March 24, 2011, Introduced by Senator HUNE and referred to the Committee on Insurance.
A bill to amend 1956 PA 218, entitled
"The insurance code of 1956,"
by amending sections 3107 and 3157 (MCL 500.3107 and 500.3157),
section 3107 as amended by 1991 PA 191.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec.
3107. (1) Except as provided in subsection (2), personal
Personal protection insurance benefits are payable for the
following:
(a) Allowable expenses consisting of all reasonable charges
incurred for reasonably necessary products, services, and
accommodations for an injured person's care, recovery, or
rehabilitation.
Allowable All of the
following apply to allowable
expenses
within personal protection insurance coverage: shall
(i) Shall not include charges for a hospital room in excess of
a reasonable and customary charge for semiprivate accommodations
except
if the injured person requires special or intensive care. ,
or
(ii) Shall not include charges for funeral and burial expenses
in excess of the amount set forth in the policy which shall not be
less than $1,750.00 or more than $5,000.00.
(iii) For attendant care or nursing services provided in the
injured person's home, all of the following apply:
(A) Payment is limited to 56 hours per week for services
performed by an individual who is not certified, registered, or
licensed to render attendant care or nursing services.
(B) Payment for services performed by an individual who is not
certified, registered, or licensed to render attendant care or
nursing services shall not be made in excess of $11.00 per hour for
basic care or in excess of $17.00 per hour for skilled care, and
payment for services performed by an individual who is certified,
registered, or licensed to render attendant care or nursing
services shall not be made in excess of $17.00 per hour. Beginning
October 1, 2011, these maximums shall be adjusted annually to
reflect changes in the cost of living under the rules prescribed by
the commissioner under subdivision (b) for annual increases in work
loss payments. Any change in the maximums shall apply only to
services rendered after the effective date of the change in the
maximum.
(b)
Work Except as provided in
subsection (2), work loss
consisting of loss of income from work an injured person would have
performed during the first 3 years after the date of the accident
if he or she had not been injured. Work loss does not include any
loss after the date on which the injured person dies. Because the
benefits received from personal protection insurance for loss of
income are not taxable income, the benefits payable for such loss
of income shall be reduced 15% unless the claimant presents to the
insurer in support of his or her claim reasonable proof of a lower
value of the income tax advantage in his or her case, in which case
the
lower value shall apply. Beginning March 30, 1973 For the
period beginning October 1, 2010 through September 30, 2011, the
benefits payable for work loss sustained in a single 30-day period
and the income earned by an injured person for work during the same
period
together shall not exceed $1,000.00 $4,929.00, which maximum
shall apply pro rata to any lesser period of work loss. Beginning
October
1, 1974 2011, the maximum shall be adjusted annually to
reflect changes in the cost of living under rules prescribed by the
commissioner but any change in the maximum shall apply only to
benefits arising out of accidents occurring subsequent to the date
of change in the maximum.
(c) Expenses not exceeding $20.00 per day, reasonably incurred
in obtaining ordinary and necessary services in lieu of those that,
if he or she had not been injured, an injured person would have
performed during the first 3 years after the date of the accident,
not for income but for the benefit of himself or herself or of his
or her dependent.
(2) A person who is 60 years of age or older and in the event
of an accidental bodily injury would not be eligible to receive
work loss benefits under subsection (1)(b) may waive coverage for
work loss benefits by signing a waiver on a form provided by the
insurer. An insurer shall offer a reduced premium rate to a person
who waives coverage under this subsection for work loss benefits.
Waiver of coverage for work loss benefits applies only to work loss
benefits payable to the person or persons who have signed the
waiver form.
(3) As used in this section:
(a) "Basic care" means any of the following:
(i) Providing personal care services, including, but not
limited to, bathing, shampooing, skin care, oral hygiene, shaving
male patients, catheter care, and toileting assistance, including
urinal and bedpan assistance.
(ii) Measuring and documenting vital signs.
(iii) Providing or assisting with exercise, ambulation, or
positioning as directed by a nurse or therapist, including
ambulation with or without assistive devices, basic range of motion
both passive and active, light pivot transfers, and assisting from
bed, chair, or commode.
(iv) Providing environmental and homemaking services, including
bed-making whether occupied or unoccupied, light housekeeping to
maintain a healthy environment, laundering of bedding and clothing,
shopping for groceries, and transportation as necessary.
(v) Assisting with self-administered medications.
(b) "Skilled care" means providing basic care services and any
of the following:
(i) Performing intermittent straight catheterization, catheter
perineal care, and colostomy care as directed.
(ii) Performing a bowel program under the direction of a
registered nurse.
(iii) Performing tube feedings and simple wound care under the
direction of a registered nurse.
(iv) Performing full 1-person transfers and transfers using a
Hoyer lift.
Sec.
3157. (1) A Subject
to subsection (2), 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 personal protection insurance.
(2) 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, or a person or institution providing rehabilitative
occupational training following the injury, is limited to, and
shall be paid by the automobile insurer at, an amount that does not
exceed the amount paid for treatment, service, accommodation, and
medicine pursuant to payment under, or schedules of maximum fees
for worker's compensation developed pursuant to, R 418.10101 to R
418.101504 of the Michigan administrative code. The commissioner
shall examine changes to R 418.10101 to R 418.101504 of the
Michigan administrative code made after the effective date of the
amendatory act that added this subsection. If the commissioner
finds that those changes further the goal of providing affordable
automobile insurance rates, those changes shall apply to this
section and the commissioner shall issue an order to this effect.
An insurer providing personal protection insurance benefits shall
provide an appropriate premium that reflects the savings obtained
by the insurer by the amendatory act that added this subsection.
Enacting section 1. This amendatory act applies to products,
services, and accommodations that are provided on and after 90 days
after the effective date of this amendatory act, but does not
affect any obligation under a written agreement or consent judgment
entered into before the effective date of this amendatory act.