Legislative Update Week of March 18th

With the Educational Achievement Authority leaving those watching the legislature waiting until the end of the week the House signaled that they are not in favor of the Medicaid expansion by leaving money out for those programs with the first movement on the Department of Community Health Budget and the Senate signaling that they aren't interested in working on the money for the exchange, health care is becoming front and center; let’s review the week:

House:

Dr. Kay Watnick speaking to the press
about the tanning legislation.

The House this week took up House Bills 4274 and 4275 that would require interested parties work with the Insurance Commissioner or create a standardized two page prior authorization form for prescriptions. Now the legislation will move to the Senate for their consideration. This week Representative Jim Townsend introduced House Bill 4405 that would restrict the use of tanning beds by minors in Michigan, 16 and under. Kay Watnick, MD, a dermatologists and Immediate Past President of the Michigan Dermatological Society attended a press conference with Representative Townsend at MSMS to discuss the legislation. "Indoor tanning beds emit up to 15 times more ultraviolet rays than what is emit from the sun," said Dr. Watnick. The legislation is referred to the House standing committee on Regulatory Reform.

Senate:

The Senate Health Policy Committee convened this week to consider two items, Senate Bills 136 and 237, 238, and 239. Senate Bill 136 would allow for a conscientious objection to providing certain treatments based on a moral or religious objection by the physician. If there is an emergent situation the physician may not use the objection to not provide treatment. MSMS has worked with the sponsor of the legislation to find a compromise that we feel will be productive for everyone and continue to work with the sponsor. MSMS continues to oppose the legislation. The legislation was sent to the Senate floor for its consideration. Senate Bills 237, 238 and 239 would amend the public health code along with the school code to update the ages needed for vaccinations. The committee took testimony on the issue and is expected to vote out the legislation at its next hearing.

The full Senate considered their version of the prior authorization legislation by passing Senate Bills 178 and 179. These bills will head to the House Health Policy committee for testimony. It is uncertain at this point which legislation will be the final bills passed.

Budget:

The House Appropriations Subcommittee passed it first version of the Department of Community Health budget (House Bill 4213) this week with leaving the Medicaid expansion out of the budget. There were concerns that lawmakers had on the costs to consumers and sustainability of the program with some on the inside asking for reforms to the program before money will be appropriated for the expansion. This is just the first of what will be many more rounds to come. The Senate is expected to pass their version in the coming weeks.

The Health Insurance Exchange it a snag this week in the Senate will the Senate Majority Leader stating that the exchange was virtually dead for the moment. It will be interesting to see what the next moves of the Senate will be with the implementation of the exchange due at the end of this year.

For more information on what is happening in Lansing and beyond stay with MSMS at http://www.msms.org/advocacy. Your voice counts; make it heard by supporting MDPAC! Find more information at http://www.mdpac.org.

Legislative Update: Weel of April 23rd

This week the legislature put the pedal to the metal you could say and was set the tackle several issues including moving the budgets to their different chambers, and tackling the issue of cyber charter schools and lifting the cap in the amount of cyber charters can be in Michigan. Both chambers worked later than usual this week pushing the budget process forward, let’s review:

House:

The House Health Policy committee met this week with what looked to be a loaded agenda but last second four bills that dealt with oral chemotherapy parity were pulled due to the lack of the needed votes to pass the legislation. The committee did take testimony on House Bills 5089 and 5090 which created a repository for prescription drugs that were not used and still within their packaging and then also providing for a process for destruction for those prescription that cannot be used. Testimony was very positive on the issue, praising the legislature to creating a system that was seen as a first step to deal with the some of the problems associated with left over prescriptions. There were some concerns about the liability issues that could arise from dispensing the drugs again as they could be seen as "second rate" drugs. It is unknown when the committee will consider taking a vote on the issue.

The committee also considered Senate Bill 723 which creates the online Piece of Mind registry. MSMS stands in support of the legislation as it looks to privately streamline the way the power of attorney, do not resuscitate orders, and other end of life issues are handled. It is expected the committee will be voting on the legislation very soon.

The House Families, Children, and Seniors committee considered a package of bills that deal with elder abuse and creating elder death teams. MSMS was interested in Senate Bill 457 that required the county medical examiner to create an elder death team to investigate suspicious elder deaths. This is an issue that could, especially in rural areas in Michigan, hamper the ability of the medical examiner to complete his/hers duties. We will continue to watch this legislation.

Senate:

The Senate considered one item this week that did pique the interest of the Medical Society that provides for the overall public good. House Bill 4393 was passed out of the Senate and ordered to the Governor's office for signature. The bill would exempt minors that turn themselves in for treatment of alcohol poisoning or other complications associated with the overuse of alcohol from receiving a minor in position ticket. This is a great tool the now takes the fear away from kids that need the help but fear running into trouble with the law. The Governor's office has not voiced any concerns with the legislation.

The Senate Insurance committee considered and voted on extremely quickly House Bills 5408 and 5421 which would require insurers pay for telemedicine. This passed through the House pretty handily and is expected to do the same in the Senate. Abortion was the issue that returned to the Senate Judiciary committee this week. The committee considered House Bill 4798, 4799, 5134, 5181, and 5182 which is a package of bills that makes it illegal for a health professional, including physicians, to coerce anyone into an abortion. The Michigan chapter of the American College of Obstetricians and Gynecologists submitted a letter in opposition to the measures, MSMS stood with ACOG in agreement with their position. It is expected that the committee will vote on these measures in the coming weeks.

Appropriations:

This week the majority of the work in both the House and the Senate was associated with the budget. The Senate passed their version of the Department of Community Health budget, Senate Bill 950. The Senate continued it stance to keep Graduate Medical Education funded with a place holder and still keeping in the requirements for the department to rework the GME formula. One surprise though, was the addition of an amendment to the DCH budget that would allow smoking for fundraising events done privately and have been in existence for more than 10 years. The language was placed in the boilerplate section of the bill so its enforcement is somewhat questionable but this is one of what MSMS is sure to be, several attempts to weaken the Dr. Ron Davis smoking law.

The House wrapped their budgets up again into to separate bills, one called the school bus (all of the education appropriations) and the big bus (everything else). The House omnibus appropriations bill is 5365. The over six hundred page bill provides appropriations for several state departments. GME was continued at the current levels for this fiscal year but included an almost additional million dollars. The House did not consider the smoking amendment to the budget.

Now bills will switch chambers and consideration and budget targets will start to align. The next big day is in mid May when the Michigan Department of Treasury, House Fiscal Agency, and the Senate Fiscal Agency come together to revise revenue estimates for the coming fiscal year for the state. The timeline for the budget in completion by June 1st.

For more information on things happening in Lansing and beyond head to www.msms.org/advocacy. With elections right around the corner, your support to MDPAC helps to support our allies, support MDPAC at www.mdpac.org.