Michigan Laws 550.53a – Disclosure of financial relationships between organization and participating health care providers, health care facilities, or other entities
Current as of: 2023 | Check for updates
|
Other versions
An organization that establishes a prudent purchaser agreement shall disclose in writing to all purchasers of its coverage and to all covered members of its plans upon request the financial relationships between the organization and its participating health care providers, health care facilities, or other similar entities, including all of the following as applicable:
(a) Whether a fee-for-service arrangement exists, under which the provider is paid a specified fee for each particular covered service rendered to each covered individual.
Terms Used In Michigan Laws 550.53a
- in writing: shall be construed to include printing, engraving, and lithographing; except that if the written signature of a person is required by law, the signature shall be the proper handwriting of the person or, if the person is unable to write, the person's proper mark, which may be, unless otherwise expressly prohibited by law, a clear and classifiable fingerprint of the person made with ink or another substance. See Michigan Laws 8.3q
- Organization: means an insurer, a dental care corporation, hospital service corporation, medical care corporation, health care corporation, or third party administrator. See Michigan Laws 550.52
- Prudent purchaser agreement: means an agreement between an organization and a health care provider under section 3. See Michigan Laws 550.52
(b) Whether a capitation arrangement exists, under which a fixed amount is paid to the provider for all covered services rendered to each covered individual.
(c) Whether payments to providers are made according to how well the provider meets criteria regarding costs, quality, patient satisfaction, or other criteria.