SENATE BILL No. 630

September 19, 2001, Introduced by Senator BULLARD and referred to the Committee on Health Policy.

A bill to amend 1956 PA 218, entitled

"The insurance code of 1956,"

(MCL 500.100 to 500.8302) by adding section 3406l.

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

1 SEC. 3406l. (1) AN EXPENSE-INCURRED HOSPITAL, MEDICAL, OR

2 SURGICAL POLICY OR CERTIFICATE THAT PROVIDES BENEFITS FOR MEDICAL

3 TRANSPORTATION SERVICES AND A HEALTH MAINTENANCE ORGANIZATION

4 CONTRACT SHALL PROVIDE FOR DIRECT REIMBURSEMENT TO ANY PROVIDER

5 OF COVERED MEDICAL TRANSPORTATION SERVICES IF THAT PROVIDER HAS

6 NOT RECEIVED PAYMENT FOR THOSE SERVICES FROM ANY OTHER SOURCE.

7 (2) SUBSECTION (1) DOES NOT APPLY TO A TRANSACTION BETWEEN

8 AN INSURER OR HEALTH MAINTENANCE ORGANIZATION AND A MEDICAL

9 TRANSPORTATION SERVICE PROVIDER IF THE PARTIES HAVE ENTERED INTO

10 A CONTRACT PROVIDING FOR DIRECT PAYMENT.

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2

1 (3) SUBSECTION (1) IS SATISFIED IF AN INSURED OR ENROLLEE

2 FILES A CLAIM FOR THE MEDICAL TRANSPORTATION SERVICE WITH THE

3 INSURER OR HEALTH MAINTENANCE ORGANIZATION, THE INSURER OR HEALTH

4 MAINTENANCE ORGANIZATION PAYS THE MEDICAL TRANSPORTATION SERVICE

5 PROVIDER DIRECTLY, AND THE MEDICAL TRANSPORTATION SERVICE PRO-

6 VIDER DOES NOT DEMAND PAYMENT FROM THE INSURED OR ENROLLEE UNTIL

7 RECEIVING PAYMENT FROM THE INSURER OR HEALTH MAINTENANCE ORGANI-

8 ZATION, AFTER WHICH THE MEDICAL TRANSPORTATION SERVICE PROVIDER

9 MAY DEMAND PAYMENT FROM THE INSURED OR ENROLLEE FOR ANY UNPAID

10 PORTION OF THE PROVIDER'S FEE.

11 Enacting section 1. This amendatory act takes effect

12 January 1, 2002.

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