Updates on the latest state and federal issues and information about how you can be involved in our grassroots efforts

The APTA Michigan Legislative Committee works with the APTA Michigan Lobbyist Firm, Muchmore, Harrington, and Smalley (Members Only - Login Required) and the APTA Michigan Board of Directors. This committee is a resource for APTA Michigan members to get answers to specific questions regarding legislation in Michigan. Advocacy and Legislation at a National level is handled by APTA. Contact the APTA Michigan office with your question at contact@aptami.org

If you have questions about any of the legislative issues please contact the APTA Michigan office with your question at contact@aptami.org

If you would like to become more involved in legislative issues please see Action Steps for PT.

The support and participation of all APTA Michigan members is much appreciated as we continue this investment in our future. If you have any suggestions, questions, answers or want to get more involved in any other way, please contact the APTA Michigan office.

Legislative News:
 

Auto No-Fault

posted: July 01, 2021

Auto No-Fault Law

https://www.legislature.mi.gov/documents/2019-2020/publicact/pdf/2019-PA-0021.pdf

Key Provisions

The Michigan No-Fault medical fee schedule, which was created by Public Acts 21 and 22 of 2019, sets dollar-amount limits on how much doctors, hospitals, clinics, institutions and persons can be paid or reimbursed under the No-Fault insurance system for providing treatment and care to car accident victims.

For some care providers, the charges and/or reimbursements they can be paid under the Michigan No-Fault medical fee schedule will be calculated as a percentage of what is payable for the same treatment and care under Medicare’s pricing structure.

For other providers whose treatment and care is not by the Medicare pricing structure, their charges and/or reimbursement rates will be set at 55% to 52.5% of what they charged on January 1, 2019.

Prior to 2019, there was no Michigan No-Fault medical fee schedule. The amount that doctors, hospitals, clinics, rehabilitation specialists and attendant care providers were paid for caring and treating car accidents is the amount that they charged so long as it was a “reasonable amount” and was not more than they would “customarily” charge in cases that did not involve insurance. (MCL 500.3157(1))

Payment Provisions

Limit on reimbursement rate for care providers (whose services are covered by the Medicare pricing structure): For physicians, hospitals, clinics and other persons who provide “treatment or rehabilitative occupational training” to car accident victims, their reimbursement under the Michigan No-Fault medical fee schedule is limited 200% of the “amount payable” under the Medicare pricing structure for treatment and training provided “after July 1, 2021 and before July 2, 2022.” The following year, the percentage drops to 195%. After the July 1, 2023, the percentage is permanently set at 190%. (MCL 500.3157(2)) [Note: “Person” includes “an institution.” (MCL 500.3157(15)(h)); “Treatment” encompasses “but is not limited to, products, services, and accommodations.” (MCL 500.3157(15)(k))

In-home attendant Care

Beginning after July 1, 2021, insurers are only required to pay for 56 hours per week of in-home attendant care provided by someone who is related to the injured person, domiciled in the household of the injured person, or with whom the injured person had a business or social relationship before the injury. An insurer may contract to pay benefits for necessary in-home care that exceeds that 56 hour cap. The insurer may choose to contract with a relative of the injured person or a professional care provider for the period exceeding 56 hours.

Additionally, insurers are required to offer a rider that will provide coverage for attendant care in excess of an insured’s PIP limit. This rider must be offered to anyone choosing a policy with PIP medical limits

Legislative Action as of July 1, 2021

House Bill 4486 was introduced on March 10, 2021, and referred to the House Insurance Committee. No action has been taken by the Committee or by the House.

Senate Bill 314 was introduced on March 24, 2021, and referred to the Senate Insurance and Banking Committee. No action has been taken by the Committee or by the Senate.

House Bill 4992 was introduced on June 10 and referred to the House Committee on Insurance.  No further action has been taken by the Committee or by the House.  

House Bill 5125 was introduced June 24 by Julie Rogers, PT, to delay the implementation of the medical fee schedule.  This bill was referred to the Committee on Insurance.  No further action has been taken by the Committee or by the House.  

On June 30, the House and Senate approved an appropriations bill that provides $25 million available state aid for brain injury rehabilitation providers.  Legislators will be in their home districts much of the summer, so progress on any legislation will most likely be quite delayed. 

 

 

 


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