What Are Public Acts 21 and 22 of 2019?
PA-21 is the main law that reformed Auto No-Fault Insurance in Michigan. This act introduces disastrous fee schedules (45% pay cuts to providers), attendant care limitations (56-hour limit for families), and several loopholes for insurance companies to exploit. PA-22 deals mainly with reforms to the type of insurance people can buy – essentially allowing Michiganders to save a few dollars in their insurance bill in exchange for extremely limited coverage… thus gutting No-Fault. Importantly, neither law includes a retroactive clause, but the wording specifically grandfathering survivors in was quietly removed from its final version before passage.
Text of PA-21 and PA-22
Summary & Analysis
56 Hour Limit
(2) SUBJECT TO SUBSECTIONS (3) TO (14), A PHYSICIAN, HOSPITAL,
25 CLINIC, OR OTHER PERSON THAT RENDERS TREATMENT OR REHABILITATIVE
26 OCCUPATIONAL TRAINING TO AN INJURED PERSON FOR AN ACCIDENTAL BODILY
27 INJURY COVERED BY PERSONAL PROTECTION INSURANCE IS NOT ELIGIBLE FOR
1 PAYMENT OR REIMBURSEMENT UNDER THIS CHAPTER FOR MORE THAN THE
3 (A) FOR TREATMENT OR TRAINING RENDERED AFTER JULY 1, 2021 AND
4 BEFORE JULY 2, 2022, 200% OF THE AMOUNT PAYABLE TO THE PERSON FOR
5 THE TREATMENT OR TRAINING UNDER MEDICARE.
6 (B) FOR TREATMENT OR TRAINING RENDERED AFTER JULY 1, 2022 AND
7 BEFORE JULY 2, 2023, 195% OF THE AMOUNT PAYABLE TO THE PERSON FOR
8 THE TREATMENT OR TRAINING UNDER MEDICARE.
9 (C) FOR TREATMENT OR TRAINING RENDERED AFTER JULY 1, 2023,
10 190% OF THE AMOUNT PAYABLE TO THE PERSON FOR THE TREATMENT OR
11 TRAINING UNDER MEDICARE.
(7) IF MEDICARE DOES NOT PROVIDE AN AMOUNT PAYABLE FOR A
8 TREATMENT OR REHABILITATIVE OCCUPATIONAL TRAINING UNDER SUBSECTION
9 (2), (3),[(5),] OR (6), THE PHYSICIAN, HOSPITAL, CLINIC, OR OTHER PERSON
10 THAT RENDERS THE TREATMENT OR TRAINING IS NOT ELIGIBLE FOR PAYMENT
11 OR REIMBURSEMENT UNDER THIS CHAPTER OF MORE THAN THE FOLLOWING, AS
13 (A) FOR A PERSON TO WHICH SUBSECTION (2) APPLIES, THE
14 APPLICABLE FOLLOWING PERCENTAGE OF THE AMOUNT PAYABLE FOR THE
15 TREATMENT OR TRAINING UNDER THE PERSON’S CHARGE DESCRIPTION MASTER
16 IN EFFECT ON JANUARY 1, 2019 OR, IF THE PERSON DID NOT HAVE A
17 CHARGE DESCRIPTION MASTER ON THAT DATE, THE APPLICABLE FOLLOWING
18 PERCENTAGE OF THE AVERAGE AMOUNT THE PERSON CHARGED FOR THE
19 TREATMENT ON JANUARY 1, 2019:
20 (i) FOR TREATMENT OR TRAINING RENDERED AFTER JULY 1, 2021 AND
21 BEFORE JULY 2, 2022, 55%.
22 (ii) FOR TREATMENT OR TRAINING RENDERED AFTER JULY 1, 2022 AND
23 BEFORE JULY 2, 2023, 54%.
24 (iii) FOR TREATMENT OR TRAINING RENDERED AFTER JULY 1, 2023,
(10) FOR ATTENDANT CARE RENDERED IN THE INJURED PERSON’S HOME,
20 AN INSURER IS ONLY REQUIRED TO PAY BENEFITS FOR ATTENDANT CARE UP
21 TO THE HOURLY LIMITATION IN SECTION 315 OF THE WORKER’S DISABILITY
22 COMPENSATION ACT OF 1969, 1969 PA 317, MCL 418.315. THIS SUBSECTION
23 ONLY APPLIES IF THE ATTENDANT CARE IS PROVIDED DIRECTLY, OR
24 INDIRECTLY THROUGH ANOTHER PERSON, BY ANY OF THE FOLLOWING:
25 (A) AN INDIVIDUAL WHO IS RELATED TO THE INJURED PERSON.
26 (B) AN INDIVIDUAL WHO IS DOMICILED IN THE HOUSEHOLD OF THE
27 INJURED PERSON.
1 (C) AN INDIVIDUAL WITH WHOM THE INJURED PERSON HAD A BUSINESS
2 OR SOCIAL RELATIONSHIP BEFORE THE INJURY.
3 (11) AN INSURER MAY CONTRACT TO PAY BENEFITS FOR ATTENDANT
4 CARE FOR MORE THAN THE HOURLY LIMITATION UNDER SUBSECTION (10).
[MCL 418.315, Worker’s Compensation Act, States:
Attendant or nursing care shall not be ordered in excess of 56 hours per week if the care is to be provided by the employee’s spouse, brother, sister, child, parent, or any combination of these persons.]
Several bills have been introduced in 2021 to fix the care crisis that this reform created, but none have received a hearing. Bi-partisan leadership at the House and Senate have blocked hearings, as have Insurance Committee leaders and the Senate Leader. These lawmakers have a moral obligation to fix the crisis they created but are refusing to act are listening only to the insurance lobby.
If all faith leaders and religious organizations in the State joined the Michigan Interfaith Coalition, we would represent the voices of a majority of Michiganders – almost 10 million of them – and could pressure legislators to take a moral stand and pass meaningful legislation immediately. We are advocating for a removal of the 56-hour attendant care limitation and the restoration of pre-2020 rates for all post-acute providers, including doctors, families, medical suppliers, pharmacists, therapists, and all those who care for survivors for a lifetime.