HB 5104 Summary

• Amends Michigan's Insurance Code to require personal protection insurance benefits be paid within 30 days of receiving reasonable proof of loss, with overdue payments bearing 12% simple interest.

• Establishes a duty of good faith dealing for insurers with claimants and service providers, with liability for compensatory, consequential, economic, noneconomic, and exemplary damages plus attorney fees for breaches.

• Prohibits insurers from demanding specific documentation types to prove health coverage coordination; allows acceptance of plan documents, explanation of benefits forms, or correspondence from other coverage providers.

• Requires insurers and assigned risk associations to accept electronic documentation of claims by January 1, 2018.

• Sets medical provider reimbursement rates at 185% of workers' compensation fee schedules (R 418.10101 to R 418.101503) effective after June 30, 2018, with annual adjustments based on the greater of workers' compensation schedule changes or medical component of the Consumer Price Index.

• Exempts level I and II trauma centers and attendant/home care services from the fee schedule limitations.