HOUSE BILL No. 5450


     January 14, 1998, Introduced by Reps. Law, Palamara and Varga and referred to the Committee on Insurance.


        A bill to amend 1978 PA 368, entitled

   "Public health code,"

   (MCL 333.1101 to 333.25211) by adding section 21053d.

               THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 1         SEC. 21053D.  (1) A HEALTH MAINTENANCE ORGANIZATION SHALL

 2    PROVIDE IN EACH GROUP AND INDIVIDUAL CONTRACT BENEFITS FOR SCALP

 3    HAIR PROSTHESIS FOR AN INDIVIDUAL WHO HAS SCALP HAIR LOSS AS A

 4    RESULT OF ALOPECIA AREATA IF THE INDIVIDUAL'S ATTENDING PHYSICIAN

 5    CERTIFIES IN WRITING THE MEDICAL NECESSITY OF THAT PROPOSED

 6    COURSE OF REHABILITATIVE TREATMENT.

 7         (2) THE COVERAGE REQUIRED BY THIS SECTION IS NOT SUBJECT TO

 8    DOLLAR LIMITS, DEDUCTIBLES, AND COINSURANCE PROVISIONS THAT ARE

 9    LESS FAVORABLE THAN THOSE FOR OTHER PROSTHESIS COVERAGE.

10    HOWEVER, A HEALTH MAINTENANCE ORGANIZATION MAY PROVIDE THAT THE

11    HEALTH MAINTENANCE ORGANIZATION WILL ONLY PAY 80% OF THE


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 1    CUSTOMARY AND USUAL COSTS OF THE SCALP HAIR PROSTHESIS EXCLUSIVE

 2    OF ANY DEDUCTIBLE.

 3         (3) AS USED IN THIS SECTION, "SCALP HAIR PROSTHESIS"

 4    INCLUDES ANY ARTIFICIAL SUBSTITUTES FOR SCALP HAIR.
















































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