The web Browser you are currently using is unsupported, and some features of this site may not work as intended. Please update to a modern browser such as Chrome, Firefox or Edge to experience all features Michigan.gov has to offer.
WC-581 - Application for Adjustment to the Workers' Compensation Maximum Payment Ratio
This form is used for hospitals that may meet the criteria for an adjustment to their current cost-to-charge ratio per the Health Care Services Rules. To find out additional information on this process and to obtain a copy of the form, contact the Resolutions, Rehabilitation and Rules Division at 517-284-8900.