HB-5218, As Passed Senate, December 5, 2018

 

 

 

 

 

 

 

 

 

 

 

SENATE SUBSTITUTE FOR

 

HOUSE BILL NO. 5218

 

 

 

 

 

 

 

 

 

 

 

      A bill to amend 1978 PA 368, entitled

 

"Public health code,"

 

by amending section 21501 (MCL 333.21501) and by adding section

 

21541.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

 1        Sec. 21501. (1) Article As used in this part:

 

 2        (a) "Aircraft transport vehicle" means that term as defined in

 

 3  section 20902.

 

 4        (b) "Ambulance" means that term as defined in section 20902.

 

 5        (c) "Emergency patient" means that term as defined in section

 

 6  20904.

 

 7        (d) "Group health plan" means an employer program of health

 

 8  benefits, including an employee welfare benefit plan as defined in

 

 9  section 3(1) of subtitle A of title I of the employee retirement

 


 1  income security act of 1974, Public Law 93-406, 29 USC 1002, to the

 

 2  extent that the plan provides medical care, including items and

 

 3  services paid for as medical care to employees or their dependents

 

 4  as defined under the terms of the plan directly or through

 

 5  insurance, reimbursement, or otherwise.

 

 6        (e) "Health benefit plan" means a group health plan, an

 

 7  individual or group expense-incurred hospital, medical, or surgical

 

 8  policy or certificate, or an individual or group health maintenance

 

 9  organization contract. Health benefit plan does not include

 

10  accident-only, credit, dental, or disability income insurance;

 

11  long-term care insurance; coverage issued as a supplement to

 

12  liability insurance; coverage only for a specified disease or

 

13  illness; worker's compensation or similar insurance; or automobile

 

14  medical-payment insurance.

 

15        (f) "Nonemergency patient" means that term as defined in

 

16  section 20908.

 

17        (g) "Participating provider" means a provider that, under

 

18  contract with an insurer that issues health benefit plans, or with

 

19  such an insurer's contractor or subcontractor, has agreed to

 

20  provide health care services to covered individuals and to accept

 

21  payment by the insurer, contractor, or subcontractor for covered

 

22  services as payment in full, other than coinsurance, copayments, or

 

23  deductibles.

 

24        (h) "Patient's representative" means any of the following:

 

25        (i) A person to whom a patient has given express written

 

26  consent to represent the patient.

 

27        (ii) A person authorized by law to provide consent for a


 1  patient.

 

 2        (iii) A patient's treating health professional, but only if

 

 3  the patient is unable to provide consent.

 

 4        (i) "Third party administrator" means that term as defined in

 

 5  section 2 of the third party administrator act, 1984 PA 218, MCL

 

 6  550.902.

 

 7        (2) In addition, article 1 contains general definitions and

 

 8  principles of construction applicable to all articles in this code

 

 9  and part 201 contains definitions applicable to this part.

 

10        Sec. 21541. (1) Subject to section 21540, before an aircraft

 

11  transport vehicle is ordered to transport a nonemergency patient or

 

12  an ambulance that is a rotary aircraft is ordered to transport a

 

13  nonemergency patient, a hospital shall do all of the following:

 

14        (a) Disclose to the nonemergency patient, or that patient's

 

15  representative, all of the following information:

 

16        (i) Whether the aircraft transport operation or ambulance

 

17  operation is a participating provider with the nonemergency

 

18  patient's health benefit plan. This subparagraph does not apply if

 

19  the hospital does not have electronic access to all of the

 

20  following information:

 

21        (A) Whether the nonemergency patient's health benefit plan

 

22  provides coverage for transportation by an aircraft transport

 

23  vehicle or an ambulance that is a rotary aircraft.

 

24        (B) A list of all aircraft transport operations and ambulance

 

25  operations that are fully contracted participating providers with

 

26  the nonemergency patient's health benefit plan and do not

 

27  participate with the health benefit plan on only a per claim basis.


 1        (ii) That the nonemergency patient has a right to be

 

 2  transported by a method other than an aircraft transport vehicle or

 

 3  ambulance that is a rotary aircraft.

 

 4        (b) Complete the notice described in subsection (2) and, after

 

 5  completing the notice, obtain on the notice the signature of the

 

 6  nonemergency patient, or that patient's representative,

 

 7  acknowledging that the nonemergency patient, or that patient's

 

 8  representative, has received, has read, and understands the notice.

 

 9  A hospital shall retain a copy of the notice required under this

 

10  subdivision for not less than 7 years.

 

11        (2) The notice required under subsection (1)(b) must be in not

 

12  less than 12-point type and in substantially the following form:

 

13        "Your physician has ordered transport by an aircraft transport

 

14  vehicle or ambulance that is a rotary aircraft. Your health benefit

 

15  plan may or may not provide coverage for this transportation. You

 

16  may be responsible for the costs of the transportation that is not

 

17  covered by your health benefit plan.

 

18        We have conducted a good-faith search to determine whether

 

19  your health benefit plan provides coverage for this transportation

 

20  and, if so, to order this transportation from a provider that

 

21  participates with your health benefit plan.

 

22        You have a right to be transported by a method other than

 

23  transport by an aircraft transport vehicle or ambulance that is a

 

24  rotary aircraft.

 

25        The hospital and the ordering physician are immune from civil

 

26  liability for injuries or damages arising out of your decision to

 

27  use a form of transportation other than the one ordered by the


 1  ordering physician.

 

 2        I have received, read, and understand this notice.

 

 

 3

________________________________________________    ___________

 4

(Patient's or patient representative's signature)      (Date)

 5

_____________________________________________________________

 6

(Type or print patient's or patient representative's name)".

 

 

 7        (3) A hospital and ordering physician are immune from civil

 

 8  liability for injuries or damages arising out of the decision of a

 

 9  patient or the patient's representative to use a form of

 

10  transportation other than the one ordered by the ordering

 

11  physician.

 

12        (4) Upon the request of a nonemergency patient's health

 

13  benefit plan or third party administrator, the hospital shall

 

14  provide a copy of the notice required under subsection (1)(b) to

 

15  the person designated in the nonemergency patient's health benefit

 

16  plan or by the third party administrator.

 

17        (5) A hospital that violates this section is liable to the

 

18  aircraft transport operation or ambulance operation for the

 

19  reasonable cost of transporting the nonemergency patient, as

 

20  negotiated between the hospital and the aircraft transport

 

21  operation or ambulance operation, to the extent that the cost

 

22  exceeds the amount covered by the patient's health benefit plan.

 

23        Enacting section 1. This amendatory act takes effect 90 days

 

24  after the date it is enacted into law.

 

25        Enacting section 2. This amendatory act does not take effect

 

26  unless all of the following bills of the 99th Legislature are

 

27  enacted into law:


 1        (a) House Bill No. 5217.

 

 2        (b) House Bill No. 5219.