED BY AND SERVE AT THE

25 PLEASURE OF THE COUNCIL.

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1 (3) THE COUNCIL SHALL ESTABLISH PROCEDURES FOR APPROVING THE

2 OFFICE'S BUDGET, EXPENDING FUNDS, AND EMPLOYING THE OMBUDSMAN AND

3 PERSONNEL FOR THE OFFICE.

4 SEC. 853. THE OMBUDSMAN SHALL DO ALL OF THE FOLLOWING:

5 (A) ADVISE THE LEGISLATURE ON ISSUES REGARDING MANAGED

6 CARE.

7 (B) REVIEW AND COMMENT ON MANAGED CARE ISSUES INVOLVING THE

8 DEPARTMENT OF COMMUNITY HEALTH OR THE OFFICE OF FINANCIAL AND

9 INSURANCE SERVICES.

10 (C) RESEARCH AND INVESTIGATE MATTERS THAT AFFECT THE QUALI-

11 TY, DELIVERY, COSTS, MANAGEMENT, AND OPERATION OF MANAGED CARE AS

12 IT AFFECTS CONSUMERS.

13 (D) PROVIDE TECHNICAL ASSISTANCE AND ACT AS A RESOURCE TO

14 CONSUMERS REGARDING MANAGED CARE INCLUDING ALL OF THE FOLLOWING:

15 (i) EDUCATING CONSUMERS ABOUT THEIR RIGHTS AND

16 RESPONSIBILITIES.

17 (ii) ASSISTING CONSUMERS WITH FILING GRIEVANCES OR APPEALS

18 OF MANAGED CARE PLAN DETERMINATIONS.

19 (iii) DISSEMINATING INFORMATION AND REPORTS CONCERNING MAN-

20 AGED CARE PLANS AND ISSUES.

21 (E) ESTABLISH A STATEWIDE TOLL-FREE TELEPHONE LINE TO GIVE

22 STATE RESIDENTS ACCESS TO THE OMBUDSMAN'S OFFICE.

23 (F) PERFORM OTHER FUNCTIONS AS DETERMINED BY THE COUNCIL.

24 SEC. 855. (1) CORRESPONDENCE BETWEEN THE OMBUDSMAN AND A

25 CONSUMER IS CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER THE

26 FREEDOM OF INFORMATION ACT, 1976 PA 442, MCL 15.231 TO 15.246.

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1 (2) THE OMBUDSMAN SHALL MAINTAIN CONFIDENTIALITY WITH

2 RESPECT TO ALL MATTERS AND THE IDENTITIES OF COMPLAINANTS OR

3 PERSONS FROM WHOM INFORMATION IS ACQUIRED, EXCEPT TO THE EXTENT

4 DISCLOSURE IS NECESSARY TO ENABLE THE OMBUDSMAN TO PERFORM THE

5 DUTIES OF THE OFFICE OR TO SUPPORT RECOMMENDATIONS RESULTING FROM

6 AN INVESTIGATION.

7 SEC. 857. THE OMBUDSMAN SHALL SUBMIT TO THE COUNCIL AND THE

8 LEGISLATURE AN ANNUAL REPORT ON THE ACTIONS OF THE OFFICE, ON

9 ISSUES AND MATTERS UNDER SECTION 853(A), (B), AND (C), AND ON THE

10 NEED FOR ANY SUGGESTED LEGISLATIVE ACTION.

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