The Devastating Impact of Michigan’s 2019 Auto Insurance Reform

Click a county to read testimonials of Michigan residents who have been affected by this dire situation:

Click on the Michigan counties that have approved a resolution to amend the catastrophic Michigan auto insurance reform:

Did Insurance Companies, Insurance Lobbyists, Insurance Association of Michigan (IAM) and the MI Catastrophic Claims Association (MCCA) lie to us??

• Why didn’t the MCCA & IAM share their updated cost controls built into their Plan of Operations with Legislators in 2019?
• Did the MCCA & IAM share their updated cost controls built into their Plan of Operations with the Governor’s office in 2019?
• Would you like to see it?
  • MCCA Plan of Operations Updated July 2018
  • MCCA Standard Operating Procedure Policy Changes September 2018
• We need to understand Member Companies must be members of the MCCA and follow any and all updates to the Plan of Operations
  • If the MCCA does not agree with Insurance Adjusters decisions, they will transfer the files to another Insurance Company
• Our Courts believe Insurance Companies & the MCCA are oppressive and wrong!
  • Stephen Gedda, Plaintiff V. State Farm Mutual Auto Insurance
  • David Martin, Plaintiff V. Progressive Michigan Insurance
  • Andrew Phelps, Plaintiff V. Auto Club Group Insurance
  • Frank Throneberry, Plaintiff V. AAA of Michigan/Auto Club
  • Randy Baldwin, Plaintiff V. State Farm Mutual Auto Insurance
• Even the Michigan Appellate Courts agree that there needs to be a fix!
  • Andary vs USAA Insurance & Citizens Insurance

What the 2019 Bill changed for Home Health Care beginning July 2021??

• SB1/PA21 eliminated a mandatory Premium for Lifetime Medical Care coverages. We now have Personal Injury Protection (PIP) Choice Coverage levels/options.
• A few intentions of this bill:
  • Eliminate or reduce fraudulent claims
  • Implement a series of cost controls for care, services and products
  • Mandate the integration of Medical Utilization Controls
    • How Medical Utilization Review Works
    • The Review Process and Origins of Medical Necessity
• Only those who select Unlimited Lifetime Medical Coverage, under Personal Injury Protection (PIP), pay the Michigan Catastrophic Claim Association (MCCA) fee to pay for their needed care.
  • Commercial Insurance (BCBS, HAP, Priority, etc.) do not cover the duration needed
  • This care includes most Post-Acute Care needs (Rehabilitation, Home Health Care, Institutional Care)

The Current Catastrophe:

• SB1/PA21 allows providers to charge no more than 200% of Medicare for covered services. (Senate, 26).
• It isn’t clear enough if Medicare provides payment for hourly care in the home (Home Health Care) (Medicare.gov, 2021)
  • Insurance Companies & the MCCA say “no”
• Medicaid, Veterans Benefits, Workman’s Compensation Benefits, Long-Term Care Insurance recognize and pay for hourly Home Health Aides and Nursing Care.
• When drafting SB1/PA21, Legislators assumed hourly Home Health Care was either covered by Medicare or wasn’t to be affected by Sec. 3157 language.
  • PA 21 Section 3157

What is Happening to our Michigan Residents needing Hourly Home Health Aide (HHA) and Nursing Care?

• The Insurance Companies & the MCCA oppressive interpretation of the 2019 Statute have resulted in Home Health Care charges reduced by 45% effective July 1, 2021 (Senate, 27).
  • Most have closed!
  • Dear Speaker Wentworth
• Home Care providers are now paying more for the hourly care than they are able to collect from Insurance companies.
• For Example: The average charges of $30/hour have been reduced to $16.50/hour (45% reduction).
• The Michigan Catastrophic Care Association (MCCA) has become a bigger ‘bully’ over the years. They are unwilling to operate in good faith to assure our most fragile are taken care of.
• More than 100 lawsuits, on behalf of the families we serve, have proven the MCCA is disinterested in the Care needed for folks to continue on their road to recovery.

Our Post-Acute Network has been collapsing since July of 2021:

• Home Health Care companies have been closing every month. Many chose not to fight and closed June of 2021
• Insurance companies & the MCCA (through the MI Catastrophic Care Fund -(MCCF) are refusing to grandfather anyone injured prior to 2019.
• As Mr. Clinton of the MCCA pointed out, as intended, Post-Acute care does (and should) account for the majority of the MCCA annual budget.
  • The first $580,000 is covered by Auto Insurance companies.
  • Only the amount over $580,000 is covered by the MCCF.

Solutions:

• Continuing the percentage formula of Medicare as outlined in SB1/PA21 (as is).
• Provide language similar to our MI Worker’s Compensation & Disability Act for Home Health Care
  • Providers shall be reimbursed either at the providers usual & customary charges or reasonable payment, whichever is less.
  • Work Comp Disability Reimbursement
• This assures critically needed care & services would continue.
• The addition of Medical Utilization Review, in the 2019 Statute, assures cost controls and sustainability.
• Shouldn’t drivers who purchase Unlimited Lifetime PIP coverage options, and therefore pay the MCCA fee, expect a robust Post-Acute network?

Suggested Action:

• Please CALL your Legislators along with House and Senate Leadership (Wentworth, Frederick, Lasinski, Shirkey, Lauwers, Schmidt) and share your story of how in home care/residential care has helped you or a loved one.
• Please CALL your Legislators and request a simple fix to the 2019 Statute.
  • Encourage adding the simple Workers Compensation Language
• Click here to find your District Representative. Click here to find your State Senator.
• Contact us for any information regarding this issue and ask for Kris Skogen, or email him directly at krisskogen@advisacare.com.

Additional Links:

• MHHA Auto No Fault Page