SB-1426, As Passed House, December 12, 2006

HOUSE SUBSTITUTE FOR

SENATE BILL NO. 1426

     A bill to provide that certain entities contracting with state

and local units of government are subject to the patient's right to

independent review act.

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

     Sec. 1. As used in this act, "local unit of government" means

any political subdivision of this state, including, but not limited

to, school districts, community and junior colleges, state

universities, cities, villages, townships, charter townships,

counties, charter counties, authorities created by the state, and

authorities created by other local units of government.

     Sec. 2. (1) An entity that contracts with a state or local

unit of government to provide, deliver, arrange for, pay for, or

reimburse any of the costs of health care services provided under a

self-funded plan established or maintained by that state or local

unit of government for its employees shall do all of the following:

     (a) Establish procedures and make available to persons covered

by the plan internal reviews as though the entity were an insurer

subject to section 2213 of the insurance code of 1956, 1956 PA 218,

MCL 500.2213.

     (b) Establish procedures and make available to persons covered

by the plan external reviews in the same manner and subject to all

the obligations, conditions, and consequences as though the entity

were a health carrier under the patient's right to independent

review act, 2000 PA 251, MCL 550.1901 to 550.1929.

     (2) The commissioner of the office of financial and insurance

services shall provide external reviews under subsection (1)(b) to

a person covered by the plan as though that person were a covered

person under the patient's right to independent review act, 2000 PA

251, MCL 550.1901 to 550.1929.

     Sec. 3. This act does not apply to a self-funded plan that

provides coverage only for dental, vision care, or any other

limited supplemental benefit.