Insurance: no-fault; utilization reviews; require compliance with decision on appeal. Amends sec. 3157a of 1956 PA 218 (MCL 500.3157a).
Take action
Record your position on this measure.
Create an account to take a stance, submit a written position, or contact your legislator.
Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Senate
- Passed House
- To Governor
- Became Law
Overview
This bill aims to strengthen Michigan’s no-fault insurance system by requiring healthcare providers to comply with decisions made during utilization review appeals. It establishes clearer guidelines for utilization review processes, including criteria for determining appropriate treatment levels and procedures for obtaining necessary information. The bill also clarifies that providers must explain the necessity of treatments and that insurers must follow department decisions.
Key provisions
- Requires healthcare providers to comply with utilization review decisions on appeal.
- Establishes criteria for utilization review based on medically accepted standards.
- Creates procedures for obtaining medical records and explaining treatment necessity.
- Allows insurers to request explanations for treatment decisions.
- Provides a process for healthcare providers to appeal utilization review determinations.
- Defines ‘utilization review’ as an initial evaluation of treatment appropriateness.
- Requires providers to submit necessary records for utilization review.
- Prohibits submitting false or misleading records to insurers or the department.
Who is affected
- Healthcare providers (physicians, hospitals, clinics)
- Insurance companies
- Individuals with personal protection insurance
- The Michigan Department of Insurance and Financial Services
Bill text
Read the latest version inline or switch to a previous version.
Document of record
- Version
- Senate Introduced Bill
- Published
- Not published in the source record
This version is published only as a document. Open the viewer to read it here, or download the file.
Sponsors
Official sponsors from legislative records.
No sponsors are on record.
Arguments
Reasons offered for and against this legislation.
Arguments in favor
No arguments in favor have been submitted.
Submit yoursArguments opposed
No arguments opposed have been submitted.
Submit yours