Bill Text: MI SB0295 | 2011-2012 | 96th Legislature | Introduced
Bill Title: Insurance; no-fault; charges, claims forms, and billing for providers rendering services in the care of accident victims; provide for. Amends sec. 3157 of 1956 PA 218 (MCL 500.3157).
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2011-03-24 - Referred To Committee On Insurance [SB0295 Detail]
Download: Michigan-2011-SB0295-Introduced.html
SENATE BILL No. 295
March 24, 2011, Introduced by Senators HUNE and SMITH and referred to the Committee on Insurance.
A bill to amend 1956 PA 218, entitled
"The insurance code of 1956,"
by amending section 3157 (MCL 500.3157).
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 3157. (1) A physician, hospital, clinic, or other person
or institution lawfully rendering treatment to an injured person
for an accidental bodily injury covered by personal protection
insurance, and a person or institution providing rehabilitative
occupational training following the injury, may charge a reasonable
amount for the products, services, and accommodations rendered. The
charge shall not exceed the amount the person or institution
customarily charges for like products, services, and accommodations
in cases not involving insurance.
(2) All charges under subsection (1) that are submitted by
paper to the appropriate insurer on behalf of the injured person
shall use the same claim forms required for seeking payment under
title XVIII of the social security act, 42 USC 1395 to 1395kkk-1,
and the same code sets required under the standards for electronic
transactions, 45 CFR parts 160 and 162, adopted pursuant to
sections 1320d to 1320d-8 of the health insurance portability and
accountability act of 1996, 42 USC 1320d to 1320d-8. If an insurer
establishes an electronic claims submission process and the charges
under subsection (1) are billed electronically, those charges shall
be billed in accordance with the standards for electronic
transactions, 45 CFR parts 160 and 162, adopted pursuant to
sections 1320d to 1320d-8 of the health insurance portability and
accountability act of 1996, 42 USC 1320d to 1320d-8.
(3) If claim forms, code sets, or standards for electronic
transactions under subsection (2) are amended after the effective
date of the amendatory act that added this subsection, the
commissioner shall determine whether those changes shall apply to
charges submitted under subsection (1). In making this
determination, the commissioner shall consider whether the
amendments further the goal of uniform submission of charges under
subsection (1).
(4) All charges under subsection (1) shall be submitted on
behalf of the injured person to the automobile insurer or, in the
case of a coordinated automobile insurance policy, the third party
payer, within 90 days after each product or service is rendered or
within 90 days after the date that the person or institution knew
or should have known the identity of the appropriate automobile
insurer or third party payer, whichever period is later. This 90-
day period is tolled from the date of submission to a third party
payer to the date the person or institution receives a response
from the third party payer. The automobile insurer shall extend the
90-day time period under this subsection if a person or institution
submits written proof providing clear and reasonable justification
for the failure to comply with the 90-day period.
(5) If licensure or registration is required by this state, a
physician, hospital, clinic, or other person or institution
lawfully rendering treatment in this state to an injured person for
an accidental bodily injury covered by personal protection
insurance, and a person or institution providing rehabilitative
occupational training in this state following the injury, shall be
fully licensed or registered to render that treatment or training.
(6) Subsection (4) does not apply to hospitals. This section
does not apply to attendant care if provided by an individual
related to the injured person by blood, marriage, or adoption; by
any nonrelated permanent resident of the injured person's
household; or by any other individual if that individual is not
required to be licensed or registered to provide those services.
