MBIPC applauds fraud investigation that nabbed alleged West Branch insurance scammer

Brain injury professionals, who have long fought for enhanced anti-fraud efforts, say there is no place for scams in the auto insurance system

BRIGHTON, Mich. — (May 17, 2021) — Tom Judd, president of the Michigan Brain Injury Provider Council (MBIPC), applauded news that a West Branch man has been sentenced to 90 days in jail and must also pay restitution of nearly $775,000 for an alleged insurance scam. The investigation into the alleged scam was conducted by the Michigan Department of Insurance and Financial Services (DIFS) and the Ogemaw County Sheriff’s Office.

“MBIPC applauds the efforts of the DIFS Fraud Investigation Unit and the Ogemaw County Sheriff’s Office for their recent investigation of insurance fraud,” Judd said. “There is no place for fraud in the auto insurance system and those who are found guilty of fraud – consumers, medical providers, or insurance companies – should be held accountable.

MBIPC — a professional association of brain injury specialists, is committed to providing high quality, ethical rehabilitation services — has long fought for enhanced anti-fraud efforts.

Judd noted that the anti-fraud unit is one of many tools included in Michigan’s 2019 auto insurance reform law — along with personal injury protection (PIP) choice, utilization review, assigned claims limits, and the Medicare-based medical provider fee schedule. Unfortunately, the law also contained an error that slashes what post-acute providers earn for their specialized services by nearly half. Two bills — House Bill 4486 and Senate Bill 314 — correct that error through a narrow technical fix.

“Contrary to the lies and misinformation being spewed by the Insurance Alliance of Michigan (IAM), HB 4486 and SB 314 actually bring more consistency to the payment structure for post-acute services and would lower costs — all the while protecting access to care that accident victims need, deserve and were promised when they faithfully paid their insurance premiums,” Judd said. “IAM continues to urge Michigan legislators to throw the baby out with the bath water and ignore these bills that offer solutions.”

The 45% slash on fees will make it impossible for specialized rehabilitation providers to continue services, including in-home care, intensive short-term rehabilitation, long-term residential care, and more – causing survivors’ “benefits” to be worthless.  

Critically, HB 4486 and SB 314 do not change other areas of the 2019 auto reform law; these bills provide assurance of savings but without decimating the entire post-acute care industry. Under these bills, providers would be held to an actual fee schedule or the lesser of their 2019 charges, guaranteeing consistency and savings that a 45% fee cut can’t guarantee.

“This is an avoidable crisis – and the time to act is now,” Judd said. “It is time legislative leaders and Governor Whitmer put a stop to IAM’s shameless rhetoric and pass HB 4486 and SB 314, which would accomplish the objectives and intent of the 2019 auto reform law while making sure the promise of needed care is kept to some of their most vulnerable constituents.”