GRAND RAPIDS, Mich. — July 2, 2021 is a date attorney Tim Sinas is keeping a close on eye. That day, everything changes for people and medical providers who help others injured in auto accidents.
“The conflict is this, beginning in July of this year medical providers who treat auto-accident victims are going to be subject to new rules of reimbursement that have never existed in our healthcare economy before,” said personal injury attorney Tom Sinas with Sinas Dramis Law. “We’re about to enter what many would call the third phase of our no-fault law and this third phase is the most severe and most significant when it comes to reimbursements to medical care providers and then, by extension, access to care by auto accident victims.”
Sinas said under the old law, attendants or family members who cared for their loved ones could receive a fair wage no matter how many hours they worked. Now, come July 2, they’ll only be paid for eight hours of work.
“For many families over the past few decades they have chosen to keep the care within their family union and many of them have restructured their lives around the idea that they can be paid an hourly-rate for the care they provide,” Sinas said during an interview at the law firm on Monday. “I have represented people who have left their careers to take care of their child or their wife or their husband.”
The new law, he continued, also impacts medical care providers. Under the old law providers, whether in hospitals or rehab clinics, were paid a “reasonable charge” for their services. Now, come July there will be a new set of rules that limit the amount of reimbursement they can receive.
“The general concept here is that reimbursement for many providers is tied to what amount Medicare pays. So you’ll hear, for example, the general rule that for many providers the reimbursement is a percentage of Medicare. 200 percent of Medicare is generally where we’re starting,” Sinas said. “Well what about all of the services that many people receive that are not the kind of service that Medicare pays for?”
Like in-home care and skilled nursing care, he said. Those are services that Medicare doesn’t cover.
The new bipartisan law was signed by the governor back in 2019 and was backed by the legislature. One of the most “troublesome parts” Sinas said is that the new law is impacting people who had contracts prior to 2019.
So, he’s taking action.
“We are seeing the insurance industry making clear that [they] intend to impose these rules on everyone whether you were injured in 2020 or in 1990,” Sinas said. “Our law firm has filed a lawsuit, challenging the Constitutionality of this law. One of the allegations in that lawsuit is that it is constitutionally unsound to impose these types of care limitation rules on people who had existing contracts before the law was passed.”
FOX 17 reached out to Michigan Senate GOP and Rep. Jason Wentworth for their perspective on the new law and have yet to hear back.
Sinas believes that proponents created it in an effort to overhaul the entire system. However, it was rushed and it is ultimately doing more harm to people than good, he said.
“They’re punishing people who played no part in whatever part of the system [they] think isn’t working, and who paid for the auto insurance premiums, and who have lived by the rules and rely on the care that they’re getting from their loved ones, and rely on the care they’re getting from their medical providers,” Sinas said. “And, all of a sudden because of a desire to fix the system [they] have upended lives, human beings. That’s the thing about this. There’s human beings on the end of every one of these cases. It isn’t just about dollars, whether it’s healthcare dollars or insurance dollars.”
