PATIENT RIGHTS TO INDEPENDENT

REVIEW:  CLARIFY TERMINOLOGY

House Bill 6032

Sponsor:  Rep. Roger Kahn

Committee:  Health Policy

Complete to 6-12-06

A SUMMARY OF HOUSE BILL 6032 AS INTRODUCED 5-4-06

The Patient's Right to Independent Review Act enables persons with health insurance to request a review by an independent review organization to resolve disputes over covered benefits.  Currently, the act defines the term "health carrier" to mean an entity subject to the state insurance laws and regulations, or subject to the jurisdiction of the commissioner the Office of Financial and Insurance Services (OFIS), that contracts or offers to contract to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services, including a sickness and accident insurance company, an HMO, Blue Cross Blue Shield of Michigan, or any other entity providing a plan of health insurance, health benefits, or health services. 

The term currently excludes a state department or agency.  House Bill 6032 would amend the act to clarify that the term "health carrier" would exclude a state department or agency that administered a plan of medical assistance under the Social Welfare Act (Medicaid).  In addition, the bill would include as a health carrier an entity that contracted or offered to contract to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services covered under a plan established or maintained by a state or local unit of government for its employees.

MCL 550.1903  

FISCAL IMPACT:

There is no fiscal impact on the State of Michigan or its local units of government.

                                                                                           Legislative Analyst:   Susan Stutzky

                                                                                                  Fiscal Analyst:   Richard Child

■ This analysis was prepared by nonpartisan House staff for use by House members in their deliberations, and does not constitute an official statement of legislative intent.