SB-0296, As Passed House, June 3, 2004

HOUSE SUBSTITUTE FOR

SENATE BILL NO. 296

                                                                             A bill to amend 1956 PA 218, entitled                                             

"The insurance code of 1956,"                                               

(MCL 500.100 to 500.8302) by adding section 3406l.                          

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

1   Sec. 3406l.  (1) Except as otherwise provided in                            

2   subsections (2) and (3), an expense-incurred hospital, medical,             

3   or surgical policy or certificate that provides benefits for                

4   emergency services shall provide for direct reimbursement to any            

5   provider of covered medical transportation services or shall                

6   provide that payment be made jointly to the insured and the                 

7   provider, if that provider has not received payment for those               

8   services from any other source.                                             

9   (2) Subsection (1) does not apply to a transaction between an               

10  insurer and a medical transportation service provider if the                

11  parties have entered into a contract providing for direct                   

Senate Bill No. 296 (H-1) as amended June 3, 2004

1   payment.                                                                    

2       (3) An insurer for a policy or certificate issued under                     

3   section 3405 or 3631 does not have to provide for direct                    

4   reimbursement to any nonaffiliated or nonparticipating provider             

5   for medical transportation services that were not emergency                 

6   health services as defined in section 3406k.                                

7       (4) Subsection (1) applies to an expense-incurred hospital,                 

8   medical, or surgical policy or certificate that provides benefits           

9   for emergency health services if the policy or certificate is               

10  delivered, issued for delivery, or renewed in this state on or              

11   after September 1, 2004.

[(5) This section does not apply to a health maintenance organization contract.]