New State Legislative Session Begins

capitol building

capitol buildingThe new session for the 102nd Michigan Legislature kicked off during the week of Jan. 9 with swearing in ceremonies in both the House and Senate. Michigan Democrats in the majority started the session by introducing legislation to repeal right to work, reinstate prevailing wage requirements and several other bills intended to provide tax relief for working families. Committee assignments were also released, giving the MHA and its member hospitals an opportunity to begin conversations with key lawmakers about 2023 legislative priorities.

Much like previous legislative sessions, both the House and Senate will feature standing committees for health policy and the Department of Health and Human Services (DHHS) budget. However, the House also created a new committee focused on behavioral health to provide a greater focus on the growing issue. Additionally, the MHA will be tracking new standing committees on labor issues created in both the House and Senate.

The Consensus Revenue Estimating Conference convened Jan. 13 to revise revenue projections for the current fiscal year. Comprised of the House Fiscal Agency, the Senate Fiscal Agency and the Department of Treasury, their forecast calls for a year-over-year decrease of 1.1% in revenues from the 2021-22 fiscal year to 2022-23. For 2022-23, the General Fund is projected to decrease by $427.7 million year-over-year, with a forecasted total of $14.8 billion.

Included below is a comprehensive list of committee assignments that are particularly relevant for MHA members. If you have any questions about the new lawmakers in your district, committee assignments or other state legislation, please contact Sean Sorenson-Abbott at the MHA.

Senate Appropriations

  • Sarah Anthony (D-Lansing) (Chair).
  • Sean McCann (D-Kalamazoo) (Vice Chair).
  • Jon Bumstead (R-Newaygo) (Minority Vice Chair).
  • Thomas Albert (R-Lowell).
  • Rosemary Bayer (D-West Bloomfield).
  • Darrin Camilleri (D-Trenton).
  • Mary Cavanagh (D-Redford Township).
  • John Cherry (D-Flint).
  • John Damoose (R-Harbor Springs).
  • Kevin Hertel (D-St. Clair Shores).
  • Mark Huizenga (R-Walker).
  • Jeff Irwin (D-Ann Arbor).
  • Veronica Klinefelt (D-Eastpointe).
  • Kristen McDonald-Rivet (D-Bay City).
  • Mallory McMorrow (D-Royal Oak).
  • Rick Outman (R-Six Lakes).
  • Sylvia Santana (D-Detroit).
  • Sue Shink (D-Northfield).
  • Lana Theis (R-Brighton).

*Senate DHHS Appropriations Subcommittee will be chaired by Sen. Sylvia Santana (D-Detroit).

Senate Health Policy

  • Kevin Hertel (D-St. Clair Shores) (Chair).
  • Sylvia Santana (D-Detroit) (Vice Chairs).
  • Michael Webber (R-Rochester Hills) (Minority Vice Chair).
  • John Cherry (D-Flint).
  • Erika Geiss (D-Taylor).
  • Roger Hauck (R-Mount Pleasant).
  • Mark Huizenga (R-Walker).
  • Veronica Klinefelt (D-Eastpointe).
  • Jim Runestad (R-White Lake).
  • Paul Wojno (D-Warren).

House Appropriations

  • Angela Witwer (D-Delta Township) (Chair).
  • Amos O’Neal (D-Saginaw) (Vice Chair).
  • Sarah Lightner (R-Springport) (Minority Vice Chair).
  • Timothy Beson (R-Kawkawlin).
  • Ann Bollin (R-Brighton).
  • Ken Borton (R-Gaylord).
  • Felicia Brabec (D-Pittsfield).
  • Julie Brixie (D-Meridian Township).
  • Cam Cavitt (R-Cheboygan).
  • Nancy DeBoer (R-Holland).
  • Alabas Farhat (D-Dearborn).
  • Andrew Fink (R-Hillsdale).
  • Phil Green (R-Millington).
  • Rachel Hood (D-Grand Rapids).
  • Thomas Kuhn (R-Troy).
  • Donovan McKinney (D-Detroit).
  • Jasper Martus (D-Flushing).
  • Denise Mentzer (D-Mount Clemens).
  • Jason Morgan (D-Ann Arbor).
  • Christine Morse (D-Texas Twp.).
  • Natalie Price (D-Berkeley).
  • Ranjeev Puri (D-Canton).
  • Bill G. Schuette (R-Midland).
  • Phil Skaggs (D-Grand Rapids).
  • Bradley Slagh (R-Zeeland).
  • Will Snyder (D-Muskegon).
  • Samantha Steckloff (D-Farmington Hills).
  • Donni Steele (R-Orion Township).
  • Regina Weiss (D-Oak Park).
  • Jimmie Wilson (D-Ypsilanti).

*House DHHS Subcommittee will be chaired by Rep. Christine Morse (D-Texas Twp.).

House Health Policy

  • Julie Rogers (D-Kalamazoo) (Chair).
  • Karen Whitsett (D-Detroit) (Vice Chair).
  • Curt VanderWall (R-Ludington) (Minority Vice Chair).
  • Brenda Carter (D-Pontiac).
  • Jennifer Conlin (D-Ann Arbor).
  • Betsy Coffia (D-Traverse City).
  • Aalabas Farhat (D-Dearborn).
  • Graham Filler (R-DeWitt).
  • John Fitzgerald (D-Wyoming).
  • Carol Glanville (D-Walker).
  • Jim Haadsma (D-Battle Creek).
  • Reggie Miller (D-Belleville).
  • Mike Mueller (R-Linden).
  • Cynthia Neeley (D-Flint).
  • Carrie Rheingans (D-Ann Arbor).
  • John Roth (R-Traverse City).
  • Kathy Schmaltz (R-Jackson).
  • Jamie Thompson (R-Brownstown).
  • Greg VanWoerkom (R-Norton Shores).

Federal Court Rules on 340B Underpayment Remedy

A recent United States District Court for the District of Columbia ruling allows the Department of Health and Human Services (HHS) to propose a remedy for hospital 340B drug underpayments for calendar years 2018 to 2021. This is the latest 340B decision following the late September ruling where the District Court ruled to vacate the 340B payment cuts for the remainder of 2022 and ordered the Centers for Medicare and Medicaid Services (CMS) to halt the cuts immediately. Hospitals are required to submit adjustments for each 2022 claim paid at the lower rate. However, that prior ruling failed to address claims from 2018 through 2021, with the CMS indicating these years would be addressed in future rulemaking prior to release of the 2024 outpatient prospective payment system (OPPS) final rule. The 2023 OPPS final rule restored 340B payments to the average sales price (ASP) plus 6%, up from ASP minus 22.5%.

The HHS has indicated a proposed remedy is expected to be released by April. The MHA, along with the American Hospital Association and others, continues to advocate for a remedy that quickly restores payments to hospitals for 2018 through 2021, with interest, and which does not penalize any hospitals.

Members with questions should contact Katie Jaskolski at the MHA.

MDHHS Expands Behavioral Health Service Providers Covered by Medicaid

The Michigan Department of Health and Human Services (MDHHS) issued a bulletin Jan. 5 to expand the types of providers who can perform Medicaid-covered, non-physician outpatient behavioral health services.

Effective Feb. 4, Medicaid will cover and reimburse outpatient behavioral health services provided by graduates of board-approved master’s or doctoral-level psychology, social work, counseling or marriage and family therapy educational training programs, so long as they have completed the requirements for a limited or temporary license; regardless of whether the license has been issued.

These staff must be supervised by a Medicaid-enrolled, fully licensed provider of the same profession. Services should be billed to Medicaid under this supervising provider, not the graduate.

This time-limited allowance for new graduates is applicable from the date the individual completed their graduate course work for a period not to exceed one year and does not replace the graduate’s obligation of obtaining the appropriate limited or temporary license from the Michigan Department of Licensing and Regulatory Affairs. It is strictly a mechanism to allow behavioral health providers to provide services while they wait for their license to be issued.

Members with questions should contact Lauren LaPine

Rural Emergency Hospital Webinar on Requirements and Conversion Process

Hospitals interested in learning more about the new Rural Emergency Hospital (REH) designation are encouraged to attend an upcoming webinar from 12:30 p.m. to 2 p.m. ET Jan. 18 hosted by Mathematica and the Rural Health Redesign Center (RHRC) for an overview of the REH designation.

Participants will learn about REH requirements and the Centers for Medicare and Medicaid Services’ conditions for REH participation and payment. Presenters will also describe how the RHDC and its partners can assist entities through the REH conversion process and access ongoing transition support.

There is no cost to participate, but registration is required. Members with questions about the REH designation should contact Lauren LaPine.

News to Know – Jan. 9, 2023

U.S. Sen. Debbie Stabenow (D-Lansing) announced Jan. 5 she will not seek a fifth term in 2024. Sen. Stabenow was first elected to the U.S. Senate in 2000, following her service as an elected official in the U.S. House of Representatives, in the Michigan Legislature and in county-level politics. Sen. Stabenow has been a healthcare champion throughout her time in elected office, including her leadership on the Children’s Health Insurance Program (known in Michigan as MI Child), community health centers, Medicare and behavioral health initiatives. Her decision not to run in 2024 means Michigan will have an open Senate seat during the 2024 midterm election.

MHA CEO Brian Peters released a statement expressing gratitude to Sen. Stabenow for her years as a healthcare champion in elected office.

MHA Appreciates Contributions of Healthcare Champion Sen. Stabenow

MHA CEO Brian Peters with U.S. Sen. Debbie Stabenow in 2019 at the Modern Healthcare Leadership Symposium.

The following statement can be attributed to Brian Peters, CEO of the Michigan Health & Hospital Association.

MHA CEO Brian Peters with U.S. Sen. Debbie Stabenow in 2019 at the Modern Healthcare Leadership Symposium.
MHA CEO Brian Peters with U.S. Sen. Debbie Stabenow in 2019 at the Modern Healthcare Leadership Symposium.

On behalf of our member hospitals, we deeply appreciate the contributions U.S. Sen. Debbie Stabenow has made and will continue to make to improving the health and wellness of individuals and communities throughout her time in elected office. While we are saddened to hear she will not be seeking a fifth term in 2024, we can confidently say Sen. Stabenow has made a profound and positive impact in Michigan through her support of healthcare issues including the MI Child program, community health centers, Medicare and behavioral health. With still two years left in her term, we look forward to continuing to work with a proven healthcare champion and a friend of the MHA.

MDHHS Releases Final Policy to Increase Rates for Certain Dental Procedures

The Michigan Department of Health and Human Services (MDHHS) recently released a final policy to increase the minimum Medicaid payment rates to $2,300 for covered dental services provided under general anesthesia at outpatient hospitals and $1,495 for services provided in an ambulatory surgical center (ASC).

The policy took effect Oct. 1, 2022 and was approved by the Centers for Medicare and Medicaid Services in early November. The policy modified the reimbursement methodology for dental services provided in these settings from the outpatient prospective payment system to a Medicaid fee schedule. Outpatient hospital and ASC fee schedules are available on the MDHHS website under the Billing and Reimbursement and Provider Specific Information tabs.

Members with questions should contact Vickie Kunz at the MHA.

Webinar Reviews CMS CoPs Critical Access Hospital Requirements

Critical Access Hospitals (CAHs) that accept Medicare and Medicaid payments must follow the Centers for Medicare & Medicaid Services (CMS) Conditions of Participation (CoP). The CMS CAH Manual has seen multiple changes to regulations and interpretive guidelines. The MHA Health Foundation five-part webinar series Critical Access Hospitals’ Conditions of Participation: Ensuring Compliance will review in detail the guidelines that serve as a basis for determining compliance.

Topics that will be covered in detail include:

  • CMS requirements of the board’s duty to enter into a written agreement if the hospital wants to provide telemedicine services.
  • CMS list of emergency drugs and equipment that every CAH must have.
  • Requirements for pharmacists, including development, supervision and coordination of pharmacy activities.
  • Requirements for security and storage of medications, medication carts and anesthesia carts.
  • CMS infection control worksheet and how it may be helpful to CAHs.
  • Hospital visitation and patient information policies.

The webinars are scheduled from 10 a.m. to noon Jan. 17, Jan. 24, Jan. 31, Feb. 7 and Feb. 14. Members can register for a connection fee of $780 for the series. Individual webinars are $195 per session.

Members with questions should contact Erica Leyko at the MHA.

 

Governor Signs Several MHA Priorities Into Law

Gov. Whitmer signed several bills into law Dec. 22 that were supported by the MHA and passed during the lame-duck session. Among these were expansions to the Michigan Reconnect Program, legislation to allow for a new rural emergency hospital licensure designation and interstate licensure opportunities for psychologists.

House Bills (HBs) 6129 and 6130legislation to expand the Michigan Reconnect program – were signed by the governor. The Michigan Reconnect program is a post-secondary scholarship program designed to provide funding to learners over the age of 25 interested in pursuing credentials or post-secondary degrees at community colleges or eligible training programs. Introduced by Reps. Ben Frederick (R-Owosso) and Sarah Anthony (D-Lansing), the package allows for several additional certifications to qualify for the scholarships including high-demand healthcare credentials. The MHA was supportive of the bills and will continue to advocate for future changes to lower the age of qualification for the program.

The legislation needed for hospitals to begin converting to Rural Emergency Hospitals (REHs) in Michigan was also signed into law. Due to limited session days left, the language to allow for REH licensure in Michigan was officially included in Senate Bill (SB) 183. REHs are a new federal designation that will require hospitals to give up inpatient services in exchange for improved federal outpatient reimbursement. Members with questions about the federal rules for REH designation can contact Lauren LaPine at the MHA for more information.

Legislation to allow Michigan to join the Psychology Interjurisdictional Compact (PSYPACT) was also approved by the governor. This will bring Michigan in line with 26 other states to create an expedited pathway to licensure for psychologists who wish to practice telepsychiatry across state lines. HBs 5488 and 5489 were introduced by Reps. Bronna Kahle (R-Adrian) and Felicia Brabec (D-Pittsfield Township) and supported by the MHA to help increase access to behavioral health services in Michigan.

Members with questions on these bills or any other lame duck action may reach out to Adam Carlson at the MHA.