LANSING, Mich. (AP) – Courtnie Bush, 16, was no longer supposed to wake up, let alone smile, stand and walk after being in a car crash in December.

Her mother, Jenna, said what Courtnie has accomplished since then was nothing short of a miracle and that she gives credit to therapists and home health workers.

“She woke up rocking, I mean she woke up, she put her thumb up and she’s been progressing ever since,” Bush said.

Despite a traumatic brain injury, Courtnie made strides in returning to her passions of making desserts, singing in the choir, playing soccer and basketball, and finishing high school with her twin brother. But she and her family fear that a change in Michigan’s no-fault auto insurance law could cause her to lose sight and momentum in her recovery.

Some companies providing rehabilitation services to people like Courtnie are alerting families who come on July 1 they will no longer provide certain services due to a 45% reduction in reimbursement by insurance companies for services not covered by Medicare.

In 2019, lawmakers responded to Michigan’s highest auto insurance premiums by passing a law giving drivers the flexibility to choose their level of personal injury protection, replacing the state’s requirement that drivers purchase unlimited lifetime coverage. The overhaul also reduced reimbursements for health care providers who treat accident victims and may charge auto insurers much more for the same services than those paid for by employer plans or government insurance.

Bush said she felt lucky that last July, when Michigan drivers were given a choice of what level of injury protection they wanted to purchase, she continued to pay for unlimited coverage.

“When things changed, I knew we shouldn’t change,” Bush said. “I knew the coverage we wanted to keep and it wasn’t a risk we were willing to take.”

In order to avoid closing its doors, the Origami Brain Injury Rehabilitation Center in Ingham County is limiting its admission requirements to people with less severe injuries, said center CEO and chairperson Tammy Hannah.

“This is the part that keeps me awake at night because we serve several residents who are quite badly injured, they are successful, we are their family, they were injured many years ago, we are their longtime home.” , Hannah said. ” Origami will not be able to continue to function as we do today for over a year. “

Under the new fee schedule, services covered by Medicare will have a reimbursement rate of 200%, while more specialized services such as home health care without a Medicare code will be reimbursed at 55% of what they pay. were charging for the services at the start of 2019.

The promoters said the fee schedule was set because providers could charge unnecessarily high fees to insurance providers, which overcharged the system. But Hannah said Origami was operating at a 7% profit margin.

Families of car crash victims are pinning their hopes on similar bills from Sen. Curtis Hertel Jr., D-East Lansing and Representative Doug Wozniak, R-Shelby Township, to extend 200% reimbursement to facilities rehabilitation.

Housekeeper Gretchen Whitmer, a Democrat who signed the law, said she was open to a “targeted approach,” but the legislation appears dead for now.

Senate Republican Majority Leader Mike Shirkey said the law should be fully implemented before any changes are considered.

“We will not accept any proposal that would increase costs for drivers, especially when we lack the data necessary to assess such proposals,” he said in March.

Wozniak, an attorney who focused on elder law and Medicaid planning, said the fee structure creates a situation where those who charged fair prices in 2019 will have to shut down while bad actors who charged more will survive.

Insurance companies are the winners because if people cannot afford treatment and have a loss of income, they will switch to Medicaid coverage and the state will foot the bill rather than the insurance companies. insurance, Wozniak said. He estimates it will cost the state $ 72 million in the first year.

More than 6,000 patients will lose care if the fee schedule is not changed, according to a survey of more than 110 post-acute care facilities commissioned by the Michigan Brain Injury Provider Council. The survey also indicated that 90% of establishments expect a total of around 4,000 jobs lost.

Lane and Emily Bargeron from Lansing are among families receiving 24/7 home health care after a car crash in 2012, left Lane with a traumatic brain injury and physical abilities similar to those of a poorly functioning quadriplegic.

With two children and one on the way, the importance of home health care is invaluable, said Emily. She worries about what will happen if her family loses their care.

“We’re going to be pretty much alone for the rest of our lives, so that’s a huge concern,” Emily said. “It affects all areas of our life, especially if we are to thrive and survive as a family unit and take life as normally as possible.”

The Michigan Insurance Alliance, an insurance industry group, said it expects 25 new auto insurance companies to start providing coverage in the state due to the fee schedule. medical, stimulating competition and lowering tariffs.

Executive Director Erin McDonough said rates were already lower due to anticipated medical savings. The alliance supports the fee structure to end the “blatant overload” by health care providers, the group said.

The fee schedule is “a kick in the teeth” for the provider industry, said Tom Constand, president and CEO of the Michigan Brain Injury Association. The idea of ​​waiting and seeing if patients lose care and then acting on it is about as dangerous to human life as pulling out a stop sign and seeing if that has an impact.

“I don’t want it that on the other side, the Michigan Insurance Alliance is lambasting the entire vendor industry as scammers,” Constand said. “These people take care of individuals. They are humanitarians. They take care of those people who need daily care, toilets, showers, baths, all the essentials of care.


Anna Liz Nichols is a member of the Associated Press / Report for America Statehouse News Initiative corps. Report for America is a national, nonprofit service program that places reporters in local newsrooms to report on secret issues.

Source link

Leave a Reply

Your email address will not be published.