Mich. Admin. Code R. 500.244 - Median amount; access to database

Current through Vol. 22-05, April 1, 2022

Rule 4.

(1) Subject to subrule (3) of this rule, a carrier may satisfy the requirement under R 500.243 by providing the department with access to a database that contains all of the carrier's median amounts. The database must meet all of the following requirements:
(a) Be updated no less frequently than quarterly.
(b) Be searchable by region, provider specialty, and health care service.
(c) Include negotiated rates for all health care services covered by the carrier.
(d) Be continuously accessible to the department.
(2) For the purposes of conducting a calculation review under section 24510 of the act, MCL 333.24510, the department may, at its discretion, consult any external database described under section 24510(2) of the act, MCL 333.24510, without regard to whether a carrier made the database accessible to the department or whether the database otherwise meets the requirements under subrule (1) of this rule.
(3) A carrier's provision of access to a database under this rule does not preclude the department from requesting any documents, materials, or other information the department believes is necessary to assist in reviewing the calculation described in section 24510(1) of the act, MCL 333.24510.

Notes

Mich. Admin. Code R. 500.244
2021 MR 12, Eff. 6/24/2021

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