Michigan Legislature Proposes Delaying Application of No Fault Fee Schedule in HB 5125
Pending legislation in Michigan seeks to delay implementation of the personal injury protection (PIP) medical provider fee schedule. This was a keystone provision of Michigan’s recently reformed no fault laws. HB 5125 was introduced on June 24, 2021 seeking to delay implementing the medical provider fee schedule until July 1, 2022. The Michigan House Bill follows months of vocal opposition from citizens groups expressing concern about the potential loss of financial support for auto-related injuries that require long term care.
Payment for medical services would still be allowed under the bill. If passed, the rates charged for auto related medical care simply may not exceed the customary charges applied to cases that do not involve auto insurance. This vague parameter is the source of much contention and interpretation. Under the pending legislation, the all-important fee schedule feature of the reformed no fault laws would not be implemented until July 2, 2022 (instead of July 2, 2021). Thereafter, the originally enacted fee schedule would apply:
a) For treatment or training rendered between July 1, 2021 and July 2, 2022, 200% of the amount payable to the person for the treatment or training under Medicare.
b) For treatment or training rendered between July 1, 2022 and July 2, 2023, 195% of the amount payable to the person for the treatment or training under Medicare.
c) For treatment or training rendered after July 1, 2023, 190% of the amount payable to the person for the treatment or training under Medicare.
HB5125 also provides that the 56 hour per week cap for family provided attendant care rendered in the injured person's home would not apply until July 1, 2022 (instead of July 2, 2021). This subsection would apply if the attendant care provider is:
An individual who is related to the injured person.
An individual who is domiciled in the household of the injured person.
An individual with whom the injured person had a business or social relationship before the injury.
Currently a version of HB 5125 has been passed by the state Senate. No timetable for reconciliation of the two bills or a final vote has been set. Thus, insurers are legally permitted to start applying the fee schedule provided by the currently applicable MCL § 500.3157. Stay tuned!
Click on the link to access the legislative history for Michigan HB 5125.
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Alexander & Angelas, P.C. represents defendants in civil liability litigation across Michigan and Northern Ohio. The firm’s practice areas include insurance defense litigation, premises liability, motor carrier (trucking) defense, corporate and commercial litigation, construction defect litigation, auto negligence, insurance coverage disputes, emergency casualty response services, alternative dispute resolution, subrogation claims, workers’ compensation, employment law, and liquor liability.
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