MHA Monday Report Nov. 10, 2025

Congressman Bergman Co-Sponsors Critical Access Hospital Relief Act

U.S. Rep. Jack Bergman (R-MI) recently co-sponsored HR. 538, the Critical Access Hospital Relief Act of 2025, which would remove the 96-hour physician certification requirement for inpatient services at critical access hospitals. The bill, introduced in January 2025, would amend …


State and Medical Partners Urge Michiganders to Get the COVID-19 Vaccine

To help ensure access to the COVID-19 vaccine for all residents, the Michigan Department of Health and Human Services, Department of Licensing and Regulatory Affairs and Department of Insurance and Financial Services …


MMMS and FIMR Aligned Recommendations to Improve Maternal and Infant Health

The Michigan Maternal Mortality Surveillance (MMMS) and Fetal Infant Mortality Review (FIMR) programs recently released aligned recommendations at improving outcomes across the maternal and infant health continuum. MMMS reviews cases of maternal deaths that occur …


Honoring Veterans Through Improved Access & Care Coordination

When observing Veterans Day, it’s important to recognize how healthcare organizations can meaningfully work together to improve health outcomes and address the unique needs of service members and their families. …


Key Findings from the Michigan Interpreter Needs Assessment Report

Understanding the critical role interpreters play in hospitals, the MHA Health Foundation recently contributed funding to support the Michigan Department of Licensing and Regulatory Affairs in conducting a needs assessment of Michigan’s interpreter landscape. …


MHA Rounds graphic of Brian PetersMHA CEO Report — Streamlining Medicaid Work Requirements

As states work toward establishing Medicaid work requirements that are a core element of H.R. 1, it’s more important than ever that we reduce the administrative burden associated with verification for beneficiaries. …


Keckley Report

The Structural Flaws that Must be Fixed to Transform the U.S. Health System

“Such is the case for health insurance coverage for millions in the U.S. as the federal government shutdown enters Week 6. Democrats are holding out for continuation of Affordable Care Act (ACA) insurance subsidies that enable 22 million to “buy” insurance cheaper, and Republicans are holding out for federal spending cuts reflected in the One Big Beautiful Act (July 2025) that included almost a trillion reduction in Medicaid appropriations thru 2036.

ACA subsidies at the heart of the shutdown successfully expanded coverage in tandem with Medicaid expansion but added to its costs and set in motion corporatization and consolidation in every sector of the health system. The pandemic exposed the structural divide between public health programs and local health systems, and insurance premium increases and prior authorization protocols precipitated hostility toward insurers and blame games between hospitals, insurers and drug companies for perpetual cost increases. …

Sixteen years later, healthcare is once again the eye of the economic storm. Insiders blame inconsistent regulatory enforcement and lack of adequate funding as root causes. Outsiders blame lack of cost controls. consolidation and disregard for affordability. Thus, while attention to subsidized insurance coverage and SNAP benefits might temporarily calm public waters, they’re not the solution. …

Healthcare’s the same. Outside forces seen or not will impact its future dramatically. Plans have to be made though Black Swans like the pandemic are inevitable.  But long-term planning built on plausible bets are necessary to every healthcare organization’s future.”

Paul Keckley, Nov. 2, 2025


New to KnowNews to Know

  • MHA offices will be closed and no formal meetings will be scheduled Nov. 11 in honor of Veterans Day.
  • The MHA will host a virtual member forum from 8:30 to 9:30 a.m. Nov. 7 to outline the MHA 2025-26 Strategic Action Plan approved by the MHA Board of Trustees.
  • Amy Brown, chief nursing officer, MHA, recently joined MHA Endorsed Business Partner (EBP) AMN Healthcare on the episode “Empowering Nurses Through Advocacy and Innovation” of the Elevate Care Podcast.
  • MHA EBP SunRx is continuing a webinar series about 340B Rebate Model Briefings on Nov. 13 and Nov. 20.

MHA in the News

Bridge published a story Nov. 5 sharing five reasons why health insurance rates are rising at increasing rates in the state, which included workforce challenges, expiring enhanced premium tax credits, inflation and drug prices. …

DIFS Releases Bulletin Protecting COVID-19 Vaccinations

The Michigan Department of Insurance and Financial Services (DIFS) issued a bulletin on Oct. 16 advising health insurers in the individual and small group markets to continue covering COVID-19 vaccinations without cost-sharing.

The bulletin was released in accordance with Gov. Whitmer’s Executive Directive 2025-7. The executive directive instructs the Michigan Department of Health and Human Services, DIFS and the Michigan Department of Licensing and Regulatory Affairs to work collaboratively to ensure COVID-19 vaccines are available to all Michiganders.

The DIFS bulletin states that under existing state law, all insurers in the individual and small group market must cover immunizations recommended by the federal Advisory Committee on Immunization Practices (ACIP). The ACIP continues to recommend the COVID-19 vaccine as of Oct. 16.

Members with questions regarding the bulletin should contact Megan Blue at the MHA.

CDC Updates Guidance for COVID-19 and Chickenpox Vaccines

The Centers for Disease Control and Prevention (CDC) recently updated its guidance for the COVID-19 and varicella (chickenpox) vaccines. The CDC’s decision uses an individual-based decision-making framework, referring to vaccination decisions made through shared clinical decision-making. The framework notes that vaccination should be determined based on patient characteristics, which can make broad-based recommendations difficult to apply.

The U.S. Food and Drug Administration approved marketing authorization for the COVID-19 vaccine to include those 65 and older and people at high risk for developing severe illness from the virus. This is in contradiction to policy in the past years, which recommended the vaccine for everyone six months and older.

The CDC also recommends updating the immunization schedule for chickenpox to be a standalone immunization rather than given in combination with the measles, mumps and rubella vaccines. This guidance is informed by evidence provided by the CDC Immunization Safety Office that states “Healthy 12–23 months old toddlers have an increased risk of febrile seizures seven to ten days after vaccination for the combined measles, mumps, rubella and varicella vaccine compared to those given immunization for chickenpox separately.”

The CDC stated that this change in decision making will continue to cover immunizations through payment systems that include Medicare, Medicaid, Children’s Health Insurance Program, the Vaccines for Children Program and private insurance plans.

Members with questions regarding this webinar or vaccine policy should contact the MHA Policy team.

MHA CEO Report — Cybersecurity Takes Center Stage

MHA Rounds image of Brian Peters

“There are only two types of companies: those that have been hacked, and those that will be.”  Robert Mueller

“Dear Health Care Leaders,

As you know, last month Change Healthcare was the target of a cyberattack that has had significant impacts on much of the nation’s health care system. The effects of this attack are far-reaching; Change Healthcare, owned by UnitedHealth Group (UHG), processes 15 billion health care transactions annually and is involved in one in every three patient records. The attack has impacted payments to hospitals, physicians, pharmacists, and other health care providers across the country. Many of these providers are concerned about their ability to offer care in the absence of timely payments, but providers persist despite the need for numerous onerous workarounds and cash flow uncertainty.”

So began a letter dated March 10 from Xavier Becerra, the Secretary of the U.S. Department of Health and Human Services (HHS), referencing what is emerging as one of the most extensive and impactful cyberattacks in U.S. history. The scrutiny directed at Change’s parent company UnitedHeath Group – from Congress, HHS, the media and others – is only just beginning, and there is no telling what sort of new regulations, penalties and associated policy change will be the end result. In the meantime, the MHA has stepped up to support our members by sharing as much information and intelligence as possible, and by advocating for flexibility and relief from both private payers and the state Medicaid program.

America’s hospitals are no strangers to external events creating seismic upheaval in our daily operations. Sometimes those events emanate from the world of public policy and politics, sometimes they come in the form of a localized natural disaster or tragic mass casualty event, and no one needs to be reminded of the impact of the global COVID-19 pandemic. But in the wake of the Change Healthcare crisis, there is no doubt cybersecurity now deserves to be on the top of the list of concerns for hospital leaders across the country, and right here in Michigan.

For some time now, the FBI has stated that healthcare organizations are the top target of cybercriminals across the globe, and these attacks have increased significantly in the last two years. Data sharing requirements in healthcare and the connectivity of health information – while well-intended – creates many potential risks for cybercriminals to exploit. Hospitals take these attacks extremely seriously. They are threat-to-life crimes because of the impact they can have on patient safety and access to care, and are formally treated as such by the FBI.

Again, this is not a new issue. A year and a half ago, cybersecurity was the topic for my CEO Report, where we expressed the potential for cybercrimes to cripple an organization. At that time, we saw how multi-national organizations with U.S.-based operations were impacted when Ukrainian government and critical infrastructure organizations were victims of cyberattacks during the Russian invasion of Ukraine. Yet again, we saw how the breach of one organization can cause rippling consequences for an entire industry; one that accounts for 17.3% of our nation’s Gross Domestic Product.

This is why the MHA has been engaged on this topic for many years and goes to great lengths to assist our members. The MHA was closely involved in the creation of the Michigan Healthcare Security Operations Center (HSOC) to help monitor and react to cyber risks with participating member organizations. We also partner with MHA Service Corporation Endorsed Business Partner CyberForceQ, a leader in the field, to assist members who need cybersecurity assistance. For the first time, we also have our very own MHA Vice President and Chief Information Security Officer, Mike Nowak, who works closely with the HSOC, our member CISOs and our external partners in this space. And Jim Lee, our senior vice president, data policy & analytics, continues to lead our MHA Health Information Technology Strategy Council, which is providing meaningful insight on the impact of this latest attack.

It can take months for a third-party review to determine what information was breached and ultimately taken. But from the hospital perspective, it is clear the Change Healthcare cyberattack is yet another example of a breach that initiates with an outside vendor, and those vendors are not always completely transparent and forthcoming with those organizations directly impacted by the breach. One thing we know for sure: our hospitals are victims in these situations and should be treated as such. We want to work with state and federal policymakers and regulatory agencies to prevent cyberattacks, and to root out and punish the criminals who perpetrate these crimes. We will be very concerned about any proposals that unfairly punish hospitals or create new barriers to our ability to provide timely access to quality care.

Our members are going to great lengths to mitigate potential risk. However, more can be done at a federal level to thwart bad actors. Hospitals and health systems are part of critical infrastructure, so our law enforcement agencies need the funding and staff to defend against cybercriminals. The American Hospital Association urged the government to use all diplomatic, financial, law enforcement, intelligence and military cyber capabilities to disrupt these criminal organizations, much like what was done in the global fight against terrorism in the wake of 9/11.

Thankfully, it appears our hospitals and health systems in Michigan have been able to manage this crisis better than counterparts in other states. The work of the MHA and our partners has helped make Michigan a leader in this space and to be prepared to respond to these situations. Our cybersecurity efforts are constantly at work, 24/7 year-round, mirroring the same cadence of our hospitals and their patient care. Yet the human component of healthcare is the most vulnerable. It only takes one individual to not notice a phishing or social engineering attempt for yet another failure that can impact hundreds of organizations, thousands of healthcare workers and tens of thousands of patients. This is why we must remain constantly vigilant as the cyber threat landscape continues to grow.

As always, I welcome your thoughts.