SENATE BILL NO. 847

January 25, 2022, Introduced by Senator SANTANA and referred to the Committee on Insurance and Banking.

A bill to amend 1956 PA 218, entitled

"The insurance code of 1956,"

(MCL 500.100 to 500.8302) by adding section 272.

the people of the state of michigan enact:

Sec. 272. (1) The office of the medical billing ombudsman is created in the department.

(2) The principal executive officer of the office is the medical billing ombudsman. The director shall appoint the medical billing ombudsman. The medical billing ombudsman shall serve at the pleasure of the director.

(3) The department shall provide for the expenditure of money appropriated for the office and for the employment of personnel for the office.

(4) The office shall assist physicians, hospitals, clinics, or other persons that provide treatment or rehabilitative occupational training to injured persons for accidental bodily injury covered by personal protection insurance under chapter 31. The office shall provide this assistance by aiding those persons in submitting to insurers claims for the treatment or training provided for payment or reimbursement under section 3157 in a manner that will meet the applicable insurer's standards for reasonable proof of the fact and of the amount of loss sustained as described in section 3142.

(5) An insurer shall cooperate with the office by providing sufficient detailed information to the office so that the office may perform its duties under subsection (4) by providing the persons that provide treatment or training the information necessary to submit a claim in a manner and with the detail that will satisfy the insurer's standards for reasonable proof of the fact and of the amount of loss sustained for purposes of section 3142.

(6) A document or communication received by the office that contains medical information of a person that sustains accidental bodily injury is exempt from disclosure under the freedom of information act, 1976 PA 442, MCL 15.231 to 15.246.

(7) The director may take action for a violation of subsection (5) as provided in section 150.

(8) As used in this section:

(a) "Insurer" means an insurer that provides personal protection insurance under chapter 31.

(b) "Office" means the office of the medical billing ombudsman.