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December
19, 2005
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Michigan Health & Hospital Association 6215 West St. Joseph Highway Lansing, MI 48917 (517) 323-3443 Fax: (517) 323-0946 |
IN THIS ISSUE Michigan
Legislature Wraps Up 2005
Michigan Legislature Wraps Up 2005
Last week, state lawmakers completed action on several top priorities and then announced a legislative recess until the week of Jan. 16. Health care issues were not among the legislature’s top priorities, as attention focused on business tax relief and welfare reform. However, several health care bills did see action in the final weeks of the legislative calendar. House Bill (HB) 4403, sponsored by Rep. Howard Walker (R-Traverse City), was moved to the governor’s desk and was signed into law Nov. 17 as Public Act 211 of 2005. The MHA-supported law allows a physician to delegate tasks involving the use of surgical instrumentation to an individual who is a specifically authorized surgical technologist or surgical first assistant when that physician is present during the procedure and provides direct supervision. House Bill 4577 has been sent to the governor, who is expected to sign it. The bill will provide whistleblower protection and monetary incentives to individuals who bring a civil suit in the name of the state of Michigan against a violator of the Medicaid False Claims Act. HB 4577 was introduced at the request of the Michigan Attorney General’s office by Rep. David Law (R-West Bloomfield) and is similar to federal laws directed at Medicare fraud. The MHA supported the bill only after a successful effort to add several amendments recommended by its members. Legislation designed to allow HMOs greater flexibility to offer employers more affordable health insurance coverage was also passed on to the governor. Senate Bill (SB) 88, introduced by Sen. Bill Hardiman (R-Kentwood), is a revised version of legislation that failed to pass last year and is heavily supported by HMOs statewide. In a compromise from the earlier legislation, this bill increases the role of the Insurance Commissioner in regulating co-insurance, co-pays and deductibles. During the final week of session, the MHA successfully partnered with other groups to prevent action on two bills that have potential risks for Michigan hospitals. SB 896, introduced by Sen. Shirley Johnson (R-Troy), would create a school employees health benefit act with a new catastrophic stop-loss fund. The MHA is concerned that the proposed law would exempt school employers from all requirements of Michigan’s insurance code, including reserve requirements and regulatory oversight, potentially placing hospitals and physicians at risk if the new plans become insolvent. The MHA also successfully opposed HB 4742, introduced by Rep. Joe Hune (R-Hamburg), which would provide a managed care option for auto no-fault protection benefits. While supporters of the bill promise lower auto insurance rates, the MHA is concerned that passage of the bill would result in payment reductions that would be extremely detrimental to hospitals and physicians that treat people severely injured in auto accidents. Negotiations on both SB 896 and HB 4742 are expected to continue early next year. Members with questions should contact Dave Finkbeiner at the MHA.
Federal Pain
Management Legislation Progresses as
Earlier this year, U.S. Rep. Mike Rogers (R-Brighton) introduced HR 1020, a bill to create a national pain care policy and establish a National Center for Pain and Palliative Care Research at the National Institutes of Health (NIH) and six regional pain research centers. The bill also proposes a number of grants and a public awareness campaign. During a Dec. 8 hearing of the House Energy and Commerce Committee subcommittee on health, witnesses testified that chronic pain costs billions of dollars, both for the health care system and in lost work time and productivity. Rogers recently announced that HR 1020 is expected to be added to legislation to reauthorize the NIH, which is likely to be acted upon next year. Federal action on the budget reconciliation that would potentially cut Medicaid funding and extend the moratorium on limited service hospitals was still pending Friday. The Senate adopted instructions to budget conferees last week, directing them not to report a reconciliation package that would “in any way undermine Medicaid’s federal guarantee of health insurance coverage.” The instruction is intended to keep Medicaid co-payments and benefit cuts in the House version of the bill from being included in the final bill. Congress was expected to adjourn by Dec. 17, with many nonhealth-related issues delaying agreement on the final reconciliation package. For more information, contact Laura Appel at the MHA. Reviews of Preliminary Rate Information Due Jan. 18 Early this week, the Medical Services Administration (MSA) anticipates mailing preliminary rate information to hospitals regarding the updated diagnosis-related group (DRG) rates for inpatient hospitals for admissions occurring on and after April 1, 2006. The information will also include the preliminary rebased per diem rates for rehabilitation hospitals and units for admissions on and after April 1, 2006. The mailing will include:
Hospitals should review the preliminary data and notify Susan Chien at the MSA regarding any errors, as data corrections must be sufficiently documented in writing no later than Jan. 18, 2006. Members with questions should contact Vickie Seal at the MHA. Michigan Hospitals Keep Costs Below National Average Recently, the American Hospital Association (AHA) released results from its annual survey reflecting hospital fiscal year (FY) 2004 operations. Based on this data, Michigan hospital costs are 6.3 percent lower than the national average, an accomplishment mirroring that of FY 2003. Considering both inpatient and outpatient volume, this means Michigan paid $1.2 billion less hospital cost for FY 2004 than if Michigan held the national average. In FY 2003, the same 6.3 percent achievement meant the state incurred approximately $1.1 billion less in costs than it would have at the national average rate. The hard work by hospitals and providers to keep costs down represents a significant savings for Michigan’s employers and other health care payers. For more information, contact Marilyn Litka-Klein at the MHA. CON Commission Approves New Surgical Services Standards
The state Certificate of Need (CON) Commission met last week and approved language amending the standards regulating surgical services. Under the new provisions, applicants seeking to expand or initiate surgical services must demonstrate that there are excess surgical procedures being done in existing operating rooms within the area. The previous standards allowed applicants seeking new operating rooms or surgical facilities to use surgical procedures not commonly done in an operating room to demonstrate need. The new standards, which were supported by the MHA, go before the legislature for a 45-day review period and will take effect on the expiration of that timeframe, unless rejected by the legislature. The commission also advanced proposed language to the surgical services standards that would adjust the volume requirements necessary to maintain or expand operating rooms and that would create distinct volume criteria for small and rural hospitals. The MHA Council on Small or Rural Hospitals was instrumental in helping to develop the proposed rural criteria. A public hearing will be scheduled to review the proposed language prior to the commission’s March 21 meeting. In other business, the commission approved new language governing radiation therapy services that better accommodates new technology and patient access. In addition, the commission directed the commencement of a standard advisory committee to review the hospital bed standards and a work group to review regulations governing long-term, acute-care hospitals. For more information, contact Amy Barkholz at the MHA. The 2006 MHA Membership Directory Has Arrived
Those who purchased copies of the latest MHA Membership Directory will soon be receiving their 2006 edition in the mail. The directory offers a wealth of hospital and health system information that can be found nowhere else. Included are comprehensive listings for every MHA-member organization, such as mailing and e-mail addresses, phone numbers, fax numbers, Web site addresses and more. The directory also includes the number of hospital and health system full-time employees, inpatient and outpatient admissions, and a listing of MHA staff and services. The directory is still available for those interested in ordering. For more information, contact Renee Cullimore at the MHA. Innovative Prevention Programs Sought
The MHA, along with the Michigan Association of Health Plans, the Michigan Osteopathic Association, the Michigan Primary Care Association and the Michigan State Medical Society, have joined with the National Kidney Foundation of Michigan in creating the Innovations in Health Care award. The award will recognize three programs or providers that offer the most innovative treatment or prevention programs in the areas of diabetes, cardiovascular disease (including physical activity and nutrition) and kidney disease (including dialysis and transplantation programs). Groups, programs and individuals qualify to apply for the award, which includes a $1,000 cash gift. The award will be given at the foundation’s annual Champion of Hope dinner, which will be held in Lansing March 29. Applications for the Innovations in Health Care award are due Feb. 10. For further information, contact Marlene Hulteen at the MHA. CMS Unveils New, Improved Web Site
The Centers for Medicare & Medicaid Services (CMS) recently announced a new and improved Web site that is now available. The new site employs a user-friendly design to help visitors access information with the fewest number of clicks through use of one-stop shopping “centers” targeted to specific provider types. These centers — available via the homepage navigation bar and the “Browse by Audience” feature — include links to pages developed specifically for hospitals, physicians and other provider types. The topic pages are organized under eight major subject areas, which are then divided into categories and sections that feature overviews and general information. The topic pages are accessible from the homepage or through the “Browse by Subject” feature. The new site also introduces an improved Google search feature to make locating information easier. To provide the best organization and navigation, the CMS will continue to evaluate the new site and has made a demonstration available. Members with questions should contact Vickie Seal at the MHA.
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