Read the full stored bill text
HB-5456, As Passed House, June 17, 2026
JJR H00115'25 (H-3)_HB5456_APH_1 m85yep
SUBSTITUTE FOR
HOUSE BILL NO. 5456
A bill to create a hyperbaric oxygen therapy grant program and
pilot program for providing treatment to veterans with traumatic
brain injuries or post-traumatic stress disorder; to provide for
the powers and duties of certain state governmental officers and
entities; and to require the promulgation of rules.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 1. This act may be cited as the "hyperbaric oxygen 1
therapy pilot program act". 2
Sec. 2. As used in this act: 3
(a) "Accreditation" means a safety or operational review 4
performed by a recognized accrediting organization that conducts 5
evaluations of hyperbaric chamber operations, facility practices, 6
or safety protocols using standards consistent with recognized 7
2
JJR H00115'25 (H-3)_HB5456_APH_1 m85yep
hyperbaric safety principles. 1
(b) "Chamber attendant" means an individual with training 2
provided by a recognized accrediting organization who is 3
responsible for direct care and supervision of a patient receiving 4
hyperbaric oxygen therapy, including operating and monitoring 5
equipment in accordance with manufacturer, facility, state, and 6
federal guidelines. 7
(c) "Department" means the department of health and human 8
services. 9
(d) "Eligible veteran" means an individual who meets all of 10
the following criteria: 11
(i) Is a veteran as that term is defined in section 1 of 1965 12
PA 190, MCL 35.61. 13
(ii) Is diagnosed with a traumatic brain injury or post-14
traumatic stress disorder. 15
(iii) Is a resident of this state. 16
(e) "510(k) clearance" means premarket clearance under section 17
510(k) of the federal food, drug, and cosmetic act of 1938, 21 USC 18
360(k). 19
(f) "Fund" means the hyperbaric oxygen therapy fund created in 20
section 3 of the hyperbaric oxygen therapy fund act. 21
(g) "Grant program" means the hyperbaric oxygen therapy grant 22
program created in section 3. 23
(h) "Hard-shelled hyperbaric chamber" means a rigid pressure 24
vessel that meets both of the following requirements: 25
(i) Is constructed in accordance with ASME PVHO-1 and has an 26
ASME PVHO-1 stamp. 27
(ii) Has 510(k) clearance from the United States Food and Drug 28
Administration for its intended use, or meets other federally 29
3
JJR H00115'25 (H-3)_HB5456_APH_1 m85yep
recognized pressure-vessel engineering standards. 1
(i) "Hyperbaric oxygen therapy" means treatment delivered 2
under increased atmospheric pressure, with or without supplemental 3
oxygen, and prescribed by a physician, physician's assistant, or 4
nurse practitioner. 5
(j) "Nurse practitioner" means an individual who is licensed 6
as a registered professional nurse under part 172 of the public 7
health code, 1978 PA 368, MCL 333.17201 to 333.17242, who has been 8
granted a specialty certification as a nurse practitioner by the 9
Michigan board of nursing under section 17210 of the public health 10
code, 1978 PA 368, MCL 333.17210. 11
(k) "Physician" means a physician who is licensed under part 12
170 or part 175 of the public health code, 1978 PA 368, MCL 13
333.17001 to 333.17097 and 333.17501 to 333.17556. 14
(l) "Physician's assistant" means a physician's assistant who 15
is licensed under part 170 or part 175 of the public health code, 16
1978 PA 368, MCL 333.17001 to 333.17097 and 333.17501 to 333.17556. 17
(m) "Pilot program" means the hyperbaric oxygen therapy pilot 18
program established under section 5. 19
(n) "Provider" means a provider of hyperbaric oxygen therapy. 20
(o) "Recognized accrediting organization" means any of the 21
following: 22
(i) American College of Hyperbaric Medicine. 23
(ii) International Board of Undersea Medicine. 24
(iii) International Hyperbaric Association. 25
(iv) National Board of Diving and Hyperbaric Medical 26
Technology. 27
(v) Undersea and Hyperbaric Medical Society. 28
(p) "Safety director" means a certified individual designated 29
4
JJR H00115'25 (H-3)_HB5456_APH_1 m85yep
by a provider to perform duties including, but not limited to, 1
overseeing chamber safety procedures, conducting operator training, 2
performing daily safety checks, and ensuring emergency protocol 3
compliance. 4
(q) "Soft-shelled hyperbaric chamber" means a flexible or 5
soft-sided chamber holding valid 510(k) clearance from the United 6
States Food and Drug Administration for its intended use. 7
(r) "Treatment plan" means a hyperbaric oxygen therapy 8
treatment plan. 9
Sec. 3. (1) As part of the pilot program, the department shall 10
create and operate a hyperbaric oxygen therapy grant program. The 11
department may make grants under this section only to a provider 12
chosen by the department under section 5 to assist the provider in 13
providing and paying the costs of hyperbaric oxygen therapy and 14
related diagnostic testing, including, but not limited to, 15
Automated Neuropsychological Assessment Metrics procedures, to 16
eligible veterans under the pilot program. All providers that 17
receive a grant under this section must offer hyperbaric oxygen 18
therapy at no cost to eligible veterans as provided in section 5. 19
(2) The department shall not make a grant under this section 20
until after the department has established the pilot program and 21
promulgated the rules required by section 5. 22
(3) The department shall not make a grant under this section 23
after the pilot program ends. 24
(4) By not later than 12 months after the effective date of 25
this act, the department shall promulgate rules to implement this 26
section under the administrative procedures act of 1969, 1969 PA 27
306, MCL 24.201 to 24.328, that must address only the following for 28
grants under this section: 29
5
JJR H00115'25 (H-3)_HB5456_APH_1 m85yep
(a) Application procedures. 1
(b) Eligibility criteria subject to section 5. 2
(c) Selection procedures subject to section 5. 3
(d) A consideration of the extent to which a provider has used 4
assistance available from other assistance programs before the 5
department makes a grant under this section to the provider. 6
However, a grant must not be denied or delayed solely on the basis 7
that assistance available from other programs has not been used. 8
(e) Department oversight and verification of the use of grant 9
money. 10
Sec. 5. (1) The department, in consultation with the 11
department of military and veterans affairs, shall establish a 12
hyperbaric oxygen therapy pilot program to assist each provider 13
that the department approves to provide hyperbaric oxygen therapy 14
and related diagnostic testing to eligible veterans. The pilot 15
program must end 3 years after the first session of hyperbaric 16
oxygen therapy is administered under the program. 17
(2) The department shall issue a request for proposals within 18
this state to provide hyperbaric oxygen therapy to eligible 19
veterans. In determining the providers that will participate in the 20
pilot program, the department shall prioritize existing providers 21
in this state that meet all of the following criteria: 22
(a) Have a medical director who is a licensed medical 23
professional who can prescribe oxygen who provides medical 24
oversight of all hyperbaric oxygen therapy delivered. The medical 25
director must be certified in hyperbaric medicine with a minimum 26
certification of a 40-hour introduction to hyperbaric medicine 27
clinician course. 28
(b) Have a safety director on-site to oversee trained chamber 29
6
JJR H00115'25 (H-3)_HB5456_APH_1 m85yep
attendants. 1
(c) Follow established treatment protocols for using 2
hyperbaric oxygen therapy to treat traumatic brain injuries and 3
post-traumatic stress disorder. 4
(3) An eligible veteran is eligible for hyperbaric oxygen 5
therapy under the pilot program if the event that caused the 6
traumatic brain injury or post-traumatic stress disorder meets both 7
of the following: 8
(a) Is documented as a service-connected disability by the 9
United States Department of Veterans Affairs. 10
(b) Is documented by a physician. 11
(4) By not later than 12 months after the effective date of 12
this act, the department, after consulting with the department of 13
military and veterans affairs, shall promulgate rules to implement 14
this section under the administrative procedures act of 1969, 1969 15
PA 306, MCL 24.201 to 24.328, that must include standards for only 16
the following: 17
(a) Confirmation by a provider that an eligible veteran is a 18
veteran eligible for participation in the pilot program by showing 19
1 of the following forms as applicable: 20
(i) DD214. 21
(ii) NGB-22. 22
(iii) DD256. 23
(b) Determination by the department that a provider is 24
eligible to participate in the pilot program with a hard-shelled 25
hyperbaric chamber, including meeting all of the following 26
requirements: 27
(i) Each hard-shelled hyperbaric chamber must be constructed in 28
accordance with ASME PVHO-1 and have 510(k) clearance from the 29
7
JJR H00115'25 (H-3)_HB5456_APH_1 m85yep
United States Food and Drug Administration for its intended use. 1
(ii) Each hard-shelled hyperbaric chamber must be operated and 2
maintained in accordance with manufacturer guidelines and 3
specifications. 4
(iii) Providers must maintain easily accessible records of all 5
of the following: 6
(A) Each hard-shelled hyperbaric chamber's ASME "U" stamp 7
certification, data plate information, and clinical and operating 8
manual. 9
(B) Proof that a designated safety director is on-site during 10
hyperbaric oxygen therapy services. 11
(C) Documentation that the provider has a medical director 12
responsible for the oversight of the facility's hyperbaric 13
operations. 14
(D) Written policies for management of the hyperbaric 15
facility, including, but not limited to, general operational 16
procedures, emergency procedures, and documentation and maintenance 17
of the equipment that must be accessible to physicians and staff in 18
the workplace, reviewed by all staff at least annually, and revised 19
periodically. 20
(iv) Providers shall obtain accreditation for each hard-shelled 21
chamber from a recognized accreditation organization. 22
(v) Providers shall undergo an independent safety audit not 23
less than every 3 years by a recognized accrediting organization or 24
a reviewer with experience evaluating hyperbaric chamber operations 25
or safety practices. 26
(c) Determination by the department that a provider is 27
eligible to participate in the pilot program with a soft-shelled 28
hyperbaric chamber, including that the provider meets the following 29
8
JJR H00115'25 (H-3)_HB5456_APH_1 m85yep
requirements: 1
(i) Each soft-shelled hyperbaric chamber must have 510(k) 2
clearance from the United States Food and Drug Administration for 3
its intended use. 4
(ii) Each soft-shelled hyperbaric chamber must be operated and 5
maintained in accordance with manufacturer guidelines and 6
specifications. 7
(iii) The oxygen concentration within each soft-shelled chamber 8
and room in which the soft-shelled chamber operates must not exceed 9
23.5% oxygen. 10
(iv) Providers must maintain easily accessible records of all 11
of the following: 12
(A) Each soft-shelled chamber's serial number, clinical and 13
operating manual, and proof of 510(k) clearance from the United 14
States Food and Drug Administration. 15
(B) Proof that a designated safety director is on-site during 16
hyperbaric oxygen therapy services. 17
(C) Documentation that the provider has a medical director 18
responsible for the oversight of the facility's hyperbaric 19
operations. 20
(D) Written policies for management of the hyperbaric 21
facility, including, but not limited to, general operational 22
procedures, emergency procedures, and documentation and maintenance 23
of the equipment that must be accessible to physicians and staff in 24
the workplace, reviewed by all staff at least annually, and revised 25
periodically. 26
(v) Providers shall obtain accreditation for each soft-shelled 27
chamber from a recognized accreditation organization. 28
(vi) Providers operating soft-shelled chambers shall undergo an 29
9
JJR H00115'25 (H-3)_HB5456_APH_1 m85yep
independent safety audit not less than every 3 years by a 1
recognized accreditation organization or reviewer with experience 2
evaluating hyperbaric chamber operations or safety practices. 3
(d) Treatment plan requirements, including all of the 4
following: 5
(i) That a provider must submit to the department, before 6
providing hyperbaric oxygen therapy to an eligible veteran, a 7
treatment plan that includes all of the following: 8
(A) A prescription from a physician, physician's assistant, or 9
nurse practitioner. Each patient must be evaluated and cleared by a 10
physician, physician's assistant, or nurse practitioner before 11
receiving hyperbaric oxygen therapy for the first time and any time 12
the patient has a major change in the patient's health status. 13
(B) Verification by the provider that the eligible veteran is 14
eligible under subdivision (a) for participation in the pilot 15
program and voluntarily accepts treatment through the pilot 16
program. 17
(C) An estimate of the cost of the eligible veteran's 18
hyperbaric oxygen therapy. 19
(D) Any other information required by the department. 20
(ii) A requirement that both of the following must occur after 21
the department receives a proposed treatment plan from a provider: 22
(A) Approval or disapproval by the department of the treatment 23
plan within 10 business days. 24
(B) Notice to the provider of approval or disapproval of the 25
treatment plan within 15 business days. 26
(iii) Contingent on the availability of sufficient funding in 27
the fund, approval of each treatment plan that meets the 28
requirements established by the department under this section. 29
10
JJR H00115'25 (H-3)_HB5456_APH_1 m85yep
(iv) The sources of funding for the estimated cost of 1
hyperbaric oxygen therapy for each eligible veteran whose treatment 2
plan is approved under this section. 3
(e) Criteria for approval of payment for hyperbaric oxygen 4
therapy that has been verified by the department to have been 5
provided under a treatment plan approved under subdivision (d), 6
including both of the following: 7
(i) Whether a drug or device used in the treatment plan has 8
been approved for any purpose by the United States Food and Drug 9
Administration. 10
(ii) A verification that an eligible veteran received the 11
hyperbaric oxygen therapy as demonstrated through billing 12
documentation from the provider, or attendance documentation signed 13
by the provider and the eligible veteran attesting to the receipt 14
of the hyperbaric oxygen therapy. 15
(f) Confidentiality of all individually identifiable patient 16
information of an eligible veteran. 17
(5) A provider shall not bill an eligible veteran for any 18
service provided under the pilot program. A provider shall bill the 19
pilot program and be paid at cost out of a grant made to the 20
provider under the grant program at a rate agreed to between the 21
provider and the department, which may be the current state or 22
federal Centers for Medicare and Medicaid Services rates, but must 23
not be more than the following amounts: 24
(a) For a hard-shelled hyperbaric chamber, not more than 25
$250.00 per dive and not more than $10,000.00 for a full session of 26
40 dives. 27
(b) For a soft-shelled hyperbaric chamber, not more than 28
$175.00 per dive and not more than $7,000.00 for a full session of 29
11
JJR H00115'25 (H-3)_HB5456_APH_1 m85yep
40 dives. 1
(6) Each provider must administer Automated Neuropsychological 2
Assessment Metrics procedures following the general guidelines of 3
the American Psychological Association for the distribution and 4
administration of psychological tests. Automated Neuropsychological 5
Assessment Metrics procedures must be administered before 6
treatment, halfway through treatment after 20 dives, and after the 7
completion of a treatment of 40 dives. Automated Neuropsychological 8
Assessment Metrics procedures may be administered by trained 9
proctors under the supervision of individuals with training in 10
psychological testing principles and test administration 11
procedures. Results must be interpreted by qualified medical 12
professionals such as clinical psychologists, neuropsychologists, 13
or physicians with training in psychological testing principles, 14
test administration procedures, and clinical test interpretation. 15
(7) An eligible veteran must provide written informed consent 16
to receive hyperbaric oxygen therapy under the pilot program, 17
subject to all of the following: 18
(a) At a minimum, the written informed consent must include 19
all of the following: 20
(i) An explanation of the products used and treatments given 21
for the traumatic brain injury or post-traumatic stress disorder 22
from which the veteran suffers. 23
(ii) A description of the best and worst potential outcomes of 24
using hyperbaric oxygen therapy and a realistic description of the 25
most likely outcomes. Both of the following apply to the 26
description of potential outcomes: 27
(A) Must include the possibility that new, unanticipated, 28
different, or worse symptoms may result and that the proposed 29
12
JJR H00115'25 (H-3)_HB5456_APH_1 m85yep
treatment may hasten death. 1
(B) Must be based on the treating provider's knowledge of the 2
proposed treatment in conjunction with an awareness of the 3
veteran's condition. 4
(b) The written informed consent must be signed by the 5
eligible veteran and attested to by the treating provider. 6
Sec. 7. (1) Each provider shall file a quarterly status report 7
concerning the services performed by the provider under the pilot 8
program with the department and the department of military and 9
veterans affairs that must include separate results for treatments 10
using hard shell chambers, soft shell chambers with supplemental 11
oxygen, and soft shell chambers without supplemental oxygen. 12
(2) By not later than 1 year after the pilot program begins 13
and each year after until the pilot program ends, the department, 14
in consultation with the department of military and veterans 15
affairs, shall prepare an annual report and submit it to the 16
governor and the chairpersons of the senate and the house of 17
representatives standing committees on military and veterans 18
affairs. The reports required under this subsection must be made 19
available on the department's website and contain, at a minimum, 20
all of the following information for the pilot program for the 21
applicable reporting period: 22
(a) An evaluation of the effectiveness of the pilot program. 23
(b) The number of eligible veterans that participated. 24
(c) The number of providers that participated. 25
(d) Separate results for treatments using hard shell chambers, 26
soft shell chambers with supplemental oxygen, and soft shell 27
chambers without supplemental oxygen. 28
(3) In addition to the reports required under subsection (2), 29
13
Final Page
JJR H00115'25 (H-3)_HB5456_APH_1 m85yep
by not later than 6 months after the pilot program ends, the 1
department shall prepare and submit a final cumulative report in 2
the same manner as the report required under subsection (2), 3
containing the information described in subsection (2) for the 4
entire duration of the pilot program. 5
Enacting section 1. This act does not take effect unless House 6
Bill No. 5457 of the 103rd Legislature is enacted into law. 7