July 27, 2021

Michigan No-Fault Insurance Reform Act Limits Reimbursement Rates

The reimbursement rates under the Michigan No-Fault medical fee schedule 1) limit the amount payable by Medicare to a health provider for treatment or services, 2) limit the reimbursement rate for care providers whose treatment or services are not covered by Medicare, and 3) limit No-Fault coverage for in-home family provided care.

Several House and Senate Bills have been proposed to modify the limitations imposed by the Michigan No-Fault Auto Insurance Reform Act. One possible change includes adjusting the fee schedule in instances where Medicare does not provide coverage to the lesser of either the amount payable under the Michigan No-Fault rehabilitation clinic fee schedule or the provider’s average charge for such treatment as of January 2019. Another reform proposes to fix reimbursement rates for facilities or providers whose treatment is not covered by Medicare. Providers would not be eligible for payment or reimbursement for more than the average amount charged for the treatment in the relevant geographic region. Finally, lawmakers also propose to simply delay both the effective date of the fee schedule and the limit on coverage for in-home family-provided care until July 22, 2022.

As of now, none of the Bills have been passed and the fee schedule that became effective on July 1, 2021 remains intact. It is up to the Michigan Legislature to decide on one of the following Bills to solidify the new changes in the Michigan No-Fault statute and set the standard for how we will proceed with these issues in the future. In the meantime, the Michigan Senate and House have approved a $25 million post-acute auto injury provider relief fund that will be used to distribute funds to care providers affected by the reimbursement rate reductions caused by the Michigan No-Fault medical fee schedule.

For more information regarding the proposed changes to the Michigan No-Fault Auto Insurance Reform Act, please contact Kerr Russell.

About the author:

Daniel G. BeyerDan Beyer - trial attorney with nearly 40 years of experience in the Michigan Circuit and District courts and the Federal Court for the Eastern District of Michigan. is a seasoned trial attorney with nearly 40 years of experience. He focuses his practice on personal injury matters related to medical malpractice, motor vehicle claims and general negligence; lender’s and owner’s title claims; insurance coverage; physician licensing and administrative complaints; commercial matters and consumer claims; and general liability.

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