The Michigan Department of Health and Human Services will implement a wage increase beginning Oct. 1 for direct care workers in MI Choice Waiver, MI Health Link and Behavioral Health programs. This will provide an additional $0.85 per hour increase in direct care worker (DCW) base wages, supplementing the $2.35 per hour increase previously appropriated. The total increase of $3.20 per hour must be applied to DCW wages, including administrative time and overtime. Members may refer to L 23-64 for more information. Members with questions may contact Kelsey Ostergren at the MHA.
The Michigan Association of Counties (MAC) has recently unveiled a range of valuable resources made available through the Michigan Opioid Settlement Fund. These resources encompass information about the agencies responsible for managing the settlement, as well as a compilation of frequently asked questions for reference and clarity.
The Michigan Opioid Settlement Funds Part I: Key Agencies and Settlements resource includes information about funding sources and the distribution of funds. It also includes a detailed list of key agencies involved in the fund appropriation.
The MAC also included the Michigan Opioid Settlement Funds Part II: Frequently Asked Questions to address complexities of the Michigan Opioid Funds. This document contains a wealth of information regarding funding, spending, reporting, considerations for tribal partners and additional resources related to the opioid settlement dollars.
Members with questions may contact Lauren LaPine at the MHA.
The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule Sept. 1 which would establish comprehensive, minimum nurse staffing standards for long-term care (LTC) facilities. There are three core components to this rule:
- Sets minimum staff hours per resident per day – 0.55 hours by registered nurses (RNs) and 2.45 hours by nurse aides (no mention of licensed practical nurses).
- Requires an RN on site 24/7.
- Enhances facility assessment requirements.
The MHA is deeply concerned about the implications of this legislation due to the current challenges securing long-term care placements and expects more beds will come offline or facilities will close to meet the proposed standard. Michigan is currently experiencing a shortage of nurses, and implementing a blanket staffing mandate for healthcare institutions will have a negative impact on access to care.
The MHA encourages members to consider responding to this proposed rule by Nov. 6. Members interested may provide comments to the MHA to be included in a comment letter.
Senate Bills (SBs) 530 and 531 were introduced Sept. 26 by Sen. Mary Cavanagh (D-Redford Twp.) and Sen. Sarah Anthony (D-Lansing) that would adjust the hospital fee schedule, clarify the definition of Medicare and provide rate certainty for post-acute care providers. Specifically, the legislation would eliminate the various rate tiers for reimbursement and coalesce hospitals around the national median reimbursement rate of 250% of Medicare. Additionally, the legislation clarifies the definition of Medicare based upon actual reimbursement experience at hospitals. The MHA issued a media statement in support of the legislation, which also creates fee schedules for post-acute care providers and adjusts the provisions related to attendant care. The legislation is referred to the Senate Insurance Committee and the MHA will keep members updated on its progress.
The legislature continued its breakneck pace this week with numerous healthcare bills seeing both committee action.
The Senate Finance, Insurance and Consumer Protection Committee voted out SBs 483, 484 and 485 sponsored by Sen. Darrin Camilleri (D-Trenton), Sen. Veronica Klinefelt (D-Eastpointe) and Sen. Kristen McDonald Rivet (D-Bay City). The legislation, creating the Prescription Drug Affordability Board, was reported along party lines with Senator Mark Huizenga (R-Walker) passing based on a potential conflict of interest. The MHA continues to work with the sponsors, stakeholder, and leadership on this legislation to ensure it accurately reflects the important role hospitals serve as purchasers and administrators of prescription drugs. The MHA is opposed to the package as it is currently written.
The Senate Health Policy Committee took up SB 133, sponsored by Sen. Sean McCann (D-Kalamazoo), which creates the Overdose Fatality Review Act. The act would allow for the establishment of overdose fatality review teams to identify potential causes of drug overdoses, as well as recommend solutions to address drug overdoses. The MHA successfully recommended changes to reflect more appropriate information sharing practices and timelines and supports this legislation. In addition, the committee reported out House Bills (HBs) 4619, 4620, 4621, 4622 and 4623, codifying aspects of the Affordable Care Act in state law. The MHA supports this work.
The House Insurance and Financial Services Committee took up several of the Affordable Care Act codification bills including SBs 356, 357 and 358 sponsored by Sen. Kevin Hertel (D-St. Clair Shores), Sen. Mary Cavanagh (D-Redford Twp.) and Sen. Veronica Klinefelt (D-Eastpointe). Both SBs 356 and 357 failed to garner enough votes in committee to be voted out of committee. SB 358 was reported to the House Floor. The MHA supports this legislation and looks forward to seeing the remaining bills reported favorably to the House floor next week.
Finally, the House Health Policy Committee took testimony on two pieces of MHA supported legislation. HB 4101, sponsored by Rep. Curt VanderWall (R-Ludington), would allow for the issuance and extended renewal period of a temporary license for individuals completing their required supervised clinical hours as a speech language pathologist (SLP). Extending the timeline for supervised clinical hour completion will deter new graduates from leaving the state to complete their supervised hours and will assist in the retention of SLPs in Michigan.
SB 384, sponsored by Sen. Kevin Hertel (D-St. Clair Shores), prohibits a disability insurer, long term care insurer or life insurer from discriminating against an individual based on their status as a living organ donor. Individuals who choose to be a living organ donor must meet stringent requirements and many of those who do donate continue to live similarly healthy lives post donation. However, the possibility of discrimination could deter individuals from choosing to be a living donor and therefore limiting access to organs for those most in need. Prohibiting discrimination based on living donor status could increase organ availability, ultimately supporting opportunities for individuals in need of an organ transplant.
Members with questions about state legislative action may contact Adam Carlson at the MHA.
The Michigan Department of Health and Human Services (MDHHS) recently released concurrent proposed and final policies to implement Medicaid rate increases included in the fiscal year (FY) 2024 budget. These increases, contingent upon approval by the Centers for Medicare & Medicaid Services (CMS), are effective for dates of service on and after Oct. 1, 2023.
The MDHHS will modify Medicaid reimbursement rates for specified services to provide:
- A hospital Diagnosis Related Group rate increase for level I and II designated trauma facilities. The increase will apply to Medicaid fee-for-service and Medicaid Health Plan hospital payments. The level of rate increase is not specified. The MHA successfully advocated for these funds in the FY 2024 budget.
- A 260% increase for transitional residential brain injury services (BIS) with these services reimbursed through a single bundled payment per day that covers both a daily rate for traditional residential care and case management services and a minimum of 15 hours of weekly therapy. BIS outpatient rates remain unchanged.
- A 7.5% increase for professional services provided by physicians, physician assistants, advanced practice nurses, psychologists, clinical social workers, professional counselors and others. This increase would not apply for professional services that received a previous rate increase such as neonatal, obstetrical and other services listed. The increase would apply to Maternal Infant Health Program professional services.
- A 10% increase for Anesthesia Professional Services represented by CPT codes 00100-01999.
- A 10% increase for home health services billed with HCPCS codes G0151-G0496.
- An increase to 100% of Medicare base rates for ground ambulance services for Locality 01 when reimbursement from the Medicaid ambulance provider assurance assessment is included.
Hospitals are encouraged to review the proposed policy and submit comments to MDHHS by Oct. 31 and should include “Medicaid Program Rate Updates FY 2024” in the subject line.
Members with questions should contact Vickie Kunz at the MHA.
The MHA and the Huron Consulting Group are hosting two webinars focused on helping hospitals attract, retain and promote high-performing talent.
The How to Have Tough Conversations in Healthcare webinar will provide practical strategies to help attendees become a more effective communicator on Oct. 12 from 1 to 2 p.m. EST. Speaker Pam Beitlich, DNP, APRN, will reveal ways to set expectations and deliver difficult messages and will allow time for participants to practice managing conflict.
A Strategic Approach to Workforce Development webinar will highlight outdated norms in the work setting on Nov. 9 from 1 to 2 p.m. EST. Speaker Holly Lorenz, DNP, RN, will share how to respond and adapt to change as values and employee expectations change.
Individuals can register for $100 per login per webinar. CME and continuing education credit for nurses and pharmacists is available for each webinar attended. By attending both webinars, participants may earn up to two (2) ACHE Qualified Education Hours toward initial certification or recertification of the Fellow of the American College of Healthcare Executives (FACHE) designation.
In the new program year, the MHA continues to prioritize several critical issues, like workforce, viability, resilience and wellbeing, behavioral health and health equity.
The MHA will host a virtual membership meeting from 2 to 3 p.m. on Nov. 9 to outline the MHA 2023 – 2024 strategic action plan approved by the MHA Board of Trustees. With presentations from MHA CEO Brian Peters and other MHA leaders, the forum will review the priorities and tactics to accomplish goals and how the membership can support these initiatives.
There is no cost to attend, but members are asked to by Nov. 7. Access information for the virtual session will be sent Nov. 8.
Questions about the member forum can be directed to at the MHA.
The Michigan Department of Health and Human Services (MDHHS) recently released a proposed policy notifying Home Help Agency providers that the National Provider Identifier (NPI) field in the Community Health Automated Medicaid Processing System (CHAMPS) will open Dec. 18, 2023. Home Help agency providers can begin entering an NPI into CHAMPS on that date. The change will result in:
- CHAMPS Modifications: A Home Help agency provider will only be able to save changes made in its CHAMPS enrollment if its NPI is entered in the NPI field as of Dec.18, 2023.
- CHAMPS Revalidation: Home Help agency providers must revalidate their CHAMPS enrollment information at minimum once every five years. The MDHHS end-dates the enrollment and stops payment to any agency provider that does not revalidate. The MDHHS will notify agency providers when revalidation is due. Effective Dec. 18, 2023, Home Help agency providers must have an NPI in the NPI field of the CHAMPS enrollment to complete revalidation.
- Electronic Visit Verification: Per Final Bulletin MMP-23-42 issued June 30, 2023, Home Help agency providers must obtain an NPI and add it to their CHAMPS enrollment in preparation for electronic visit verification (EVV). Home help payments may be impacted if an agency provider has not entered an NPI in CHAMPS.
Providers should complete the online application at the National Plan and Provider Enumeration System website to obtain an NPI. Home Help agency providers should enroll as a Type 2 (Organization) NPI. Comments are due to the MDHHS Oct. 31, 2023.
Members with questions should contact Vickie Kunz at the MHA.
The MHA hosted more than 60 public health and hospital leaders from across the Michigan Sept. 27 in East Lansing for the Talking Health: Research-Based Communication Strategies for Public Health & Healthcare event.
Organized by the de Beaumont Foundation and in collaboration with the Michigan Association for Local Public Health, faculty provided an in-person training based on the foundational concepts include in the book Talking Health: A New Way to Communicate About Public Health. Participants received collaborative learning, group discussion, exercises and problem solving focused on the perceptions of and distinction between public health and healthcare, the importance of framing, messaging and storytelling and bolstering the effectiveness of communication.
Event faculty included Brian C. Castrucci, DrPH, co-editor of Talking Health and president and CEO of the de Beaumont Foundation. Castrucci expressed the importance of collaboration between public health and hospitals and the need to establish partnerships with respected community messengers to establish credibility with the public and policymakers. Additional speakers included Doug Hattaway, president, Hattaway Communications and Nat Kendall-Taylor, PhD, chief executive officer, FrameWorks Institute.
Members with questions about the event or the MHA Public Health Task Force may contact Lauren LaPine at the MHA.
The MHA received media coverage the week of Sept. 25 regarding new auto no-fault legislation introduced in the Michigan Legislature and hospital staffing issues.
The MHA issued a media statement Sept. 26 from MHA CEO Brian Peters in support of Senate Bills 530 and 531, which would reform specific aspects of Michigan’s current auto no-fault insurance law.
Below is a collection of headlines from around the state.
Wednesday, Sept. 27
- Michigan Advance: Lawmakers propose bipartisan auto insurance reforms to support accident victims
- Becker’s Hospital Review: The push for nurse staffing ratios nationwide: 5 updates
- Bridge: Munson to trim inpatient services at rural northern Michigan hospitals
- Michigan Business Network: MHA Issues Statement On Important Auto No-Fault Legislation
Tuesday, Sept. 26
- Detroit Free Press: Hospitals, caregivers would see pay raise under proposed no-fault reimbursement reform
Members with any questions regarding media requests should contact John Karasinski at the MHA.