May 5, 2005, Introduced by Reps. Hune, Gaffney, Hildenbrand, Sheen, Hummel, Emmons and Marleau and referred to the Committee on Insurance.
A bill to amend 1956 PA 218, entitled
"The insurance code of 1956,"
(MCL 500.100 to 500.8302) by adding chapter 21A.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
CHAPTER 21A MANAGED CARE
Sec. 2151. As used in this chapter, "managed care" means all
monitoring and adjudication of an injured person's care, which may
include, but is not limited to, all of the following:
(a) First notice of loss/initial intake.
(b) Preauthorization.
(c) Treatment plan review.
(d) Telephonic case management.
(e) Field case management.
(f) Medical bill review.
(g) Utilization review.
(h) Preferred provider selection and accreditation.
Sec. 2153. This chapter applies to all automobile insurance
whether written on an individual, group, franchise, blanket policy,
or similar basis.
Sec. 2155. A managed care option for allowable expenses
consisting of all reasonable charges incurred for reasonably
necessary products, services, and accommodations for an injured
person's care, recovery, or rehabilitation under section 3107 is
subject to all of the following:
(a) Shall be uniformly offered to all of an automobile
insurer's insureds.
(b) Reflects reasonably anticipated reductions in losses or
expenses.
(c) Shall not apply to emergency care.
Sec. 2157. Managed care applies only to the insured who
selects in writing the managed care option, his or her spouse, and
a relative of either domiciled in the same household, who is
claiming personal protection insurance benefits under the policy
with the managed care option.
Sec. 2159. Managed care may be used on all medical services
provided to an injured insured after the selection of a managed
care option, regardless of the date of the original claim.