Personal protection insurance (PIP) benefits; Whether a healthcare provider has a right to seek payment of the balance due (the difference between what the provider billed & what the insurer paid); Centria Home Rehab, LLC v Philadelphia Indem Ins Co

For the reasons given in Centria Home Rehab, the court held that the trial court erred in granting plaintiff-insurer summary disposition in this dispute over payment for attendant care services under the No-Fault Act. From 2/17 through 6/21 plaintiff paid defendant-care provider “$582,722.40 for attendant care services, which was $233,462.53 less than what defendant had billed for its services.” When plaintiff sued alleging “it had mistakenly issued two payments to defendant and had overpaid defendant” by $8,375, defendant answered and filed a counterclaim for the balance due on its billings. Plaintiff successfully argued in the trial court that defendant did not have a right under the Act to seek payment of the difference between what defendant had billed and what plaintiff had paid. On appeal, the court noted that Centria Home Rehab presented the same legal question presented here. As it “stated there: ‘When a health care provider, acting under an assignment of rights from an insured or under a direct cause of action under MCL 500.3112, seeks to recover the balance due for PIP benefits from an insurer and there is a dispute over the reasonableness of the charges, the health care provider has standing to bring such a claim directly against the insurer.’” Reversed and remanded.