Michigan Supreme Court to Decide if Fee Schedule Applies to Accidents that Occurred Before June 11, 2019

As expected, the Michigan Supreme Court has agreed to review the court of appeals’ decision in Ellen M. Andary et al v. USAA Casualty Insurance Company et al. In Andary, the court of appeals ruled that the new No-Fault Fee Schedule, which was a part of the 2019 changes to Michigan’s No-Fault Act, did not apply to patients injured in motor-vehicle accidents prior to June 11, 2019.

The insurance company, USAA, asked the Michigan Supreme Court to ‘fast-track’ its review of the Andary decision, and the Court agreed to do so, setting the case for a hearing in March 2023. However, the Court denied USAA’s request to “stay” the court of appeals’ decision until it decides the ruling in Andary, meaning Andary remains the law in Michigan for now. Until the Court decides that the Andray decision no longer stands, providers should continue to expect full payment of their charges for the treatment of patients injured in accidents prior to June 11, 2019.

This was recently emphasized by the director of the Department of Insurance and Financial Services (DIFS). On October 5, 2022, the director issued a bulletin in light of the Andary decision clarifying the insurance industry’s obligation to pay medical providers’ charges without regard to the No-Fault Fee Schedule for accidents prior to June 11, 2019. The bulletin also emphasizes that providers who are due additional reimbursement for claims subject the Andary decision should resubmit their bills to the insurer for payment.

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