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SB 547

Insurance: no-fault; utilization reviews; require compliance with decision on appeal. Amends sec. 3157a of 1956 PA 218 (MCL 500.3157a).

2025-2026 Regular Session Introduced by Rosemary Bayer and 8 co-sponsors

Michigan bill requires no-fault insurers to honor utilization review appeal decisions, preventing coverage denials after patients successfully challenge initial treatment rejections.

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Bill Summary · SB 547

Legislative bill overview

SB 547 amends Michigan's no-fault insurance law to require insurance companies to comply with decisions made on appeal regarding utilization reviews. Currently, insurers can deny coverage for medical treatments through utilization reviews, but this bill strengthens the appeals process by making those appeal decisions binding on the insurer rather than optional.

Why is this important

No-fault insurance in Michigan covers medical expenses for car accident injuries without regard to fault. Utilization reviews determine whether treatments are medically necessary, and insurers often deny coverage. This bill affects injured accident victims seeking treatment by ensuring that if they successfully appeal a denial, the insurance company must actually pay for the approved care—preventing situations where appeals win but coverage is still refused.

Potential points of contention

  • Insurer costs: Insurance companies may argue this increases their expenses by limiting their ability to control medical spending, potentially raising premiums for all policyholders
  • Medical necessity standards: Disagreement over whose standards should govern—insurers' cost-control measures versus patients' physicians' recommendations—remains contentious
  • Appeal process scope: Unclear whether "compliance with decision on appeal" covers all aspects equally or creates gaps in enforcement mechanisms

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

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