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Summary Analysis of HB 4959 Proposed No-Fault Legislation October 2, 2013

Recently introduced HB 4959 gives Medicare eligible citizens the right to opt-out of mandatory no-fault coverage. In effect, this bill will put Michigan's senior drivers who are injured in an auto accident at risk, by taking away their comprehensive, lifetime medical care and rehabilitation benefits to which they are entitled under the current Michigan Auto No-Fault Law. CPAN is opposed to this legislation for several reasons: Allowing people who are over 65 years old to completely opt out of no-fault PIP coverage is inherently misleading, as it suggests to seniors that, because they are eligible for Medicare, they no longer need no-fault PIP coverage. The truth is that Medicare does not cover a large number of services that are compensable under no-fault. As a result, patients will not have the necessary access to services or the intensity and duration of services needed to maximize their recovery. Should this legislation be approved, seniors who opt-out of PIP will unknowingly be opting out of access to critical services like in home attendant care, long-term custodial care and home and vehicle modifications. In addition, unlike Michigans current auto no -fault system, Medicare limits nursing home care, does not support assisting living and imposes caps on important therapies. Without auto no-fault, seniors would also not have access, or would have limited access, to the following: Reimbursement for ambulance, ER, ICU and acute care as well as inpatient rehabilitation; Transportation services, vehicle modifications, or devises for assistive driving controls that assure accessibility for people in wheelchairs or with other post-accident limitations; Replacement services such as help with housekeeping, meal preparation, and other household responsibilities; Coverage for physical, occupational, or speech would be limited to the acute episode and no coverage for therapies for chronic ongoing problems arising from a motor vehicle accident; Assistive, or adaptive equipment, to help compensate for physical or cognitive deficits, for example, watches or alarms to help with memory loss; Socialization therapies - used to reduce emotional pain, depression, or anxiety frequently associated with injury trauma resulting from the motor vehicle accidents; Alternative pain management therapies; Communication assistive devices, such as iPad or computer with voice recognition software;

Specialists (orthopedic, plastic surgeons, neurologists, psychologists, or vestibular specialists) as most do not participate in Medicare; Behavioral counseling or therapists for patients, caregivers and their families; Case management services; Recreational therapy to assist those now in wheelchairs or other traumatic injuries to help them to engage in activities they participated in prior to their injury; Residential treatment centers; Professional home care giving services family would need to provide care without compensation; Limited skilled nursing care Medicare pays for 100 percent for 20 days, 80 percent for 80 days. There is no coverage for skilled nursing care over 100 days often leaving families with large financial burdens; Wage loss replacement for seniors who still are working.

There are over 1,285,794 Michigan Drivers ages 65 and over (18.2 percent of all Michigan drivers). Currently 14.5 percent of the claimants serviced by the Michigan Catastrophic Claims Association (approximately 4,730) are individuals who were 65 years or older at the time of their accident. The bill could result in higher costs for all drivers. If all eligible seniors were to opt-out of this coverage, it would reduce the risk pool by 18.2%, which would increase the cost for the remaining policy holders. Additionally, the bill does not guarantee any specific, long term rate reduction for seniors. And perhaps most importantly, by passing this bill the original promise of no-fault which obligates auto insurance companies to pay All reasonable charges incurred for reasonably necessary products, services and accommodations for an injured person's care, recovery, or rehabilitation." would be broken for Michigans seniors. ### Questions or concerns about this legislation? Please contact CPAN Administrative Director Martha Levandowski at 517-882-1096 or by email at You can also visit our website at