Action Reports

On May 25, 2023, the Michigan Court of Appeals issued a decision in True Care Physical Therapy v. Auto Club Group Insurance Company (COA Docket No. 362094), an auto no-fault case that involved a health care provider who filed suit against an auto insurance company rather than first appeal the insurer’s utilization review determination to the Michigan Department of Insurance and Financial Services (DIFS). According to the COA, Michigan’s revised auto no-fault insurance statute does not require a medical provider to administratively appeal an insurance company’s utilization review. Rather, the administrative appeal process is optional, and providers may instead file suit without an appeal to DIFS.

In April 2022, legislation promising prior authorization (PA) reform was signed into law by Governor Whitmer. The goal of the new law (Public Act 60 of 2022) is making the PA process faster, more effective, and transparent. It includes a standardized electronic prior authorization request transaction process, a requirement that prior authorization requirements be based on peer-reviewed clinical review criteria that meet certain requirements, and expedited review timelines. The new law is fully effective as of June 1, 2023.

On March 14, 2023, the Chiropractic Coverage Modernization Act (S. 799 / H.R. 1610) was re-introduced in the U.S. House of Representatives. The bill would allow chiropractors in Medicare to practice to their state’s full chiropractic scope of practice, enabling chiropractic patients to safely access medically necessary conservative, drug- and surgery-free care.

Legislation to modernize chiropractic coverage in Medicare will soon be introduced! Stay tuned and learn how YOU and YOUR PATIENTS can get involved...