Legislative Update (Special Edition)

With the Legislature finally closing its books on the 96th Legislature there were many issues that made their way through the process that kept MSMS on its toes. We provided several letters of support or opposition, provides hours of testimony to the House and Senate, and made hundreds of office visits and phone calls and e-mails. All of this truly helped shape the health policy that Michigan gained over the past two years. Now that the session is over we want to take a look at the issues that affected all of us:

Liability Reform:

Drs Elmassian and Chafty Testifying

The largest victory for MSMS this year was the passage of reforms that would bring Michigan's tort climate back toward what was originally passed by the legislature in 1993. Senate Bills 1115 and 1118 were passed by the legislature in, what some would call, a legendary lame duck session of the Michigan Legislature. These reforms did not come without the battles including five committee hearings in the Senate on these bills which lead to huge crowds in the committee rooms. Those who were for and those against the reforms packed the room wanting to make their presence known to the committee and how they felt.

View at tort reform hearing.

After hours and hours of testimony the Senate committee moved the legislation to the floor and from there the legislation had covered it first real hurdle. Deliberations, discussions, amendments, and speeches against and for the legislation lead us to the final day of working session for the legislature where the House finally took up the legislation on the floor and gave it its blessing to send it to the Governor for his signature. It has been almost twenty years since there has been some significant tort reform for medical malpractice in Michigan until the end of this session, these tort reforms will be good for physicians but more importantly good for patients.

Wayne State Medical Students
 lobbying for Tort Reform.

Earlier in the term MSMS worked on legislation that would allow those physicians who are employed to volunteer in clinics and be provided protections that are afforded to those who are retired and work in the clinics (House Bill 4350). There was contention with this legislation since it provided what some classified as blanket immunity has they had in the later tort reform debate. Working with the members of the Senate, MSMS and other parties were able to come to an agreement that would provide the protection to those who are not contractually compelled to work in clinics to receive the liability protections of those who are retired and volunteering. It was a great day for medicine by opening the door to those physicians who wish to give of their time to help those who need the help the most.

Medical Marihuana:

Dr. Newman testifying to the Senate
Judiciary committee on Medical Marihuana

In this term Medical Marihuana left us with the question of what a "bona-fide patient/physician relationship" was in the eyes of the law. In medicine that question can lead to several answers. The face to face relationship all the way to telemedicine can lead to the definition of a patient/physician relationship. The Medical Marihuana statute stated that grey area that required patients to have this relationship with their physician but did not state what that relationship looked like and left law enforcement and the medical community scratching their heads. Insert House Bill 4851 which for the purposes of Medical Marihuana defined what that relationship looked like. Now patients would have to have contact with their physicians regularly rather that a one and done visit as some were seeing for those who were looking to obtain a certification for Medical Marihuana.

Insurance:

Insurance was an issue that started right away in the session with the attempt by the House to change the Michigan Auto No Fault system. House Bill 4936 wanted to provide levels of coverage that a person can obtain that would provide a certain level of financial coverage for any personal injury that occurred in an auto accident. From the state this was an issue that MSMS was against. Legislators were looking to provide choice for those individuals who were looking to save on car insurance and also provide relief to the Michigan Catastrophic Claims Fund, the fund that covers those gravely injured in an auto accident. Proponents of the legislation stated that the changed needed to happen since in its current form it would bankrupt the system. Opponents of the legislation asked to see the numbers and in the end were never given the opportunity to see the hard data. The House Insurance committee did pass a series of reformed and sent it to the House floor for their consideration but were never able to obtain the votes. Expect this issue back again the new session.

It wouldn't be a complete legislative session if Blue Cross/Blue Shield wasn't involved in some way. This term they had the backing of the Governor and finally found a way to get out from under PA 350 or the Nonprofit Health Care Corporation Reform Act. This act provided the tax breaks that the Blues enjoyed but also provided some requirements that the Blues did not enjoy. With the impending implementation of the health insurance exchange in Michigan, the Governor thought it was time to bring a change to the Blues and give them the ability to compete in the insurance exchange among other reasons and push for legislation to reform the Blues. The Legislature responded and created a nonprofit mutual insurer in the state of Michigan and providing a path to those incorporated under PA 350 to convert into this mutual insurer. This legislation did not come without a cost, requiring that the Blues pay to the state $1.56 Billion from now until 2018. This money will be placed in a health fund used to cover health projects and subsides Medigap policies until 2021 at a cost of $120 Million a year. The Governor received his wish and Senate Bills 1293 and 1294 were sent to his desk where they await his eventual signature.

Helmets:

Before the Legislature left for the summer break this past year they decided to take up an issue that has been on the burners of the legislature for years. They finally made a decision on the age old question, should you be required to wear a helmet while operating a motorcycle? In their opinion you should not be required since it was your individual right to determine whether you ride with a helmet or not. Senate Bill 291 made its way through the legislature going through its ups and downs, being amended several time, and at one point being used in the same conversation the changes with Auto No Fault, but in the end it was finally time according to the legislature to act on this measure. MSMS was adamantly opposed to the legislation reasoning that the having helmet on in an accident will give you the greatest chance to walk away from that accident but the Governor and Legislature did not see it that way and now today we have those who cherish their individual freedoms riding without a helmet. Time will tell if this was a wise decision for Michigan.

Graduate Medical Education:

Every year at MSMS we always face small battles when it comes to the budget, whether it’s trying to get more money for Medicaid, trying to stop the cut to public health funding, or trying to keep J-1 visa waivers in the budget we always have some small battles. One that always continued to come up and we feel will continue to, is the funding for Graduate Medical Education. The Governor has presented his last two budgets to the legislature with significant cuts to the program citing that the priority should be funding Medicaid at a higher level so that physicians will service more patients on Medicaid rather than funding the training of new physicians, fresh out of medical school. We see and understand the investment on Graduate Medical Education and what care this provides to those who need to care the most. Through work and education of the legislators we have been able to stay away from the deep cuts proposed by the Governor and only work hard to absorb small cuts from the legislature. In the coming years we will have to continue this fight to keep GME at its current level rather than seeing another cut to the program.

Affordable Care Act:

This is the only federal issue that made out list this year. We all know about the sustainable growth rate (SGR) and how we face looming cuts into Medicare but somehow Congress always finds a way to kick the can down the road. This time we think it will be the same but with the fiscal cliff casting a shadow on other impending issues, it could take some serious lifting by Congress to get this done on time.

US Supreme Court rendering opinion
in Affordable Care Hearings.

But now on to the Affordable Care Act and the decision from United States Supreme Court that some say rocked and other say solidified the nation in the future of its health care. The Supreme Court upheld the law saying that it was in the taxing authority of Congress to mandate insurance for people and was not within the commerce clause of the US Constitution. This left many states that were waiting for a decision under the gun if they were going to start creating their own health insurance exchanges. As for Michigan an attempt was tried with legislation that was sent from the Senate to the House, Senate Bill 693, but failed to gain the proper support from the committee. The state will now have a state/federal partnership exchange in 2014.

Scope of Practice:

This year the Medical Society found itself involved in looking at the future of medicine and how the team approach to care can continue to grow in Michigan. At the start of the term, physician assistants and physicians came together to find ways to grow their partnership in Medicine and came out of those discussions with Senate Bill 384 which brought more clarification on the relationship between PA's and Physicians, strengthening it, providing greater avenues to provides the best care.
Physical Therapists made an attempt this year to provide direct access for patients, bypassing the physician in House Bill 4603. Nurses also were looking for some clarification on their profession and how they fit into the team approach of medicine with Senate Bill 481. Both of these pieces of legislation did not make through the entire legislative process but MSMS is looking forward to continuing discussions with these groups to better strengthen the medical team in Michigan.

Autism:

Dr. Phillip Wise with Lt. Governor
Brian Calley at the signing of the Autism
Legislation.

This legislative term saw the largest advancement in mental health parity in Michigan in decades. MSMS has always had a long standing policy to support mental health parity in the insurance coverage of treatment of mental health conditions. Michigan took a step towards that this term by requiring the coverage of services surrounding the treatment of Autism. This was a priority of the Lieutenant Governor, Brian Calley; an issue that he worked hard for when he was a member of the Michigan House. Senate Bills 414, 415, and 981 started in June of 2011 with 981 adding in March 2012 and by April 18, 2012 it was the law of the land that insurers had to start to cover Autism services and treatment in Michigan. This is one small victory towards the larger goal of mental health parity.

Claims Tax:

Starting in 2011 there were rumblings from the federal government that the use tax that was set up by Michigan to tax the insurers that held Medicaid plans in Michigan was going to be ruled illegal and could penalize the State by holding back funds for Michigan's Medicaid program. A dilemma was presented to the legislature on what to do to replace the revenue needed to obtain the funds needed for Medicaid. Thus the claims tax proposal was created. Senate Bills 347 and 348 eliminated the use tax and created a claims assessment or tax on each of the insurance claims filed at a 1% level in Michigan. This was supposed to solve the revenue shortfall that would come with the elimination of the Use Tax but that as time moved on it proved not to be the case and this year the Medicaid faces a $140 Million shortfall that has to be filled somehow. The Senate tried to move Senate Bill 1359 which would provide an adjustable rate to make the need for revenue but was rejected by the Senate Appropriations committee. The legislature continues to look for solutions for the shortfall.

Abortion:

Abortion was an issue that seemed to be on the forefront this term with the legislature as looked tightens up regulations surrounding this hot button issue. There were several bills introduced and has testimony taken but in the end, these bills were placed into one large bill House Bill 5711. This legislation took a look at four major issues the legislature felt needed to be addressed: the licensing of facilities that perform abortions, the disposal of remains, and the liability protections needed by a physician who performs abortions, and the use of telemedicine in an abortion. Those against this bill called this issue the War on Women and continued to push for its stall in the House and the Senate. Those efforts did fail and in the early morning hours of the last day of session, the House concurred with the Senate and sent the bill to be enrolled and presented to the Governor. It’s currently uncertain if the Governor will sign the legislation.

Abortion found its way into the blue cross mutualization changes mentioned above with amendments that were added by the House to require that coverage for elective abortions be an opt-in coverage rather than an opt-out situation when purchasing coverage. We will have to wait and see the impact it will have on Michiganders.

Impaired Drivers:

Dr. Spanaki testifying with Senator
Schuitmaker on Senate Bills 402 & 403

An issue that MSMS has been working on for several years was finally accomplished this legislative term by providing liability protections for physicians who report to the Michigan Secretary of State that a person may be impaired to operate a motor vehicle. Senate Bills 402 and 403 started in the Senate Transportation committee and made their way through the entire process landing on the Governor's desk at the end of the second week of December. With the Governor's signature on this legislation physicians can report those patients they feel should not be operating a motor vehicle and let the Secretary of State decide whether that individual should be driving.

Bullying:

A major issue for the MSMS Alliance with past term was the creation of regulations for schools on how to handle instances of bullying. House Bill 4163 was created to provide the school districts have plans in place to handle bullying and plans that are specific to their school district but meet certain requirements required in the act. In December of 2011 Michigan joined other states by have the Governor sign Matt's Safe School Law into law.

Concussions  and High School Athletes:

Watching local high school sports over the past several years there continues to be a push to be faster, be stronger, hit harder and just become more physical overall. With this drive the amount of concussions happening in High School athletics was rising sharply leaving physicians, parents, coaches, and school personal concerned for the safety of the students playing athletics. This lead to the introduction of Senate Bill 1122 and House Bill 5697. Both of these pieces of legislation set into motion procedures that needed to be taken by school personal, what clearance was needed to be obtained by the athlete to compete again and what literature was needed to be provided to the athletes and parents on concussions and their treatment. We are hopeful that this will protect those athletes that want to compete at their highest levels.

With a busy legislative term over, MSMS is looking forward to what the next legislative term will bring. Some of the same issues mentioned today could very well make their way back into the legislative picture in the coming term. Stay with MSMS to get the latest information on issues going through the legislature that affect you and your practice at http://www.msms.org.advocacy. We will be taking a break now until the start of the new term, hope you all have a great new year!

 

Legislative Update: Spring Wrap Up

Now that the legislature has moved into a summer session calendar it’s time to wrap up on some of the issues that have been on the radar of the Medical Society, let’s review:

Budget:

This year saw another cut scheduled for Graduate Medical Education with the introduction of the Governor's budget recommendation. Governor Snyder wanted to take $17 Million out of the program for other uses, the legislature in some ways disagreed with that recommendations and only took $8.5 Million which was much better than what the Governor has recommended. Primary care physicians will now start to see an increase in Medicaid rates thanks to the Affordable Care Act providing an increase in Medicaid funding to the tune of $281 Million. Included in Medicaid now is payment for services surrounding Autism and OB/GYN's receiving a small bump in their reimbursement rates. We now look to find a way to restore the $8.5 Million that was cut from GME in the coming months.

Helmet Law:

This spring the long battle to keep helmets on motorcyclists was finally lost with the Senate pushing the repeal of the helmet requirement for all motorcyclists in Michigan. As disappointing as this development was MSMS continues to push for the safety of all motorists on the roads, motorcyclists or not and is pushing for the tracking of individuals that were involved in accidents and whether a helmet was used to see if personal freedom is really worth the safety of all.

Medical Marihuana:

MSMS worked with members in the House and the House Judiciary committee to help create a narrow definition of what a patient-physician relationship is when concerning Medical Marihuana. The statute currently in place provided no direction on that relationship leaving many ambiguities when dealing with Marihuana. This definition now provides protections to both patient and physician when dealing with certification for the substance. This bill was sent to the Senate where it is in the Senate Judiciary committee awaiting a vote to the Senate floor.

Abortion:

Before the House left for the summer they attempted to jam a package of bills through the House that dealt with four issues supported by right to life. These issues ranged from the banning of the practice of tele-abortions to requiring increased levels of liability coverage for those who perform a certain amount of abortions. This was a heated issue between those for and against leaving for one interesting committee meeting where then the bills were voted out of committee on the same day as the hearing, which is uncommon for this legislature. This practice left some with a sour taste in their mouths leaving for nothing short of a floor fight which left some members without speaking privileges after the debates on the House floor. The main bill of the package was passed out sent to the Senate, where it is unknown if the Senate even wants to address this hot potato.

Autism:

A small victory but one that could lead to total mental health parity, the legislature finally required that health insurers, private and public, cover the costs associated with Autism. Those who were against providing the coverage were finally able to come to a compromise with the help and encouragement of the Lieutenant Governor. This issue has been close to him since he was a member of the House, so it was fitting that he signed the bill the put this into law. MSMS hopes that this issue will not stop here and the fight will continue until we get total mental health parity.

Tort Reform:

MSMS over the past month has started to push tort reforms for the purposes of finding ways to increase access to patients all over Michigan who need the care. With the Affordable Care Act reforms hanging the balance, the increase of patients who cannot gain access just by the sure numbers of physicians are staying stable while the demand rises sharply, we find that there is simply not enough in the workforce to meet the demand. With the reforms it would make Michigan a more attractive place to practice medicine providing more opportunities for physicians to come and practice here, answering the question of how we address those who need the care and can't find it. The bills started in the Senate and still await a vote from the Senate Insurance committee. MSMS is hopeful that the legislation will be move soon to help those patients who need it the most.

MSMS now looks towards the fall where issues like tort reform, auto insurance reform, and others still linger from the spring session. Once the legislature gets back into session, MSMS will continue to cover all of the activity for you. Just go to http://www.msms.org/advocacy to stay up to date with all that is happening in Lansing and beyond. The Legislative update will be back in July to cover the one session day scheduled for the legislature.

Legislative Update: Week of June 11th

As time winds down on the legislative calendar with the summer break coming at the end of Thursday, the activity in both chambers ramped up with the chambers considering school retiree reform, tax reform, the new bridge to Canada, abortion and more. Let's review the activities of the final week before summer break:

House:

With session times being set to earlier times this week, most House committees did not meet this week.

The full House considered several issues this week but one of the most controversial came from the House Health Policy committee, the abortion omnibus, House Bill 5711. This bill was the main part of the three bill package that addressed several issues that Right to Life Michigan considered important to consider. Debate on the floor was emotional, heated, and provided for several gavels from the speaker for inappropriate remarks. Several members from both sides of the aisle had commented on their desire not to vote on the legislation stating that it went way to far based on the comments of supporters of the package said were a problem. After the debate, the House did vote on 5711 with it passing 70-39 (Roll Call # 448).

Senate:

The Senate did have committees this week but were very limited in the time they had to meet. The Senate Insurance committee continued again to take testimony on the Patient's First Reform package. Many stories were with the committee that said their physician had some if not all of the responsibility in their stories and how the package would not allow the physician and those who were wronged to receive the justice they deserve. At the end of the committee they did not take a vote on the package, with it now moving into the summer months.

The Senate Judiciary committee considered and took testimony on several items concerning Michigan's Medical Marihuana program including the MSMS supported House Bill 4851 which defines the patient/physician relationship when dealing with medical marihuana. It is unknown when the committee is expected to vote out the legislation. The Senate Health Policy committee also met to consider Senate Bill 975 which provides an opportunity for a health professional if they choose not to treat based on religious objections to what treatment is required. The committee just took testimony on the legislation similar to what they did last week on the nursing scope expansion bill. It is unknown when the committee will consider the legislation again.

The Senate floor was less lively than the House's this week but they did move a two pieces of legislation that is supported by MSMS. Senate Bills 402 and 403 that provides protections for physicians to voluntarily report patients to the Secretary of State if they believe in their professional judgment that the patient is impaired and not able to drive. Physicians are not making the decision whether the patient can drive or not, that is the duty of the Secretary of State, but it allows them to report and have liability protections for reporting to the Secretary of State. These bills were voted out of the Senate and sent to the House for their consideration.

Now the legislature goes on break until July 18th where they will meet for one day. The MSMS Legislative blog will be taking a break until the Legislature comes back into session unless there is breaking election news to post. Stay with the MSMS advocacy section of the website at http://www.msms.org/advocacy. Also with elections right around the corner your support of the candidates helps keep things like tort reform intact. Go to http://www.mdpac.org to see how you can help!

Legislative Update: Week of May 7th

With the week before being a busy week for medicine, personal property tax was the big item working its way through the legislature this week. Let's review activity from this week:

House:

The House Health Policy committee did not meet this week after its presentation last week from the chair of the Certificate of Need commission. The House as a whole did work on some elections issues this week with the Senate. The bigger news from the House was what was introduced this week. House Bill 5605 which would repeal the requirement of hospitals to vaccinate their employees for influenza. MSMS stands adamantly opposed to this legislation and will continue to monitor and advocate against the measure.

Senate:

The Senate did act on two bills that deal with Michigan's Medical Marihuana program. Senate Bill 321 would exempt automobile no-fault insurance carriers from covering marihuana as treatment. Senate Bill 505 would amend the requirements for caregivers, placing any felony conviction as a reason for disqualification as a caregiver. These bills will now head to the House for further action. The Senate Health Policy committee did not meet this week.

Budget:

All pending budgets have been sent to their respective conference committees to hammer out the differences in the House and Senate versions of the budgets, here are the conferees for the budgets:

House Bill 5365 (General Ominbus): House: Moss, Haveman, LeBlanc; Senate: Kahn, MD, Moolenaar, Anderson.

Senate Bill 950 (DCH Budget): House: Lori, MacGregor, Tlaib; Senate: Moolenaar, Kahn, MD, Gergory.

The legislature now waits for the revenue estimating conference that will be happening next week.

Tort Reform:

Last week the Senate introduced Senate Bill 1115, 1116, 1117, and 1118 that would change the Michigan's tort climate putting Patient Care first. This set of bills looks to address the following:

• Close a confusing loophole that allows unnecessary suits to be filed, a solution Michigan Justices have been asking for;
• Require legal disclosure from trail lawyers, preventing them from using a loophole into default judgments against physicians by failing to notify when they are subject to a lawsuit;
• Protect patients by bringing more health care professionals under medical malpractice guidelines;
• Put patients first, not their lawyers by preventing trials lawyers from artificially inflating awards; and more.

The House will be introducing the same bills this coming week. MSMS stands ready to support these vital changes for Michigan's physicians but more importantly Michigan's patients.

For the most up to date information, the ability to connect with your legislator, and more head to the web at http://www.msms.org/advocacy.

MSMS needs your help!!! Elections are just a few short months away and we need to continue to support those who support Michigan Physicians! Go to http://www.mdpac.org and consider supporting MDPAC, your support keeps Michigan a physician friendly state.

Legislative Update: Week of March 26th

With the Supreme Court taking the attention from most people this week the Michigan legislature made a few waves themselves this week just before they take off for Spring Break. Autism made its way through the House and the Senate along with the Senate make a surprise move by the Senate to pass Senate Bill 291 that would eliminate the requirement for Motorcyclists in Michigan to use a crash helmet. Let's take a look at the rest of the activity this week:

House:

The House received the autism insurance package this week from the Families, Children, & Seniors committee. It was voted out of committee on Tuesday and sent to the House floor where they were determined to pass the legislation. By the end of the day on Thursday the House and Senate had concurred on the bills and sent them to the Governor for his signature. It has been reported that the Governor will be signing the bills sometime early next week.

The House Judiciary committee met on Thursday to consider the changes to Michigan's Medical Marihuana act. There were a few changes that the Medical Society worked with the bill sponsor and other stakeholders to finalize House Bill 4851. This and the other bills are now expected to head to the House floor where a larger fight might be waiting to pass these bills.

Senate:

The Senate received the autism bills from the House on Thursday which allowed them to concur in the amendments from the House and then send them to the Governor. Other than the helmet repeal being passed by the Senate, activity was pretty quiet on the health care front this week.

Appropriations:

The House and Senate subcommittees this week released their recommendation for the Department of Community Health Budget for the coming fiscal year. The House in a exciting move for medicine did not concur with the funding cut in Graduate Medical Education and added additional dollars for GME. Although the additional dollars did not make whole the cut GME experienced last year it is still a positive step forward. The Senate on the other hand had a different idea when reporting out the budget  placing $100 placeholders in line items through out the bill. Now the bills will be sent to the full appropriation committee for their consideration.

For more information, including information on the Supreme Court hearing on the Affordable Care Act go to MSMS's advocacy page for information and more. The Legislature will now be on Spring Break, and so will we, unless breaking news happens. Enjoy and we'll see you in two weeks!

Legislative Update: Week of March 19th

The big issue this week in the legislature was autism. Both chambers took a turn at working on the issue with a suspected bill signing for this legislation sometime in early April. Let's review the activity taken on this issue and others this week:

House:

In House Health Policy this week they continued taking testimony on chemotherapy drug parity. Many of those who testified we're in opposition of the legislation stating that insurers already cover the drugs in a parity way and by mandating this could lead to an increase in costs for the patients. The committee did not take action on the bills.

In House Families, Children, and Seniors committee they received from the Senate the Autism package mandating coverage of Autism by insurance companies and here the Governor has proposed money for Medicaid and MIChild, state programs that provide health care for children in Michigan. The committee took testimony throughout the day and is expected to vote out the measures to the House floor when it meets at it's regular time Tuesday morning.

 

Senate:

 

The full Senate acted on the Autism measures early in the week and passed them to the House for their consideration. As you can see from above the House was quick to act on the measures. Its expected that the measures will be voted out of the House and Senate be late next week before the legislature heads on break the first week of April.

 

The Senate Health Policy committee considered one item House Bill 5131 which allows insurers to access the Michigan Automated Prescription System (MAPS) in efforts to prevent fraud. Testimony on the issue was quick and the measure to voted to the Senate floor for their consideration.

 

Dr. Steven Newman, President
testifying on Senate Bill 977

Senate Judiciary committee continued it's work in Medical Marihuana by considering Senate Bill 977 which would take Glaucoma of the lists of qualifying conditions to use Medical Marihuana. Dr. Steven Newman testified in the committee supporting the measure to take Glaucoma off the list. The committee did vote this legislation to the full Senate for their consideration.

 

In the coming week the Supreme Court of the United States (SCOTUS) will begin to take testimony on the legality of the Patient Protection and Affordable Care Act (PPACA) Stay with MSMS and MDPAC to find up to date information along with audio from the hearings.

Legislative Update: Week of March 12th

With the weather warming up and bringing spring early in some places around Michigan this also motivated the legislature to work on some bigger issues, let's run through the activity:

House:

The House Health Policy committee took testimony on four bills that provide for chemotherapy drug parity for insurance reimbursement purposes. The intent of the legislation is to make reimbursement and coverage of I.V. and oral chemotherapy prescriptions on the same plane. Much testimony was given providing insights of physicians and patients and interactions with the two different methods of treatment. The committee could bring the legislation to a vote very soon.

The House Judiciary committee HB 5338 and SB 789 which would give the Department of Community Health the ability to temporally assign or reassign drugs to the different levels in the controlled substance schedule. This gives the department the ability to take of substances off the street or curb the abuse of the substances by allowing law enforcement and others to act in situations of abuse. The past couple committee meetings had been about Medical Marihuana, that issue has now provided some amendments to the legislation introduced and testified on in committee. The committee looks to act on Medical Marihuana in the coming weeks.

Senate:


Dr. Steven Newman testifying
in support of Senate Bills
429 and 430.

The full Senate acted on the autism insurance requirements this week and passed the legislation to the House for their consideration. The autism package was in the Health Policy committee in the Senate, it will now be sent to the House Families, Children's, and Seniors committee for further consideration.

The Senate Health Policy committee considered three items that included SB 973 (creating an interstate compact for health insurance between states), and SB 595 that creates a low costs insurance program in lieu of the insurance exchange. Both of these bills were just brought forward to testimony only, it's unknown when the committee will vote on these issues.

The Senate Judiciary committee considered one bill that caught our eye, SB 974 that would restrict the use of Medical Marihuana in certain locations. It allows private property owners, if they choose to, restrict the use of Marihuana on their property. The committee did vote this out and now is referred to the full Senate for their consideration.






From left to right:
Kurt C. Anderson, DO President MOA,
William R. Morrone, DO MAOFP
Steven E. Newman, MD President MSMS

The Senate Insurance committee considered two bill SB 429 and SB 430 which amends the insurance code and PA 350 (Blue Cross/Blue Shield statue) to create a prior authorization form that is universal throughout all insurers. Dr. Steven Newman, MSMS President testified along with physicians from the Michigan Osteopathic Association and the Michigan Academy of Osteopathic Family Physicians. Both of these bills were voted out by the committee and await consideration on the Senate Floor.

Appropriations:

The House subcommittee for Community Health heard public testimony and testimony from the department on behavioral health services and services to the aging. The Senate committee heard testimony on Michigan's Medicaid program. Both committees are scheduled to wrap up hearing testimony here in the coming weeks.

For information on upcoming legislative activities check out our website at http://www.msms.org/advocacy.

Legislative Update: Week of March 5th

Happy Friday to everyone. Recapping the week in Lansing, it has been pretty quiet concerning health issues on the floors of the House and Senate. This week’s controversial issue goes to the limited graduate students to unionize bill. A bill that failed to get immediate effect in the House was then substituted in the Senate with another bill that did get immediate effect and was sent to the House for just a simple concurrence vote. Graduate students now have some limitations on forming unions on college campuses. Committees thought were another story; let’s take a look at the action this week:

House:

The House Health Policy committee took testimony on Senate Bill 732 that creates a Piece of Mind registry that is online, automated, and confidential, providing those wanting to know the last wishes of a dying person. The committee is expected to vote on this legislation at the next meeting. The committee also took votes to pass out legislation that would require insurers to reimburse for telemedicine and for the state to create and implement a state wide diabetes plan.

The House Judiciary committee continued taking testimony on the changes to Michigan's medical marihuana program. Colin Ford from MSMS testified to the committee its support of House Bill 4851 as substituted which defines what a "bona-fide patient/physician relationship" is for the purposes of this act alone. The current statute does not allow the Board of Medicine to go far enough in providing policing of its profession. It only allows the Board to act on issues that arise from the initial evaluation of the patient, with the changes; it would now include follow up care which falls within the normal scope of practice. The committee will continue next week to take public testimony on the issue.

Senate:

The Senate Health Policy committee took more public testimony and then voted out on Thursday Senate Bills 414, 415 and 981 that require insurers to cover Autism and creates a fund to cover the costs insurers incur from covering Autism. The Senate Judiciary committee considered and voted out Senate Bill 933 which disallows the coverage of medical marihuana by workers compensation. All of these bills move to the Senate floor for action.

Appropriations:

Both House and Senate subcommittees met this week to continue their hearings on the Department of Community Health Budget for the coming fiscal year. This week they heard testimony from the medical administration, public health, and mental and substance abuse divisions of the department. Testimony will continue through the next few weeks.

Check out our website at http://www.msms.org/advocacy to get the latest updates on national news, social media, and legislative activity.

Legislative Update: Week of February 27th

Happy leap week to everyone. On this leap week the House was a fury of activity including hearings on medical marihuana and diabetes. Changes to Michigan's Auto No-Fault continue to stay stagnant in the House which is a promising sign. Information has surfaced that could tie to hold of the legislation to the differences in fee schedules for physicians, MSMS will continue to monitor this issue has it continues to develop. Last week the Legislature was primarily concentrated on finding a funding solution to the Highland Park school financial crisis but committees continued to do their work in the mean time.

House:

House Health Policy committee this week considered House Bill 5204 which requires the Department of Community Health to research the financial and health impact of Diabetes on Michigan's citizens and create an action plan to curb diabetes. The DCH testified against this bill stating that they already do what the bill states but with the lack of financial support from the legislature, the programs and measures to help curb diabetes and obesity are stopping their efforts. Those that testified for the plan stated that this was an excellent step forward in fighting the disease but did not mention the efforts already put forward by the department. The committee just took testimony on the legislation; a vote could come as early as next week.

The House Judiciary committee continued taking testimony on House Bills 4851, 4853, and 4856 all three dealing with Medical Marihuana. MSMS is concerned with House Bill 4851 which defines what a bona-fide patient/physician relationship is. Included in the definition it would require for a relationship to exist: a full history and review of the patients history including an in-person physical examination, follow-up care is provided by the physician and there is continuing contact with the physician who has certified for the use of marihuana, and if given permission by the patient, notification is given to the patient's primary care physician of certification, if the physician who certifies is not the primary care physician of the patient. Testimony that was heard by the committee yesterday was all against these changes stating that it would take away from the patient their rights of privacy and cause inconvenience for having multiple physicians. MSMS stands in support of the changes and feel that is now gives authority to the Board of Medicine the ability to police the actions taken under the act where before there was very limited authority to do so. The committee will continue to hear testimony in the coming weeks.

Senate:

The Senate Health Policy committee met this week to discuss the Governor's push for insurance coverage on Autism. They considered Senate Bills 414, 415, and 981 which provide the changes to the Insurance Code and the Non Profit Health Care Corporation Act. MSMS supports moving forward with covering Autism since we see it as a first step toward our ultimate goal of mental health parity. The committee will continue to take testimony on the issue in the coming weeks.

Appropriations:

Both House and Senate Appropriations Subcommittees continued their hearings this week. The Senate heard the general overview from the DCH director, Olga Dazzo while the House heard testimony from Steve Finton, director of Michigan's Medicaid program. Both committees will be meeting in the coming weeks.

If you are looking for when committees are scheduled or what the State House or Senate have on their agendas for the day go to http://www.msms.org/advocacy to check out our calendar for all the upcoming legislative and MDPAC events.

Legislative Update: Week of February 20th

We apologize for the lengthy absence but we're are back at it this week and we have a lot to cover, so lets dive right in! The attempted changes in Michigan's Auto No-Fault system continue to loom in the House. In its current version many members are finding that voting for this would leave a sour taste in their mouths and make them vote on an issues that they really just don't want to vote on. Conversations on this issue have gone quiet for the moment, but we will continue to watch and act when the time is needed.

Last week the Governor Snyder presented his budget to both House and Senate Appropriations committees. On the Health side of things there are some positives and some negatives. On the positive side there will be an increase in Medicaid rates for primary care physicians excluding emergency room physicians to 100% of Medicare rates, which totals just over $281 Million. On the downside the Governor put GME back in his sights and reduced GME another 17% which overall totals 32% from this fiscal year and the coming fiscal year. Now the House and Senate subcommittees will begin to hear testimony from DCH concerning the budget and work to create their own.

The House Health Policy committee has been working on a couple issues, one the consolidation of substance abuse with community mental health and the other requiring reimbursement for telemedicine. The committee next week looks to vote on the telemedicine issue while the other issue was voted out of committee. The committee of the next few weeks thought will be Judiciary. The House Judiciary committee began taking testimony on changes to Michigan's Marihuana Act, providing changes to the act including defining what a bona-fide patient/physician relationship is. In the coming weeks the committee will take public testimony.

In the Senate, the Senate Health Policy committee will also be starting their Medical Marihuana hearings. MSMS will be taking active roles in both the House and Senate committees by providing testimony to the committee members on the position of the society on this issue.

For an updated calendar of all committee meetings and session schedules go to http://www.msms.org/advocacy.