SENATE BILL No. 1623

 

 

November 12, 2008, Introduced by Senator CROPSEY and referred to the Committee on Economic Development and Regulatory Reform.

 

 

 

     A bill to amend 1980 PA 350, entitled

 

"The nonprofit health care corporation reform act,"

 

by amending section 207 (MCL 550.1207), as amended by 2003 PA 59.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 207. (1) A health care corporation, subject to any

 

limitation provided in this act, in any other statute of this

 

state, or in its articles of incorporation, may do any or all of

 

the following:

 

     (a) Contract to provide computer services and other

 

administrative consulting services to 1 or more providers or groups

 

of providers, if the services are primarily designed to result in

 

cost savings to subscribers.

 

     (b) Engage in experimental health care projects to explore

 

more efficient and economical means of implementing the

 


corporation's programs, or the corporation's goals as prescribed in

 

section 504 and the purposes of this act, to develop incentives to

 

promote alternative methods and alternative providers, including

 

nurse midwives, nurse anesthetists, and nurse practitioners, for

 

delivering health care, including preventive care and home health

 

care.

 

     (c) For the purpose of providing health care services to

 

employees of this state, the United States, or an agency,

 

instrumentality, or political subdivision of this state or the

 

United States, or for the purpose of providing all or part of the

 

costs of health care services to disabled, aged, or needy persons,

 

contract with this state, the United States, or an agency,

 

instrumentality, or political subdivision of this state or the

 

United States.

 

     (d) For the purpose of administering any publicly supported

 

health benefit plan, accept and administer funds, directly or

 

indirectly, made available by a contract authorized under

 

subdivision (c), or made available by or received from any private

 

entity.

 

     (e) For the purpose of administering any publicly supported

 

health benefit plan, subcontract with any organization that has

 

contracted with this state, the United States, or an agency,

 

instrumentality, or political subdivision of this state or the

 

United States, for the administration or furnishing of health

 

services or any publicly supported health benefit plan.

 

     (f) Provide administrative services only and cost-plus

 

arrangements for the federal medicare program established by parts

 


A and B of under title XVIII of the social security act, chapter

 

531, 49 Stat. 620, 42 U.S.C. 1395c to 1395i, 1395i-2 to 1395i-5,

 

1395j to 1395t, 1395u to 1395w, and 1395w-2 to 1395w-4 42 USC 1395

 

to 1395hhh; for the federal medicaid program established under

 

title XIX of the social security act, chapter 531, 49 Stat. 620, 42

 

U.S.C. 1396 to 1396r-6, and 1396r-8 to 1396v 42 USC 1396 to 1396v;

 

for title V of the social security act, chapter 531, 49 Stat. 620,

 

42 U.S.C. USC 701 to 704 and 705 to 710; for the program of medical

 

and dental care established by the military medical benefits

 

amendments of 1966, Public Law 85-861; , 80 Stat. 862; for the

 

Detroit maternity and infant care--preschool, school, and

 

adolescent project; and for any other health benefit program

 

established under state or federal law.

 

     (g) Provide administrative services only and cost-plus

 

arrangements for any noninsured health benefit plan, subject to the

 

requirements of sections 211 and 211a.

 

     (h) Establish, own, and operate a health maintenance

 

organization, subject to the requirements of the insurance code of

 

1956, 1956 PA 218, MCL 500.100 to 500.8302.

 

     (i) Guarantee loans for the education of persons who are

 

planning to enter or have entered a profession that is licensed,

 

certified, or registered under parts 161 to 182 of the public

 

health code, 1978 PA 368, MCL 333.16101 to 333.18237, and has been

 

identified by the commissioner, with the consultation of the office

 

of health and medical affairs in the department of management and

 

budget, as a profession whose practitioners are in insufficient

 

supply in this state or specified areas of this state and who

 


agree, as a condition of receiving a guarantee of a loan, to work

 

in this state, or an area of this state specified in a listing of

 

shortage areas for the profession issued by the commissioner, for a

 

period of time determined by the commissioner.

 

     (j) Receive donations to assist or enable the corporation to

 

carry out its purposes, as provided in this act.

 

     (k) Bring an action against an officer or director of the

 

corporation.

 

     (l) Designate and maintain a registered office and a resident

 

agent in that office upon whom service of process may be made.

 

     (m) Sue and be sued in all courts and participate in actions

 

and proceedings, judicial, administrative, arbitrative, or

 

otherwise, in the same cases as natural persons.

 

     (n) Have a corporate seal, alter the seal, and use it by

 

causing the seal or a facsimile to be affixed, impressed, or

 

reproduced in any other manner.

 

     (o) Subject to chapter 9 of the insurance code of 1956, 1956

 

PA 218, MCL 500.901 to 500.947, invest and reinvest its funds and,

 

for investment purposes only, purchase, take, receive, subscribe

 

for, or otherwise acquire, own, hold, vote, employ, sell, lend,

 

lease, exchange, transfer, or otherwise dispose of, mortgage,

 

pledge, use, and otherwise deal in and with, bonds and other

 

obligations, shares, or other securities or interests issued by

 

entities other than domestic, foreign, or alien insurers, as

 

defined in sections 106 and 110 of the insurance code of 1956, 1956

 

PA 218, MCL 500.106 and 500.110, whether engaged in a similar or

 

different business, or governmental or other activity, including

 


banking corporations or trust companies. However, a health care

 

corporation may purchase, take, receive, subscribe for, or

 

otherwise acquire, own, hold, vote, employ, sell, lend, lease,

 

exchange, transfer, or otherwise dispose of bonds or other

 

obligations, shares, or other securities or interests issued by a

 

domestic, foreign, or alien insurer, so long as the activity meets

 

all of the following:

 

     (i) Is determined by the attorney general to be lawful under

 

section 202.

 

     (ii) Is approved in writing by the commissioner as being in the

 

best interests of the health care corporation and its subscribers.

 

     (iii) For an activity that occurred before the effective date of

 

the amendatory act that added subparagraph (iv) July 23, 2003, will

 

not result in the health care corporation owning or controlling 10%

 

or more of the voting securities of the insurer or will not

 

otherwise result in the health care corporation having control of

 

the insurer, either before or after the effective date of the

 

amendatory act that added subparagraph (iv) July 23, 2003. As used

 

in this subparagraph and subparagraph (iv), "control" means that

 

term as defined in section 115 of the insurance code of 1956, 1956

 

PA 218, MCL 500.115.

 

     (iv) Subject to section 218 and beginning on the effective date

 

of the amendatory act that added this subparagraph July 23, 2003,

 

will not result in the health care corporation owning or

 

controlling part or all of the insurer unless the transaction

 

satisfies chapter 13 of the insurance code of 1956, 1956 PA 218,

 

MCL 500.1301 to 500.1379, and the insurer being acquired is only

 


authorized to sell disability insurance as defined under section

 

606 of the insurance code of 1956, 1956 PA 218, MCL 500.606, or

 

under a statute or regulation in the insurer's domiciliary

 

jurisdiction that is substantially similar to section 606 of the

 

insurance code of 1956, 1956 PA 218, MCL 500.606.

 

     (p) Purchase, receive, take by grant, gift, devise, bequest or

 

otherwise, lease, or otherwise acquire, own, hold, improve, employ,

 

use and otherwise deal in and with, real or personal property, or

 

an interest therein, wherever situated.

 

     (q) Sell, convey, lease, exchange, transfer or otherwise

 

dispose of, or mortgage or pledge, or create a security interest

 

in, any of its property, or an interest therein, wherever situated.

 

     (r) Borrow money and issue its promissory note or bond for the

 

repayment of the borrowed money with interest.

 

     (s) Make donations for the public welfare, including hospital,

 

charitable, or educational contributions that do not significantly

 

affect rates charged to subscribers.

 

     (t) Participate with others in any joint venture with respect

 

to any transaction that the health care corporation would have the

 

power to conduct by itself.

 

     (u) Cease its activities and dissolve, subject to the

 

commissioner's authority under section 606(2).

 

     (v) Make contracts, transact business, carry on its

 

operations, have offices, and exercise the powers granted by this

 

act in any jurisdiction, to the extent necessary to carry out its

 

purposes under this act.

 

     (w) Have and exercise all powers necessary or convenient to

 


effect any purpose for which the corporation was formed.

 

     (x) Notwithstanding subdivision (o) or any other provision of

 

this act, establish, own, and operate a domestic stock insurance

 

company only for the purpose of acquiring, owning, and operating

 

the state accident fund pursuant to chapter 51 of the insurance

 

code of 1956, 1956 PA 218, MCL 500.5100 to 500.5114, so long as all

 

of the following are met:

 

     (i) For insurance products and services the insurer, whether

 

directly or indirectly through 1 or more subsidiaries, only

 

transacts worker's compensation insurance and employer's liability

 

insurance, transacts disability insurance limited to replacement of

 

loss of earnings, and acts as an administrative services

 

organization for an approved self-insured worker's compensation

 

plan or a disability insurance plan limited to replacement of loss

 

of earnings and does not transact any other type of insurance

 

notwithstanding the authorization in chapter 51 of the insurance

 

code of 1956, 1956 PA 218, MCL 500.5100 to 500.5114. This

 

subparagraph does not preclude the insurer, from providing either

 

whether directly or indirectly through 1 or more subsidiaries, from

 

providing noninsurance products and services as otherwise provided

 

by law.

 

     (ii) The activity is determined by the attorney general to be

 

lawful under section 202.

 

     (iii) The health care corporation does not directly or

 

indirectly subsidize the use of any provider or subscriber

 

information, loss data, contract, agreement, reimbursement

 

mechanism or arrangement, computer system, or health care provider

 


discount to the insurer.

 

     (iv) Members of the board of directors, employees, and officers

 

of the health care corporation are not, directly or indirectly,

 

employed by the insurer unless the health care corporation is

 

fairly and reasonably compensated for the services rendered to the

 

insurer if those services were paid for by the health care

 

corporation.

 

     (v) Health care corporation and subscriber funds are used only

 

for the acquisition from the state of Michigan of the assets and

 

liabilities of the state accident fund.

 

     (vi) Health care corporation and subscriber funds are not used

 

to operate or subsidize in any way the insurer including the use of

 

such funds to subsidize contracts for goods and services. This

 

subparagraph does not prohibit joint undertakings between the

 

health care corporation and the insurer to take advantage of

 

economies of scale or arm's-length loans or other financial

 

transactions between the health care corporation and the insurer.

 

     (2) In order to ascertain the interests of senior citizens

 

regarding the provision of medicare supplemental coverage, as

 

described in section 202(1)(d)(v), and to ascertain the interests of

 

senior citizens regarding the administration of the federal

 

medicare program when acting as fiscal intermediary in this state,

 

as described in section 202(1)(d)(vi), a health care corporation

 

shall consult with the office of services to the aging and with

 

senior citizens' organizations in this state.

 

     (3) An act of a health care corporation, otherwise lawful, is

 

not invalid because the corporation was without capacity or power

 


to do the act. However, the lack of capacity or power may be

 

asserted:

 

     (a) In an action by a director or a member of the corporate

 

body against the corporation to enjoin the doing of an act.

 

     (b) In an action by or in the right of the corporation to

 

procure a judgment in its favor against an incumbent or former

 

officer or director of the corporation for loss or damage due to an

 

unauthorized act of that officer or director.

 

     (c) In an action or special proceeding by the attorney general

 

to enjoin the corporation from the transacting of unauthorized

 

business, to set aside an unauthorized transaction, or to obtain

 

other equitable relief.

 

     (4) A health care corporation shall not condition the sale or

 

vary the terms or conditions of any product sold by the corporation

 

or by a subsidiary of the corporation by requiring the purchase of

 

any other product from the corporation or from a subsidiary of the

 

corporation.

 

     Enacting section 1. This amendatory act is curative and

 

intended to express the original intent of the legislature in 1999

 

PA 210.