No-fault auto opponents get high-profile supporter in call for change
Birmingham — Former Red Wings defenseman Vladimir Konstantinov joined opponents of the 2019 auto no-fault insurance law on Tuesday in criticizing a fee cut that slashed payments to medical providers almost in half.
Konstantinov, who turns 55 in March, like others affected by changes to the law, stands to lose the round-the-clock care he has received at home for nearly 25 years because of the medical care reimbursement schedule that went into effect July 1, 2021, according to his attorney, Jim Bellanca. The former player was injured in a limousine crash less than a week after the Wings won the Stanley Cup in 1997, leaving him with a closed-head injury.
“Vladi will probably be warehoused in a nursing home with unspecialized care by people who aren't familiar with his injury,” said Bellanca. “… He will not continue to exist in the life that he exists in now.”
Bellanca spoke on behalf of Konstantinov at a press conference at Arcadia Home Care and Staffing in Birmingham calling on lawmakers to amend the home care provision of the auto no-fault insurance reform law in order to address problems providers say it has created.
Konstantinov attended the conference, nodding in agreement when his caregivers and Bellanca spoke.
The fee cut limited insurance reimbursements for medical providers to 55% of what they charged in 2019 or 200% of the 2019 Medicare rate for Medicare-reimbursable services, a move that advocates said has made it nearly impossible to provide services, and led to patients being discharged from home care programs and being sent to already crowded hospitals.
Theresa Ruedisueli, regional director of operations with Arcadia, said Tuesday that it provided services to around 30 catastrophic car crash victims in Michigan, and that the company had accrued a $1.5 million deficit for their care since July 1.
Michigan Rep. Phil Green, R-Millington, introduced a bill in January meant to address the effect on medical providers. The bill would allow providers, for non-Medicare covered services, to charge 200% of Medicaid rates for Medicaid-covered services and 150% of U.S. Department of Veterans Affairs rates for VA-covered services, leaving few services in the 55% reimbursement schedule.
The Insurance Alliance of Michigan, which advocated for the law’s passage, said in January that drivers in the state had saved a collective $4 billion on auto insurance premiums since the law took effect in July 2020.
“Auto no-fault reforms are creating savings for Michigan drivers, providing choice, reducing fraud and reining in rampant overcharging by medical providers who previously charged three and four times as much for the exact same medical procedures under the old, broken system," said Erin MCDonough, executive director of the alliance. "More than 7 million drivers are seeing savings coming their way, anticipating $400 per-vehicle checks, and we should let these reforms keep working."
Bellanca said no-fault insurance was a contract residents entered into with the state and the insurance industry that was modified whileresidents paid the price.
“The beneficiaries of this contract who relied on it, people like Vladi and 18,000 other people in Michigan, now are at a chance of losing the very thing that they bargained for, when they bought their insurance,” said Bellanca.
“If you're going to change the law, and you want to do it prospectively, that's one thing, but this change is retroactive,” said Bellanca. “… What's gonna happen to Medicare and Medicaid when all of these folks who were covered now need coverage from those sources, rather than the ones that are currently providing it?”
Konstantinov still has access to the care he has had only because Aracadia had been paying for the deficit the law created since July, Bellanca said, but that that will come to an end soon when the company no longer is able to cover the costs.
The former hockey player also has access to a vehicle that can accommodate his wheelchair that Bellanca said he may lose if the law is not reformed.
A survey of brain injury service providers indicated about 1,500 crash victims have been discharged by their health providers and 3,000 jobs eliminated since the fee cut took effect.
Nursing homes and group home settings may not be an option for people like Konstantinov either, according to his medical case manager Linda Krumm, as the fee cut would apply to them as well.
In the past, Krumm said case managers haddifferent avenues to find care for their patients in nursing agencies that no longer are available. Many shut down under the new law, she said, and the ones that remain no longer accept auto injury victims.
Arcadia will soon have to discharge their auto injury clients, Ruedisueli said, as containing to pay for the deficit in their care costs is not sustainable.
“We literally help (Konstantinov) with every granular, molecular piece of his existence,” said Ruedisueli, “When you think about (Konstantinov) going into an institution, where there's just no capacity to sustain that level of care that he needs and has grown accustomed to and frankly deserves … is just really devastating.”
Advocates like Barry Cargill of the Michigan Home Care & Hospice Association are not calling for a repeal of the entire 2019 law, saying that some changes it introduced were positive.
Reform like Green’s bill could be done “very easily,” especially with the bill seemingly gaining popularity in the Legislature, he said.
Reform is important not only for the people who were already receiving care following catastrophic car crashes, but for people who may need it in the future.
“If you were to choose to have unlimited personal injury protection in your auto no-fault policy, and then all of a sudden you go out and you have a catastrophic injury, are you going to get the care? The evidence is there that you're not,” said Cargill.