HB 5858 Summary

• Establishes tiered reimbursement rates for medical treatment and rehabilitative occupational training under Michigan's no-fault auto insurance, with rates declining annually from 200% of Medicare amounts (July 1, 2021-July 2, 2022) to 190% by July 1, 2023.

• Provides higher reimbursement rates (230%-220% of Medicare) for facilities with 20-30% indigent patient volume or designated freestanding rehabilitation facilities meeting specific criteria.

• Creates a Michigan auto no-fault rehabilitation clinic fee schedule to cap payments for rehabilitation clinics, requiring accreditation by the Commission on Accreditation of Rehabilitation Facilities or similar organization for certain services.

• Implements alternative payment calculations based on January 1, 2019 charge description master rates for providers when Medicare has no comparable payment amount, with percentages declining from 55% to 52.5% depending on provider category.

• Applies all reimbursement provisions to treatment rendered after July 1, 2021, and limits attendant care benefits provided by family members or household residents to worker's compensation hourly rates unless insurers contract for higher amounts.