Auto No-Fault Legislation Highlights Healthcare Activity in Michigan Legislature

capitol building

capitol buildingSenate Bills (SBs) 530 and 531 were introduced Sept. 26 by Sen. Mary Cavanagh (D-Redford Twp.) and Sen. Sarah Anthony (D-Lansing) that would adjust the hospital fee schedule, clarify the definition of Medicare and provide rate certainty for post-acute care providers. Specifically, the legislation would eliminate the various rate tiers for reimbursement and coalesce hospitals around the national median reimbursement rate of 250% of Medicare. Additionally, the legislation clarifies the definition of Medicare based upon actual reimbursement experience at hospitals. The MHA issued a media statement in support of the legislation, which also creates fee schedules for post-acute care providers and adjusts the provisions related to attendant care. The legislation is referred to the Senate Insurance Committee and the MHA will keep members updated on its progress.

The legislature continued its breakneck pace this week with numerous healthcare bills seeing both committee action.

The Senate Finance, Insurance and Consumer Protection Committee voted out SBs 483, 484 and 485 sponsored by Sen. Darrin Camilleri (D-Trenton), Sen. Veronica Klinefelt (D-Eastpointe) and Sen. Kristen McDonald Rivet (D-Bay City). The legislation, creating the Prescription Drug Affordability Board, was reported along party lines with Senator Mark Huizenga (R-Walker) passing based on a potential conflict of interest. The MHA continues to work with the sponsors, stakeholder, and leadership on this legislation to ensure it accurately reflects the important role hospitals serve as purchasers and administrators of prescription drugs. The MHA is opposed to the package as it is currently written.

The Senate Health Policy Committee took up SB 133, sponsored by Sen. Sean McCann (D-Kalamazoo), which creates the Overdose Fatality Review Act. The act would allow for the establishment of overdose fatality review teams to identify potential causes of drug overdoses, as well as recommend solutions to address drug overdoses. The MHA successfully recommended changes to reflect more appropriate information sharing practices and timelines and supports this legislation. In addition, the committee reported out House Bills (HBs) 4619, 4620, 4621, 4622 and 4623, codifying aspects of the Affordable Care Act in state law. The MHA supports this work.

The House Insurance and Financial Services Committee took up several of the Affordable Care Act codification bills including SBs 356, 357 and 358 sponsored by Sen. Kevin Hertel (D-St. Clair Shores), Sen. Mary Cavanagh (D-Redford Twp.) and Sen. Veronica Klinefelt (D-Eastpointe). Both SBs 356 and 357 failed to garner enough votes in committee to be voted out of committee. SB 358 was reported to the House Floor. The MHA supports this legislation and looks forward to seeing the remaining bills reported favorably to the House floor next week.

Finally, the House Health Policy Committee took testimony on two pieces of MHA supported legislation. HB 4101, sponsored by Rep. Curt VanderWall (R-Ludington), would allow for the issuance and extended renewal period of a temporary license for individuals completing their required supervised clinical hours as a speech language pathologist (SLP). Extending the timeline for supervised clinical hour completion will deter new graduates from leaving the state to complete their supervised hours and will assist in the retention of SLPs in Michigan.

SB 384, sponsored by Sen. Kevin Hertel (D-St. Clair Shores), prohibits a disability insurer, long term care insurer or life insurer from discriminating against an individual based on their status as a living organ donor. Individuals who choose to be a living organ donor must meet stringent requirements and many of those who do donate continue to live similarly healthy lives post donation. However, the possibility of discrimination could deter individuals from choosing to be a living donor and therefore limiting access to organs for those most in need. Prohibiting discrimination based on living donor status could increase organ availability, ultimately supporting opportunities for individuals in need of an organ transplant.

Members with questions about state legislative action may contact Adam Carlson at the MHA.

Headline Roundup: New Auto No-Fault Legislation & Hospital Staffing

Brian Peters

The MHA received media coverage the week of Sept. 25 regarding new auto no-fault legislation introduced in the Michigan Legislature and hospital staffing issues.

The MHA issued a media statement Sept. 26 from MHA CEO Brian Peters in support of Senate Bills 530 and 531, which would reform specific aspects of Michigan’s current auto no-fault insurance law.

Below is a collection of headlines from around the state.

Wednesday, Sept. 27

Tuesday, Sept. 26

Members with any questions regarding media requests should contact John Karasinski at the MHA.

MHA Issues Statement on Important Auto No-Fault Legislation

Brian Peters

The following statement can be attributed to Brian Peters, CEO of the Michigan Health & Hospital Association.

Brian Peters“The auto no-fault insurance bills introduced today will improve access to care for auto accident survivors and patients. The reforms implemented several years ago created an environment of extreme uncertainty. This bill package is an important step towards providing better access to services and reimbursement clarity, bringing Michigan healthcare provider reimbursement in line with national averages and ensuring they all have the resources needed to care for auto accident survivors throughout their recovery.

The Michigan Health & Hospital Association is proud to join the many stakeholders supporting Senate Bills 530 and 531.”

DIFS Bulletin Clarifies Auto No-Fault Provisions

The Michigan Department of Insurance and Financial Services (DIFS) recently issued a bulletin clarifying that provisions of the auto no-fault law signed in May 2019 do not apply for services provided to individuals injured in motor vehicle accidents occurring before June 11, 2019. This bulletin is in response to the Michigan Supreme Court affirmation of the Court of Appeals’ opinion in Andary v USAA Cas Ins Co.

Hospitals and other providers who believe they are due additional reimbursement for claims subject to the Andary decision should contact the insurer to request claims reprocessing. If a dispute related to a reprocessed claim cannot be resolved directly with the insurer, the provider should contact DIFS for assistance.

Similarly, hospitals and other providers who filed an appeal with the DIFS Utilization Review unit involving claims that are subject to the Andary decision, and whose appeals were resolved in an order issued prior to Aug. 25, 2022, should first attempt to resolve any reimbursement disputes with the insurer. If the dispute cannot be resolved, the provider may request that DIFS consider modifying the Utilization Review order in their case by submitting their request in writing to DIFS-URAppeals@michigan.gov.

Members with questions should contact Vickie Kunz at the MHA.

Michigan Supreme Court Decides Auto No-Fault Retroactivity Case

The Michigan Supreme Court issued an opinion July 31 upholding the Michigan Court of Appeals’ decision that changes to the auto no-fault law passed in 2019 on attendant care and other lifetime benefits cannot be applied to individuals injured before the law went into effect.

This is a positive decision for these auto accident survivors and their families, as those injured prior to the reforms can receive the lifetime benefits they were promised.

The MHA issued a media statement the morning of the decision expressing the importance of this decision for auto accident survivors and their access to needed healthcare services.  The MHA has been in contact with the Michigan Department of Insurance and Financial Services (DIFS) to initiate efforts on how to determine and bill for the appropriate reimbursement which results from this court ruling. DIFS is not prepared to issue any guidance yet, but the MHA will again push for clear direction to both insurers and hospitals for reimbursement rates and practices. The MHA will also pursue the previously introduced legislative reforms in House Bill 4884 to expand access to care for patients.

Members with questions may contact Laura Appel at the MHA.

MHA Issues Statement on Andary v. USAA Decision

Brian Peters

The following statement can be attributed to Brian Peters, CEO of the Michigan Health & Hospital Association following the Michigan Supreme Court decision on Andary v. USAA.

Brian PetersThe MHA, on behalf of our member hospitals and health systems, are pleased with the Michigan Supreme Court decision that will provide greater access to care for auto accident survivors. It will make a positive impact on the lives of those survivors seriously injured prior to the recent changes to Michigan’s auto no-fault law who continue to have significant ongoing care needs.

In addition to this decision, the MHA remains engaged with lawmakers on identifying and supporting reforms to the auto no-fault law to improve access to care and support healthcare providers.

Headline Roundup: State Budget, Healthcare Workforce and More

Brian Peters

The MHA received media coverage the week of June 26 regarding the state budget, the healthcare workforce and auto no-fault utilization review.

MHA CEO Brian Peters is quoted in multiple stories. Below is a collection of headlines from around the state.

Friday, June 30

Thursday, June 29

Wednesday, June 28

Monday, June 26

Members with any questions regarding media requests should contact John Karasinski at the MHA.

MHA Monday Report Oct. 10, 2022

MHA Monday Report

DIFS Publishes Bulletin on No-fault Reimbursement Following Andary Decision

The Michigan Department of Insurance and Financial Services (DIFS) issued Bulletin 2022-17-INS Oct. 5 in the matter of payment and billing guidance for no-fault automobile insurers and healthcare providers following an order from the Michigan Supreme Court in the Andary v. USAA lawsuit …


MDHHS Releases Proposed Policy to Resume Required Enrollment Activities

The Michigan Department of Health and Human Services (MDHHS) released a proposed policy to rescind remaining waived provider enrollment (PE) requirements implemented by MSA 20-28 and resume required enrollment activities that were waived during the federal COVID-19 Public Health Emergency (PHE) …


CMS Announces 2023 Medicare Premiums and Deductibles

The Centers for Medicare & Medicaid Services (CMS) recently announced the calendar year 2023 Medicare fee-for-service Part A deductible for inpatient hospital services will increase by $44 to a new total of $1,600 …


MHA Creates Workforce Sustainability Communications Toolkit

As hospitals and health systems across Michigan continue to face workforce challenges, the MHA has developed a downloadable communications toolkit focused on workforce sustainability …


Michigan Harvest GatheringsMichigan Harvest Gathering Launches Oct. 10

Food insecurity and health outcomes go hand in hand, as those who struggle to put food on the table are at a higher risk of conditions like diabetes, hypertension and heart disease. In 2020, more than one million Michiganders faced food insecurity – including 300,000 children …


Opportunities for Immunization Grants – Applications Due Nov. 1

The American Academy of Pediatrics (AAP) recently announced multiple grant opportunities for health organizations and AAP Chapters to improve community confidence in vaccines and to support pediatricians in the delivery of on-time vaccinations …


Webinar Dispels Misinformation About Unionization and Outline Legal Guidelines

Healthcare workforce shortages, particularly nursing shortages, are severely hindering the ability to provide patient-centered care. Unionizing to negotiate for policies like staffing ratios is popular but does not consider the complexity of significant workforce shortages …


MHA Race of the Week – Michigan Secretary of State

The MHA’s Race of the Week series highlights the most pivotal statewide races and ballot questions for Election 2022. The series will provide hospitals and healthcare advocates with the resources they need to make informed decisions on Election Day, including candidates’ views and background …


Paul KeckleyThe Keckley Report

The White House Strategy for Nutrition and Hunger: Three Glaring Oversights

“Last Wednesday, the White House hosted the White House Conference on Hunger, Nutrition, and Health in DC—the first since the Nixon administration’s conference in 1969. Noting that food insecurity is an issue in one in four US households and the eroding nutritional value of the food supply chain, the Administration laid out its strategy in a 44-page document featuring 5 pillars of its attention…

The White House Strategy is a great start but the issues of food insecurity and nutritional deficiency require urgent, comprehensive and dedicated attention. The White House says it has secured pledges of $8 billion from the private sector to advance the strategy: that’s a good start, but only a fraction of what’s needed.”

Paul Keckley, Oct. 3, 2022


Logo for MI Vote Matters, Tuesday Nov. 8News to Know

  • A second gubernatorial debate is scheduled for 7 p.m. Oct. 25 on the Oakland University campus between Gov. Gretchen Whitmer and Republican candidate Tudor Dixon.
  • Early in-person voting by absentee ballot at a clerk’s office is currently available.
  • Complimentary MI Vote Matters informational posters and the 2022 Candidate Guide remain available for MHA members.

Laura AppelMHA in the News

Bridge Michigan published an article Oct. 4 which focuses on the staffing challenges impacting behavioral health providers that limit bed capacity. The article begins by reviewing the number of reduced beds at state psychiatric facilities …

DIFS Publishes Bulletin on No-fault Reimbursement Following Andary Decision

The Michigan Department of Insurance and Financial Services (DIFS) issued Bulletin 2022-17-INS Oct. 5 in the matter of payment and billing guidance for no-fault automobile insurers and healthcare providers following an order from the Michigan Supreme Court in the Andary v. USAA lawsuit that effectively reinstated the obligation of auto no-fault insurers to cover benefits for the catastrophically injured as those benefits had been in place prior to June 11, 2019.

The lawsuit was brought by a group of catastrophically patients injured before June 11, 2019, which is prior to passage of changes to Michigan’s auto no-fault law. Auto insurers implemented benefit and payment reductions for all claims including for patients who were injured before the new law took effect. The plaintiffs in Andary sued their insurer to establish that they are entitled to full lifetime no-fault benefits (such as unlimited hours of family attendant care) and claimed the limited reimbursement for medical and other personal injury protection coverage does not apply retroactively.

The bulletin explains the process providers who believe they are due additional reimbursement for claims subject to the Andary decision should follow if a provider believes a reprocessing of a claim is necessary. As outlined in the bulletin, providers are advised to first contact the insurer to request reprocessing of those claims. If a dispute related to a reprocessed claim cannot be resolved directly with the insurer, the provider may contact DIFS for assistance at DIFSComplaints@michigan.gov.

The Michigan Supreme Court also issued a separate order granting USAA’s application for permission to appeal the question of whether the Court of Appeals erred when it:

  • Held that claimants injured before June 11, 2019 are not subject to the reduced reimbursement for care under the new law.
  • Held that application of the new law to claimants injured before June 11, 2019 violates the Contracts Clause of the Michigan Constitution.
  • Remanded the case to the circuit court for discovery to determine if the new law passes constitutional muster.

The MHA is evaluating the DIFS bulletin and have submitted clarifying questions to external legal counsel. Members with questions may contact Laura Appel at the MHA.

Court of Appeals Rules for Providers in ANF Case

The Michigan Court of Appeals ruled 2-1 in favor of providers to declare that statutorily set reimbursement rates for auto accident no-fault claims could not be applied retroactively. The new reimbursements went into effect in July, 2021.

The 2-1 ruling, in Ellen M. Andary, Philip Krueger, & Eisenhower Center, v. USAA Casualty Insurance Company and Citizens Insurance Company of America, called upon the fact that legislative intent did not make it clear that the new rates were intended to be retroactive for cases that had arisen previous to the rates that went into effect, and even if it had, the legislature would be unable to make such a law due to impairments of constitutional contract provisions.

While the case is a victory for providers, especially those caring for auto accident victims from prior to 2019, it is highly likely that the case will be appealed for a final decision at some point before the Michigan Supreme Court. There is not an automatic right to appeal for the defendants, but the Michigan Supreme Court could grant leave to appeal. Under the Court of Appeals ruling, payments to providers for patients with injuries incurred before the effective date of the law return to charges 21 days after this ruling unless there is further court action. The MHA will provide an analysis to members of the policy impact of this decision and will keep members apprised of the legal status of challenges to the amended auto no fault law.

Those with questions may contact Laura Appel at the MHA.