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BLUE CROSS v. COMMISSIONER OF INSURANCE

Docket No. 106469.

179 Mich. App. 246 (1989)

445 N.W.2d 215

BLUE CROSS & BLUE SHIELD OF MICHIGAN v. COMMISSIONER OF INSURANCE

Michigan Court of Appeals.

Decided August 8, 1989.

Attorney(s) appearing for the Case

Foster, Swift, Collins & Coey, P.C. (by Stephen O. Schultz), for Blue Cross & Blue Shield of Michigan.

Frank J. Kelley, Attorney General, Louis J. Caruso, Solicitor General, and Harry G. Iwasko, Jr., and Sharon L. Feldman, Assistant Attorneys General, for the Commissioner of Insurance.

Amici Curiae:

Honigman, Miller, Schwartz & Cohn (by Stuart H. Teger), for the Michigan Hospital Association.

Gilbert M. Frimet & Associates, P.C. (by Gilbert M. Frimet and Bruce C. Blanton), and Andrew B. Wachler, P.C. (by Andrew B. Wachler and Karen Berkery), for the health care providers.

Before: DANHOF, C.J., and HOOD and R.L. TAHVONEN, JJ.

R.L. TAHVONEN, J.

Blue Cross and Blue Shield of Michigan appeals as of right a circuit court order entered on January 20, 1988, affirming a declaratory ruling by the Commissioner of Insurance. We affirm.

BCBSM, a nonprofit health care corporation, makes payments for medical services directly to participating health care providers, pursuant to agreements entered with them. The agreements stipulate that BCBSM will pay for only medically necessary and appropriate...

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