Michigan Statutes
Parity Report
Legislation Signed into Law
2018
Primary Focus | Medicaid |
Title/Description | Medicaid-covered specialty services and supports; management and delivery; specialty prepaid health plans |
Citation | Michigan Compiled Laws § 400.109f |
Summary | The state department shall support the use of Medicaid funds for specialty services and supports for Medicaid beneficiaries with a serious mental illness, developmental disability, serious emotional disturbance, or substance use disorder. |
Effective Date | 3/20/2018 |
Notes | Enacted through SB 649 (Regular Session 2017) |
2016
Primary Focus | Disability Insurance |
Title/Description | Diagnosis and treatment of autism spectrum disorders; coverage; prohibition; availability of other benefits; conditions; qualified health plan offered through American health benefit exchange pursuant to federal law; short-term or 1-time limited duration policy or certificate; prescription drug plan; coordinated benefits; definitions |
Citation | Michigan Compiled Laws § 500.3406s |
Summary | This statute requires an insurer that delivers a health insurance policy shall provide coverage for the diagnosis of autism spectrum disorders and treatment of autism spectrum disorders. Insurers are prohibited from terminating or refusing to provide coverage solely based on an individual’s diagnosis with autism spectrum disorder. Insurers cannot limit the number of visits used for treatment of autism spectrum disorders, or deny or limit coverage because the treatment is educational or habilitative in nature. An insurer may limit coverage for treatment of autism spectrum disorders to an insured enrollee through 18 years old and may apply a maximum annual benefit amount. Insurers may apply certain coverage conditions to treatment for an autism spectrum disorder. |
Effective Date | 7/1/2016 |
Notes | Enacted through HB 4935 (Regular Session 2016) |
Primary Focus | Mandated Benefit: substance use disorders |
Title/Description | Health insurance policies; coverage for intermediate and outpatient care for substance abuse disorder required; charges, terms and conditions; reduction of coverage; deductibles and copayment provisions; definitions |
Citation | Michigan Compiled Laws § 500.3425 |
Summary | An insurer that delivers a health insurance policy shall provide coverage for intermediate and outpatient care for substance use disorder. The charges, terms, and conditions for coverage of such services shall not be less favorable than the maximum prescribed for other comparable services. The insurer shall not reduce coverage required for such services by terms or conditions applicable to other items of coverage in the policy. |
Effective Date | 7/1/2016 |
Notes | Enacted through HB 4935 (Regular Session 2016) |
2011-2012
Primary Focus | Mandated Benefit: Provider |
Title/Description | Diagnosis and treatment of autism spectrum disorders; coverage; prohibition; availability of other benefits; conditions; qualified health plan offered through American health benefit exchange pursuant to federal law; prescription drug plan; coordinated benefits; definitions |
Citation | Michigan Compiled Laws § 550.1416e |
Summary | A health care corporation group or nongroup certificate shall provide coverage for the diagnosis of autism spectrum disorders and treatment of autism spectrum disorders. Insurers cannot limit the number of visits used for treatment of autism spectrum disorders, or deny or limit coverage because the treatment is educational or habilitative in nature. An insurer may limit coverage for treatment of autism spectrum disorders to an insured enrollee through 18 years old and may apply a maximum annual benefit amount. Insurers may apply certain coverage conditions to treatment for an autism spectrum disorder. |
Effective Date | 4/18/2012 |
Notes | Enacted through SB 414 (2011 Regular Session) |
National Parity Map
View the state parity reports to learn about legislation, regulation, and litigation related to parity implementation
National Parity MapGet Support
- Michigan Insurance Division
- http://www.michigan.gov/difs/0,5269,7-303-12902_12907---,00.html
- difs-HICAP@michigan.gov
- 877-999-6442
Common Violations
In seeking care or services, be aware of the common ways parity rights can be violated.