SB-0807, As Passed Senate, March 5, 2014

SUBSTITUTE FOR

SENATE BILL NO. 807

     A bill to amend 1984 PA 233, entitled

"Prudent purchaser act,"

by amending section 2 (MCL 550.52).

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

     Sec. 2. As used in this act:

     (a) "Commissioner" means the commissioner of insurance.

     (b) "Dental care corporation" means a dental care corporation

incorporated under Act No. 125 of the Public Acts of 1963, being

sections 550.351 to 550.373 of the Michigan Compiled Laws.1963 PA

125, MCL 550.351 to 550.373.

     (c) "Health care corporation" means a health care corporation

incorporated under the nonprofit health care corporation reform

act, Act No. 350 of the Public Acts of 1980, being sections

550.1101 to 550.1704 of the Michigan Compiled Laws.1980 PA 350, MCL

550.1101 to 550.1704.

     (d) "Health care provider" means a health facility or a person

licensed, certified, or registered under parts 61 to 65 part 62 or

parts 161 to 182 of the public health code, Act No. 368 of the

Public Acts of 1978, being sections 333.6101 to 333.6523 and

333.16101 to 333.18237 of the Michigan Compiled Laws. However,

health 1978 PA 368, MCL 333.6230 to 333.6251 and 333.16101 to

333.18237, and chapter 2A of the mental health code, 1974 PA 258,

MCL 330.1260 to 330.1287. Health care provider does not include a

pharmacist or pharmacy engaged in the retail sale of drugs, until

January 1, 1987.

     (e) "Health facility" means:

     (i) A facility or agency licensed or authorized under parts 201

to 217 of the public health code, 1978 PA 368, MCL 333.20101 to

333.21799e, or a licensed part thereof, except a facility or agency

licensed under part 203 of the public health code.of that facility

or agency. Health facility does not include an ambulance operation,

aircraft transport operation, nontransport prehospital life support

operation, or medical first response service.

     (ii) A mental hospital, psychiatric hospital, psychiatric unit,

or mental retardation other facility defined in 42 USC 1396d(d)

operated by the department of mental community health or certified

or licensed under Act No. 258 of the Public Acts of 1974, being

sections 330.1001 to 330.2106 of the Michigan Compiled Laws.the

mental health code, 1974 PA 258, MCL 330.1001 to 330.2106.

     (iii) A facility providing outpatient physical therapy services,

including speech pathology services.

     (iv) A kidney disease treatment center, including a

freestanding hemodialysis unit.

     (v) An organized ambulatory health care facility.

     (vi) A tertiary health care service facility.

     (vii) A substance abuse treatment program licensed under parts

61 to 65 part 62 of the public health code, Act No. 368 of the

Public Acts of 1978, being sections 333.6101 to 333.6523 of the

Michigan Compiled Laws.1978 PA 368, MCL 333.6230 to 333.6251, or

chapter 2A of the mental health code, 1974 PA 258, MCL 330.1260 to

330.1287.

     (viii) An outpatient psychiatric clinic.

     (ix) A home health agency.

     (f) "Health maintenance organization" means a health

maintenance organization licensed under article 17 of the public

health code, Act No. 368 of the Public Acts of 1978, being sections

333.20101 to 333.22181 of the Michigan Compiled Laws.that term as

defined in section 3501 of the insurance code of 1956, 1956 PA 218,

MCL 500.3501.

     (g) "Hospital service corporation" means a hospital service

corporation incorporated under Act No. 109 of the Public Acts of

1939, being sections 550.501 to 550.517 of the Michigan Compiled

Laws.former 1939 PA 109.

     (h) "Insurer" means an insurer as defined in section 106 of

the insurance code of 1956, Act No. 218 of the Public Acts of 1956,

being section 500.106 of the Michigan Compiled Laws.1956 PA 218,

MCL 500.106.

     (i) "Medical care corporation" means a medical care

corporation incorporated under Act No. 108 of the Public Acts of

1939, being sections 550.301 to 550.316 of the Michigan Compiled

Laws.former 1939 PA 108.

     (j) "Organization" means an insurer, a dental care

corporation, hospital service corporation, medical care

corporation, health care corporation, or third party administrator.

     (k) "Provider panel" means a panel of health care providers

providing health care services pursuant to under a prudent

purchaser agreement.

     (l) "Prudent purchaser agreement" means an agreement between an

organization and a health care provider pursuant to under section

3.

     (m) "Third party administrator" means an administrator

operating under a certificate of authority issued by the

commissioner pursuant to the third party administrator act.