DOCTOR/PATIENT COMMUNICATION - H.B. 4394: FLOOR ANALYSIS

House Bill 4394 (as reported without amendment)

Sponsor: Representative Joseph Palamara

House Committee: Health Policy

Senate Committee: Health Policy and Senior Citizens

CONTENT

The bill would amend the Insurance Code to forbid a disability insurer from prohibiting or discouraging a health professional: from discussing with an insured certain treatments, services, or financial arrangements; or from advocating on behalf of an insured for appropriate medical treatment options, pursuant to the grievance procedures specified in the Insurance Code.

The bill provides that a disability insurer could not prohibit or discourage a health professional from discussing with an insured health care treatments and services; quality assurance plans required by law, if applicable; or the financial relationships between the insurer and the health care provider. Financial relationships between the insurer 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 500.3407a - 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.