SB-0296, As Passed Senate, May 18, 2004                                     

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                              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                   

                                                                                


                                                                                

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 April 1, 2004.