Legislative Policy Panel Convenes for Program Year

The MHA Legislative Policy Panel convened Oct. 12 to develop recommendations for the MHA Board of Trustees on legislative initiatives impacting Michigan hospitals.

The meeting was highlighted by a presentation from Ruthanne Sudderth, senior vice president, public affairs and communications, MHA, on a storytelling campaign advocating for funding solutions to the financial challenges facing MHA members. Sudderth described the objectives of the campaign, strategies that will be utilized and ways members can get involved. The campaign is a direct result of an MHA Board directive from the strategic action plan.

The panel also held a discussion on Certificate of Need in relation to pediatric psychiatric beds in Michigan and potential measures to improve access to care and patient experience. An additional portion of the meeting was dedicated towards reviewing challenges associated with placing patients in post-acute care settings and potential legislative options to assist hospitals.

Regarding an action item, the panel recommended the MHA support proposed state legislation to expand the swing bed program.

The panel received updates on other issues at the state level, including a preview of the upcoming lame-duck session, the November election and the 340B drug pricing program.

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

Behavioral Health Supplemental Budget, Policy Bills Advance

capitol building

capitol buildingThe Michigan Legislature advanced several hospital-related bills during the week of June 13. Most notably, the Senate advanced a $590 million supplemental appropriations bill related to behavioral health. Several other policy bills the MHA is watching also received committee action in the House and Senate.

The supplemental funding bill that includes the MHA’s request to support behavioral health was approved by the state Senate. Senate Bill (SB) 714, introduced by Senate Majority Leader Mike Shirkey (R-Jackson), would appropriate $590 million and includes several MHA-supported one-time line items for behavioral health. Included in the supplemental bill is $100 million in infrastructure grants for pediatric inpatient psychiatric services, $20 million in infrastructure grants for hospital behavioral health intake enhancements, $25 million to prepare for the expansion of the essential health provider loan repayment program, and $30 million to expand the state’s apprenticeship program for new behavioral health staff. The legislation now moves to the House for its consideration as the Legislature continues its work on the fiscal year 2023 state budget.

The House Health Policy Committee took testimony on a package of Certificate of Need (CON) bills that were reintroduced from the 2019-2020 session. Senate Bills (SBs) 181182183 and 190 would remove psychiatric bed capacity from CON oversight, increase the threshold for capital expenditures, increase the number of members on the CON Commission and remove air ambulance services from CON. The bills were introduced by Sens. Curt VanderWall (R-Ludington), Lana Theis (R-Brighton) and Michael MacDonald (R-Macomb Township). The MHA opposes the tie-barred package of bills and provided written testimony to the committee in support of Michigan’s current CON program. No votes were held on the bills.

The House Health Policy Committee also heard testimony on bills to change lead testing requirements for children. House Bills (HBs) 4678 and 4679, introduced by Reps. John Cherry (D-Flint) and Helena Scott (D-Detroit), would require minors to be screened for lead poisoning between the ages of 9 and 12 months and the ages of 2 and 3 years old and would include this information as part of the child’s immunization record. Providers would also be expected to identify high risk factors such as the age of the child’s residence, but it is unclear how penalties would be assessed for the new requirements. The MHA has not yet taken a position on the bills but will continue to monitor any action taken.

In the Senate Health Policy and Human Services Committee, bills to allow Michigan to join the Psychology Interjurisdictional Compact were taken up again. This compact is a legal agreement among states that creates 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), respectively, and are supported by the MHA. The bills now go to the Senate floor for a final vote and, if approved, will be sent to the governor desk for final consideration.

The Senate Health Policy and Human Services Committee also took up HB 5163, which was introduced by Rep. Angela Witwer (D-Delta Township) and would create an opt-out grant program for hospitals to establish medication-assisted treatment (MAT) for substance use disorders in their emergency departments. Hospitals provided MAT programs prior to introduction of the bill, and the MHA has already partnered with the Michigan Department of Health and Human Services to implement the first round of grants provided under this legislation. No hospitals would be required to participate in the program. HB 5163 was advanced to the Senate floor for further action.

For more information on these and other state bills related to healthcare, contact Adam Carlson at the MHA.

Michigan Legislature Addresses Multiple Healthcare Bills

The Michigan Legislature took up several bills impacting hospitals during the week Feb. 7. Some of the covered topics included legislation to expand the essential health provider loan repayment program, make changes to nonopioid directive forms, new regulation for pharmacy benefit managers (PBMs) and transparency bills for the Certificate of Need (CON) Commission.

The House Health Policy Committee reported Senate Bills (SBs) 246 and 435 to the House floor. Introduced by Sens. Curt VanderWall (R-Ludington) and Mike MacDonald (R-Macomb Township), the two bills would expand the essential health provider loan repayment program. SB 246 would raise the maximum allowable loan repayment from $200,000 to $300,000 for providers who agree to serve in a health resource shortage area for two to 10 years. SB 435 would expand the program to allow mental health professionals working in a health resource shortage area to qualify for the loan repayment program. The MHA supports both bills, which were passed in the full House and now go to the governor’s desk for signature.

The approved version of SB 435 includes an MHA-proposed amendment to extend the Physician Licensure Compact (PLC) law that was set to expire in March. The PLC is an important recruitment and retention tool for Michigan hospitals that allows physicians in good standing to more easily obtain licenses to practice medicine in multiple states. The MHA will continue to advocate for the governor to quickly sign SBs 246 and 435 into law and will keep members apprised of any action.

The House Health Policy Committee also reported to the House floor House Bill (HB) 5637, which would allow physicians to prescribe certain off-label medications to patients terminally ill with COVID-19. The bill amends the “Right to Try Act,” which is intended to give patients access to medications that are still in trial at the Food and Drug Administration for their condition or already approved to treat another diagnosis. As currently written, the medications could be prescribed only by the patient’s treating physician and the bill would not require health facilities to offer new medications or services that they do not already provide. The MHA has not taken a position on HB 5637.

The full House of Representatives approved and moved to the Senate four Certificate of Need (CON) bills that make no substantive changes to covered services. HBs 5074, 5075, 5076 and 5077 would require CON Commission reports and minutes to be posted online pursuant to certain deadlines and would require the Legislature’s Joint Legislative Committee, which oversees the CON Commission, to meet annually. The MHA does not have a position on the bills and has confirmed that the Michigan Department of Health and Human Services does not expect the bills to hinder the success of the program.

In the Senate Health Policy and Human Services Committee, members reported HB 4348, which would regulate and establish licensure for PBMs in Michigan. HB 4348 was introduced by Rep. Julie Calley (R-Portland) and is supported by the MHA to help slow the rising cost of prescription medications. The bill now moves to the Senate floor for consideration.

The Senate Health Policy and Human Services Committee also took testimony on HB 5261, an MHA-supported bill introduced by Rep. Abdullah Hammoud (D-Dearborn). HB 5261 would create specific exemptions for providers to administer opioids to a patient who has an active nonopioid directive form when the opioids are provided during a surgical operation or if the provider deems them medically necessary. No votes were taken on the bill.

Questions on state legislation related to healthcare may be directed to Adam Carlson at the MHA.

Adam Carlson Discusses CON with The Alpena News

Adam Carlson

Adam Carlson, vice president, advocacy, MHA, discussed certificate of need in a story published July 22 with The Alpena News. Certificate of Need (CON) is a program that ensures only needed services are developed in Michigan. CON benefits Michiganders by ensuring high-quality, accessible, cost-effective care for patients in our state while restraining the proliferation of unnecessary facilities and services.

The story looks at a package of bills introduced in the state House that seeks to add into law specific transparency requirements. Carlson described how the CON process in Michigan works and the benefits associated with the program.

“The whole goal of the program is to protect health care consumers from excess or low-quality healthcare services and the cost associated with them,” Carlson said. “By ensuring certain standards that must be met, we’re ensuring the healthcare procedures that are being performed are those that actually need to be performed.”

Read the article

State House Works on Healthcare Legislation

capitol building

The Michigan House of Representatives addressed several bills impacting hospitals during the week of May 31. Some of the topics addressed include a new legislative package to make changes to the behavioral health system in Michigan, Certificate of Need (CON) legislation and a bill to ban the use of COVID-19 vaccine passports.

In the House Health Policy Committee, initial testimony was taken on a package of bills that would implement a new approach to behavioral health services in Michigan. The bills would direct the Michigan Department of Health and Human Services (MDHHS) to replace the 10 Prepaid Inpatient Health Plans with a single nonprofit or administrative services organization that would manage administration across the entire state. House Bills (HBs) 4925 through 4929 were introduced by Reps. Mary Whiteford (R-Casco Township), Abdullah Hammoud (D-Dearborn), Phil Green (R-Millington), Sue Allor (R-Wolverine) and Shri Thanedar (D-Detroit). The MHA submitted a memo supporting the legislation in concept and encouraging the Legislature to form a work group that would address other shortcomings of the existing system that this legislation does not include.

The House Health Policy Committee also voted on Senate Bill (SB) 440, which would remove full-body positron emission tomography (PET) scanner services from CON oversight. That legislation was introduced by Sen. Winnie Brinks (D-Grand Rapids) and seeks to address a specific technology that is expected to be before the CON Commission at its June meeting. The MHA is opposed to the bill, which would undermine the program that ensures high-quality, accessible and cost-effective care for patients in Michigan. SB 440 now moves to the House Floor for a final vote before heading to the governor’s desk for signature.

The full House of Representatives voted on HB 4667, which would prohibit governmental entities from producing or issuing vaccine passports for COVID-19, requiring proof of vaccination status as a precursor for a public service or imposing a penalty based on vaccination status. The MHA successfully advocated for a bill substitute to ensure that HB 4667 would not impact hospitals’ ability to use the Michigan Care Improvement Registry, which would have been forbidden under the bill’s original language. The MHA remains opposed to the legislation, which could still have negative effects on statewide vaccination efforts. The bill was referred to the Senate Health Policy and Human Services Committee, where it now awaits another hearing.

Members with questions on any of these or other legislative efforts in Michigan should contact Adam Carlson at the MHA.

MHA Members Testify Before Senate Committee on CRNA Legislation

capitol building

The Senate’s Health and Human Services Policy Committee addressed a pair of bills relevant to hospitals during the week of May 17. The committee took testimony on House Bill (HB) 4359, which would modernize the scope of practice for certified registered nurse anesthetists (CRNAs). The committee also took up Senate Bill (SB) 440, which would remove certain positron emission tomography (PET) scanner services from Certificate of Need (CON) oversight.

Steve Barnett, president and CEO, McKenzie Health, and David Jahn, president and CEO, War Memorial Hospital, provided testimony May 20 to the committee in support of HB 4359. “This legislation will increase access to healthcare for Michigan residents. It will reduce costs for Michigan residents. It will permit CRNAs to practice to the full extent of what their license already provides for – and it will do all of this while maintaining every bit of patient safety,” said Jahn.

The MHA supports HB 4359 that, by modernizing the scope of practice for CRNAs, would allow flexibility for each hospital to choose the anesthesia care model that best fits its location, staffing and resources to offer safe and effective patient care. The bill, sponsored by Rep. Mary Whiteford (R-Casco Township), would also bring Michigan in line with 42 other states and the U.S. military on this issue. This change would eliminate a costly regulation while maintaining patient safety and would put into law a policy that has been allowed and proven effective during the COVID-19 pandemic. Current Michigan law requires a licensed physician of any specialty to supervise a CRNA to deliver anesthesia care.

The committee also voted to report SB 440, introduced by Sen. Winnie Brinks (D-Grand Rapids), to the Senate floor. The MHA supports Michigan’s existing CON process and is opposed to the bill that would, by removing certain full body PET scanner services from CON oversight, undermine the program that ensures high-quality, accessible, cost-effective care for patients in the state. The specific technology this bill seeks to address is expected to be before the CON Commission at its June meeting. The MHA will continue to monitor any action that is taken.

For more information on state legislation affecting healthcare, contact Adam Carlson at the MHA.