The MHA received media coverage since March 15 on efforts to reform the state’s auto no-fault insurance system as well as the future for healthcare teams.
The Detroit News published an article March 17 describing how auto no-fault insurance reforms have reduced access to care for auto accident survivors and impacted providers. Senate Bills 530 and 531 have passed the full Michigan Senate and would address reimbursement for providers, including simplifying and increasing Medicare hospital reimbursements, clarifying the definition of Medicare and creating a new post-acute care provider fee schedule. MHA Executive Vice President Laura Appel is quoted in the article expressing the importance of including hospitals in any reform efforts.
“Everything is not only more expensive but much more expensive,” said Appel.
Becker’s Hospital Review also published a story where they asked 35 C-suite healthcare executives across the U.S. to share areas of growth for the next few years. MHA CEO Brian Peters participated, sharing insights on technological innovation, advocacy engagement and health equity.
“First, we need to look at every emerging challenge through the lens of technological innovation; in other words, is there a better, more effective way to deal with an issue by deploying technology, which will become even more robust in the years ahead,” said Peters. “Second, because more and more of the people we serve will be covered by Medicare, Medicaid, and other governmental programs, everyone in healthcare needs to have a comfort level with the public policy and political arena — how the process works, and the elected officials who make the decisions in state capitols and in Washington, DC. Politics is not a spectator sport! And third, while we are clearly on the health equity journey, we need to continue to embed it firmly in our organization’s cultures.”
Members with any questions regarding media requests should contact John Karasinski at the MHA.
The Michigan Legislature officially adjourned sine die for the calendar year Nov. 14. The top priority for the association this fall was opposing harmful, one-size fits all nurse staffing ratio legislation (House Bills 4550-4552 and Senate Bills 334-336). The House Health Policy Committee took testimony on the legislation where the MHA and member nursing leaders participated, but the committee did not take the legislation up for a vote and will not do so this calendar year. While much attention was dedicated to opposition to nurse staffing ratio legislation, the final weeks of session included action on a variety of other bills that impact Michigan hospitals and health systems. Below is a summary of where proposed legislation currently stands that the MHA has been monitoring.
Affordable Care Act State Codification – Signed by the Governor
The legislature acted on a group of bills that add protections found in the Affordable Care Act to Michigan law. Governor Whitmer signed House Bills (HBs) 4619-4623 and Senate Bills (SBs) 356-358 into law and they are now Public Acts (PAs) 156-163 of 2023. These new laws memorialize important protections for Michiganders such as no-cost essential services, including preventive, mental health and emergency services. The MHA supported this bill package throughout the legislative process.
Violence Against Healthcare Workers – Awaiting Governor’s Signature
HBs 4520 and 4521, which increase the penalties for assaulting a healthcare worker, are headed to the governor’s desk to be signed into law. These bills are a positive step in ensuring violence against healthcare workers is not tolerated. The MHA continues to work on more opportunities to protect the healthcare workforce from violence in the workplace.
Auto No-Fault Updates – Passed the State Senate
The MHA continues to advocate for targeted updates to the state’s auto no-fault insurance law. SBs 530 and 531 passed the Senate and were referred to the House Insurance and Financial Services Committee. The MHA supports the changes proposed in this legislation, including moving reimbursement rate tiers back to the 2021 levels, smoothing the indigent volume factor timeline and creating an appropriate definition of Medicare rates for the purpose of auto no-fault insurance claim reimbursement.
Telemedicine Access – Passed the State House
HBs 4131, 4213, 4579 and 4580, which provide payment parity for telehealth services and provide limitations on the ability of health plans to dictate site specific visit requirements, were voted out of the House. The MHA supported the bipartisan package, which codifies many provisions in place during the public health emergency (PHE). The legislation makes additional changes to support the provider ability to serve patients and protect in-person visits that are vital to health outcomes. The bills were referred to the Senate Health Policy Committee.
Sharps Containers – Passed the State Senate
The Senate unanimously passed SB 482, which lifts the state’s 90-day disposal requirement for sharps containers. The MHA membership voiced concerns about the 90-day disposal requirement, which mandated sealing and disposing of containers before they reach their ¾ fill mark. The FDA regulated containers are costly and difficult to obtain, as hospitals experienced following a manufacturing facility fire. Disposal of partially full containers contributes to unnecessary and preventable medical waste. The MHA worked directly with the bill sponsor, Sen. Kristen McDonald Rivet (D-Bay City), on this legislation to address concerns about cost, access and environmental impact. The MHA supports this important policy change that will directly benefit the membership.
Behavioral Health Parity – Passed the State Senate The Senate approved SB 27, which would ensure behavioral health parity laws are meaningfully applied at the state level, with a strong bipartisan vote. The MHA-supported legislation was referred to the House Health Policy Committee. Similarly, the House Health Policy Committee reported out HB 4707, which would specify behavioral health parity, in addition to other services that would be required to be covered. HB 4707 awaits a vote by the full chamber.
Maternal and Infant Health – Passed Committee
HBs 5167-5173, which present several opportunities to support maternal and infant health, were reported out of the House Health Policy Committee. The MHA worked closely with the bill sponsors and committee chair on the legislative language and supports several bills in the package, including:
HBs 5167 and 5168, which allow for coverage of blood pressure monitors by commercial insurance and Medicaid for individuals who are pregnant or within the postpartum period.
HB 5169, which allows for mental health screenings to take place in postpartum follow up and pediatric settings when clinically appropriate. This bill was paired with HBs 5170 and 5171 that require insurance coverage for those screenings.
HB 5172, which sets up an opportunity for the state to publish maternal levels of care verifications and offer incentive payments for participation in verification and safety bundle utilization.
This package of bills awaits a vote by the full House and further legislative action is anticipated in the new year.
Rare Disease Advisory Council – Reported out of Committee
The Senate Health Policy Committee reported out HB 4167, which creates the Rare Disease Advisory Council, after being approved by the full House earlier in the year. The MHA supports this legislation and expects further action on it in 2024.
Breast Milk Donor HIV Testing – Reported out of Committee
The House Health Policy Committee reported out HB 4728, which updates the requirements for testing a breast milk donor for HIV or an HIV antibody. The proposed legislation removes the requirement to test a donor quarterly, while retaining the requirement for initial testing for potential donors. The MHA supports this legislation. HB 4728 is awaiting a vote by the full House.
340B Contract Pharmacy Legislation – Introduced
MHA member covered entities continue to share concerns about manufacturer-imposed limitations on contract pharmacy arrangements. The MHA worked with Rep. Alabas Farhat (D-Dearborn) to introduce legislation prohibiting contract pharmacy arrangement discrimination. HB 5350 was officially introduced on the last day of session for the year and referred to the House Health Policy Committee.
Interstate Nurse Licensure Compact – Introduced HB 4935, also known as the Michigan Nurse Licensure Compact (NLC), would enter Michigan into the national Nurse Licensure Compact. The NLC allows registered nurses to have one multistate license with the privilege to practice in their home state and other compact states. Permanent relocation to another compact state requires obtaining licensure in the new state, as the nurse’s residency has changed. HB 4935 would declare Michigan a compact participating state, allowing the mutual recognition of nursing licenses among the other member compact states. The bill was referred to the House Health Policy Committee.
Opposition to Repeal of Local Government Labor Regulatory Limitation Act
The Senate did not take a vote on SB 171, sponsored by Sen. Sean McCann (D-Kalamazoo). The bill repeals the local government labor regulatory limitation act, which prohibits localities from regulating employment relationships. Repealing this act would allow for a local unit of government to impose local labor ordinances such as a higher local minimum wage than the state, or potentially institute local staffing and scheduling regulations. The MHA and a coalition of other business and employer groups oppose this legislation over concerns of a patchwork of local regulations that could jeopardize access to healthcare services in Michigan.
Additional MHA Supported Legislation Signed by or Awaiting Signature from Gov. Whitmer
SB 219 preserved many PHE flexibilities regarding vaccinations and testing services offered by a pharmacist at a local pharmacy. Michigan continues to see post-PHE declines in vaccination rates. Promoting increased access points for individuals to get vaccinated is a public health benefit and one the MHA supports. Gov. Whitmer signed SB 219 into law in late July 2023.
HBs 4495-4496 cleaned up aspects of the Health Michigan Plan Act (HMP), including removal of cost sharing requirements that have proved to be exceedingly burdensome, and the elimination of language requiring the repeal of the HMP if state costs ever exceeded state savings. The HMP has increased access to healthcare throughout the state, providing coverage for over a million Michiganders. The MHA supported this legislation, which the governor signed into law in July 2023.
HBs 4616 and 4617 prohibit mental health professionals from providing conversion therapy to a minor. The MHA supported the legislation, which Gov. Whitmer signed into law in August 2023 and are now PAs 117 and 118 of 2023.
SB 384 and HBs 4362-4364 make positive changes to state law related to organ donation. SB 384 prohibits insurance discrimination against a living organ donor and HBs 4361-4364 allow for increased opportunities to identify as an organ donor. These changes have the potential to increase organ donation, helping the many individuals in need of transplants. The MHA supported this bill package which, Gov. Whitmer signed into law in November 2023. The bills are now PAs 100-102 and 192 of 2023.
SB 227 will update the state’s child caring institution licensing laws to align with emergency intervention language used in the Mental Health Code. Specifically, this legislation is important to any facility interested in becoming licensed as a Pediatric Residential Treatment Facility (PRTF) and alignment between the Mental Health Code and the licensing structure for child caring institutions. SB 227 is headed to the governor’s desk for her signature.
SB 133 would create the Overdose Fatality Review Act. The MHA worked closely with the bill sponsor to ensure language in the bill accurately includes and reflects the role hospitals play in their communities. The governor is expected to sign the bill into law soon.
SB 410 rescinds limitations on products liability for drugs with FDA approval. The MHA supports SB 410 which Gov. Whitmer is expected to sign.
Information on healthcare bills proposed during the 2023-2024 legislative session can be found through the MHA state legislative bill tracker.
Multiple bills monitored by the MHA moved in the Michigan Legislature during the week of Oct. 16.
Legislation increasing penalties for violence committed against healthcare workers was unanimously voted out of the Senate Civil Rights, Judiciary, and Public Safety Committee. The MHA-supported bills increase fines for assaulting a healthcare professional or volunteer, doubling the current fines for assault and assault with a deadly weapon. House Bills (HBs) 4520 and 4521 were introduced by Reps. Kelly Breen (D-Novi) and Mike Mueller (R-Linden). A substitute adopted in committee expanded the care locations covered by the increased fines to include behavioral health facilities. Addressing violence against healthcare workers and deterring potential attacks continues to be an MHA priority. HBs 4520 and 4521 now move to the Senate Floor for a full chamber vote.
MHA supported bills to improve Michigan’s Amended Auto no-fault laws were passed by the full Michigan Senate in a bipartisan vote. Senate Bills (SBs) 530 and 531, introduced by Sens. Mary Cavanagh (D-Redford Township) and Sarah Anthony (D-Lansing), would simplify and increase Medicare hospital reimbursements, clarify the definition of Medicare and create a new post-acute care provider fee schedule. The MHA’s executive vice president of government relations and public policy, Laura Appel, testified in committee last week. Appel stressed the importance of a strong healthcare system to care for auto accident patients. The bills now move to the House for their consideration.
Senate Health Policy took testimony on SB 482, sponsored by Sen. Kristen McDonald Rivet (D-Bay City), which lifts the state’s 90 day disposal requirement on sharps containers. The MHA membership voiced concerns about the 90-day disposal requirement, sharing that it would lead to sealing and disposing of containers before they reached their ¾ fill mark. The FDA regulated containers can be costly and difficult to obtain, as hospitals experienced following a manufacturing facility fire, and further disposal of an underutilized container contributes to unnecessary and preventable medical waste. The MHA worked directly with Sen. McDonald Rivet on this legislation, based on the feedback of hospitals who shared concerns about cost, access and environmental impact. The MHA is supportive of this important policy change that will directly benefit the membership.
The governor also signed into law several bills intended to codify Affordable Care Act protections at the state level. House Bills 4619 – 4623 and Senate Bills 356 – 358 were signed by Gov. Whitmer on Oct. 19. The MHA is supportive of the package, which has been passed in at least 15 other states and would protect Michigan consumers in the event there were future amendments or judicial changes to the current federal law.
MHA EVP Laura Appel discusses auto no-fault legislation with the Michigan Business Network.
The MHA received media coverage the week of Oct. 16 regarding auto no-fault legislation passed in the Michigan Senate and nurse staffing ratio legislation.
The coverage is based on interviews conducted with MHA CEO Brian Peters and MHA Executive Vice President Laura Appel.
Below is a collection of headlines from around the state.
MHA EVP Laura Appel testifying in the Senate Finance, Insurance and Consumer Protection Committee.
The Michigan Senate Finance, Insurance and Consumer Protection Committee continued to hear testimony during the week of Oct. 9 on Senate Bills 530 and 531. Introduced by Sen. Mary Cavanagh (D-Redford Township) and Sen. Sarah Anthony (D-Lansing), the legislation would clarify and increase Medicare hospital reimbursements, clarify the definition of Medicare and create a new post-acute care provider fee schedule. The committee heard testimony from Laura Appel, executive vice president of government relations and public policy, MHA, who stressed the importance of a strong healthcare system to care for auto accident patients.
“Hospitals across Michigan stand ready to care for victims of auto accidents,” said Appel. “Whether you’re located in Detroit, Grayling, Battle Creek or the Upper Peninsula, you need hospitals prepared to provide access to high quality care at a moment’s notice.” The committee has not yet taken a vote on the legislation and the MHA will continue to advocate for improvements to Michigan’s auto no-fault laws.
The House Health Policy Committee advanced several bills that would enter Michigan into interstate licensure compacts. The legislation included House Bills 4169 and 4170 for occupational therapists, introduced by Rep. Julie Rogers (D-Kalamazoo) and Rep. Doug Wozniak (R-Shelby Township), and House Bills 4504 and 4505 for physical therapists, introduced by Rep. John Fitzgerald (D-Wyoming) and Rep. Dale Zorn (R-Onsted). The MHA supported both packages in keeping with broad support for interstate licensure compacts to assist with ongoing professional shortages. The legislation now awaits a vote from the full House.
Members with any questions may contact Elizabeth Kutter at the MHA.
MHA CEO Brian Peters speaks with the Michigan Business Network.
The MHA received media coverage the week of Oct. 2 regarding auto no-fault legislation introduced in the Michigan Legislature and nurse staffing ratio legislation.
The coverage is based on interviews conducted with MHA CEO Brian Peters and MHA Executive Vice President Laura Appel.
Below is a collection of headlines from around the state.
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 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.
The following statement can be attributed to Brian Peters, CEO of the Michigan Health & Hospital Association.
“The auto no-fault insurance bills introduced today will improve access to care for auto accident survivors and patients. The reforms implemented several years ago created an environment of extreme uncertainty. This bill package is an important step towards providing better access to services and reimbursement clarity, bringing Michigan healthcare provider reimbursement in line with national averages and ensuring they all have the resources needed to care for auto accident survivors throughout their recovery.
The Michigan Health & Hospital Association is proud to join the many stakeholders supporting Senate Bills 530 and 531.”
The Michigan Department of Insurance and Financial Services (DIFS) recently issued a bulletin clarifying that provisions of the auto no-fault law signed in May 2019 do not apply for services provided to individuals injured in motor vehicle accidents occurring before June 11, 2019. This bulletin is in response to the Michigan Supreme Court affirmation of the Court of Appeals’ opinion in Andary v USAA Cas Ins Co.
Hospitals and other providers who believe they are due additional reimbursement for claims subject to the Andary decision should contact the insurer to request claims reprocessing. If a dispute related to a reprocessed claim cannot be resolved directly with the insurer, the provider should contact DIFS for assistance.
Similarly, hospitals and other providers who filed an appeal with the DIFS Utilization Review unit involving claims that are subject to the Andary decision, and whose appeals were resolved in an order issued prior to Aug. 25, 2022, should first attempt to resolve any reimbursement disputes with the insurer. If the dispute cannot be resolved, the provider may request that DIFS consider modifying the Utilization Review order in their case by submitting their request in writing to DIFS-URAppeals@michigan.gov.
Members with questions should contact Vickie Kunz at the MHA.
