Section 500.3580 - Consumer guide to health maintenance organizations; publication; contents; data; writing, presentation, promotion, and distribution of guide; access through internet.
THE INSURANCE CODE OF 1956 (EXCERPT)
Act 218 of 1956
500.3580 Consumer guide to health maintenance organizations; publication; contents; data; writing, presentation, promotion, and distribution of guide; access through internet.
Sec. 3580.
(1) The commissioner shall prepare and beginning January 1, 2001 and annually thereafter publish a consumer guide to health maintenance organizations as provided in this section.
(2) The consumer guide to health maintenance organizations shall include all of the following for the most recent year and for the immediately preceding year for which the information is available:
(a) The national accreditation status of and any limitation on accreditation for each health maintenance organization.
(b) Measurements of the quality of care provided by each health maintenance organization, as required by the commissioner, including, but not limited to, the following health employer data information set categories:
(i) Child and adolescent care.
(ii) Maternity care.
(iii) Cardiac care.
(iv) Staying healthy.
(v) Member satisfaction.
(vi) Women's health.
(c) The toll-free telephone number at the office of financial and insurance services that consumers may call to make requests for the consumer guide and make inquiries and complaints about health maintenance organizations.
(d) A summary for each health maintenance organization of the report required to be provided to the commissioner under section 23 of the patient's right to independent review act.
(3) The commissioner may request, and a health maintenance organization and the department of community health shall provide in a timely manner, audited health employer information set data and other information that the commissioner needs to prepare the annual consumer guide under subsection (1).
(4) The annual consumer guide under subsection (1) shall be written in plain English and shall be presented in a manner that facilitates comparisons among individual health maintenance organizations. The commissioner shall promote and publicize to the general public the existence of the annual consumer guide. The commissioner shall distribute the guide to members of the public upon request and shall provide access to the consumer guide through the internet.
History: Add. 2000, Act 249, Imd. Eff. June 29, 2000
Popular Name: Act 218
Popular Name: HMO