MI SB0945

Adds definition of "medically accepted standards" to mean standards developed by federal government or national/professional medical academies, associations, boards, or societies, explicitly excluding standards developed by private for-profit corporations.

Requires providers explaining treatment necessity to use medically accepted standards as the basis for determining whether treatment is unusual, longer in duration, more frequent, or extends beyond typical requirements for a diagnosis or condition.

Defines "utilization review" as evaluation of appropriateness of treatment, products, services, or accommodations in terms of both level and quality, based on medically accepted standards.

Maintains existing requirements that physicians, hospitals, clinics, and other providers submit to utilization review and comply with department decisions, with penalties for submitting false or misleading information.

Preserves provider right to appeal insurer or association determinations of overutilization or inappropriate treatment to the department under established procedures.