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Reimbursement for catastrophically injured car accident survivors in Michigan could be cut by 45% on July 1

Survivors say if Michigan lawmakers don't act, their lives are at risk
Posted at 11:37 PM, May 21, 2021
and last updated 2021-05-21 23:37:45-04

SOUTHFIELD, Michigan — Many car accident survivors with catastrophic injuries say if Michigan lawmakers don’t act, their lives are at risk.

In 2019, lawmakers passed a large legislation package to lower insurance rates. One provision that goes into effect July 1 is raising concerns for thousands of families. It slashes reimbursement for catastrophically injured victims by 45%.

“I am worried about the future,” said Erica Coulston.

When Coulston was 23 years old, a car accident left her quadriplegic. She relies on attendant care for independence. It has allowed her to thrive personally and professionally. She is President of Walk the Line Recovery Therapy, which provides physical therapy to patients with brain trauma or spinal cord injuries. Many are also accident survivors.

“If our clients don’t have the care they need to get to the places they need, that impacts us as a business,” she said.

At Walk the Line Recovery Therapy in Southfield, Justin Sabbaugh received physical therapy on Friday. The Novi man is quadriplegic since a car accident in 1991. He relies on attendant care for his basic needs. Caregivers help him dress, eat, get out of the house into the community and live a full life. He says some attendants would make below minimum wage if the 45% cut goes into effect.

“The agency that takes care of me might go out of business,” Sabbaugh said.

He said thinking about what his future will be if that happens is taking a mental toll.

“Honestly, it is almost suicidal, to tell you the truth,” he said. “The thought of me going bankrupt to try to supplement what the insurance is taking away. And this is my life.”

“I can’t be left alone for any period of time,” said Brian Woodward, who is also quadriplegic.

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Woodward said he is able to live a full life and work in the auto industry because of attendant care provided through auto insurance. He says his attendant literally saved his life just last night.

“I passed out completely and they were able to help me come around. We wouldn’t be having this interview right now if I didn’t have that care,” he said.

He says he feels like legislators who passed the 45% cut are trying to steal from him what was already paid for.

“They are allowing the insurance companies to break a contract,” said Woodward.

First Call Home Health Care in Clinton Township said if the cuts go into effect, it will have to close.

“We will not be able to provide services with a 45% paycut and our patients will not be able to find a place within the medical system here in Michigan all in one day,” said Bob Mlynarek, First Call Home Health Care co-owner.

Some of its patients are on ventilators and they have not been able to find facilities that can keep them alive to move to.

“Our patients are going to be dropped off at the hospital," Mlynarek said. "Guardians are going to be called. Adult protective services is going to be called. This is not a drill. It is not a hyperbole,” said Mlynarek.

When the legislation was passed, the insurance industry said it would end price gouging in the attendant care industry. Businesses that serve patients say an arbitrary 45% cut, not based on original prices, puts those who were not price gouging out of business. Their margins are far below the legislated cuts.

Mlynarek says it is not about price gouging. It is about ending care completely by leaving the industry underfunded. He says insurance companies already had the ability to challenge rates and regularly did so in court. Judges would review claims of gouging and force adjustments.

“We charge $70 an hour for nursing as a reimbursement rate from the insurance company. We pay a nurse $40 an hour. Now you have to add in 20% for payroll taxes and worker’s comp. And we have 13 support people in the office. And they want to reimburse us $38 of that $70. You can see the math doesn’t work."

Mlynarek said he has heard people say that caregiving companies can be eliminated and patients can coordinate their own care. He said it is a significant job to coordinate employment of people around the clock while complying with state and federal employment laws. He says people have to remember some survivors of catastrophic accidents can’t speak. Insurance companies are also not always easy to work with

The Michigan Brain Injury Provider Council said a survey found eight out of 10 rehab and home health providers expect to close their doors if the cuts go into effect. It said 6,000 accident victims as a result are expected to lose care and 5,000 health care providers to lose jobs.

Two lawmakers have introduced legislation to prevent the 45% cut.

State Senator Curtis Hertel, a Democrat from Lansing, introduced Senate Bill 314.

“This is something the Legislature should go back and fix,” Hertel said.

State Representative Douglas Wozniak, a Republican from Shelby Township, introduced House Bill 4486. He said he did so thinking of his neighbor’s daughter who suffered a catastrophic accident.

Rep. Doug Wozniak on concerns on the impact of new no-fault reform

“When I look at the age of his daughter and my daughter, about the same. And if that would have happened to my daughter. Not good,” Wozniak.

7 Action News reached out to Governor Gretchen Whitmer’s office, as she signed the 2019 legislation passed by the House and Senate into law. This letter she wrote in response to inquiries about the 45% cut was shared with us in response.

BIAM Letter 050621 by WXYZ-TV Channel 7 Detroit on Scribd

Lawmakers are only scheduled to be in session for a few more weeks. If you have an opinion on this, the time to contact your lawmaker is right now.

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