I’ll Have What They’re Having: Amount Charged by Medical Providers to Other Types of Insurers Relevant to Evaluating Reasonableness of Charges in No-Fault Claims

In Spectrum Health Hospitals v Farm Bureau ___ Mich App ___ (2020) (Docket No. 347553 and No. 348440) held while not dispositive, amounts paid by health insurers, and others such as Medicaid and Medicare, may be considered by a fact-finder for determining whether the amount a healthcare provider charged a no-fault insurer was reasonable.

The Court distinguished prior caselaw noting the significant distinction between customary and reasonable. The Court held prior caselaw precluding consideration of third-party payments in the context of the customary inquiry does not control whether those payments may be considered when determining reasonableness.

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