During Brain Injury Awareness Month, MBIPC highlights little-known aspect of new law that will be devastating for brain injury survivors

Retroactivity of fee schedule will lead to crisis of care for patients

BRIGHTON, Mich.— (March 23, 2021)— During this Brain Injury Awareness month, the Michigan Brain Injury Provider Council is calling attention to a widely misunderstood element of the state’s looming rehabilitation care crisis: that current accident survivors—not just future victims—will have their care cut nearly in half without a fee schedule fix. 

“Auto accident victims—especially those who have received traumatic brain injuries—often require specialized care for the remainder of their lives,” said Tom Judd, MBIPC President. “Prior to their accidents, they paid their premiums that came with an agreement with their insurance companies that all necessary care would be covered. Without a fix, these survivors will lose access to that care—and they will have nowhere else to turn. We’ve found that even some lawmakers are not aware that the fee schedule affects existing claims.” 

On its website, the Michigan Department of Insurance and Financial Services clearly states that the fee schedule “will apply to new and existing claims for treatment rendered after July 1, 2021.”

This aspect of retroactivity is just one of the unintended consequences that have come to light since Michigan’s new auto insurance law was passed in 2019. House Bill 4486, introduced by State Rep. Doug Wozniak, offers a narrow fix to the law that would protect access to care and keep ethical providers in business without adding additional costs to the system.

Last week, MBIPC released the results of a statewide survey of its members about the crisis, which found that nearly nine in 10 post-acute care facilities have little or no confidence that they will be staying in business after July 1 of this year if House Bill 4486 is not passed. That could result in the loss of care for more than 6,000 from just those facilities alone.  

HB 4486 contains a technical legislative fix to the state’s auto insurance law. Under the 2019 auto insurance reform, health care services that do not have a corresponding “Medicare code”—which includes most services provided by brain injury rehabilitation centers—would be required to slash reimbursements by 45%.

March is Brain Injury Awareness Month in Michigan. One in every 60 people in the United States are living with a brain injury.   

“Thousands of brain injury survivors in Michigan are running out of time,” Judd said. “If HB 4486 is not passed well in advance of July 1, their care will be in serious jeopardy. We need to do right by survivors and act now.”