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.
The 2019 amendments to Michigan’s No-Fault Act changed the landscape for medical providers. One change was to vest medical providers with a statutory cause of action against an insurer who wrongfully denies or delays payment of a claim for motor vehicle accident related medical charges. see MCL 500.3112. That change was a huge win for […]
On August 1, 2023, the United States Court of Appeals for the Sixth Circuit issued its decision in Patterson v. United HealthCare Insurance Company. The Court’s decision serves as a reminder to carefully scrutinize health plan provisions when dealing with plan reimbursement claims. Eric Patterson was injured in an auto accident. United HealthCare paid for […]
On November 17, 2022, the Michigan Court of Appeals issued a decision in Encompass Healthcare, PLLC, v. Citizens Insurance Company, which clarified the tolling provision of the no-fault act and the timelines that medical providers have to file a lawsuit to recover their unpaid charges. For nearly two decades it has been the law, under […]
According to the Michigan State Police, 282,640 traffic crashes happened in Michigan in 2021 – 1068 of those accidents resulted in a fatality. Accidents involving a motorcycle accounted for 1.1% (3,271). But motorcycles were involved in 16% (171) of the traffic crashes that resulted in a fatality. From a potential for injury standpoint – motorcycle […]
In the new world of “PIP choice,” consumers can now choose how much PIP (primarily medical coverage) to carry on their no-fault insurance policies. Depending upon eligibility, some are choosing only $50,000; others are selecting $250,000 or $500,000; and many have wisely continued with unlimited lifetime coverage. Still others have decided to exclude medical coverage […]
On September 29, 2022, the U.S. House of Representatives approved passage of the Employee and Retiree Access to Justice Act, a bill that if enacted into law has significant implications for providers seeking payment of health plan claims governed by the Employee Retirement Income Security Act, commonly known as ERISA. Currently, ERISA authorizes benefit plan […]
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 […]
On August 10, 2022 the United States Court of Appeals for the 11th Circuit ruled that private parties have four years to file suit to recover double damages under the Medicare Secondary Payor Act (“MSPA”). MSPA Claims 1, LLC v Tower Hill Prime Insurance Co, 11th Circuit Case No. 21-1135. This is the first time […]
The Michigan no-fault act contains many important deadlines. If any of these deadlines are missed, a medical provider may be unable to collect payment for the services provided to a patient eligible for no-fault benefits. First, written notice of the injury must be provided to the responsible no-fault insurer within 1 year of the date […]
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