Healthcare

in committee · Michigan · Senate Sep 17, 2025

SB 552: Insurance: health insurers; coverage for a nonopioid analgesic drug for pain treatment; require. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406ll.

SB 552 requires Michigan health insurers to cover non-opioid pain medications prescribed for pain treatment, directly affecting insurers and policyholders. The bill mandates that insurers include such drugs on preferred drug lists within 90 days of FDA approval, prohibits discouraging coverage relative to opioids (e.g., labeling non-opioid drugs as "nonpreferred" when opioids are preferred), and prevents overly restrictive prior authorization for non-opioid options. It does not require insurers to cover specific drugs but ensures equal treatment compared to opioid alternatives in formularies. The law applies to all health insurance policies covering prescription drugs in Michigan.

Topics ✓ HealthcareSupports HealthcareMandates insurer coverage of non-opioid pain meds, prohibits discouraging alternatives to opioids, improving patient access to safer pain management options.95% confidence

Sub-Topics Insurance Prescription Drugs Substance Abuse

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in committee · Michigan · House Mar 19, 2026

HB 4537: Human services: medical services; use of artificial intelligence tools to make decisions regarding claims; prohibit. Amends 1939 PA 280 (MCL 400.1 - 400.119b) by adding sec. 107b.

This bill prohibits Michigan's medical assistance program (Medicaid) from using artificial intelligence tools to deny, modify, or delay claims. It directly affects the state Department of Health and Human Services and private health plans contracted to administer benefits. The law explicitly bans AI-driven reviews as the sole basis for claim decisions, requiring human review instead. This change aims to prevent automated systems from making final determinations on healthcare coverage eligibility or payments.

Topics ✓ HealthcareSupports HealthcareProhibits AI from denying Medicaid claims, requiring human review to protect patient rights and prevent automated coverage denials.95% confidence ✗ TechnologyOpposes TechnologyProhibits AI from making final Medicaid claim decisions, requiring human review instead, restricting AI use in healthcare administration.95% confidence

Sub-Topics Artificial Intelligence

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in committee · Michigan · House Mar 19, 2026

HB 4536: Insurance: health insurers; use of artificial intelligence tools to make decisions regarding claims; prohibit. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406ss.

HB 4536 prohibits health insurers in Michigan from denying, modifying, or delaying insurance claims based solely on artificial intelligence reviews. It directly affects health insurers operating in the state and the policyholders whose claims are processed by these insurers. The bill amends Michigan's Insurance Code (MCL 500.100-500.8302) by adding Section 3406ss, which requires insurers to use human review for claim decisions instead of relying exclusively on AI tools. This creates a clear policy change: insurers must not use AI as the sole basis for adverse claim actions.

Topics ✓ HealthcareSupports HealthcareProhibits insurers from using AI to deny/modify claims, requiring human review to protect policyholders' rights and prevent automated claim denials.95% confidence ✗ TechnologyOpposes TechnologyProhibits health insurers from using AI solely for claim decisions, restricting AI deployment in insurance sector per bill's explicit language.95% confidence

Sub-Topics Artificial Intelligence

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passed both · Michigan · House Sep 18, 2025

HB 4713: Insurance: health insurers; definition of health care insurer; include automobile insurers providing personal injury protection coverage. Amends sec. 2 of 1984 PA 323 (MCL 752.1002).

This bill amends Michigan's Health Care False Claim Act to expand the definition of "health care insurer" to include automobile insurers providing personal injury protection (PIP) coverage. PIP coverage pays for medical expenses after car accidents, and this change brings auto insurers into the same legal framework as health insurers for false claim enforcement. Previously, the law applied only to health insurers and self-insured entities, but now false claims related to PIP benefits will be subject to the same standards. This directly affects auto insurance companies operating in Michigan that offer PIP coverage.

Topics ✓ HealthcareSupports HealthcareExpands Health Care False Claim Act to include auto insurers for PIP medical coverage, strengthening enforcement against false claims for accident-related healthcare expenses, thus protecting healthcare resources.90% confidence

Sub-Topics Insurance

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passed · Michigan · Senate Jun 26, 2025

SB 266: Human services: medical services; certain personal service agreements; allow. Amends 1939 PA 280 (MCL 400.1 - 400.119b) by adding sec. 112l.

SB 266 allows individuals applying for Michigan's medical assistance program (like Medicaid) to pay family members or household members for personal care services without triggering asset divestment penalties. It creates two types of valid agreements: "qualified" (written, signed in advance) and "affirmed" (oral or partial written, with documentation), both requiring payments at fair market value. Payments under these agreements won't count as asset transfers that disqualify applicants, provided they meet specific criteria like documented service details and local rate comparisons. The bill directly affects people seeking medical assistance who rely on family caregivers instead of paid providers.

Topics ✓ HealthcareSupports HealthcareAllows Medicaid applicants to pay family caregivers without asset penalties, expanding access to personal care services under medical assistance programs.95% confidence

Sub-Topics Medicaid

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passed both · Michigan · House Jan 29, 2026

HB 4734: Human services: county services; designation of a patient surrogate for health care decisions; allow. Amends sec. 66h of 1939 PA 280 (MCL 400.66h).

HB 4734 expands who can legally consent to medical treatment for patients unable to make decisions themselves. It adds "designated surrogates" (people formally appointed under Michigan's Estates Code) to the list of authorized decision-makers, alongside relatives, patient advocates, and guardians. This directly affects patients without decision-making capacity, healthcare providers needing consent, and the individuals authorized to act for them. The bill clarifies that emergency care can still be provided without consent during urgent situations requiring immediate action.

Topics ✓ HealthcareSupports HealthcareExpands patient rights by allowing designated surrogates to consent for incapacitated patients, improving access to healthcare decision-making.95% confidence

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passed · Michigan · House Jan 28, 2026

HB 4878: Health: pharmaceuticals; reporting certain information and regulating certain conduct related to drugs and the federal 340B program; provide for. Creates new act.

HB 4878 regulates Michigan's participation in the federal 340B drug pricing program, which allows qualifying hospitals to purchase drugs at discounted prices. The bill requires drug manufacturers to report annual price increases exceeding 15% for drugs costing over $40 per treatment course (Sec. 7), and mandates hospitals using 340B discounts to spend savings on patient services or community health programs (Sec. 11). Hospitals must also report detailed financial data about 340B drug transactions to the state by November 2026 (Sec. 15). These provisions directly affect drug manufacturers, hospitals, and pharmacies participating in the 340B program, aiming to increase transparency and ensure discounts benefit patient care.

Topics ✓ HealthcareSupports HealthcareMandates hospitals using 340B discounts to spend savings on patient services/community programs (Sec. 11), directly advancing patient access and healthcare funding.95% confidence

Sub-Topics Prescription Drugs

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passed · Michigan · Senate Jul 1, 2025

SB 397: Human services: medical services; exemption of certain prescription drugs from the medical assistance prior authorization process; provide for. Amends sec. 109h of 1939 PA 280 (MCL 400.109h).

SB 397 removes the prior authorization requirement for specific prescription drugs under Michigan's medical assistance program (Medicaid). This directly affects Medicaid beneficiaries and healthcare providers by allowing immediate coverage for designated drugs without waiting for insurer approval. The bill amends state law to automatically cover these medications, eliminating a step that previously delayed access. It applies only to drugs explicitly named in the legislation, streamlining treatment for covered conditions.

Topics ✓ HealthcareSupports HealthcareRemoves prior authorization barriers for Medicaid prescription drugs, improving immediate patient access to covered medications.95% confidence

Sub-Topics Medicaid Prescription Drugs

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passed · Michigan · Senate Jul 1, 2025

SB 400: Insurance: health insurers; prior authorization for certain opioid use disorder and alcohol use disorder medications; prohibit. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406ww.

SB 400 prohibits Michigan health insurers from requiring prior authorization for medications treating opioid use disorder or alcohol use disorder. This directly affects health insurance companies and patients seeking these specific treatments, removing a common administrative barrier. The bill amends Michigan’s Insurance Code to explicitly ban prior authorization requirements for these medications, using the existing definition of "prior authorization" from Section 2212e. The law ensures faster access to evidence-based treatment without insurer delays.

Topics ✓ HealthcareSupports HealthcareRemoves prior authorization barriers for opioid/alcohol use disorder medications, improving patient access to essential treatments without administrative delays.95% confidence

Sub-Topics Insurance Substance Abuse

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passed · Michigan · Senate Jul 1, 2025

SB 402: Human services: medical services; coverage for street medicine services; require. Amends sec. 109 of 1939 PA 280 (MCL 400.109).

SB 402 requires health insurance plans to cover street medicine services, which provide medical care directly to homeless individuals in non-clinical settings like streets or shelters. The bill amends state law (MCL 400.109) to mandate this coverage, directly affecting homeless residents and healthcare providers offering street-based care. This policy change ensures that street medicine services can be billed through insurance, improving access to healthcare for vulnerable populations who might otherwise avoid traditional clinics. The requirement applies to all health insurers covered under the amended statute.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for street medicine services, expanding healthcare access for homeless individuals by requiring insurers to cover non-clinical care.95% confidence

Sub-Topics Insurance Mental Health

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