Court of Appeals Issues Rulings Protecting Home Care for Post-2019 Accident Victims

The Michigan Court of Appeals’ and Supreme Court’s decisions in Andary v. USAA confirmed that auto insurers could not retroactively apply the new fee caps, schedules, and limitations in MCL 500.3157 to those injured prior to June 11, 2019 (the date of No-Fault reform), thereby protecting their ability to obtain the care they need. Unfortunately, those suffering injuries in auto accidents after June 11, 2019, have continued to experience the devastating impacts of auto insurers’ misapplication of the new fee caps and schedules, with auto insurers cutting reimbursements for home care nearly in half. The Michigan Court of Appeals, however, recently confirmed that auto insurers have it wrong: there are Medicare amounts for in-home care that can be used to set the reimbursement cap and allow for payment of reasonable home-care rates.

In West Michigan Home Care Services, Inc. d/b/a First Light Home Care of Grand Rapids v. Meemic Insurance Company, Susan Horn suffered a spinal cord injury in a 2020 accident and required 24/7 care.[1] First Light provided her with that care. Meemic claimed that, because there are no Medicare amounts for 24/7 care, it could cut First Light’s reasonable rates nearly in half, paying only around $19/hour. First Light, however, argued that Medicare publishes amounts and rates for in-home care that can be used to set a high enough reimbursement cap such that reasonable rates must still be paid.  In a published decision issued on October 20, 2025, the Michigan Court of Appeals agreed with First Light, ruling that the cap in MCL 500.3157(2) applies to in-home care and that the Medicare rates cited by First Light can be used to set the cap, after which reasonable reimbursement is required.

Similarly, on October 27, 2025, the Court of Appeals issued an opinion in AdvisaCare Home Healthcare Solutions, Inc. v. Auto Club Group Insurance Company d/b/a AAA, again ruling that the Medicare cap applies to in-home care and those rates can be used to set the cap for purposes of MCL 500.3157(2).[2]  That case also involved a post-2019 accident victim needing 24/7 care, which was provided by AdvisaCare. AAA cut reimbursements to AdvisaCare to financially unsustainable amounts by ignoring the Medicare amounts for home care, requiring AdvisaCare to file suit to seek proper and reasonable reimbursement. The Court of Appeals agreed with AdvisaCare that the Medicare cap applied and the Medicare rates cited by AdvisaCare could be used to set the cap.

The importance of these decisions for Michigan accident victims and their families cannot be overstated. Published law in Michigan now requires auto insurers to recognize the Medicare rates for home care that allow for reasonable reimbursement to home-care providers.  If you or your provider have continued to experience large cuts in reimbursements due to an auto insurer’s reliance on the new fee caps/schedules, you should act quickly to protect your rights and ability to obtain reasonable reimbursement.

The Court’s decisions reaffirm the rights of accident victims and their care providers to receive reasonable reimbursement for necessary services. Our Personal Injury and No-Fault Litigation teams continue to assist clients in navigating these evolving issues and securing the care and benefits they deserve.

[1] First Light v Meemic, Court of Appeals Case No. 369151, issued 10.20.25.

[2] AdvisaCare v AAA, Court of Appeals Case No. 368589, issued 10.27.25.