Senate Bill 4 amends Michigan's insurance code to require health insurers that provide prescription drug coverage to comply with section 12 of the prescription drug cost and affordability review act. This means insurers delivering or renewing health policies in the state must adhere to specific provisions outlined in that separate act related to prescription drug costs. The bill's enactment is dependent on Senate Bill No. 3 also becoming law.
Senate Bill 5 mandates that Michigan's medical assistance program, which includes Medicaid, must comply with section 12 of the "prescription drug cost and affordability review act," subject to federal law. This means the state's program for medical assistance will be required to follow specific rules related to prescription drug costs and affordability outlined in that separate act. The bill will only become effective if Senate Bill No. 3 of the 103rd Legislature is also passed into law.
Senate Bill 107 requires health insurance policies delivered or renewed in Michigan to provide coverage for specific services administered or ordered by pharmacists, starting January 1, 2026. This includes immunizations listed on CDC schedules, certain laboratory tests, and drugs dispensed by a pharmacist, provided these services are received at an in-network pharmacy and are within the scope of practice defined by the public health code. The bill allows insurers to apply existing utilization management, prior authorization, and cost-sharing requirements, such as deductibles or co-pays, to this coverage.
SB 135 requires Michigan health insurers to provide dependent coverage until age 26, with identical benefits and premiums as other dependents. It mandates coverage for newborns from birth, including treatment for congenital defects, and prohibits denying coverage based on factors like out-of-wedlock birth or tax filing status. The bill also bans lifetime and annual dollar limits on essential health benefits (such as hospital care, maternity services, mental health, and prescription drugs) and requires no cost-sharing for preventive services meeting federal guidelines. These changes apply to individual and small group health insurance policies sold in Michigan, directly affecting insurers and their policyholders.
Senate Bill 33 amends Michigan's Estates and Protected Individuals Code concerning patient advocate designations. The bill allows individuals to include specific instructions within their patient advocate designation regarding desired life-sustaining treatment, even if they are pregnant. It removes the existing legal prohibition that prevents patient advocates from making decisions to withhold or withdraw life-sustaining treatment from a pregnant patient if such a decision would result in the patient's death. This change enables a patient advocate to follow a pregnant patient's pre-expressed wishes concerning end-of-life care.
SB 30, known as the "Biased and Unjust Care Reporting Act," requires the Michigan Department of Health and Human Services (DHHS) to collect reports from individuals who are pregnant or in the postpartum period. These reports concern gynecological or perinatal care that does not meet standards for being culturally congruent, unbiased, just, or dignified. The DHHS will use a validated tool to identify instances of "obstetric violence" and "obstetric racism," as defined in the bill. The department will then provide a report containing de-identified data on the incidence and prevalence of these issues to the governor and relevant legislative committees, without identifying specific healthcare providers.
Senate Bill 34 amends Michigan's Elliott-Larsen Civil Rights Act to broaden the definition of "sex." For employment situations, it clarifies that "sex" includes pregnancy, lactating status, childbirth, termination of a pregnancy, or related medical conditions. For places of public accommodation and public service, the bill specifies that "sex" includes pregnancy or lactating status. This bill aims to expand civil rights protections for individuals based on these defined statuses.
SB 38 amends Michigan's Social Welfare Act to explicitly include perinatal and gynecological services in Medicaid coverage for eligible individuals. The bill updates Section 109 (MCL 400.109) to require the department to provide guidelines ensuring these services are covered under the state's medical assistance plan. This directly affects Medicaid recipients in Michigan who need care related to pregnancy, childbirth, postpartum recovery, or women's health conditions. The change ensures these services are formally recognized in coverage rules, aligning with existing Medicaid requirements for other medical services.
Senate Bill 39 requires Michigan's medical assistance program to provide coverage for remote ultrasound procedures and fetal nonstress tests. This allows patients to receive these services in their residence or other off-site locations through telemedicine. The bill mandates the department to update reimbursement rules for fee-for-service and managed care plans, enabling payment for these remote services using established CPT codes when the same standard of care is met. Reimbursement for these remote services is contingent on using HIPAA-compliant, FDA-approved digital technology for data transmission and FDA-cleared monitoring solutions for at-home use.
SB 37 requires Michigan health insurers to cover gynecological and perinatal care services provided by in-network physicians, certified nurse midwives, or midwives at in-network facilities or at home. This applies to any health insurance policy that already includes coverage for these services. The bill defines key terms like "certified nurse midwife" and "midwife" to clarify which providers and settings qualify for the required coverage. The policy change ensures patients using in-network providers for these services have access without gaps in coverage.
