DIFS Issues Updated Enhanced Auto Reimbursement List

On November 14, 2024, the Michigan Department of Insurance and Financial Services issued bulletin 2024-25-INS, which has significant implications for medical providers seeking payment of auto no-fault claims.

Under the no-fault law, medical providers are eligible for enhanced reimbursements where the provider’s percentage of indigent volume meets or exceeds 20% or, for further enhancement, 30%.  A provider’s indigent volume is determined pursuant to the methodology used by the Department of Health and Human Services in determining inpatient medical/surgical factors used in measuring eligibility for Medicaid disproportionate share payments.

The DIFS bulletin can be accessed here.

DIFS has compiled a list of medical providers eligible for enhanced reimbursements based upon its determination of indigent volumes meeting or exceeding these thresholds.  The current DIFS’ list can be accessed here.

Providers listed here whose reported indigent volumes are incorrect can take appropriate action to correct the error.  Likewise, providers with indigent volumes meeting or exceeding applicable thresholds, but who are not listed on the DIFS disclosure, can take appropriate action to correct the omission.  Failure to take either action can mean getting auto no-fault reimbursements below what the law requires, and in many cases substantially below.

If you have questions about this or any other medical reimbursement issue, please contact any one of our provider reimbursement counsel at mjmedrecovery.com.