Subject-matter jurisdiction; Failure to exhaust administrative remedies; PIP benefits; No-Fault Act (NFA); Interplay between & construction of MCL 500.3112 & MCL 500.3157; “Utilization review”; MCL 500.3157a(5); True Care Physical Therapy, PLLC v Auto Club Group Ins Co; Department of Insurance & Financial Services (DIFS)

The court held that “MCL 500.3157a(5) does not deprive a circuit court of jurisdiction to entertain a healthcare provider’s action for the recovery of PIP benefits under MCL 500.3112 if the provider did not pursue an administrative appeal of an adverse utilization-review decision.” It noted that defendant-insurer (Meemic) did “not otherwise make any arguments supporting summary disposition under MCR 2.116(C)(8) or (10).” Thus, the court concluded the trial court had “subject-matter jurisdiction and did not err by denying Meemic’s motion for summary disposition.” Plaintiff-healthcare provider sought PIP benefits from Meemic for services rendered to Meemic’s insured after he was in an auto accident. The dispute on appeal regarded “the interplay between and construction of MCL 500.3112 and MCL 500.3157a, as amended by the sweeping changes to the” NFA. The issue was “whether a healthcare provider is required to administratively appeal an adverse utilization-review decision to the DIFS under MCL 500.3157a(5) before bringing an action in circuit court for the recovery of PIP benefits under MCL 500.3112.” The court noted it has “issued binding precedent answering the question in favor of” plaintiff (True Care), and that the “Supreme Court subsequently and recently denied leave after first entertaining oral argument on an application for leave in the case.” This case was not materially distinguishable from True Care. The court’s “analysis and holding in True Care are equally applicable to the case at bar and compel us to conclude that the appeal procedure in MCL 500.3157a(5) is voluntary and not mandatory. None of Meemic’s statutory arguments to the contrary overcome the ruling in True Care, which is binding precedent.” Further, while the “Supreme Court granted and heard oral argument on the application for leave filed in True Care, . . . it ultimately decided to deny leave.”