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HB 6154

Insurance: health insurers; coverage for medically necessary treatment related to or as a result of an acquired brain injury; require. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406cc.

2023-2024 Regular Session Introduced by Kelly Breen and 8 co-sponsors

Michigan bill requires health insurers to cover medically necessary treatment for acquired brain injuries, potentially increasing insurance costs while expanding patient access to rehabilitation services.

bill electronically reproduced 11/26/2024
#insurance:healthbenefits #insurance:healthinsurers
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Bill Summary · HB 6154

Legislative bill overview

HB 6154 would require Michigan health insurers to cover medically necessary treatment related to or resulting from acquired brain injuries. The bill amends the state's insurance code by adding a new section (3406cc) that establishes coverage mandates for brain injury care. This applies to health insurance policies regulated under Michigan's Insurance Code.

Why is this important

Acquired brain injuries—caused by traumatic accidents, strokes, aneurysms, infections, or other non-congenital conditions—often require extensive rehabilitation and ongoing treatment that can be costly and sometimes denied by insurers. Mandating coverage could improve access to critical therapies and reduce financial barriers for patients recovering from these injuries. However, coverage mandates typically increase insurance premiums for all policyholders, as insurers pass costs to consumers.

Potential points of contention

  • Cost and premium increases: Expanding mandatory coverage raises insurance premiums across the market, affecting all policyholders regardless of whether they use the covered services
  • "Medically necessary" definition: The bill doesn't specify what treatments qualify, potentially creating disputes between insurers and patients over coverage eligibility
  • Scope of acquired brain injuries: The broad definition could include many conditions; clarity is needed on which treatments and rehabilitation types are covered versus excluded

Compiled from official sources — confirm details with the bill’s official record.

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