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.