Michigan Office of Administrative Hearings and Rules  
611 W. Ottawa Street  
Lansing, MI 48909  
Phone: 517-335-8658 Fax: 517-335-9512  
AGENCY REPORT TO THE  
JOINT COMMITEE ON ADMNINISTRATIVE RULES (JCAR)  
1. Agency Information  
Agency name:  
Insurance and Financial Services  
Division/Bureau/Office:  
Insurance  
Name of person completing this form:  
Julie Agueros  
Phone number of person completing this form:  
517-894-3713  
E-mail of person completing this form:  
AguerosJ@michigan.gov  
Name of Department Regulatory Affairs Officer reviewing this form:  
Sarah Wohlford  
2. Rule Set Information  
MOAHR assigned rule set number:  
2020-113 IF  
Title of proposed rule set:  
Surprise Medical Billing  
3. Purpose for the proposed rules and background:  
These rules implement the provisions of MCL 333.24510 and MCL 333.24511 by doing the  
following: 1) establishing procedures for the department to review and resolve requests for  
calculation determinations submitted pursuant to MCL 333.24510; 2) establishing procedures for the  
department to request documents, materials, or other information necessary to perform calculation  
reviews and issue determinations under MCL 333.24510; 3) establishing procedures for processing  
requests for binding arbitration submitted pursuant to MCL 333.24511; and 4) establishing standards  
for approving arbitrators to provide binding arbitration pursuant to MCL 333.24511.  
4. Summary of proposed rules:  
MCL 24.242 and 24.245  
Agency Report to JCAR-Page 2  
This is a new rule set that implements the provisions of MCL 333.24510 and MCL 333.24511 by  
doing the following: 1) establishing procedures for the Department of Insurance and Financial  
Services to review and resolve requests for calculation determinations submitted pursuant to MCL  
333.24510; 2) establishing procedures for the Department to request documents, materials, or other  
information necessary to perform calculation reviews and issue determinations under MCL  
333.24510; 3) establishing procedures for processing requests for binding arbitration submitted  
pursuant to MCL 333.24511; and 4) establishing standards for approving arbitrators to provide  
binding arbitration pursuant to MCL 333.24511.  
5. List names of newspapers in which the notice of public hearing was published and  
publication dates:  
Lansing State Journal: February 19, 2021  
Oakland Press: February 19, 2021  
Daily Press (Escanaba): February 19, 2021  
6. Date of publication of rules and notice of public hearing in Michigan Register:  
3/1/2021  
7. Date, time, and location of public hearing:  
3/12/2021 10:00 AM at Virtual Room , http://bit.ly/SMBDraftRulesPublicHearing  
8. Provide the link the agency used to post the regulatory impact statement and cost-benefit  
analysis on its website:  
https://ARS.apps.lara.state.mi.us/Transaction/RFRTransaction?TransactionID=1239  
9. List of the name and title of agency representative(s) attending public hearing:  
Sarah Wohlford, Senior Deputy Director  
Julie Agueros, Administrative Law Specialist  
10. Persons submitting comments of support:  
No comments were submitted in clear support of the rule set.  
11. Persons submitting comments of opposition:  
The Department received comments indicating opposition by Joseph Kheder (J. Kheder Associates,  
LLC) and Dr. Antonio Bonfiglio, TeamHealth.  
12. Identify any changes made to the proposed rules based on comments received during the  
public comment period:  
MCL 24.242 and 24.245  
Agency Report to JCAR-Page 3  
Name &  
Comments made at Written  
Agency Rationale Rule number  
Organization public hearing  
Comments  
for change  
& citation  
changed  
1
Jeff Romback,  
Deputy  
Director,  
When requesting The cited rules are R 500.243(1),  
information from not intended to  
a carrier beyond depart from the  
(2)(b); R  
500.244(3)  
Michigan  
Association of  
Health Plans  
the median  
amount for the  
purposes of a  
calculation  
review, the  
Department  
should be  
authority under  
MCL 333.24510  
(2) allowing the  
Department to  
request  
information  
necessary to  
required to  
provide the  
carrier its  
reasoning in  
writing.  
review the  
calculation  
described in MCL  
333.24510(1).  
Rule 500.243(1)  
and (2)(b) and  
Rule 500.244(3)  
have been  
amended to clarify  
this point by citing  
the corresponding  
statutory provision  
and language.  
2
Jeff Romback,  
Deputy  
The rule provides Rule 500.243(3) R 500.243(3),  
the Department has been amended (4)  
Director,  
14 days to  
to allow the  
Michigan  
Association of  
Health Plans  
respond to a  
request for a  
calculation  
suggested 14-day  
period for carriers’  
responses. A  
review; carriers corresponding  
should also be clarifying change  
provided 14 days has been made to  
to respond to any R 500.243(4).  
of the  
Department’s  
requests for  
information.  
13.Date report completed:  
4/22/2021  
MCL 24.242 and 24.245  
;