Mich. Comp. Laws § 500.3533. Prudent purchaser contracts; reimbursement for unauthorized services or services by nonaffiliated providers: Health Maintenance Organizations – Michigan

Status: Enacted
Year Enacted: 2000
Year Amended: 2016
File: Download

Subject to section 3405, a health maintenance organization may offer prudent purchaser contracts to groups or individuals and in conjunction with those contracts a health maintenance organization may pay or may reimburse enrollees, or may contract with another person to pay or reimburse enrollees, for unauthorized services or for services by nonaffiliated providers in accordance with the terms of the contract and subject to copayments, coinsurances, deductibles, or other financial penalties designed to encourage enrollees to obtain services from affiliated providers.

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