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State agency says some insurers are not following intent of no-fault auto reform law

Anita Fox, director of Michigan's Department of Insurance and Financial Services, has issued 2 bulletins in October clarifying the responsibilities insurance companies still have under the new law
NFA WEB
Posted at 5:43 PM, Oct 14, 2021
and last updated 2021-10-14 19:33:12-04

LANSING, Mich. — The director of Michigan's Department of Insurance and Financial Services has issued two bulletins in October clarifying the responsibilities insurance companies still have under the state's new no-fault auto insurance law, saying some are not following the intent of the law.

Anita Fox Director of DIFS

Advocates for survivors of catastrophic auto crashes say the new law, in many cases, has made it extremely difficult to find medical services they need to survive.

Under the new law, which took effect on July 2, any medical service not already covered under our federal Medicare law, which includes in-home caregivers and transportation to medical services, will now only be reimbursed by insurance companies at 55 percent of what they were back in 2019. The law also caps the number of hours that family members can provide care to just 56 hours a week.

There are roughly 18,000 Michiganders currently receiving medical benefits from their auto no-fault policies.

On Oct. 5, Anita Fox, director of Michigan's Department of Insurance and Financial Services, issued a bulletin aimed at telling insurance companies that they need to be reimbursing care providers in a timely manner, and must be working collaboratively with care providers to process reimbursements.

“We wanted to do what we could within our authority as the Department of Insurance and Financial Services to make sure that we one: told insurers and providers that we expected them to work with one another for a billing system that push these bills through in a timely manner," Fox said Thursday.

"And second: to remind the insurance companies what the obligations are and what the penalties were, if there's not timely payment of those bills.”

If insurers are doing things like rejecting bills repeatedly without offering assistance to a provider, they can be subject to administrative action.

“It gives providers some more support to engage with insurance companies and say, 'No, you've got to pay these bills... you've got to engage in a process that works towards a resolution, and stop these delay tactics,'" said Tom Judd, president of the Michigan Brain Injury Providers Council.

On Monday, Oct. 11, Fox issued another bulletin, this one providing a list of services that, in their interpretation of the law, should not be subject to the 55 percent reduced rate.

“We wanted to clear that up because those are services that the catastrophically injured need,” Fox said.

“When you think about things that a catastrophically injured person might need, like a modified van, or modifications to their home, those are things that are not within what the fee schedule was looking at.”

Advocates like Judd say these bulletins are promising but want lawmakers in Lansing to look at more overarching fixes to the new fee schedule.

"They're obviously listening to what's happening out there, and they're doing what they can within their scope and within the law... unfortunately, the larger picture in the big problem needs a legislative fix," Judd said Thursday.

“I’m hopeful… 'cautiously optimistic' is a little strong because I don't see indication yet from leadership or from the Insurance Committee Chair people that this is an issue they want to bring up anytime soon."

FOX 17's Coverage of No Fault Auto Reform Care Crisis
May 17, 2021 — New Law Could Have Devastating Consequences
June 2, 2021 — "We're Paying the Price With Our Lives": FOX 17 Extended Coverage
June 9, 2021 — Hundreds of Survivors Protest at Capitol
June 10, 2021 — Rep. Berman Introduces Bill to Prevent Cuts
June 23, 2021 — Advocates Rally Again at Capitol
June 26, 2021 — House Approves $10M Fund
June 30, 2021 — Advocates Say $25M Isn't Enough
July 7, 2021 — Family Scared to Lose Caregivers
July 23, 2021 — Providers Begin Closing their Doors
Aug. 4, 2021 — Patients Continue to Lose Care
Sept. 24, 2021 — Changes Causing Chaos for Survivors
Sept. 27, 2021 — 'We Can't Wait' ArtPrize Entry Highlights Care Crisis
Oct. 4, 2021 — Protest Outside Business of SML Shirkey

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