Legislative Update Week of April 22nd

This week saw the start of an issue that MSMS has been concerned with for the past decade. The second attempt in the past four years to reform Michigan's Auto No Fault system officially started; while at the same time taking attention away from both chambers passing their respective budget bills furthering that process down the road. Let’s review the activities of the past week:

House

This week the full House took action on their budget bills sending their usual two budget bills to the Senate for their consideration. The general government budget omnibus legislation saw the least amount of controversy with the education omnibus bill, affectionately known as the "School Bus" has a harder time moving due to some language that dealt with employee contracts. Both bills are now in the Senate passing another hurdle in the budget process.

More importantly the House finally sent Senate Bills 178 and 179 to the Governor for his consideration. These pieces of legislation would help create the uniformed prior authorization forms for physicians when looking to obtain authorization for prescriptions. This will finally bring some solid reforms providing physicians more time with patients and less time doing paperwork.

The House Health Policy committee this week had a presentation on CRE infections. This topic came about from an article that was in the WashingtonPost concerning the increase in the dangerous infections around the country and that only a few states were tracking them. Matthew Sims, MD, who is the Director of the Department of Infectious Disease Research at Beaumont hospital, testified for the medical society on the effects of the infections in Michigan what health systems and physicians are doing about it. There could be future legislation that could require physicians report the instances of CRE infections.

Picture inside committee room for
the No-Fault hearing.

The House Insurance committee takes the award this week with the most active and anticipated committee. House bill 4612 was introduced this week that would provide a major overhaul of the automotive no-fault insurance system that Michigan currently has. As we mentioned last week in the Update, this would provide a cap of coverage for those in a catastrophic accident to $1 Million, provide a pilot program for those looking for low cost insurance and have a low value vehicle, and a major attempt to strike back against fraud. Tempers flared and words were heated between those testifying and member of the committee which boiled over to member to member heated exchanges.

The committee was held in the largest room available to the House for committees and still had four more rooms and hallways full of people wanting to testify and get their voice heard on the issue. The committee went late into the afternoon with the promise that those who wanted to testify could. Finally at the end of the day the committee was not able to get through everyone leaving with more committee meetings to happen here in the near future. MSMS is working with the Coalition Protecting Auto No-Fault (CPAN) in providing information for the committee members on why this is the wrong move for Michigan. We will continue working with our partners to stop this harmful legislation.

Senate:

The senate had more of a mundane week by having them primarily working on their budgets, sending each individual budget to the House for their consideration; a different move from the House that bundled their budgets together. Multiple amendments were made on the floor including the amendment to place the Medicaid expansion money in the Department of Community Health budget, but failed along party lines. With the expansion money still left out it leaves supporters working and pushing for the money to be included. At this point we wait to see the work of the crucial conference committees that will ultimately make the decision on the expansion money.

This week is the MSMS House of Delegates in Grand Rapids. We will be providing an overview of the issues that happened at the annual meeting. Follow MSMS at http://www.msms.org/advocacy to get the up to date information from our Twitter and Facebook feeds. Stay with us as well to get the most up to date information on the issue affecting physicians around Michigan.

 

Legislative Update Week of April 15th

This week saw a flurry of legislative activity on health issues and other that are big for the medical community, lets get into the review:

House:



Dr. Kenneth Elmassian testifying
to the House Health Policy Committee

This week the House Health Policy committee took testimony on House Bill 4524, the Patient Right to Know legislation. Dr. Kenneth Elmassian, MSMS President-Elect, testified to the committee providing his expertise to the committee on this issue. "It gives patients more information when they are seeking and receiving their health care," Elmassian said. "Let's be honest, the health care system is very confusing. Patients deserve better than the system is currently giving them." The committee members fired back though leaving those in the committee wondering if the legislation would have a hard time getting out. We will be waiting to see what the committee will do in the coming week and we will let you know if the legislation moves further in the process.

Senate:

Dr. Rose Ramirez answering questions
in the Senate Triple R committee.

The Senate Reform, Restructuring, and Reinventing committee this week took its final week of testimony and moved Senate Bill 2 out of the committee to the full Senate Floor for its consideration. We reported before that this legislation would provide a sweeping change to the Public Health code providing independance for NP's CNM's and CNS-C's. For more indepth information on the original bill click on "2" above to obtain bill language and legislative analysis from the Senate Fiscal Agency. Dr. Rose Ramirez, MSMS's Speaker of the House, testified to the committee with her personal professional experience starting out in nursing and then obtaining her MD and working as a physician. "As physicians, our overarching concern is with the well-being of our patients and that the laws and regulations of Michigan lead to health care that is safe, efficient, and of the highest quality.  Patients benefit from having a focused, team-based approach that encourages communication and collaboration among the various members of the team," Dr. Ramirez testified. Through the efforts of the testimony the legislation still made its way out of the committee with a vote count of 6-1.

Budget:

This week saw the Senate Appropriations committee working on their budgets getting them through committee and sent to the full Senate for their consideration. Still left out of the budget was the money for the MSMS supported expansion of Medicaid. Many people around the capitol say that this is a vote that some of the members are either against or uneasy about taking. We could see the budgets get to their final conference committee before a decision is made about the Medicaid expansion.

Auto No Fault:

This week the Governor, along with House and Senate Insurance Chairman, introduced their plan to reform Michigan's Auto No-Fault system. This is round two to a fail attempt last session. That plan created levels of coverage that a individual could purchase that would bring savings to the buyer of the plan. This time around they are taking a different approach by providing a cap for coverage up to $1 Million. Also in the new proposal there will be a pilot program that would provide lower cost insurance for those who in poverty, have a clean driving record, and have a low value vehicle. With this program they are hoping that it will entice those who do not have insurance to purchase it. In terms of fraud they are want to begin an auditor program that will be constantly looking for fraud. With this plan officials say that families with two vehicles could see a yearly savings of $250. 

“Take a good look at this plan: is it really in the public’s best interest? I hardly think so. Capping lifetime benefits at $1 million for the catastrophically injured ultimately will shove the most vulnerable victims onto Medicaid and will pile the financial responsibility to the taxpayers," said John Cornack, President of the Coalition Protecting Auto No-Fault (CPAN). We expect here in the next few weeks that hearings will begin in the appropriate committees.

Stay with MSMS to get the up to date information on twitter @msmsgovtaffairs, on Facebook or online at http://www.MSMS.org/advocacy.

Legislative Update Week of April 8th

Budgets were the word for the legislature this week as the public had the first opportunity to see what the legislature was thinking in funding the government for the next fiscal year. In term of the Community Health budget, Medicaid was put front and center. Let’s review the activities of the past week:

House:

The House this made noise in what was introduced rather than the action that was taken by the body. Representative Gail Haines introduced House Bill 4524 that would require health professionals to wear identification cards so that patients will know who is who. There have been discussions that patients are sometimes confused on who their physician, PA, NP, nurse, etc are; by providing an increased identification hopefully it will provide clarity for the patient and the patient's family.


Dr. Elmassion and Representative Haines
at Patient Right to Know Press Conference.

MSMS hosted a press conference with Rep. Haines and Dr. Kenneth Elmassian, MSMS's President-Elect. They discussed with WLNS the importance of the legislation and the importance of providing clarity to those receiving the care. The House Health Policy committee will be considering the legislation, only taking testimony at their upcoming meeting on April 16th.

The House Health Policy committee has continued their work by furthering their education and knowledge base on the issue effecting Michigan's health care. The topic for this committee meeting was long term care and the effects it is having on insurance carriers. Blue Cross Blue Shield of Michigan along with the Michigan Association of Health Plans testified to the committee providing their insights on the issue of long term care. The committee will be meeting next week to consider several issues including House Bill 4524.

Senate:

The Senate this week considered one piece of legislation that would have direct effects in the medical community, licensure of pharmacy technicians, Senate Bill 92. Currently in Michigan pharmacy techs are not licensed or controlled by the Michigan Board of Pharmacy but rather fall under the purview of the Pharmacist. Because of this, pharmacy techs that are engaged in illegal activities are being let go and then are picked up by another employer where they can continue their illegal activities. By being licensed they now will have to face sanctions and fear of losing a license and having to have a license to practice; it will create a failsafe to keep the bad actors out. This legislation did get through the full Senate and will now be heading to the House Health Policy committee. The Senate Health Policy committee did not meet this past week.

Budget:

This week the Senate subcommittee for the Department of Community Health passed out their recommendation for the upcoming fiscal year. MSMS has been a proponent with the Governor in the Medicaid expansion. Both the House and Senate committees were not so excite about expanding the rolls of Medicaid and left the expansion money out of their budget plans. The Senate did provide language in their bill to ask the federal government to provide a waiver for their program to allow Medicaid to add incentives in the Medicaid program to lead to healthier lifestyles .
Also the committee deciced that restoring funding for Graduate Medical Education would be a priority of the committee. Dr. John Bizon, MSMS President had this to say about it, "By preserving these critical education tools, is is clear that the primary focus of the Subcommittee on the Department of Community Health was imporving the health of Michigan patients for generations and that;s great new for families across our state. Senator John Moolenaar and his colleagues are to be commended for their work on this important issue."

The House, in usual fashion for the past couple years, took all of their budgets and combined them into one massive budget bill. For more information on the House or Senate bills, click on the links provided. With the budgets now out, the legislature has taken one step in what will be many more to come.

For more information on what is happening in Lansing and beyond stay with MSMS at http://www.msms.org/advocacy.

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 Week of March 11th

With the budget and road funding taking the front seat for the legislature over the past couple weeks, this week the House switched to education with the House Education committee passing out the Education Achievement Authority legislation; while in the Senate bear petting seemed to be on their minds. Lets review what happened in the terms of health care:

House

This week the House Health Policy committee meet to hear a presentation and consider House Resolution 11 which requests that syringe and scalpel safety scores be included in the accreditation audits of health facilities. Over the past couple years there has been a push from some within the legislature along with other outside groups with a vested interest in sharps safety to push for the safety scores to be added to the standards. The committee did take testimony and reported the resolution favorably to the full House for their consideration. It was adopted by the House on the next day after the committee meeting.

Senate:

The Senate Health Policy committee meet to consider Senate Bill 136, commonly known as the Conscientious Objector act, it would provide limited provisions for physicians to decline providing treatment to patients if they have an objection due to their conscience. The committee took testimony but did not act on the legislation. The committee also considered Senate Bill 165 which would require health facilities to provide information to patients on the life-sustaining treatment options or denial of nonbenifical treatment within a facility. If a minor is involved they legal guardian would receive the information. The committee did act on the legislation, voting it to the Senate floor.

Budget:

The subcommittees took a break this week to prepare their perspective budget bills to begin moving the budgets between the chambers. The House bill is HB 4213 with the Senate bill still to come. This is the start of the legislative votes that will continue from now until just before June. Stay with MSMS for updates on the budget along with other activities in the Michigan Legislature at http://www.msms.org/advocacy.

Legislative Update Week of March 4th

With the House sending the bill to fund the insurance exchange and with the expansion of Medicaid, the Affordable Care Act was and has been front and center on the minds of those in the legislature over the past couple weeks. There were other items that made their radar as well though, lets review the actions of the week:

House:

The House Health Policy committee meet this week and in true fashion took a vote on House Bills 4274 and 4275 which would bring stakeholders together to create a new prior authorization form that would be two pages and uniform for all insurance providers in Michigan. The legislation did pass the committee with support from all of the committee except for one member. The legislation will now head to the House floor for a vote to send it to the Senate.

Senate:

The Senate Insurance committee considered their versions of the prior authorization legislation. Senate Bills 178 and 179 which are the same as the House bill mentioned above. Steven Newman, MD and MSMS Immediate Past President came to testify to the Senate committee on their importance. The committee did pass the legislation out to the full Senate for their consideration which could be as early as next week.

Budget:

This week both committees heard testimony from the Department of Community Health on Michigan Mental Health and Substance Abuse systems and for the Office of the Aging. The Governor in his budget recommendation wanted to provide jail diversion programs and innovations to the Mental Health system and place those who need mental health care and on Medicaid to have that covered by Medicaid. Huge steps forward towards total mental health parity. Though these changes the department along with the Governor feel they can provide savings and while not cutting the care. Those wanting to testify will have the opportunity on Monday when the House committee will take public testimony on the subjects.

Medical Student Lobby Day:

This past Tuesday, close to 25 medical students from the 4 medical schools in Michigan came to Lansing to lobby key legislators on issues that were important to them. They arrived at MSMS at 9:00am to begin their day with a program happening at MSMS in the morning. John Bizon, MD and MSMS President joined the group in the morning to discuss the issues that are affecting the physician community currently and lay out the issues that MSMS is fighting for.

After lunch and a review of the issues the students broke up into groups, covering close to 20 meeting with different House and Senate members discussing their positions on Graduate Medical Education and the Medicaid Expansion. At the end of their day, the students had the opportunity to meet with Sentor Roger Kahn, MD for just a brief minute. At the end of their visit, the students took a group photo on the steps of the Capitol.

Want to stay involved with whats happening in Lansing following MSMS at http://www.msms.org/advocacy. Looking to make a difference in the legislature support MDPAC. Go to http://www.mdpac.org for information on how you can help.

Legislative Update Week of February 25th

The legislature continued their work on the budget for the coming fiscal year while finally providing a solution to the Blue Cross question on whether action would be finalized, lets take a look at the week's activities:

House:

The House finally answered the questions of those around Lansing wondering when the Blue Cross mutualization legislation would be passed by the House and would the language of the legislation have the damaging abortion language that stopped the package in its tracks at the Governor's desk. On Thursday that answer was it was time to get this legislation to the Governor and without the abortion amendments that killed the legislation last time. The Governor will sign the legislation in the coming weeks.

Steven Newman, MD testifying
to the House Health Policy Committee

The House Health Policy Committee meet to discuss House Bills 4274 and 4275. These bills would create a group of stakeholders that would have to create a two page prior authorization form for prescription prior authorizations. Steven Newman, MD and MSMS Immediate Past President testified to the committee offering MSMS's support. If tradition continues in the committee then it is expected that the committee will take a vote next week.

Senate:

The Senate Reforms, Restructuring, and Reinventing committee continued taking testimony this week on Senate Bill 2 which would expand scope for Advanced Practice Nurses. It is unclear when action will happen on this legislation but we assume that some action will happen and could in the near future. The Senate also concurred on the changes the the Blue Cross mutualization passing the final legislative hurdle sending the legislation on its way to the Governor.

Budget:

This week both the House and Senate Committees working on the Department of Community Health budget had presentation from those associated with Public Health and health policy and administration. The Public Health side of the department has several situations and programs working, the Governor's 4x4 plan, meningitis outbreak, and infant mortality just to name a few. The House committee will take public testimony on these budgets this coming Monday.

For information on what's happening in Lansing and Washington follow MSMS at http://www.msms.org/advocacy.