Section 550.1915 – Decision as Final Administrative Remedy; Other Remedies.
550.1915 Decision as final administrative remedy; other remedies. Sec. 15. (1) An external review decision and an expedited external review decision are the final administrative remedies available under this act. A person aggrieved by an external review decision or an expedited external review decision may seek judicial review no later than 60 days from the […]
Section 550.1917 – Approved Independent Review Organizations; Application; Form; Fee; Expiration; Termination; Updated List.
550.1917 Approved independent review organizations; application; form; fee; expiration; termination; updated list. Sec. 17. (1) The director shall approve independent review organizations eligible to be assigned to conduct external reviews under this act to ensure that an independent review organization satisfies the minimum standards established under section 19. (2) The director shall develop an application […]
Section 550.1919 – Approved Independent Review Organization; Requirements.
550.1919 Approved independent review organization; requirements. Sec. 19. (1) To be approved under section 17 to conduct external reviews, an independent review organization must do all of the following: (a) Have and maintain written policies and procedures that govern all aspects of both the standard external review process and the expedited external review process under […]
Section 550.1921 – Independent Review Organization; Liability for Damages.
550.1921 Independent review organization; liability for damages. Sec. 21. An independent review organization or clinical peer reviewer working on behalf of an independent review organization is not liable in damages to any person for any opinions rendered during or upon completion of an external review conducted under this act, unless the opinion was rendered in […]
Section 550.1903 – Definitions.
550.1903 Definitions. Sec. 3. As used in this act: (a) “Adverse determination” means a determination by a health carrier or its designee utilization review organization that an admission, availability of care, continued stay, or other health care service that is a covered benefit has been reviewed and, based on the information provided, does not meet […]
Section 550.1905 – Scope.
550.1905 Scope. Sec. 5. (1) Except as otherwise provided in subsection (2), this act applies to all health carriers. (2) This act does not apply to a policy or certificate that provides coverage only for specified accident or accident-only coverage, credit, disability income, hospital indemnity, long-term care insurance, as that term is defined in section […]
Section 550.1837 – Autism Coverage Fund; Creation Within State Treasury; Investment; Credit of Interest and Earnings; Administration of Fund by Department for Auditing Purposes; Expenditures; Reimbursement; Insufficient Money in Fund; Notice of Insufficient Funds; Money in Fund at Close of Fiscal Year; Payment of Claim Approved Under MCL 550.1835; Reimbursement to Carrier or Third Party Administrator; Formula.
550.1837 Autism coverage fund; creation within state treasury; investment; credit of interest and earnings; administration of fund by department for auditing purposes; expenditures; reimbursement; insufficient money in fund; notice of insufficient funds; money in fund at close of fiscal year; payment of claim approved under MCL 550.1835; reimbursement to carrier or third party administrator; formula. […]
Section 550.1838 – University Autism Programs and Autism Family Assistance Services; Appropriation; Reimbursement.
550.1838 University autism programs and autism family assistance services; appropriation; reimbursement. Sec. 8. In addition to any other use for money in the fund under section 7, for the 2014-2015 fiscal year only, up to $8,500,000.00 may be expended from the fund, upon appropriation, for university autism programs and autism family assistance services as specified […]
Section 550.1839 – Annual Report.
550.1839 Annual report. Sec. 9. The department shall submit an annual report to the state budget director and the senate and house of representatives standing committees on appropriations not later than April 1 of each year that includes, but is not limited to, all of the following: (a) The total number of applications received under […]
Section 550.1841 – Implementation of Program.
550.1841 Implementation of program. Sec. 11. (1) The department shall not implement the program under this act until the legislature has appropriated sufficient funds to cover the same. (2) Not more than 1% of the annual appropriation made to the autism coverage fund may be used for the purpose of administering the program authorized under […]