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.

Legislative Update Week of February 18th

The legislature this week continued their work on the budget for the upcoming fiscal year. The House finally has been receiving work done by the committees, allowing for consideration and for the first votes on the House floor for this young legislative session. Let's review the activities of the past week:

House:

The House Insurance committee took its last bits of testimony on Senate Bills 61 and 62, which would provide for the mutualization of Blue Cross in Michigan. The legislation came out of committee lacking the controversial abortion amendments that hampered the legislation last time, hopefully gaining support from the Governor this time without the amendments. The legislation will now head to the House floor where the amendments could be tacked on or added to the legislation, but it is accepted that the House will act on the legislation in the coming week.

Senate:

The Senate Reforms, Restructuring and Reinventing committee meet to continue taking testimony on Senate Bill 2 which would expand the scope of practice for advanced practice nurses. This legislation has been somewhat controversial in the medical community and many have found it interesting that the legislation was sent to this committee rather than the Senate Health Policy committee. It was unclear before the hearing whether or not the committee was going to take action on the legislation but in the end did not. MSMS is continuing to work with the sponsor of the legislation to find a compromise that would be suitable for all of the interested parties. We will keep you up to date on the actions of this legislation.

Appropriations:

Both House and Senate subcommittees meet this week to hear testimony from the largest part of the Department of Community Health budget, medical services or Medicaid. The expansion of Medicaid, which is a policy MSMS supports, was a hotly contested topic among the Senators while their presentation from the Medicaid director, Director Fitton. Many of the Senators on the committee had a hard time of seeing where the savings would come from if the state went ahead and expanded Michigan Medicaid program. Looking at the Medicaid 67% of the money is federal where the state only provides 16% of general fund / general purpose dollars to the program. It will be interesting to see how the expansion will play out in the coming months.

MSMS New Lawmakers Reception:

MSMS, as they do at the start of every legislative session, held its New Lawmakers reception at the MSMS Headquarters in East Lansing. The event was well attended by physicians and lawmakers alike with Senator Roger Kahn, MD and Representative Sean McCann to name a few that joined us. "This is a great opportunity to reach out to our lawmakers", said Raymond Rudoni, MD who is the chair of the MSMS Legislative and Regulations committee. The event went on past its end time and was hailed as a success with participation from medical students to retirees.

Legislative Update Week of February 11th

With the budget being presented by the Governor we're now off to the races on what can be described as an up and down next couple months for the next couple months. Blue Cross Blue Shield is still in the works in the House with the Senate waiting for the House's next move with the health insurance issues. Let's review the week:

House:

The House Appropriations Subcommittee for Community Health started its work on the FY 2014 budget by welcoming the Director of the Michigan Department of Community Health to the committee for an overview of the State Budget. Out of this presentation the Director laid out the priorities of the administration as it pertained to Michigan's health care Major topics were the Medcaid expansion, mental health, and infant mortality to mention a few. Now the committee will have presentation from Medicaid, Behavioral Health, and Office of Services for the Aging in the coming weeks.

The House Insurance committee took testimony on Senate Bills 61 and 62 which provides for the mutualization of BC/BS. The House, similar to last time, started discussions about the abortion language that was in the previous legislation and one of the major reasons of why the Governor vetoed the legislation last time. It is uncertain at this point whether abortion language will be in the bills moving forward.

Senate:

The Senate Committee on Reform, Restructuring and Reinventing took testimony on Senate Bill 2 which would define the scope of practice for advanced practice nurses which included nurse practitioners, nurse midwifes, and certified nurse specialists. This is an issue that the society is leary about but have been working tirelessly with the sponsor to answer his question on the the concerns that the medical community has with the legislation. It is uncertain at this point when the legislation will move but rumblings have said that it could be as early as next month.

Stay with MSMS to get the latest up to date information on all that is happening in Lansing and beyond at http://www.msms.org/advocacy. You support of MDPAC helps those in Lansing work better with physicians go to http://www.mdpac.org to find out how you can help.

Legislative Update Week of February 4th

The past two weeks the Legislature has started to pick up some steam with the Senate moving the blue cross mutualization part two through the Senate and the Governor presenting this budget to the Legislature, let’s review the activities of the past couple weeks:

House:

Committees have been finally formed with Rep. Gail Haines continuing her leadership as Chair of the House Health Policy committee. Rep. Matt Lori will continue his leadership as Chair of the Appropriations subcommittee on the Department of Community Health. The House Health Policy committee started it normal routine for the beginning of the year with briefings from the Department of Community Health for the new members of the committee. With the budget being presented the House Appropriations subcommittees will start to have presentations from their respective state departments.

Senate:

The Senate Insurance Committee over these past couple weeks considered the Blue Cross mutualization issue that started in the last term of the Legislature. This time the Senate listened to the Governor's recommendations in his veto of the previous legislation and passed what the Senate has passed the first time out of committee. The legislation made its way to the Senate floor where it was approved and sent to the House for their consideration where it was sent to the House Insurance Committee.

Budget Presentation:

The Governor this past Thursday Governor Snyder presented to the Legislature his recommendations for fiscal year 2014. With this announcement on Wednesday of supporting the implementation of the Medicaid expansion in Michigan the Governor set out to provide his road map for the financial future for Michigan in the coming fiscal year.

With the Medicaid expansion already being revealed, his announcement for increasing funding for Michigan's infrastructure and budgeting a 2% increase for K-12 funding, the Governor just gave the Legislature some specifics on what he wanted to do for FY 2014.

The Governor asked for increase funding for mental health services, mental health homes, and innovation programs all in an effort to support and strengthen a program that needs it. Many of Michigan's children continue to go without proper dental care, with this budget as with the last, the Governor proposes support Healthy Kids Dental by adding additional funding for the program. With the Governor's report from the task force on Infant Mortality being release middle of last year, he was unable to provide funding for any solutions that the report found, with this fiscal year that is different and proposes adding $2.5 Million to help curb mortality.

With medicine changing the need for innovation is needed now more than ever and the Governor recognizes this, and did so by adding $3 Million for innovation grants for those looking to pioneer medicine's next big breakthrough in Michigan. On the downside Graduate Medical Education took another blow with a recommendation of a cut around $7 Million.

Now it will be up to the legislature on their direction with the budget for FY 2014. MSMS will continue to track and advocate the best for all of Michigan's patients and physicians. Continue to stay with MSMS to receive updates on what is happening at http://www.msms.org/advocacy.