HOUSE BILL No. 5838


     May 24, 2000, Introduced by Rep. Law and referred to the Committee on Insurance and Financial Services.


        A bill to amend 1978 PA 368, entitled

   "Public health code,"

   (MCL 333.1101 to 333.25211) by adding section 21052c.

               THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

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           SEC. 21052C.  (1) A HEALTH MAINTENANCE ORGANIZATION SHALL

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      NOT ENCOURAGE OR DIRECT AN INSURED TO AN EMERGENCY HEALTH SERV-

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      ICES RESPONSE AND TRANSPORTATION SYSTEM THAT IS IN COMPETITION

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      WITH OR IS A SUBSTITUTION FOR THE 9-1-1 EMERGENCY HEALTH SERVICES

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      SYSTEM OR OTHER STATE OR LOCAL UNIT OF GOVERNMENT EMERGENCY

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      HEALTH SERVICES SYSTEM.

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           (2) SUBSECTION (1) DOES NOT PROHIBIT A HEALTH MAINTENANCE

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      ORGANIZATION FROM USING OR REQUIRING TRANSPORTATION OUTSIDE THE

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      9-1-1 EMERGENCY HEALTH SERVICES SYSTEM OR OTHER STATE OR LOCAL

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      UNIT OF GOVERNMENT EMERGENCY HEALTH SERVICES SYSTEM FOR

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      NONEMERGENCY HEALTH SERVICES.


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           (3) A HEALTH MAINTENANCE ORGANIZATION SHALL NOT REQUIRE AN

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      ENROLLEE TO OBTAIN PRIOR AUTHORIZATION BEFORE ACCESSING THE 9-1-1

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      SYSTEM OR OTHER STATE OR LOCAL UNIT OF GOVERNMENT EMERGENCY

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      HEALTH SERVICES SYSTEM FOR EMERGENCY HEALTH SERVICES.

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           (4) A HEALTH MAINTENANCE ORGANIZATION SHALL NOT USE FALSE OR

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      MISLEADING LANGUAGE IN ANY MATERIALS PROVIDED TO ENROLLEES TO

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      DISCOURAGE OR PROHIBIT AN ENROLLEE FROM ACCESSING THE 9-1-1

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      SYSTEM FOR EMERGENCY HEALTH SERVICES.








































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