After Years of Advocacy, Michigan Introduces Legislation to Rein In Insurance Clawbacks

Dear Michigan Social Workers,

We’re excited to share an important legislative development that directly affects mental health providers across Michigan. After several years of coordinated advocacy, new legislation has been introduced in the Michigan House of Representatives—HB 5478—to limit the amount of insurance payments insurers can “claw back” from health care providers, including licensed social workers.

This issue has been a growing concern for clinicians across the state, particularly in light of recent clawback actions by insurers such as Blue Cross Blue Shield and Meridian. For this reason, NASW-Michigan has made insurance clawbacks a top legislative priority and has worked closely with national coalitions to identify effective policy solutions.

What are insurance clawbacks?

Insurance “clawbacks”—also known as chargebacks, takebacks, or recoupments—occur when an insurance company demands repayment for services that were already provided and paid for. These demands often come months or even years after care was delivered, and frequently with little clarity or justification. Insurers may request repayment directly or deduct the amount from future claim payments.

For many social workers—especially those in private practice—clawbacks make it difficult to predict income or maintain financial stability. As a result, some providers have felt forced to leave insurance panels, including Medicaid. This ultimately harms client access to care, particularly for those who rely on insurance to afford mental health services.

Notably, Michigan is currently one of only 10 states with no time limits on insurance clawbacks.

Background on recent advocacy

Beginning in mid-2023, behavioral health professionals across Michigan—including social workers, counselors, agencies, and hospitals—began receiving unexpected notices of potential clawbacks for past client services. In many cases, the amounts ranged from thousands to tens of thousands of dollars, often accompanied by unclear or incomplete communication from insurers.

In response, NASW-Michigan:

• Held listening sessions with social workers statewide to understand the scope and impact

• Met with insurance representatives and coalition partners

• Began legislative discussions with policymakers, including Representatives Brabec, Coffia, MacDonell, VanderWall, and Senator Chang

On March 25, 2025, NASW-Michigan Executive Director Duane Breijak and NASW-Michigan lobbyist De’Shondria Bedenfield (Capitol Services) met with Representative Curtis VanderWall, Chair of the House Health Policy Committee, and his staff. The meeting also included partners from the Michigan Mental Health Counselors Association (President Chris DeBoer, Treasurer Krystin Sankey, and organizational legislative lobbyist at Acuitas).

This collaborative discussion focused on the financial strain caused by unpredictable insurance recoupments and laid important groundwork for legislative action. Representative VanderWall and his team were engaged and expressed genuine interest in addressing these concerns.

Legislation introduced: HB 5478

On January 27, 2026, Representative VanderWall formally introduced HB 5478, a bill to address insurance clawbacks in Michigan.

Legislative status:

• 1/27/2026 – Introduced in the House

• 1/27/2026 – Read for the first time

• 1/27/2026 – Referred to the House Committee on Insurance

This marks a significant milestone in our shared effort to protect mental health providers from excessive and unpredictable financial risk.

HB 5478 would:

• Establish a 90-day limit on claim re-adjudication and recoupment (except in cases of fraud)

• Create clear standards and requirements insurers must follow when requesting a chargeback

What’s next & how you can help

NASW-Michigan will continue working closely with Representative VanderWall and his staff as the bill moves through the legislative process. We will also remain in active collaboration with our advocacy partners, including MMHCA, MPA, MHHA, the Michigan Association of Chiropractors, and others.

As HB 5478 advances, we will share opportunities for social workers to engage—such as contacting legislators, supporting cosponsorship, and participating in testimony.

• Track the bill: legislature.mi.gov (HB 5478)

• Interested in testifying (written or in person)?
  Email NASW-Michigan Policy & Advocacy Manager Jess Riley at
  jriley.naswmi@socialworkers.org

Thank you for your dedication to the people of Michigan and for the essential work you do every day. And a special thank you to NASW members—your support makes this advocacy possible.