Healthcare Bills See Action as Session Resumes

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capitol buildingThe Michigan Legislature returned to session the week of April 10, taking up several bills the MHA is monitoring. In the House of Representatives, MHA-supported legislation to create a new tax credit for blood donations and to regulate the sale of kratom received hearings in their respective committees. In the Senate, a package of bills to license and regulate professional guardians was introduced and testimony was held on a bill to allow for pharmacists to order and administer certain vaccinations and diagnostic tests.

The House Committee on Tax Policy held a hearing on House Bill (HB) 4068 to create a new tax credit for blood donations in Michigan. Introduced by Rep. Rachel Hood (D-Grand Rapids), the bill would allow for a $25 state income tax credit for each blood donation during the tax year. The MHA is supportive of the bill, which is a unique way of encouraging good public health decisions in the state. A vote was not held at this hearing.

In the House Regulatory Reform Committee, an initial hearing was held on legislation to regulate the sale of kratom in Michigan. Kratom is a tropical tree native to Southeast Asia, with leaves that contain compounds which can have psychotropic effects similar to opioids and stimulants. HB 4061 would ban adulterated kratom products, require warning labels addressing the potential health impacts and require lab testing for kratom products to ensure consumers know what substances are present. HB 4061 is a reintroduction by Rep. Lori Stone (D-Warren) and was supported by the MHA’s Legislative Policy Panel last session. No vote on the bill was taken.

In the Senate’s Health Policy Committee, Sen. Sylvia Santana presented a new bill intended to increase access to vaccines and certain laboratory tests. Senate Bill (SB) 219 would allow pharmacists to order and administer vaccinations and certain diagnostic tests for their patients without physician supervision. Under the bill, the diagnostic tests pharmacists would be allowed to perform would be limited to those that are waived for home use by the Food and Drug Administration or approved for waiver under the Clinical Laboratory Improvement Amendments of 1988. The MHA has not yet taken a position on SB 219, which has also been introduced in the House as HB 4316 by Rep. Alabas Farhat (D-Dearborn). The MHA expects further testimony to be taken on the bill and no votes were held at this time.

In the Senate, a new package of six bills to amend regulations for professional guardians was introduced. SBs 253258 include a wide range of proposals to increase the requirements for professional guardians, limit the number of cases a guardian can take and change the priority list for court-appointed guardians. The MHA has concerns with the legislation impacting a hospital’s ability to secure court appointed guardians in a timely manner to engage with healthcare and placement decisions. No hearing is scheduled on the bills at this time.

Members with questions about state legislative action can reach out to Adam Carlson for more information.

MHA Monday Report March 27, 2023

MHA Monday Report

capitol buildingMHA-supported Bills See Action Before Break

The Michigan House of Representatives acted on a pair of MHA-supported bills during the week of March 20. In the House Health Policy Committee, members voted to report legislation to strengthen Michigan’s Healthy Michigan statute. …


Speakers of the Protect Our Care press conference.MHA Celebrates ACA Anniversary with Congresswoman Slotkin

MHA Executive Vice President Laura Appel joined U.S. Rep. Elissa Slotkin and other healthcare advocates March 23 as part of a virtual press conference organized by Protect Our Care to celebrate the 13th anniversary of …


As individuals and families across the state and country continue to face food insecurity, Michigan’s hospitals, health systems and community leaders are engaged in creating collaborative solutions. MHA CEO Brian Peters joined fellow food security …

Expanding Advocacy Roots with the Next Generation

The MHA collaborated with Wayne State University for the first-ever student-led advocacy day March 22. Science Policy Network-Detroit is a student organization at Wayne State that aims to advocate for science-related issues in …


March 30 Webinar Outlines Considerations for the End of the Public Health Emergency

The Department of Health and Human Services COVID-19 public health emergency expires May 11, 2023, which may significantly decrease the flexibility providers have become accustomed to. The MHA will host The End of the …


Medicaid Eligibility Redetermination Webinar Recording Available

The Michigan Medicaid program has grown to nearly 3.2 million Michiganders, an increase of more than 700,000 when compared to pre-pandemic levels, due to federal statutory limitations on states’ abilities to remove people from the …


MHA Webinar Explores PACE Program Partnerships

With the closure of nursing homes and long-term care facilities, hospitals and health systems need options to care for seniors. Dually eligible frail seniors are one of the most complex cohorts with multiple co-morbidities, frequent …


Applications Open for Excellence in Governance Fellowship, Prepares Trustees to Lead

The MHA Excellence in Governance Fellowship is now available to healthcare board members looking for innovative, effective ways to lead their organizations as hospitals and health systems navigate financial strain and labor challenges. Applications are …


The Keckley Report

Paul KeckleyAffordable Care Act 2.0: New Trends and Issues, New Urgency

“Thursday marks the 13th anniversary of the signing of the Affordable Care Act– perhaps the most consequential healthcare legislation since LBJ’s passage of the Medicare Act in 1965. Except in healthcare circles, it will probably go unnoticed. …

Complicating matters, the political environment today is more complicated than in 2010 when the ACA became law. The economic environment is more challenging: the pandemic, inflation and economic downturn have taken their toll. Intramural tensions in key sectors have spiked as each fights for control and autonomy i.e. primary care vs. specialty medicine, investor-owned vs. not-for-profit hospitals, retail medicine & virtual vs. office-based services, carve-outs, direct contracting et al . Consolidation has widened capabilities and resources distancing big organizations from others. Today’s media attention to healthcare is more sophisticated. Employers are more frustrated. And the public’s confidence in the health system is at an all-time low. …“

Paul Keckley, March 19, 2023


News to Know

  • Registration is now open for the MHA Keystone Center Safe Patient Handling Conference.
  • The MHA is issuing a request for proposal for a $50 million competitive grant program for Michigan healthcare entities to expand access to pediatric inpatient behavioral health services.
  • The MHA Health Foundation will host a four-part webinar series MHA Board Governance Education that outlines the trends affecting current and future strategic plans, techniques for effectively communicating with stakeholders on key issues and ways to build trust, drive engagement and develop relationships.
  • The MHA will host an in-person Human Resources Member Forumat the MHA Headquarters in Okemos from 8:30 a.m. to noon April 26, with a virtual option available as well.
  • The Root Cause Coalition is accepting requests for proposals to present at the 8th Annual National Summit on the Social Determinants of Health Dec. 3-5 in Kansas City.

MHA-supported Bills See Action Before Break

capitol building

capitol buildingThe Michigan House of Representatives acted on a pair of MHA-supported bills during the week of March 20.

In the House Health Policy Committee, members voted to report legislation to strengthen Michigan’s Healthy Michigan statute. House Bill (HB) 4224, introduced by Rep. Julie Rogers (D-Kalamazoo), would remove Michigan’s Medicaid work requirements that are currently held up by the courts. The MHA has provided testimony in support of the bill and expects additional improvements to the Healthy Michigan statute to be introduced in the coming weeks. HB 4224 now awaits a floor vote by the full House of Representatives and the MHA will continue to monitor any action in future Monday Report articles.

Another MHA-supported bill, HB 4167, was passed by the full House of Representatives and transmitted to the Senate for further consideration. Introduced by Rep. Jason Morgan (D-Ann Arbor), HB 4167 would establish a new rare disease advisory council at the Department of Health and Human Services to provide guidance on research, diagnosis and treatment efforts in Michigan. The MHA hopes this council will help identify opportunities to improve care for the one in 10 U.S. residents impacted by rare diseases according to the National Institutes of Health.

In the other chamber, Sen. Sylvia Santana (D-Detroit) introduced a new bill intended to increase access to vaccines and certain laboratory tests. Senate Bill (SB) 219 would allow for pharmacists to order and administer vaccinations and certain diagnostic tests for their patients without physician supervision. Under the bill, the diagnostic tests pharmacists would be allowed to perform would be limited to those waived for home use by the Food and Drug Administration or approved for waiver under the Clinical Laboratory Improvement Amendments of 1988 (CLIA). The MHA has not taken a position on SB 219, which has been referred to the Senate Health Policy Committee.

Legislators will now return to their districts for a two-week break from session before returning to focus on the fiscal year 2024 state budget.

Members with questions about state legislative action can reach out to Adam Carlson for more information.

MHA Monday Report March 20, 2023

MHA Monday Report

State Medicaid Office Addresses Legislative Policy Panel

The MHA Legislative Policy Panel convened March 15 to develop recommendations for the MHA Board of Trustees on legislative initiatives impacting Michigan hospitals. The meeting was highlighted by a presentation on Medicaid redetermination from Brian …


MHA Provides Testimony Supporting State Psychiatric Care and Healthy Michigan Plan

During the week of March 13, the MHA provided testimony to both the Michigan House Appropriations Subcommittee on Health and Human Services and the House Health Policy Committee. Laura Appel, executive vice president of Government …


RFP Available for Pediatric Inpatient Behavioral Health Grant

The MHA is issuing a request for proposal for a $50 million competitive grant program for Michigan healthcare entities to expand access to pediatric inpatient behavioral health services. The funding was appropriated by the …


MHA Keystone Center PSO Annual Meeting May 3

The healthcare workforce is at higher risk of harm due to violence than other professional fields.  Recent increases in workplace violence represent a major barrier to both staff and patient safety, prompting the need for …


Registration Open for MHA Human Resources Member Forum

The MHA will host an in-person Human Resources Member Forum at the MHA headquarters in Okemos from 8:30 a.m. to noon April 26, with a virtual option available as well. The forum is structured as …


Changes to Medicaid Dental Coverage Effective April 1

The Michigan Department of Health and Human Services will implement a new service delivery model for adult dental benefits effective April 1, 2023. The following groups will be eligible: Medicaid beneficiaries ages 21 years and …


Changes to Telemedicine Policy Post-COVID-19 Public Health Emergency

The Michigan Department of Health and Human Services will rescind certain COVID-19 telemedicine flexibilities beginning May 12, 2023, with the conclusion of the federal health public health emergency. Policy MMP 23-10 outlines flexibilities that …


Michigan Dispensing Law Changes

Michigan state law will be updated beginning March 29, 2023, to allow pharmacists to dispense a non-controlled prescription written by a prescriber licensed in another state or province of Canada. Public Act 80 of 2022 …


Latest AHA Trustee Insights Covers Board Development and Behavioral Health

One of the strongest predictors of health system performance is the quality of governance that shapes its response in an unstable environment. The March edition of Trustee Insights, the monthly digital package from the American …


The Keckley Report

Paul KeckleyThe Biden Budget: Key Signals to Voters and an Important Implications for the Health Industry

“Last Thursday, the Biden administration released its proposed FY24 federal budget which is certain to spark political posturing by partisans on all sides and long-term speculation by political pundits and economists. At a high level, it includes… …

In total, healthcare spending represents 30% of the total outflow of federal funds in this budget compared to 29% in ’22 (Medicare 12%, Veteran’s Health 2% and Other Line Items 15%)—almost 50% more than Social Security and more than 100% above defense spending. …”

Paul Keckley, March 12, 2023


News to Know


MHA CEO Brian PetersMHA in the News

The MHA received media coverage the week of March 13 regarding conversations around workforce funding and current challenges amid the third anniversary of the COVID-19 pandemic.

MHA Provides Testimony Supporting State Psychiatric Care and Healthy Michigan Plan

During the week of March 13, the MHA provided testimony to both the Michigan House Appropriations Subcommittee on Health and Human Services and the House Health Policy Committee.

Laura Appel, executive vice president of Government Relations and Policy and Lauren LaPine, senior director of Legislative and Public Policy at the MHA  provided testimony Mar. 15 to the House Appropriations Subcommittee.

Laura Appel, executive vice president of Government Relations and Policy at the MHA, provided testimony Mar. 15 to the House Appropriations Subcommittee on Health and Human Services. Appel provided an overview of the impact healthcare workforce challenges are having on state psychiatric care and the need for additional support.

“We share the frustration of families, caregivers and our colleagues at the Michigan Department of Health & Human Services when state psychiatric beds go offline,” said Appel. “We appreciate the Governor’s proposed investments and understand there are many needs in our state – I hope the subcommittee will consider an investment in healthcare for our most vulnerable residents among the highest priorities.”

Adam Carlson, senior vice president of Advocacy at the MHA provided testimony Mar. 16 to the House Health Policy Committee.

Adam Carlson, senior vice president of Advocacy at the MHA, provided testimony Mar. 16 to the House Health Policy Committee in support of House Bill (HB) 4224, introduced by Rep. Julie Rogers (D-Kalamazoo). HB 4224 would repeal the Medicaid work requirement law that was passed in 2018. That legislation would require Michigan’s Medicaid beneficiaries to report employment or evidence of their search for work in order to maintain coverage.

“Ensuring coverage and access for our lower-income community members improves the health and wellness of our state, while having a positive effect on securing and maintaining employment,” said Carlson.

Members with questions about workforce funding or other state legislative action may contact Adam Carlson at the MHA.

State Medicaid Office Addresses Legislative Policy Panel

Carlos Jackson, federal lobbyist, Cornerstone Government Affairs.

The MHA Legislative Policy Panel convened March 15 to develop recommendations for the MHA Board of Trustees on legislative initiatives impacting Michigan hospitals.

The meeting was highlighted by a presentation on Medicaid redetermination from Brian Keisling, director, Bureau of Medicaid Policy, Operations and Actuarial Services. The state is starting the renewal process this month for nearly three million Medicaid beneficiaries. Keisling discussed the approach they’re taking to review beneficiaries as part of the redetermination process and planned communications with beneficiaries whose eligibility will expire or renew.

Moving to action items, the panel recommended the MHA advocate for incentives that would support birthing hospital participation in Levels of Maternal Care.

In addition, the panel discussed issues around telehealth and the potential discrimination against living organ donors.

The panel received updates on other issues including a federal update from federal lobbyist Carlos Jackson with Cornerstone Government Affairs, hospital workforce funding, state budget negotiations and MHA efforts related to behavioral health.

For more information on the MHA Legislative Policy Panel, contact Adam Carlson at the MHA.

Supplemental Signed into Law, MHA Provides Additional Testimony

Laura Appel, executive vice president of Government Relations and Policy. MHA, provided testimony to the Senate’s Health Policy Committee.

Governor Gretchen Whitmer signed a supplemental appropriation bill on March 8 that includes $75 million for hospital recruitment, retention and training of healthcare workers. The funding was included as a part of House Bill (HB) 4016, now Public Act 5 of 2023.

Laura Appel, executive vice president of Government Relations and Policy at the MHA, provided testimony to the Senate’s Health Policy Committee. Appel provided a general overview of the role hospitals play in the healthcare continuum, the continuing post-pandemic patient transfer issues and potential solutions to address these challenges and the workforce crisis.

“The cost of maintaining standby trauma resources is millions of dollars for each level I and II trauma designated hospital location and those costs are incurred regardless of the number of patients that need those services every day,” said Appel.

Lastly, a new bill introduced in the Michigan House of Representatives would make improvements to Michigan’s Healthy Michigan statute. HB 4224, introduced by Rep. Julie Rogers (D-Kalamazoo), would remove Michigan’s Medicaid work requirements. The work requirement is currently disallowed by the courts. The MHA supports HB 4224 and expects additional legislation to make improvements to the Healthy Michigan statute in the coming weeks.

Members with questions about workforce funding or other state legislative action may contact Adam Carlson 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.

 

2022 Legislative Session Adjourns

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capitol buildingThe Legislature took their final votes for the 2021-2022 legislative session during the week of Dec. 5. Given the results of the election, very few bills passed during the legislative lame-duck session compared to a typical year. While the lack of a supplemental agreement prohibited additional funding for healthcare, the MHA was able to secure several victories on policy issues and no MHA-opposed legislation was passed before the end of the year.

House Bills (HBs) 6129 and 6130, legislation to expand the Michigan Reconnect program, was sent to the Governor’s desk for final approval. The Michigan Reconnect program is a postsecondary scholarship program designed to provide funding to learners over the age of 25 to return to the classroom to pursue credentials or postsecondary 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 is supportive of the bills and will continue to advocate for future changes to lower the age for individuals to qualify for the program.

Legislation to allow Michigan to join the Psychology Interjurisdictional Compact (PSYPACT) was also sent to the Governor’s desk. If signed into law, 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.

Another MHA-tracked bill, Senate Bill (SB) 450, was sent to the Governor. Introduced by Sen. Jim Stamas (R-Midland), SB 450 would ensure visitors of cognitively impaired patients are permitted in healthcare facilities. The bill would prohibit the directors of the Michigan Department of Health and Human Services or a local health officer from issuing an order that prohibits a patient representative from visiting a cognitively impaired individual in a healthcare facility. As written, the legislation does not prevent a healthcare facility from implementing reasonable safety measures for visitors and will still allow for facilities to limit the number of representatives per patient. The MHA is neutral on the bill, based upon previous feedback received from our Legislative Policy Panel.

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

Lame Duck Session Begins in Senate

capitol building

capitol buildingThe 2022 lame-duck session in the legislature got off to a slow start in the Senate during the week of Nov. 28. Several bills impacting hospitals saw unsuccessful votes on the floor, including legislation to make changes to the operation of the 340B drug pricing program and a package to integrate behavioral and physical health for state regulated insurance plans.

The 340B legislation, Senate Bill (SB) 1088, threatened to strike important protectionist language that was secured in Public Act 12 of 2022. That bill signed into law in February prohibits a pharmaceutical manufacturer from requiring the use of a modifier on non-Medicaid claims, protecting 340B entities from industry implemented administrative hurdles. Removing this language would negatively impact the communities served by Michigan 340B hospitals. The MHA and its member hospitals have been working hard to advocate to elected officials the importance of the program. SB 1088 was introduced as a vehicle bill by Sen. Curt VanderWall (R-Ludington) and was discharged and substituted on the floor before voting. The vote on SB 1088 on Nov. 29 ultimately failed twice on the floor and it is not clear if the legislation will be considered again.  The MHA will continue to oppose SB 1088 and other threats to the 340B program.

SB 597 and 598, the Senate’s behavioral health integration package, also did not find the votes to pass on the floor. Introduced by Sen. Majority Leader Mike Shirkey (R-Jackson) and Sen. John Bizon (R-Battle Creek), the package would create new specialty integrated plans (SIPs) that would replace the current prepaid inpatient health plans (PIHPs) and contract with each community mental health (CMH) services program to deliver physical and behavioral health services to Michigan’s Medicaid population. The bills would also eliminate language requiring CMH entities to coordinate substance use disorder (SUD) and school based behavioral health services and create a new statewide ombudsman.

The Senate’s Health Policy and Human Services Committee also met to advance several bills to the floor for a potential vote in the final days of session. Among those bills was House Bill (HB) 6086, introduced by Rep. Jeff Yaroch (R-Richmond). HB 6086 would establish an alternate licensure process for paramedics in Michigan. HB 6086 would require the state to develop a new Michigan-specific certification course, separate from the currently required course from the National Registry of Emergency Medical Technicians. The MHA is opposed to HB 6086, which could have implications for a paramedic’s ability to work in multiple states. The National Registry of Emergency Medical Technicians certification is currently used in 48 states and is required for all newly licensed paramedics in Michigan.

The MHA will continue to monitor all these bills for any further action in the coming weeks. Members with questions about these issues or other state legislation related to healthcare can be directed to Adam Carlson at the MHA.