Reimbursement cap under no-fault; MCL 500.3157(2); Central Home Health Care Servs v Progressive MI Ins Co; No-Medicare-rate cap; MCL 500.3157(7); Unpreserved MCL 500.3157(8) argument; AAA Life Ins Co v Department of Treasury

The court held that the trial court correctly applied MCL 500.3157(2) to cap payments for the claimant’s home-health-aide and skilled-nursing services and affirmed the grant of partial summary disposition. The patient was injured in 2020 and received in-home care provided by plaintiff. After the 2021 no-fault amendments defendant-insurer reduced the hourly reimbursement. The trial court ruled that Medicare provides amounts payable for the services, so subsection (2) controls. It granted plaintiff’s motion for partial summary disposition. On appeal, the court held that the dispositive inquiry is whether Medicare provides an amount payable and explained that “the simple question to answer is whether Medicare covers the service at issue,” not how Medicare calculates payment. It noted Medicare billing codes for the services and the insurer’s use of those codes, concluding that there are amounts payable under Medicare and that subsection (2) applies. The court found defendant’s reliance on distinctions between fee-for-service and prospective payment systems immaterial because the statute defines Medicare “‘without regard to the limitations unrelated to the rates in the fee schedule . . . .’” It further found defendant’s subsection (8) limitation argument waived because it was raised for the first time on reconsideration. The court declined to overlook preservation given factual disputes about 2019 average charges.