§ 550.1510

550.1510 Additional determinations by commissioner. Sec. 510. (1) After considering the information and factors described in section 509(4), the goals of a health care corporation as provided in section 504, and the objectives contained in the provider class plan, the commissioner shall determined 1 of the following: (a) That the provider class plan achieves the goals of the corporation as provided in section 504. (b) That although the provider class plan does not substantially achieve 1 or more of the goals of the corporation, a change in the provider class plan is not required because there has been competent, material, and substantial information obtained or submitted to support a determination that the failure to achieve 1 or more of the goals was reasonable due to factors listed in section 509(4). (c) That a provider class plan does not substantially achieve 1 or more of the goals of the corporation as provided in section 504. (2) The commissioner shall notify the health care corporation, and each person who has requested a copy of such notice, of a determination under subsection (1) by certified or registered mail.

n 504. (2) The commissioner shall notify the health care corporation, and each person who has requested a copy of such notice, of a determination under subsection (1) by certified or registered mail. Determinations made pursuant to subsection (1)(b) or (c) shall include a concise written statement of specific findings supporting that determination. (3) An existing provider contract or reimbursement arrangement shall remain in effect until a new provider class plan has been retained and placed into effect as provided in section 506(4). A provider class plan shall not be subject to further review until the expiration of the time period provided in section 509(1). (4) A provider class plan with respect to which a determination was made under subsection (1)(a) or (b) shall not be subject to further review until the expiration of 2 years following the determination. History: 1980, Act 350, Eff. Apr. 3, 1981 Compiler's Notes: Near the end of subsection (1), 'determined' evidently should read 'determine.'Popular Name: Blue Cross-Blue ShieldPopular Name: Act 350