LANSING, Mich., July 20, 2022 — State Rep. Brenda Carter (D-Pontiac) and state Sen. Curtis Hertel Jr. (D-East Lansing) recently introduced legislation to improve accessibility to the Post-Acute Auto Injury Provider Relief Fund for medical providers requesting financial assistance for rate reimbursements.
“While it’s great that there’s a fund set up to help providers stay in business and keep supporting their patients, that fund is useless if the ones who need it the most can’t get the help they need,” Carter said. “We can no longer sit idly by while critical, potentially life-saving care is taken away from auto accident victims and local businesses have to close up shop. We need to make it easier for home care providers to access the funds they need to make up for losses due to the unintended consequences of auto no-fault reform.”
Under the 2019 no-fault auto insurance reform, medical providers’ reimbursement rates for certain essential services were capped at 55% of what they were previously charging in January 2019. In response to medical providers’ concerns regarding these cuts, the Legislature created the $25 million Post-Acute Auto Injury Provider Relief Fund. Providers facing financial duress due to the fee cut could claim up to $500,000 from the fund through September 2022.
However, to qualify, post-acute care providers are required to show proof of a systemic deficit. Almost a year after the Post-Acute Auto Injury Provider Relief Fund’s creation, none of the money has been allocated to providers. Although several medical providers have applied for assistance, all applications have been marked as incomplete or denied.
“The Post-Acute Auto Injury Provider Relief Fund is problematic for two reasons,” Hertel said. “$25 million is not enough to cover the actual costs of providing the care that patients need and deserve, and the language was specifically written in a way that providers would not be able to access this fund. It is long past time for us to fix this and give the providers a chance to access these funds to provide families the care they need and deserve.”
In order to increase access to the funds, House Bill 6341 and Senate Bill 1126 would:
- Simplify the necessary documents required as part of the application process.
- Ensure the metrics for qualification are based on the reimbursement received.
- Reduce timeframes for the Department of Insurance and Financial Services’ (DIFS) review, approval and disbursement process.
- Eliminate the utilization review process, which unnecessarily delays the application process.
- Remove the requirement to demonstrate an undefined “systemic deficit.”
- Limit the scope of DIFS’ discretion to add on requirements to the application process.
- Remove the unnecessary limit of $500,000 annual cap on access to the funds for providers.
- Encourage more applications with a first-come-first-served basis.