Call to Action regarding Auto No-Fault Funding, Access to Care, and House Bill 4486
To Our Valued Clients, Family Members, Employees and Stakeholders:
I am writing to give you an important update on Michigan’s Auto No-Fault Law and request your help in reaching out to your lawmakers. I ask that you call or write your State Representative, State Senator, and Governor to let them know the legislature needs to pass House Bill 4486 this spring. Whether you were injured in an auto accident, or are a family member, employee, caregiver, or are receiving services through some other means but rely upon Michigan’s system of care, this issue impacts us all.
In June of 2019, the Michigan Legislature passed Public Act 21, making sweeping changes to the Michigan Auto No-Fault Law. Some changes were effective immediately in 2019, some became effective in July of 2020, and the final fee schedule-related changes become effective in July of this year.
The new fee schedule or fee cap rules have two main criteria to determine how much providers will be paid for various services starting in July 2021.
- If Medicare happens to list an amount Medicare would pay for a given service, then No-Fault will pay the provider up to 200% of that amount.
- If Medicare happens to not list an amount for the service, then No-Fault will pay the provider 55% of whatever amount the provider happened to be charging on January 1, 2019
The first criteria (200% of Medicare) is a sustainable approach that can be applied consistently to some services provided by providers. However, the second criteria (55% of historical charges) is arbitrary and a significant problem for most long-term care providers. Paying 55% of historical charges does not provide a consistent or fair method of establishing a reasonable payment for services. This will force many care providers out of business, and result in many people living with long-term care needs due to car crashes without care.
Medicare was not designed for long-term care, supervision, or ongoing private duty home care. As a result, Medicare does not list an amount payable for many of the long-term care benefits available to individuals under No-Fault. This means that unless the law is fixed before July, providers are scheduled to have an arbitrary 45% reduction in payments for many services. This was a mistake that needs to be fixed.
House Bill 4486 is a simple fix to the law. HB4486 would adopt the use of a new fee schedule which was developed to provide an approximation of 200% Medicare for those services where Medicare does not list an amount payable. Thus, long-term care, supervision, private duty home care and other non-Medicare payable services would be paid at a measurable and sustainable rate, yet still helping to reduce overall costs and in line with the original legislative intent of the law.
Rainbow, the Michigan Brain Injury Provider Council, and many similarly situated care providers around the state have been lobbying in Lansing since the passage of the No-Fault law change in 2019 to correct this mistake (55% of historical charges provision). We believe that if HB4486 were put up for a vote today, it would pass both the House and Senate, and the Governor would sign it. But to date, this needed fix has not been prioritized. Please write to your State Representative, State Senator, and Governor and encourage them to prioritize the immediate passage of House Bill 4486.