On July 1, Michigan Gov. Gretchen Whitmer signed House Bill 4449, which ends a No-Fault insurer’s ability to refuse to reimburse licensed chiropractic physicians for certain lawfully delivered and reasonably necessary services that would be covered and reimbursed to other healthcare providers.
In 2010, the scope of chiropractic care in Michigan, found in the Public Health Code at MCL 333.16401, was expanded by Public Act 223 (2009) to include treatment to other areas of the body as opposed to simply the spine. The methods of chiropractic treatment were also expanded to include, among other things, the adjustment of the extremities, differential diagnosis, the use of physical measures, and specific diagnostic services.
However, despite expanding the scope and methods of chiropractic, the Michigan Legislature did not extend a No-Fault insurer’s obligation to pay for the same. Instead, the Legislature specifically limited a No-Fault insurer’s responsibility for chiropractic services to those that existed before the Legislative amendment expanding the scope of chiropractic. The Legislature did this by stating in MCL 500.3107b(b) that “allowable expense” PIP benefits are not recoverable for chiropractic treatment, “unless that service was included in the definition of practice of chiropractic under section 16401 of the public health code... as of January 1, 2009.”
As a result, services that do not fall within the definition of “practice of chiropractic” as the definition existed in January 2009, are currently not required to be reimbursed under auto insurance PIP coverage when performed by a chiropractor. Examples of excluded services included such things as massage, heat or cold therapy, traction, electrical stimulation, ultrasound, and therapy and examinations that go beyond the spine.
House Bill 4449 removes the limitation imposed by MCL 500.3107b(b). The bill permits recovery of “allowable expense” PIP benefits for any treatment or service that a chiropractor is now authorized by the Public Health Code to provide, subject only to MCL 500.3107(1)(a)’s requirement that the treatment is “reasonably necessary” for the injured person’s “care, recovery, or rehabilitation.”
Notably, the expanded list of chiropractic services for which a No-Fault insurer may be required to pay does not go into effect until July 2, 2021. These chiropractic services will also be subject to the new No-Fault medical benefit fee schedule, which starts on July 1, 2021. The reimbursement rate will range from 190% to 250% of the amount payable under Medicare.
A member of Plunkett Cooney’s Transportation Law Practice Group, Michael C. Dennis concentrates his practice on the defense of insurers, corporations, and individuals in a broad range of civil litigation matters, including ...
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