Bill > SB0547

This bill amends Michigan's insurance code to strengthen regulations around utilization reviews in personal protection insurance (PIP) claims for medical treatments after an accidental bodily injury. The bill requires healthcare providers (physicians, hospitals, clinics) to submit necessary records for utilization review and comply with department decisions, while establishing clear procedures for reviewing the appropriateness of medical treatments. Specifically, the bill mandates that the state department create rules to establish criteria for identifying when medical treatments exceed typical utilization standards, including procedures for acquiring records, allowing insurers to request explanations for treatments, and providing appeal processes. The bill also introduces a new provision requiring insurers to comply with the department's decisions on utilization review appeals. Notably, the bill considers submitting false or misleading records to be a fraudulent insurance act, and it allows insurers to request written explanations from healthcare providers when treatments appear unusual or excessive in duration, frequency, or cost. The overall aim is to ensure more accurate, appropriate, and cost-effective medical treatment in auto insurance personal injury protection claims.

Budget and Finance

https://legislature.mi.gov/Bills/Bill?ObjectName=2025-SB-0547