DOCTOR/PATIENT COMMUNICATION - S.B. 501: FLOOR ANALYSIS

Senate Bill 501 (as reported without amendment)

Sponsor: Senator Dale L. Shugars

Committee: Health Policy and Senior Citizens

CONTENT

The bill would amend the Nonprofit Health Care Corporation Reform Act to forbid Blue Cross and Blue Shield of Michigan (BCBSM) from prohibiting or discouraging a health professional: from discussing with a subscriber certain treatments, services, or financial arrangements; or from advocating on behalf of a subscriber for appropriate medical treatment options, pursuant to the grievance procedures specified in the Act.

The bill provides that BCBSM could not prohibit or discourage a health professional from discussing with a subscriber health care treatments and services; quality assurance plans required by law, if applicable; or the financial relationships between BCBSM and the health care provider. Financial relationships between BCBSM and the provider would include whether:

-- There existed a fee-for-service arrangement, under which the provider was paid a specified amount for each covered service rendered to the participant.

-- There existed a capitation arrangement, under which a fixed amount was paid to the provider for all covered services that were or could be rendered to each covered individual or family.

-- Payments to providers were made based on standards relating to cost, quality, or patient satisfaction.

Proposed MCL 550.1501b - Legislative Analyst: G. Towne

FISCAL IMPACT

The bill would have no fiscal impact on State or local government.

Date Completed: 5-16-97 - Fiscal Analyst: J. Walker

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This analysis was prepared by nonpartisan Senate staff for use by the Senate in its deliberations and does not constitute an official statement of legislative intent.