This bill amends Michigan's insurance code to protect individuals and organizations from legal liability when they report suspected or confirmed insurance fraud. It allows people, insurers, and agencies to share information with fraud detection groups like the National Insurance Crime Bureau without fear of being sued for libel, slander, or other civil claims, provided they do not act with malice or knowingly spread false information. The law also shields these entities from lawsuits when they publish official reports or comply with court orders related to fraud investigations. Ultimately, the measure aims to encourage cooperation in fighting insurance fraud by removing the risk of civil lawsuits for those acting in good faith.
This Michigan bill, known as the Drug Manufacturer Data Reporting Act, requires pharmaceutical companies to submit specific cost and development data to the Department of Insurance and Financial Services. Manufacturers must report within 30 days if they increase the price of a high-cost drug by 15% in a year or 40% over three years, providing details on research expenses, patent status, and drug types. Additionally, companies must notify the department within three days when launching a new specialty-priced drug, including information on FDA designations and acquisition costs if applicable. The department will compile this data into an annual report for legislative committees and the public while keeping individual company information confidential. Failure to comply with these reporting requirements could result in civil fines of up to $100,000 per month.
This bill amends Michigan's Health Care False Claims Act to explicitly include automobile insurers that provide personal injury protection coverage within its definition of a "health care insurer." By making this change, the law ensures that these auto insurers are subject to the same rules and penalties as other health insurance providers regarding the submission of false or deceptive claims for benefits. The update does not alter the existing definitions of what constitutes a false claim or the penalties for fraud, but rather expands the scope of entities to which those rules apply.
This bill allows the Michigan Attorney General to investigate claims that individuals or companies have violated the state's event online ticket sales laws. It establishes a civil penalty of up to $5,000 for each ticket sold in violation of the act and permits the Attorney General to seek court orders to stop ongoing violations or collect restitution. Additionally, the legislation authorizes the recovery of legal fees and costs incurred during enforcement actions. The bill does not take effect unless it is passed together with a companion bill, HB 5661.
This bill directs the state insurance director to work with the Michigan health insurance exchange to officially certify qualified health and dental plans. It requires the director to create specific rules for this certification process while preserving the ability to regulate insurance businesses and exempt these plans from certain laws. The definitions for qualified health and dental plans are taken directly from existing state legislation. The bill will not become law unless a related companion bill, Senate Bill 633, is also passed.
This bill repeals a specific section of Michigan's insurance code that previously required health insurers to cover emergency refills of prescription medications for up to 30 days. By removing this mandate, the legislation allows insurance companies to stop providing these extended emergency supplies under their current rules. The change directly affects health insurance plans and the patients who rely on them for urgent medication access.
SB 634 updates Michigan's insurance code to align with the state's health insurance exchange by clarifying definitions for roles like navigators and certified application counselors. The bill establishes strict rules requiring these individuals to be state-certified before they can receive funding or assist people with health plan enrollment. It explicitly prohibits them from selling insurance or recommending specific plans, limiting their duties to providing impartial information and helping consumers select coverage. Additionally, the legislation mandates privacy training and background checks for these roles to protect personal data.
This bill directs the state insurance department to request a federal waiver to create a reinsurance program that helps stabilize health insurance markets. If approved, the program would allow insurers to recover costs for high-risk enrollees, potentially increasing federal funding for these efforts. The legislation requires the department to share draft plans with the public and lawmakers before finalizing the application and mandates reporting on necessary funding sources. Importantly, the bill does not take effect unless a separate companion bill, SB 633, is also passed into law.
This bill requires health insurers in Michigan to provide a plain English summary of their policies to consumers, ensuring the document clearly explains coverage details, costs, and limitations. The legislation mandates that these summaries include specific information such as deductibles, copayments, provider networks, and instructions on how to access the full policy or a list of doctors. Additionally, the bill establishes strict timelines for delivering this summary, such as within seven business days of receiving an application or within 30 days of a policy renewal. By standardizing these disclosures, the measure aims to help individuals better understand their health insurance options and make informed decisions about their coverage.
This bill establishes a new nonprofit corporation in Michigan to operate a state-based health insurance exchange that helps consumers buy and sell qualified health plans. The legislation creates a Board of Exchange with specific powers and duties, including rules to prevent conflicts of interest among its members. It also defines the roles of state officials, sets up a marketplace platform for insurance plans, and outlines how the exchange can charge fees to fund its operations. By creating this exchange, the bill aims to foster a competitive health insurance market and provide information to consumers about available coverage options.
This bill expands the legal definition of racketeering in Michigan to explicitly include insurance fraud. It directly affects individuals and organizations accused of committing organized crime schemes that involve defrauding insurance companies. By adding insurance fraud to the list of qualifying offenses, the law allows prosecutors to charge such activities as part of a broader pattern of criminal behavior rather than isolated incidents. This change aims to provide law enforcement with clearer tools to investigate and prosecute complex financial crimes that target the insurance industry.
This bill amends Michigan's insurance code to establish clear civil penalties for individuals or entities that violate insurance regulations without a specific penalty already defined. It requires the insurance director to provide a hearing before imposing fines, which can range from $1,000 to $5,000 per violation depending on whether the violation was intentional, with a maximum total fine of $50,000. In addition to monetary penalties, the director may suspend, limit, or revoke licenses for non-compliance and can impose a $20,000 fine for knowingly ignoring cease and desist orders. The bill also allows the director to reopen previous penalty decisions if facts or laws have changed and permits the use of court injunctions to stop ongoing violations.
