Michigan's Health Insurance Claims Assessment Act (the
"Act") was approved by Governor Snyder on September 20,
2011 and given immediate effect. Pursuant to the Act, for
dates of service beginning on or after January 1, 2012, every
carrier, stop-loss insurer and third party administrator
("TPA"), as those terms are defined in the Act, will be
assessed a tax of 1% on "paid claims."
The term "paid claims" includes actual payments, net
of recoveries, made to a health and medical services provider or
reimbursement to an individual by a carrier, TPA, or stop-loss
insurer. If a carrier or TPA is contractually entitled to
withhold a certain amount from payments that are due to providers
of health and medical services in order to help ensure that the
providers can fulfill any financial obligations they may have under
a managed care risk arrangement, the full amounts due the providers
before that amount is withheld shall be included in paid
claims.
