No-Fault Rate Establishment Process: Unveiling Key Changes

Changes in No-Fault Rate Establishment Process Huge Topic These Days…

For decades Michigan drivers have benefited from reasonable and necessary payments for the costs of care associated with qualifying auto accidents that occur within the State of Michigan. For many, injuries after these accidents are truly catastrophic, resulting in traumatic brain, spinal cord, back and other injuries. In some cases, the trauma has led to chronic wound development or the reactivation of previous wounds whose healing has been negatively impacted by the trauma of the motor vehicle accident.

Everyone who buys auto insurance in the State of Michigan contributes to a fund managed by the Michigan Catastrophic Claims Association (http://michigancatastrophic.com/) which reimburses the cost of care, after the first $440,000.00 which rests with the insurance company. The per vehicle cost effective July 1, 2019 becomes $220.00 annually. For the most part insurance adjusters, actuaries and others have researched and established usual and customary rates for services. This has led to a market driven process, although many complain of serious excesses when compared to what is billed to other payer sources.

Today, things are handled a bit differently for both commercially provided Attendant Care and Residential Care. When these new cases crop up, the MCCA must approve the rates before an agreement to pay is provided. This is not a drawn out process and the seasoned provider adjusts to this new process accordingly.

It is likely more adjustments are coming. While no one wants to see thousands of injured parties thrust into Medicaid based care in substandard conditions, more oversight and/or intervention affecting the cost of care is likely going to happen. Oh well, life and business both have it: Its called change.

Love to hear your thoughts.

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