Defendants, Home-Owners Insurance Company and Auto-Owners Insurance Company, appeal as of right a trial court order granting summary disposition in favor of plaintiff, Bronson Methodist Hospital, pursuant to MCR 2.116(C)(10) in these consolidated cases concerning the reasonableness of charges for surgical implant products billed by plaintiff to defendants’ insureds under the no-fault insurance act, MCL 500.3101 et seq. Plaintiff cross-appeals that portion of the trial court’s order denying its motion for attorney fees under MCL 500.3148. We consolidated the appeals and affirm in part, reverse in part, and remand. We conclude that, in accordance with defendants’ clear statutory right and obligation to question the reasonableness of the charges, the no-fault act permits defendants to discover the wholesale cost to plaintiff of the surgical implant products for which the insureds were charged. Thereforе, the trial court erred when it denied defendants’ prior motion to compel discovery. Because of the error denying discovery, summary disposition was granted prematurely. We also stress that the ultimate burden of proof regarding the reasonableness of the charges rests with the provider. Finally, we conclude that the attorney-fee penalty provision of the no-fault act was not triggered.
I. BASIC FACTS AND PROCEDURAL HISTORY
These consolidated appeals arise from disputes over the reasonableness of plaintiffs charges for surgical implant products provided to defendants’ insureds, Gavin Powell and Hector Serrano-Ruiz, each of whom were treated at plaintiff hospital after suffering serious injuries in separate and unrelated automobile accidents. At issue is whether defendants were entitled to information pertaining to the cost of the surgical implant products to plaintiff when defendants were determining whether the charges billed to defendants’ insureds for those surgical implant products were “reasonable” under the no-fault act and, accordingly, whether that information was discoverable during the course of litigation over the charges.
Powell was injured on July 2, 2009, when the vehicle he was driving struck a tree. Serrano-Ruiz was injured on July 17, 2009, when the motorcycle he was driving was struck by another vehicle. Both Powell and Serrano-Ruiz suffered broken bones that were treated with surgical implant products, including screws and plates. Plaintiffs charges for the medical treatment afforded to Powell totaled $242,941.09, of which $61,237.50 was for “supply/implant” products; plaintiffs total charges for Serrano-Ruiz’s medical treatment were $143,477.76, of which $28,800 was for “supply/implant” products. Auto-Owners is responsible for payment of the insurance benefits for Powell’s medical treatment; Home-Owners is responsible for payment of the insurance benefits for Serrano-Ruiz’s medical treatment. Plaintiff provided defendants with uniform billing forms, itemized statements, and medical records identifying the medical treatment provided to Powell and Serrano-Ruiz, respectively. Defendants timely paid the portion of plaintiffs bills for all charges other than for the surgical implant products used to treat the two men. Defendants requested invoices showing
Home-Owners admitted that it did not pay the $28,800 charge for surgical implant products and denied that such payment was due and owing on the basis that plaintiff had failed to provide reasonable proof of the fact and аmount of the loss and failed to comply with MCL 500.3158(2) by refusing to provide copies of the invoices showing the cost to plaintiff of the items billed as “supply implants.” Home-Owners claimed that, without such information, it was unable to make a determination regarding the reasonableness of the charges for the implants. Similarly, Auto-Owners admitted that it did not pay $61,237.50 for surgical implants because Auto-Owners believed that plaintiff had failed to provide sufficient documentation regarding the cost of treatment as required by MCL 500.3158(2) and failed to provide reasonable proof of the fact and amount of loss as required by MCL 500.3142 by refusing to provide copies of purchase invoices showing the cost to plaintiff of the items billed as “Supply/Implants in the amount of $61,237.50.”
Defendants submitted discovery requests seeking information regarding the wholesale cost to plaintiff of the surgical implant products at issue, plaintiffs “total revenue and operating expenses and the ‘cost-to-charge ratio’ which is derived from these numbers,” the percentages of plaintiffs patients that are uninsured or covered by no-fault insurance, the average annual increase in plaintiffs charges over the last five years, and any billing manuals or guidelines used to prepare itemized charges or other billing documents. Plaintiff objected to defendants’ discovery requests, arguing that the information sought was irrelevant to the claims asserted in plaintiffs complaints and that defendants were not entitled to the information sought because the information regarding “costs of treatment” to which defendants were entitled under MCL 500.3158(2) pertained to the cost to the “injured person” of the medical care and treatment that person received, i.e., the charges incurred by the patient at plaintiffs hospital.
Defendants later moved to cоmpel discovery, asserting that the information sought was relevant to their determination whether the charges billed were reasonable under the no-fault act. Pursuant to MCL 500.3158(2), plaintiff was required to provide insurers with information relating to the cost of treatment of the injured person, which, defendants argued, included the wholesale cost to the provider of the surgical implant products for which the insured was charged. Defendants also asserted that MCR 2.302 required that plaintiff produce the requested information because the information was relevant to the factual question whether plaintiffs charges for the surgical implant products were “reasonable” within the meaning of the no-fault act. Defendants noted that they paid plaintiff a substantial portion of the total charges billed in each case and that the unpaid portions of plaintiffs bills related solely to charges for the surgical implant products for which defendants sought, and plaintiff refused to provide, underlying cost information. Defendants further asserted that whether plaintiffs charges are “reasonable” and whether plaintiff provided “reasonable proof” of the fact and amount of loss as required by the act are determinations to be made by the finder of fact and were issues to which the requested materials were relevant and discoverable.
At the hearing on the motions, defendants reiterated their position that the no-fault act required them to determine whether the charges assessed were reasonable and that MCL 500.3158(2) entitled them to documentation regarding the cost to plaintiff of the surgical implant products in order to make that determination. Defendants argued that by failing to provide that information, plaintiff had not met its burden of providing reasonable proof of loss under the act so as to entitle it to payment for the surgical implant products. In response, plaintiff argued that by submitting a uniform billing form, an itemized statement, and the patient’s medical records, it had met its burden in each case to provide defendants with reasonable proof of the amount of the loss under MCL 500.3142 and that, thereafter, defendants failed to evaluate the claims, pay what they believed to be reasonable, and deny what they believed to be excessive. Plaintiff argued that defendants were required to conduct an investigation to determine whether the charges were reasonable by comparing costs among providers “similarly located geographically” for the products at issue. Plaintiff also asserted that allowing insurers to obtain providers’ cost data would undermine the goals and objectives оf the no-fault act and would cause that reparation system to come to a grinding halt. Plaintiff reiterated that all it is required to do is put the insurer on notice of the charges and the services provided to the insured and that, once it does so, the insurer then has the obligation to go out and use whatever resources it has at its disposal to evaluate the reasonableness of the charges.
The trial court concluded that the no-fault statute did not require plaintiff to provide its cost of surgical implant products and denied the discovery request. The trial court afforded defendants the opportunity to amend their answers to include allegations that plaintiffs charges were unreasonable. Following the court’s ruling, defendants, through their audit consultant, CorVel Corporation, estimated a price at which the surgical implant products had been purchased and, on the basis of thоse estimates, paid plaintiff $34,701.02 of the outstanding $61,237.50 charges related to Powell’s treatment and $21,612.65 of the outstanding $28,800 charges related to Serrano-Ruiz’s treatment. The payments were “calculated on a basis of cost of the product to the hospital plus 50%. ” As a result of the additional payments, the balances remaining in dispute were $26,536.48 for Powell’s treatment and $7,187.35 for Serrano-Ruiz’s treatment. Defendants amended their answers to plaintiffs complaints accordingly, to specifically deny the reasonableness of the outstanding charges for surgical implant products.
II. STANDARDS OF REVIEW
This Court reviews for an abuse of discretion a trial court’s ruling on a motion to compel discovery. Cabrera v Ekema,
We review de novo a trial court’s decision on a motion for summary disposition, reviewing the record in the same manner as must the trial court to determine whether the movant was entitled to judgment as a matter of law. Latham v Barton Malow Co,
We review de novo questions of statutory construction. Feyz v Mercy Mem Hosp,
Finally, we review for an abuse of discretion a trial court’s decision whether to award attorney fees under the no-fault act. Moore v Secura Ins,
III. ANALYSIS
A. IS THE COST OF PROVIDING MEDICAL SERVICES AND PRODUCTS DISCOVERABLE UNDER MCL 500.3158(2), MCL 500.3159, AND MCR 2.302?
The primary issue on appeal is whether defendants are permitted by the no-fault act to discover the wholesale cost to plaintiff of surgical implant products used in treating defendants’ insureds when determining whether plaintiffs charges for those surgical implant products are reasonable under the aсt. We conclude that, in accordance with defendants’ clear statutory right and obligation to question the reasonableness of the charges, the no-fault act permits defendants to discover the wholesale cost to plaintiff of the surgical implant products for which the insureds were charged. We also stress that the ultimate burden of proof regarding the reasonableness of the charges rests with the provider.
The Michigan court rules establish “ ‘an open, broad discovery policy ....’” Cabrera,
The no-fault act provides for a system of mandatory no-fault automobile insurance, which requires Michigan drivers to purchase personal protection insurance. MCL 500.3101 et seq. “Under personal protection insurance^] an insurer is liable
A physician, hospital, clinic or other person or institution lawfully rendering treatment to an injured person for an accidental bodily injury covered by personal protection insurance, and a person or institution providing rehabilitative occupational training following the injury, may charge a reasonable amount for the products, services and accommodations rendered. The charge shall not exceed the amount the person or institution customarily charges for like products, services and accommodations in cases not involving insurance. [Emphasis added.]
MCL 500.3158(2) further requires that
[a] physician, hospital, clinic or other medical institution providing, before or after an accidental bodily injury upon which a claim for personal protection insurance benefits is based, any product, service or accommodation in relation to that or any other injury, or in relation to a condition claimed to be connected with that or any other injury, if requested to do so by the insurer against whom the claim has been made, (a) shall furnish forthwith a written report of the history, condition, treatment and dates and costs of treatment of the injured person and (b) shall produce forthwith and permit inspection and copying of its records regarding the history, conditiоn, treatment and dates and costs of treatment. [Emphasis added.]
Finally, MCL 500.3159 provides:
In a dispute regarding an insurer’s right to discovery of facts about an injured person’s earnings or about his history, condition, treatment and dates and costs of treatment, a court may enter an order for the discovery. The order may be made only on motion for good cause shown and upon notice to all persons having an interest, and shall specify the time, place, manner, conditions and scope of the discovery. A court, in order to protect against annoyance, embarrassment or oppression, as justice requires, may enter an order refusing discovery or specifying conditions of discovery and may order payments of costs and expenses of the proceeding, including reasonable fees for the appearance of attorneys at the proceedings, as justice requires. [Emphasis added.]
Because benefits are payable as losses accrue, benefits are considered overdue “if not paid within 30 days after an insurer receives reasonable proof of the fact and of the amount of loss sustained.” MCL 500.3142(2) (emphasis added). Similarly, “if the court finds that the insurer unreasonably refused to pay the claim or unreasonably delayed in making proper payment,” attorney fees shall be a charged against the insurer in addition to the benefits recovered. MCL 500.3148(1).
Defendants argue that the cost to the providers of the products used in treating an insured is an appropriate consideration in determining whether the charge for those products is reasonable and that the trial court erred by construing the phrase “costs of treatment” in MCL 500.3158(2) as referring only to the charges of the health-care providers in their own billing to the patients and not to documentation of the
In contrast, plaintiff argues that the cost of the surgical implant products, whether actual or estimated, was not a permissible consideration in determining whether plaintiffs charges were reasonable and that defendants’ method is equivalent to a fee schedule, which is not authorized under the act; rather, the act contemplates only a “charge-to-charge” comparison. Plaintiff believes that defendants were limited to comparing plaintiffs charges to those of other similar providers of the same services.
The trial court concluded that defendants were not permitted to consider either plaintiffs cost for the surgical implant products or the average cost of those products to providers generally, as calculated by a third-party auditor. Instead, defendants were restricted to сomparing plaintiffs charges with the charges of other similar providers of these products. We believe the trial court erred by so concluding.
Both parties rely on our holding in AOPP,
whether, under the language of the [no-fault] act, defendant insurance companies are required to pay the full amount charged as long as the charge constitutes a “customary” one, or if defendants are entitled to independently review and audit the medical costs charged to their insureds to determine whether a particular charge is “reasonable.” [AOPP,257 Mich App at 372 .]
Citing both MCL 500.3157 and MCL 500.3107, we noted that the amount an insurer is obligated to pay to a health-care provider is limited to “a reasonable amount.” AOPP,
Under this statutory scheme, an insurer is not liable for any medical expense that is not both reasonable and necessary. Hofmann v Auto Club Ins Ass’n,211 Mich App 55 , 93-94;535 NW2d 529 (1995), quoting Nasser v Auto Club Ins Ass’n,435 Mich 33 , 49-50;457 NW2d 637 (1990). The reasonableness of the charge is an explicit and necessary element of a claimant’s recovery against an insurer, and, accordingly, the burden of proof on this issue lies with the plaintiff. Id. “Where a plaintiff is unable to show that a particular, reasonable expense has been incurred for a reasonably necessary product and service, there can be no finding of a breach of the insurer’s duty to pay that expense, and thus no finding of liability with regard to that expense.” Nasser, [435 Mich] at 50.
As the United States Court of Appeals for the Sixth Circuit recognized, these statutory provisions leave open the questions of (1) what constitutes a reasonable charge, (2) who decides what is a reasonable charge, and (3) what criteria may be used to determine what is reasonable. See Advocacy Organization for Patients & Providers (AOPP) v Auto Club Ins Ass’n,176 F3d 315 , 320 (CA 6, 1999). [Id. at 374-375.]
We rejected the provider’s claim that insurers must pay all reasonable necessary medical expenses incurred for accidental bodily injuries as long as the charges did not exceed the amount the provider customarily charged for comparable services to patients without insurance. Id. at 375. While MCL 500.3157 specifically sets forth that a provider’s charge “shall not exceed the amount the person or institution customarily charges
In fact, this Court in McGill [v Auto Ass’n of Mich,207 Mich App 402 ;526 NW2d 12 (1994)] discussed at length the policy considerations underlying the act in rejecting the plaintiffs’ argument that the defendant insurers were required to pay the full amount of medical expenses billed by health-care providers:
“It is to be recalled that the public policy of this state is that ‘the existence of no-fault insurance shall not increase the cost of health care.’ Indeed, ‘[t]he no-fault act was as concerned with the rising cost of health care as it was with providing an efficient system of automobile insurance.’ To that end, the plain and ordinary language of § 3107 requiring no-fault insurance carriers to pay no more than reasonable medical expenses, clearly evinces the Legislature’s intent to ‘place a check on health care providers who have “no incentive to keep the doctor bill at a minimum.” ’
“For the above reasons, we reject plaintiffs’ argument that, pursuant to the no-fault act, defendants are obligated to pay the entire amount of plaintiffs’ mediсal bills. Such an interpretation would require insurance companies to accept health care providers’ unilateral decisions regarding what constitutes reasonable medical expenses, effectively eliminating insurance companies’ cost-policing function as contemplated by the no-fault act. This result would directly conflict with the Legislature’s purpose in enacting the no-fault system in general and § 3107 in particular. ‘[I\t is clear that the Legislature did not intend for no-fault insurers to pay all claims submitted without reviewing the claims for lack of coverage, excessiveness, or fraud.’ ” [Id. at 407-408 (citations omitted; emphasis added).] [AOPP,257 Mich App at 377-378 .]
Thus, insurers are required to challenge the reasonableness of charges, and providers should expect no less. Id. at 378-379.
In concluding that insurers were only obligated to pay benefits for reasonable charges, we acknowledged that what was “reasonable” had yet to be defined. “[Consequently, insurers must determine in each instance whether a charge is reasonable in light of the service or product provided.” Id. at 379. Ultimately, the determination of what is a reasonable charge is for the trier of fact. Id. In a footnote, we acknowledged that the case had policy ramifications, but that those should not be overstated:
We believe both sides overstate the effects of either side prevailing. Under the statute, plaintiffs necessarily make the initial determination of reasonableness by charging the insured for the services. Once plaintiffs charge the insured, the insurer then makes its own determination regarding what is reasonable and pays that amount to plaintiffs. Although, as plaintiffs argue, the cost-benefit analysis may cause fewer legal actions over the disputed amount, the fact-finder will ultimately decide what isreasonable. Whether this procedure is the best is a matter for the Legislaturе. [Id. at 379 n 4 (citations omitted).]
Naturally, “[p]laintiffs may challenge defendants’ failure to fully reimburse them for medical bills as a violation of the act, but they have the burden of establishing the reasonableness of the charges in order to impose liability on the insurer,” and “[t]he question whether expenses are reasonable and reasonably necessary is generally one of fact for the jury ....” Id. at 380. Thus, “[i]f plaintiffs disagree with a defendant’s assessment of reasonableness, they have the right to contest the amount of such payment and must prove by a preponderance of the evidence that the expenses were both reasonable and necessary.” Id.
While AOPP supports an insurer’s practice of determining the reasonableness of a provider’s charges for surgical implant products by comparing those charges to the amounts charged for those products by other, similar providers, AOPP does not suggest that this is the only permissible approach under the act. In AOPP, we specifically dеclined to “delineate the permissible factors” that defendants may consider when determining whether a charge is reasonable, while specifically rejecting the notion that providers are permitted to “unilaterally determine the ‘reasonable’ charge to be paid by the insurer” by way of their customary charges or that the act should be interpreted in a manner that effectively eliminates the cost-policing function of insurance companies as contemplated by the no-fault act. Id. at 377, 379. To limit assessing the reasonableness of provider charges solely to a comparison of such charges among similar providers would be to leave the determination of reasonableness solely in the hands of providers, as a collective group, and would abrogate the cost-policing function of no-fault insurers, contrary to the intention of the Legislaturе. Accordingly, defendants’ ability to assess the reasonableness of provider charges is not limited to a comparison of customary charges among similar providers. Rather, the act contemplates that, as happened here, insurers will assess the reasonableness of a provider’s charges, paying that portion deemed reasonable, with the provider having the prerogative to then challenge the insurer’s decision not to pay the entire charge submitted by filing suit. Once an action is filed, the provider has the burden of proving by a preponderance of the evidence the reasonableness of its charges. Id. at 379-380. The parties are free to introduce evidence to the fact-finder regarding the reasonableness of plaintiffs charges. Plaintiff is free to argue that its charges are in line with those of other similar providers for the surgical implant produсts at issue here, and defendants may respond by asserting that plaintiffs markup over the average wholesale cost of those products renders the charges excessive. But ultimately, the burden of proof is on the provider to show how and why the charges are reasonable.
We find further support in our recent opinion in Hardrick v Auto Club Ins Ass’n,
Here, the question presented is not whether an agency rate is reasonable per se under the circumstances, but whether evidence of an agency rate may assist a jury in determining a reasonable charge for family-provided attendant-care services. The fact that an agency charges a certain rate for precisely the same services that [the] parents provide does not prove that the rate should apply to the parents’ services. However, an agency rate for attendant-care services, routinely paid by a no-fault carrier, is a piece of evidence that throws some light, however faint, on the reasonableness of a charge for attendant-care services. In other words, an agency rate supplies one measure of the value of attendant care and is worthy of a jury’s consideration. A jury may ultimately decide that an agency rate carries less weight than the rate charged by an independent contractor, or no weight at all. But the fact that different charges for the same service exist in themarketplace hardly renders one charge irrelevant as a matter of law. [Id. at 669 (citation omitted).]
Similarly, in this case, plaintiffs actual cost for surgical implant products is but one piece of information that a jury might find relevant in determining whether plaintiff’s charges were reasonable. Hardrick stresses what we have already discussed at length — the jury is charged with the responsibility of determining the reasonableness of plaintiffs charges. Because actual costs to plaintiff would most certainly “throw some light on” the reasonableness of the chargеs, the trial court should have compelled plaintiff to provide the information.
Hardrick also confirms the notion that a hospital’s itemized bills and records do not, standing alone, satisfy the “reasonableness” requirement. We analogized a “charge” to an attorney’s bill for services. When an attorney seeks a court order for payment of a “reasonable attorney fee,” he or she may not simply provide a bill, but must also demonstrate that the bill is reasonable by showing more than his or her actual “wage.” Id. at 673-674. We explained:
Given that many factors influence the determination of a “reasonable charge” for attendant-care services, a jury may consider a provider’s wage as one piece of evidence relevant to this calculation. We view the reasonableness inquiry as encompassing any evidence bearing on fair compensation for the particular servicеs rendered. The principles supporting the relevancy of agency rates equally support the relevancy of other evidence. For example, [the expert witness] testified that an agency would pay its employees less than the $25 to $45 hourly rate charged to the patient. Evidence of the employee’s hourly wage throws some light, however faint [,] on the reasonableness of a charge for attendant-care services. [The insurance company] correctly notes that the jury should hear such evidence to more fully and accurately calculate a reasonable rate for the services rendered.
... Limiting a family member’s “reasonable charge” to a wage ignores ... other costs. In the end, the Legislature commanded that no-fault insurers pay a “reasonable charge” for attendant-care services, thereby consigning to a juiy the necessary economic-value choices.
None of the evidence proffered by [either party], or even mentioned by this Court, is dispositive of the reasonable-charge issue. Rather, the evidence provides a collage of factors affecting the reasonable rate that may be charged by [the] parents for the services they provide. [Id. at 675-678 (citation omitted).]
Similarly, plaintiffs actual cost for the surgical implant products is not dispositive on the issue whether its charges were reasonable; however, the actual cost of the durable medical equipment is certainly a piece of the overall “collage of factors affecting the reasonable rate” of plaintiffs charges. Again, it cannot be overstated that, when factually disputed, the reasonableness of the charges is a question of fact for the jury to determine. The jury can only make such a determination if it has been provided with all relevant and probative evidence.
Accordingly, given our conclusion that defendants were entitled to discover the actual cost of the surgical implant products to plaintiff under MCL 500.3158 and MCL 500.3159, the trial court erred when it denied defendants’ motion to compel discovery. Because of the error, it follows
B. DID THE TRIAL COURT ERR BY GRANTING PLAINTIFF SUMMARY DISPOSITION?
Defendants argue that, considering the cost data presented by defendants, which is a permissible consideration under the no-fault act in determining reasonableness, and considering plaintiffs lack of admissible evidence supporting the reasonableness of its charges, a rational fact-finder could conclude that plaintiffs charges for surgical implant products were not reasonable and, therefore, summary disposition in plaintiffs favor was not wаrranted. We agree.
Plaintiff sought summary disposition on the basis that defendants’ method of determining that plaintiffs charges for the surgical implant products were excessive was arbitrary and unreasonable. Plaintiff did not proffer anything to support its assertion that its charges were reasonable, nor did it offer any evidence regarding how its charges compared with those of similar providers of the same products. Instead, plaintiff claimed that when it established and submitted its charges to defendants it necessarily made the determination regarding the reasonableness of those charges, thus shifting the burden to defendants to employ a reasonable method to challenge the validity of plaintiffs charges. Thus, plaintiff argued, defendants had the burden of legitimately auditing plaintiffs charges under the no-fault act and, when they failed to do so, they failed to create a triable issue for the jury. We disagree.
Plaintiffs position is at odds with established case-law. The burden of proof on the reasonableness of its fees lies with plaintiff. Hofmann,
C. DID THE TRIAL COURT ERR BY REFUSING TO AWARD ATTORNEY FEES UNDER MCL 500.3148?
In its cross-appeal, plaintiff argues that the trial court clearly erred by failing to award plaintiff its attorney fees after defendants refused to pay for the surgical implant products. We disagree.
The no-fault act provides for an award of reasonable attorney fees when an insurer unreasonably withholds benefits. MCL 500.3148(1). Our Supreme Court has held:
MCL 500.3148(1) establishes two prerequisites for the award of attorney fees.First, the benefits must be overdue, meaning “not paid within 30 days after [the] insurer receives reasonable proof of the fact and of the amount of loss sustained.” MCL 500.3142(2). Second, in postjudgment proceedings, the trial court must find that the insurer “unreasonably rеfused to pay the claim or unreasonably delayed in making proper payment.” MCL 500.3148(1). Therefore, assigning the words in MCL 500.3142 and MCL 500.3148 their common and ordinary meaning, “attorney fees are payable only on overdue benefits for which the insurer has unreasonably refused to pay or unreasonably delayed in paying.” Proudfoot v State Farm Mut Ins Co, 469 Mich 476 , 485;673 NW2d 739 (2003) (emphasis omitted). [Moore,482 Mich at 517 .]
“The purpose of the no-fault act’s attorney-fee penalty provision is to ensure prompt payment to the insured.” Ross v Auto Club Group,
Defendants asserted in the trial court, as they do here, that the refusal to pay the full amount of plaintiffs charges for surgical implant products was based on both a legitimate question of statutory construction and factual uncertainty regarding the reasonableness of those charges. The trial court determined that defendants’ conduct was based on a legitimate question of statutory construction. We agree and conclude that the trial court did not abuse its discretion by declining to award plaintiff attorney fees.
As discussed earlier in this opinion, an insurer is not foreclosed from assessing the reasonableness of a provider’s charges merely because those charges are the prоvider’s customary charges; rather, insurers have a duty under the act to “ ‘audit and challenge the reasonableness’ ” of charges submitted for payment. AOPP,
Because we conclude that the no-fault act permits defendants to discover the wholesale cost to plaintiff of the surgical implant products for which the insureds were charged, we reverse that portion of the trial court’s order that granted plaintiff summary disposition, affirm that portion of the trial court’s order that denied plaintiffs request for attorneys fees, and remand for further proceedings. We do not retain jurisdiction.
Notes
Following our decision in AOPP, our Supreme Court granted the providers’ application for leave to appeal, directing that “defendants are to explain in detail the computations they use in determining whether a particular charge meets the ‘80th percentile test.’ ” Advocacy Org for Patients & Providers v Auto Club Ins Ass’n,