Last week, the Michigan House of Representatives passed House Bill (HB) 6086, a supplemental appropriation for fiscal year (FY) 2010, for which Michigan faces a shortfall of $302.7 million. HB 6086 includes $81 million in general fund appropriations ($253 million gross) to fund higher projections of Medicaid caseload, utilization and inflation. Most of the state money for the increased projections comes from the enhanced federal medical assistance percentage (FMAP) and its application to the Medicare Part D prescription drug program. The higher FMAP resulted in a lower amount of state contribution for Part D costs, also known as the "clawback." HB 6086 must pass the Michigan Senate and be signed by Gov. Jennifer Granholm to take effect. The anticipated additional funding should balance the FY 2010 budget and avoid any Medicaid rate cuts.

While the state House is scheduled for session Wednesday, the Senate will not meet this week and the FY 2010 budget is not expected to be completed until after Labor Day. Upon their return, state lawmakers are also required by the state constitution to pass a FY 2011 budget by the start of FY 2011 on Oct. 1, 2010. For more information, contact David Finkbeiner at the MHA.

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Last week, the Michigan Office of Financial and Insurance Regulation (OFIR) announced enrollment will begin Aug. 31 in a new insurance program for people with specific pre-existing conditions. Commonly referred to as the "high-risk pool," this insurance mechanism is an element of healthcare reform created in the Affordable Care Act. Coverage will be offered through health maintenance organization Physicians Health Plan of Mid-Michigan (PHP), which has contracted directly with the U.S. Department of Health and Human Services to administer this program.

OFIR will have regulatory oversight for the state-implemented pool, which will be funded entirely by subscriber premiums and an estimated $141 million in federal subsidies. The temporary pool will operate until Jan. 1, 2014, when federal law requires all insurers to accept enrollees, regardless of pre-existing conditions.

Michigan residents with pre-existing conditions who have been uninsured for the previous six months will be eligible to enroll in the coverage, which is scheduled to take effect Oct. 1. Consumers interested in this program should begin collecting the documents required for enrollment, including:

• Proof of U.S. citizenship and Michigan residency.
• Either certification by a physician, issued within the past six months, demonstrating that the individual suffers from a medical condition found in the pool's list of pre-existing conditions OR evidence that a carrier has refused to issue coverage to the individual within the previous six months due to health reasons.

Michigan consumers interested in detailed enrollment, benefit and eligibility information should contact PHP between 9 a.m. and 5 p.m. EDT weekdays at (877) 459-3113. Members with questions should contact Laura Appel at the MHA.

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The MHA Health Foundation Governance Leadership Forum is Michigan's most comprehensive healthcare governance and leadership conference, offering innovative approaches to becoming a more engaged, informed and vital organization and board. This year's conference, titled Integrating the Pieces of healthcare Reform, focuses on actions healthcare leaders can take to be ahead of the curve of healthcare reform. Governing board members, executives and senior leaders from across Michigan will:

• Brainstorm and forecast how they will do things differently in the midst of complex health reform.
• Decide what reform initiatives can bring immediate or near-immediate return and "crib" the notes from organizations that are piloting ideas.
• Develop work plans with physicians, as well as business and community stakeholders, to improve health and reduce cost.
• Discuss how to excite people about their potential to help develop a valuable, sustainable healthcare model.

The forum will take place Oct. 24 and 25 at The Inn at St. John's in Plymouth. Members can stretch education budgets by using the available discounts for registrations made on or before Sept. 20 and for organizations that register multiple attendees. For details on the 2010 Governance Leadership Forum or opportunities to sponsor a portion of the event, contact Erin Steward at the MHA.

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The MHA Patient Safety Organization (PSO) has announced its latest patient safety educational opportunity for member hospitals. On Sept. 14, MHA PSO hospitals are invited to attend a webinar, free of charge, titled Preventing Wrong Site Surgery. The event, which will be held from 1 to 2 p.m., will feature faculty John R. Clarke, MD, FACS, clinical director for Patient Safety and Quality Initiatives at the MHA PSO's partner PSO ECRI Institute. Clarke, also clinical director of the Pennsylvania Patient Safety Authority, will discuss key elements of preventing these surgical errors, including:

• Why wrong-site surgeries occur.
• What can be done to minimize the risk of such errors.
• Successful approaches to gaining compliance with the practices necessary to prevent wrong-site surgeries.

The MHA PSO encourages member hospitals to attend this free educational presentation to gain further knowledge about the prevention of surgical errors and aid in their continued efforts to enhance patient safety statewide. Additional details about accessing the webinar will be available in early September. Members with questions should contact Sam R. Watson at the MHA.

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Last week, the MHA submitted its comments to the Centers for Medicare & Medicaid Services (CMS) regarding the 2011 Medicare outpatient prospective payment system (OPPS) proposed rule that includes changes to the OPPS, ambulatory surgical center (ASC), and graduate medical education costs. The MHA expressed concern about several provisions of the proposed rule, including:

• Supervision requirements of outpatient therapeutic services, particularly for small and critical access hospitals.
• Outpatient quality data reporting requirements, especially the imaging efficiency measures that were adopted for use beginning in 2010.
• Payment rates for separately payable drugs.
• Continuing failure of the CMS to implement an ASC quality reporting system.
• The lack of information needed to comment on the ASC productivity adjustment factor.
• The elimination of residency slots from hospitals that have not trained below their residency caps in all three of the most recent cost reporting years.

The MHA encourages hospitals to submit their comments to the CMS by 5 p.m. tomorrow. A final rule is expected by Nov. 1 for the Jan. 1, 2011, effective date. Members with questions should contact Vickie Seal at the MHA.  

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The Patient Protection and Affordable Care Act of 2010, passed by the U.S. Congress and signed by President Barack Obama last spring, will change the healthcare landscape forever. Human resource and employee benefit professionals have many questions, such as what plan-related changes are required by the act? Will these changes raise costs? What penalties and fees might organizations face for noncompliance? When do provisions require action? The MHA Health Foundation webinar The Patient Protection and Affordable Care Act of 2010: Employee Benefits and Implications for Hospitals will help attendees be informed and ready. The webinar will explore changes applicable to fully insured and self-insured group health plans; grandfathered health plans and those not grandfathered; and the financial impact, including tax on high-cost coverage and employer mandates and penalties. The webinar is scheduled from 1 to 2 p.m. Oct. 5 and has a connection fee of $195 per MHA-member organization. For more information or to register, contact Leigh Anne Jewison at the MHA.

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September is Infant Safe Sleep Month in Michigan, which was declared to help stem the growing tide of infant deaths caused by unsafe sleeping environments. Infant Safe Sleep Month provides an opportunity to remind professionals and institutions who care for families of the importance of safe sleep practices. The fourth observance coincides with registration for the  2010 Michigan Baby Walks. The MHA is a sponsor and supporter of the four Tomorrow's Child/Michigan SIDS' fundraising walks, to be held Sept. 18 in Sterling Heights, Sept. 19 in Wayne County, Sept. 26 in Portage, and Oct. 3 in Lansing. Funds collected will be used to keep babies healthy and support families that have experienced an infant death. A public service announcement will also run during the month of September and beyond to promote the seven steps for infant safe sleep. For more information, contact Paige Hathaway at the MHA.

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• Part 3 of the MHA Health Foundation webinar series, The Good, The Bad and The Ugly of Electronic Discovery, will be held from 11 a.m. to 12:30 p.m. Monday, Aug. 30. Participants will review the costs and potential ramifications of not correctly responding to the rules for electronic discovery. For more information, contact Leigh Anne Jewison at the MHA.

• The Michigan Green Healthcare Committee will meet from 10 a.m. to noon Tuesday, Sept. 7, at MHA headquarters, Lansing. Attendees and conference call participants will discuss final preparations for the 2010 Michigan Green Healthcare Conference, scheduled for Oct. 22 at Spectrum Health Butterworth Hospital, Grand Rapids. For more information, contact Paige Hathaway at the MHA.

• The Blue Cross Blue Shield of Michigan Participating Hospital Agreement Payment Practices Committee will meet Wednesday, Sept. 8. For more information, contact Marilyn Litka-Klein at the MHA.

• The Blue Cross Blue Shield of Michigan Participating Hospital Agreement Benefit Administration Committee will meet Wednesday, Sept. 8. For more information, contact Marilyn Litka-Klein at the MHA.

• Hospitals can still sign up to participate in the 2010 Michigan Harvest Gathering Campaign before the official Sept. 16 kickoff. Forms may be submitted electronically to designate project leaders who will coordinate individual food drives. Do not miss out on this opportunity to help feed hungry Michigan residents and have an impact on local communities! For more information, contact Paige Hathaway at the MHA.

• The MHA Monday Report will not be published Sept. 6 in honor of Labor Day. The next issue is scheduled for Sept. 13. Have a happy, healthy holiday!