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.

Legislative Update: Week of April 16th

As the legislature comes back into session after its two week spring break, money, appropriations and budgets weigh on the minds of the legislators. What does that mean for health care, well Medicaid and Medicaid funding are now the top topics floating around the halls of the Capitol, lets review the activities of this last week:

House:

The House Health Policy Committee did meet on Thursday to consider one bill House Bill 4718 which would allow dental assistant to work with dental hygienists when the dentist was not in the office to supervise, under current statues the dentist needs to be present in the office for a dental assistant to provide a second set of hands. Testimony was taken on the legislation and should be taken up for a vote next week. They also had a presentation from J & B Medical to demonstrate telemedicine and the products they were offering for physicians and patients.

Senate:

The Senate did not have Health Policy committee this week and the majority of the work done by the Senate surrounded environmental protections and rules for the Department of Environmental Quality.

Appropriations:

This is where the majority of the work in the Legislature was done this week. Both full Appropriations Committees considered their respective budget bills. The Senate continued with the recommendation from the subcommittee and had the $100 placeholder for graduate medical education and kept in the boilerplate (language that says how the money is needed to be spent or offers legislative intent) that the Department of Community Health needs to create a formula for GME funding that promotes primary care and keeping residents in Michigan.

The House committee agreed with their subcommittee and kept the $18 Million appropriated to graduate medical education. This is an increase from this current fiscal year of just under $1 Million. The chambers are expected to swap bills and start the process over again to come to some conclusion and to hopefully have the budget done by June 1.

Autism:

This week Governor Snyder was in Afghanistan to meet with the members of the Michigan National Guard and soldiers from Michigan offering support for those serving and letting them know there will be support for them when they return to Michigan. With the Governor being out of the country Lieutenant Governor Brian Calley was acting Governor for the past week and had the privilege of signing the Autism insurance bills. Lieutenant Governor Calley has personal experience dealing with Autism which made the bill signing an extra special event. MSMS was invited to attend the signing and did.

For more information concerning government and health activities or if your wondering what the legislature is doing, check out our website at http://www.msms.org/advocacy.

For those wanting to get involved in helping shape Michigan's direction visit and support MDPAC at http://www.mdpac.org

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 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.

Legislative Update: Week of December 12th

The legislature went into their last week of session for the year with a plan to move a significant amount of legislation surrounding a variety of topics. Some of the bigger headline pieces dealt with lifting the caps on the amount of charter schools there can be in Michigan and some clean up and changes within the different tax codes.

The one piece of legislation that both chambers considered that would effect the physician community directly was House Bill 5014 that would provide a supplemental appropriation for different departments. Included in the list of those where money was appropriated was towards Graduate Medical Education. Just over $8 Million gross was appropriated towards GME which only filled half of the gap that was left from the beginning of the year.

Committees did not meet this week with it being the last session week of the year. The legislature will reconvene on January 11 at Noon. The Governor is slated to present his State of the State address on January 18th usually around 6:30-7:00 p.m. We will be taking a break for the holidays, we wish you and yours the best for this holiday season, see you in 2012.

Legislative Update: Week of November 28th

The legislature was back in session this week after the two week holiday break. Auto no fault continues to stay at the fore front of the issue MSMS is working on but for the legislature that was a different story. The House still continues to work on the no fault issue, trying to find members of their caucus to support the changes while the Senate looks on. There were two issues that MSMS was interested in that did get some movement this week, lets review:

House:

The House this week received back HB 5014 that provides supplemental appropriations for several state departments. Included in the appropriations proposal that came back from the senate was a $3 Million General Fund / General Purpose (GF/GP) appropriations for graduate medical education. This would calculate to a just over $8 Million increase in GME funding with state and federal dollars. The House Appropriations Subcommittee for the Department of Community Health took testimony this week on the inclusion of the GME money and what it meant for programs. Dr. Eric Scher from Henry Ford Health Systems testified at the committee hearing.

The House Health Policy Committee continued taking testimony from interested parties involved with the implementation of a health insurance exchange.The House in general worked on issues dealing with local governments and watercraft safety.

Senate:

The Senate this week dealt primarily with issues surrounding unemployment but did consider one issue that the legislation and regulations committee of MSMS considered. SB 798 allows for the temporary scheduling of drugs and controlled substances if deemed necessary by the Department of Community Health. It was passed out of the Senate and sent to the House for their consideration. The Senate Health Policy committee was scheduled to meet but did not because of the lengthy session day on Thursday.

Legislative Update Week of November 7, 2011

With this the final week leading up to the legislature taking a two week break for the upcoming holiday, a flurry of activity was scheduled for each chamber. This as the House loses one of its own, now leaving two vacant seats in the House. Rumors of movement with the Auto No-Fault legislation moving this week seemed to have died down later on in the week leaving the House members to continue to work on the issue.

Not many items moved this week within the chambers that would directly affect the physician community but there were two:

Senate:

The Senate moved House Bill 5014 which is a Appropriations supplemental bill that would provide funding for electronic medical records, this bill was substituted in the Senate to add more appropriations other other departments and was sent back to the House to concur in the amendments. The Senate also moved Senate Bill 693 which creates the framework for the Michigan Health Marketplace (health insurance exchange). With the affordable care act, this had to be created for the State to continue to control its health insurance market and if they do not have something in place by the deadline (end of 2013) the federal government will take over the selling of health insurance. The reason of why the legislature is choosing to act now is that there are federal grants that are attached to programs that are created and approved early which could ease the financial burden on the State.

House:

The House continues do to its work with the Auto No-Fault reform. Expected activity this week did not come to a head so work continues on their reforms.

Election Day Review:

Tuesday people all around Michigan went to the polls, voting on local issues and local leaders. There was one election that would leave some effect on the state located on the east side. The final day of the recall efforts against Rep. Paul Scott finally saw its end.

The efforts out oust Scott were started by the Michigan Education Association for tenure as House Education committee chairman working on a passage that revised the tenure system for teachers in Michigan. The changes were not welcomed by the MEA and sparked the efforts to recall the chairman. Those efforts came to fruition last night when the votes ended up in the MEA's favor and successfully recalled Rep. Scott. Once the votes are certified by the Secretary of State the seat will be officially vacated until a primary and general election are announced by the Governor to finish the term.

The House and Senate are now in Recess, returning after the Thanksgiving holiday. Look for a report the week they are back.