HOUSE BILL No. 6062

 

 

November 29, 2016, Introduced by Rep. Faris and referred to the Committee on Insurance.

 

     A bill to amend 1956 PA 218, entitled

 

"The insurance code of 1956,"

 

by amending section 3406a (MCL 500.3406a), as added by 1982 PA 527.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 3406a. (1) A An expense-incurred hospital, medical, or

 

surgical expense incurred group or individual policy or certificate

 

delivered, issued for delivery, or renewed in this state and a

 

health maintenance organization group or individual contract shall

 

offer benefits provide coverage for prosthetic devices to maintain

 

or replace the body parts of an individual who has undergone a

 

mastectomy. This coverage shall must provide that reasonable

 

charges for medical care and attendance for an individual who

 

receives reconstructive surgery following a mastectomy or who is

 

fitted with a prosthetic device shall be are covered benefits after

 

the individual's attending physician has certified the medical


necessity or desirability of a proposed course of rehabilitative

 

treatment. The cost and fitting of a prosthetic device following a

 

mastectomy is included within the type of coverage intended

 

required by this section.subsection.

 

     (2) An insurer shall not require a physician to discharge a

 

patient who has undergone a mastectomy before the physician

 

determines that the patient has reached the point of stabilization.

 

As used in this subsection, "stabilization" means the point at

 

which no material deterioration of a condition is likely, within

 

reasonable medical probability, to result from discharge of the

 

patient.