Michigan Department of Insurance and Financial Services Addresses Legislative Policy Panel
Posted on January 10, 2020
The MHA Legislative Policy Panel convened Jan. 8 and developed recommendations for the MHA Board of Trustees on legislative initiatives impacting Michigan hospitals. The meeting was highlighted by a presentation from Chad Arnold, director, Office of Policy, Research and Communications, and Karin Gyger, chief of staff and legislative director, from the Michigan Department of Insurance and Financial Services. They discussed how the state of Michigan is implementing the new auto no-fault insurance reforms passed in May, Public Acts 21 and 22 of 2019. Panel members also received updates on the 2019 Health PAC fundraising campaign, the Medicaid Health Plan Pharmacy Drug Coverage Transition (1936-Pharmacy), the state budget and certificate of need. On the federal level, they learned about the No Surprises Act recently introduced in the House and the proposed Medicaid Fiscal Integrity Rule.
Moving to action items, the panel recommended the MHA oppose Senate Bill (SB) 433 as written. SB 433 would regulate Kratom by including it as a schedule II controlled substance. Kratom is a tropical tree native to Southeast Asia whose leaves contain compounds that can have psychotropic effects like opioids and stimulants. The American Kratom Association promotes it to help treat pain and anxiety and to ease opioid addictions. However, the U.S. Drug Enforcement Administration currently lists Kratom as a “drug of concern.” The U.S. Food and Drug Administration has warned there are no medical uses for it and that Kratom contains properties that expose users to risks of addiction and abuse. While the MHA supports efforts to protect the public from dangerous substances, including Kratom as a schedule II controlled substance implies there is a medical use for it. The MHA will work with the bill sponsor to accomplish the shared goal of public safety in regard to Kratom.
The panel recommended the MHA support draft telehealth legislation related to the site where care originates. Medicaid insurance coverage for telehealth services is determined by the originating site, or the location of the patient when they seek virtual care. Medicaid patients must be physically present at a designated, approved health facility to receive coverage. The panel supports expanding the eligible sites for reimbursement under Michigan’s medical assistance program and Healthy Michigan. Telehealth addresses multiple barriers of access, such as lack of transportation, difficult work or school schedules, and certain comorbidities that might delay service. It can also be beneficial in managing physician resources, as more patients can have access to specialists without wait or travel for the patient or provider.
The panel also recommended the MHA support draft telehealth legislation for Medicaid reimbursement for store and forward, or asynchronous, visits. Store and forward allows patients and providers to interact through a secure email or messaging app rather than in real time. Michigan statute currently requires providers to have real-time audio or video interactions with a patient to receive Medicaid reimbursement. Asynchronous telehealth visits promote efficiency of resources and an easy way for patients and providers to share questions and provide preventive care without costly office visits.
The panel recommended the MHA support Medicaid reimbursement for remote patient monitoring (RPM), which is currently not covered in Michigan’s Medicaid statute. RPM is the use of technology to collect health data and securely send it to a provider for assessment from another location. RPM devices would potentially reduce readmission rates and improve the quality of telehealth visits.
For more information on the recommendations of the MHA Legislative Policy Panel, contact Adam Carlson at the MHA.
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