HB 4243 amends Michigan's Publicly Funded Health Insurance Contribution Act to include regional airport authorities as covered public employers under the law. This means employees of regional airport authorities (such as those managing airports across the state) will now be subject to the same health insurance contribution rules as other public employees, like state workers or school district staff. The bill clarifies that these authorities must contribute to health insurance costs for their employees, following the same framework as other public employers defined in the existing law. It does not create new benefits but ensures airport authorities comply with the same health insurance contribution requirements as other public entities.
SB 135 requires Michigan health insurers to provide dependent coverage until age 26, with identical benefits and premiums as other dependents. It mandates coverage for newborns from birth, including treatment for congenital defects, and prohibits denying coverage based on factors like out-of-wedlock birth or tax filing status. The bill also bans lifetime and annual dollar limits on essential health benefits (such as hospital care, maternity services, mental health, and prescription drugs) and requires no cost-sharing for preventive services meeting federal guidelines. These changes apply to individual and small group health insurance policies sold in Michigan, directly affecting insurers and their policyholders.
HB 4464 requires Michigan health insurers to provide dependent coverage until age 26 without discrimination based on a child's birth status, tax filing, or residence. It mandates coverage for newborns from birth (including congenital defects) and prohibits lifetime or annual dollar limits on essential health benefits like emergency care, hospitalization, and maternity services. The bill also requires insurers to cover specific preventive services - such as evidence-based screenings and immunizations recommended by federal guidelines - without cost-sharing for eligible patients. These requirements apply to most individual and small group health insurance plans in Michigan, excluding grandfathered plans, retiree coverage, and short-term policies.
SB 371 prohibits Michigan health insurers from limiting coverage for inpatient psychiatric care based on the length of a patient's stay. This directly affects health insurers operating in Michigan and individuals receiving inpatient psychiatric treatment. The bill amends Michigan's Insurance Code to add a new provision (Sec. 3406mm) that explicitly bans insurers from imposing duration-based restrictions on such coverage. The key mechanism is a clear prohibition on using time limits as a basis for denying or restricting psychiatric inpatient care coverage. This represents a concrete policy change to ensure continuous coverage for patients needing extended psychiatric hospitalization.
HB 4683 requires Michigan health insurers to cover medically necessary mental health and substance use disorder treatments (including inpatient, intermediate, and outpatient care) without restrictive prior authorization practices. It mandates that insurers use clinical review criteria aligned with generally accepted medical standards, rather than arbitrary rules, when evaluating these services. The bill also prohibits insurers from making mental health coverage terms less favorable than those for other medical treatments. This directly affects health insurers operating in Michigan and patients seeking mental health or substance use disorder care through their insurance plans.
HB 4740 requires health insurance plans sold in Michigan to cover diagnosis and treatment for autism spectrum disorders (ASD), directly affecting insured individuals with ASD and their families. It mandates coverage for behavioral health treatments like applied behavior analysis, with age-based annual limits: $50,000 for children under 6, $40,000 for ages 7-12, and $30,000 for ages 13-18. Insurers cannot deny coverage based on an ASD diagnosis, limit treatment visits, or apply stricter cost-sharing than for physical illnesses (though annual caps apply). The bill also allows insurers to request periodic diagnostic reviews (e.g., autism diagnostic observation schedule every 3 years) and annual development evaluations.
SB 37 requires Michigan health insurers to cover gynecological and perinatal care services provided by in-network physicians, certified nurse midwives, or midwives at in-network facilities or at home. This applies to any health insurance policy that already includes coverage for these services. The bill defines key terms like "certified nurse midwife" and "midwife" to clarify which providers and settings qualify for the required coverage. The policy change ensures patients using in-network providers for these services have access without gaps in coverage.
This bill requires Michigan health insurers to cover group prenatal care services for all policyholders. It defines these services as evidence-based, group-based prenatal visits in a family-centered setting that include health assessments, social support, education, and peer interaction. The law applies to all health insurance policies issued in Michigan, directly affecting pregnant individuals and their insurers by mandating coverage for this specific care model.
Senate Bill 4 amends Michigan's insurance code to require health insurers that provide prescription drug coverage to comply with section 12 of the prescription drug cost and affordability review act. This means insurers delivering or renewing health policies in the state must adhere to specific provisions outlined in that separate act related to prescription drug costs. The bill's enactment is dependent on Senate Bill No. 3 also becoming law.
HB 4814 requires Michigan health insurers to cover medically necessary treatments for menopause and perimenopause (the transition period before menopause), including hormone replacement therapy approved by the FDA. Insurers cannot demand prior authorization, step therapy, or fail-first protocols for these treatments. The bill defines menopause as permanent cessation of menstruation and perimenopause as the transition period near the end of reproductive years. This directly affects all health insurance policyholders in Michigan who need these treatments, ensuring coverage without extra approval hurdles.
