MDHHS Announces Medicaid Health Plan Rebid Requirements

The Michigan Department of Health and Human Services (MDHHS) announced new information Aug. 22 related to the rebidding of contracts for health plans that provide services to 2.2 million Michiganders receiving coverage through Medicaid and Michigan’s Healthy Michigan Plan. The announcement included network requirements and minimum qualifications for bidders in its upcoming request for proposals for the Comprehensive Health Care Program contract for Michigan’s Medicaid health plans.

The MHA has been and will continue to monitor all relevant aspects to the Medicaid health plan bidding/proposal process and continue to advocate when appropriate to ensure Michigan residents get the coverage and networks they need and deserve to receive high-quality, timely services.

Members with questions may contact Jason Jorkasky at the MHA.

Governor Signs New Budget Including Investments in Hospitals

capitol building

capitol buildingGov. Whitmer signed the fiscal year 2024 state budget Aug. 1, which includes $92 million in new investments directly to hospitals. It specifically provides $59 million to support increased Medicaid reimbursement rates at Level I and II trauma centers and $33 million to support an increase in Medicaid inpatient psychiatric reimbursement rates. The signed budget will go into effect Oct. 1.

In addition to the ongoing and targeted new investments, the agreement provides necessary resources to assist hospitals and health systems in advancing the health of individuals and communities throughout Michigan. It maintains funding for the Healthy Michigan Plan, Medicaid, graduate medical education, disproportionate share hospitals and the rural access and obstetrical stabilization pools.

The MHA is also pleased with new investments in workforce by lowering the age for Michigan Reconnect from 25 years to 21 years of age and investing $2.5 million to support recruitment and retention programs for behavioral health professionals. The budget also increases ongoing funding for the Michigan Achievement Scholarship, which provides significantly reduced tuition for many students at public universities.

Consistent with the strategic action plan of the MHA, the budget places a new emphasis on health equity and reducing disparities for maternal health care with specific, targeted new investments. Funding is included for the Michigan Alliance for Innovation on Maternal Health and $49.5 million for community health programs, healthy community zones, IT improvements and mobile health units to address racial disparities in health. Additionally, the budget further expands the Medicaid program by eliminating the five-year waiting period for pregnant and new mothers who are legally residing in Michigan.

Members with questions on the state budget may contact Adam Carlson.

Governor Signs MHA Supported Legislation and Announces Round of GoingPro Awards

capitol building

capitol buildingGov. Whitmer signed several MHA-supported bills during the week of July 17 related to the Healthy Michigan Plan (HMP), organ donation and vaccine distribution. Those bills include:

  • House Bills 44954496 (Public Acts (PAs) 98-99 of 2023), sponsored by Reps. Will Snyder (D-Muskegon) and Graham Filler (R-DeWitt), make important updates to the HMP, Michigan’s expanded Medicaid. The program will no longer include cost sharing requirements that have proved to be exceedingly burdensome. Further, the statute no longer includes language allowing for the program to be summarily abandoned if state costs exceeded state savings. The HMP has allowed for increased access to healthcare throughout the state, providing coverage for over a million Michiganders.
  • House Bills 4362, 4363 and 4364 (PAs 100-102 of 2023), sponsored by Reps. Felicia Brabec (D-Ann Arbor), Cynthia Neeley (D-Flint) and Natalie Price (D-Berkley), include the option for individuals to denote their organ donor status when filing state income taxes. Over 103,000 individuals nationwide are waiting for organ donations, including approximately 2,300 Michiganders. These policies will increase opportunities for residents of the state to opt-in to organ donation. Increasing the number of people on the organ donation list benefits those in need while also supporting long term organ availability.
  • Senate Bill 219 (PA 97 of 2023), sponsored by Sen. Sylvia Santana (D-Detroit), allows pharmacists to order and administer qualifying vaccines and lab tests independently. Michigan continues to seek ways to increase vaccination rates. State solutions like SB 219 allow Michigan to support additional access points. The law allows a pharmacist to order and administer vaccines and lab tests in certain circumstances without the supervision of a physician, following completion of approved training.

In addition to signing important healthcare legislation, Gov. Whitmer announced $13.5 million in GoingPro awards, with several MHA members receiving funds to support upskilling and retooling team members. GoingPro launched in 2014 and allows employers to apply for grant funding to support their employees in earning industry-recognized credentials. Over 8,500 employees across the state have benefited from the program and this recent round of grant awards included nearly $750,000 for hospitals. The MHA continues to support Gov. Whitmer’s recognition of hospital workforce needs and her dedication to growing the state’s talent pipeline.

Members with questions about state legislative action may contact Adam Carlson at the MHA.

Headline Roundup: Healthy Michigan Plan & Healthcare Workforce

Brian Peters

Brian PetersThe MHA received media coverage the week of July 17 regarding the healthcare workforce, federal legislation to address drug shortages and bills signed by Gov. Whitmer eliminating burdensome provisions in the Healthy Michigan Plan and making changes to help ensure the program’s long-term success.

MHA CEO Brian Peters is quoted in multiple stories. Below is a collection of headlines from around the state.

Thursday, June 20

Wednesday, July 19

Tuesday, July 18

Members with any questions regarding media requests should contact John Karasinski at the MHA.

MHA CEO Report — The Story of the MHA Program Year

MHA Rounds Report - Brian Peters, MHA CEO

“Plans are only good intentions unless they immediately degenerate into hard work.”Peter Drucker

MHA Rounds Report - Brian Peters, MHA CEOThe theme of the 2022-2023 MHA program year was telling our story. With focus and passion, we told the stories of our hospitals and health systems, the challenges and adversity they face, and how they still provide high quality and accessible healthcare to their communities. This theme was intended to ensure that we as healthcare leaders continue to help those who don’t live and breathe healthcare understand the ways we are working to meet the most pressing needs, but also the support we need from other sectors to continue to offer strong and daily access to care for all. Our theme served to frame the four distinct pillars of our association strategic action plan, which included the financial sustainability of hospitals, workforce restoration and well-being, the behavioral health crisis and continued efforts towards achieving health equity.

I’m pleased to share we made significant progress in telling our story and achieving tangible, impactful results under each of the four strategic pillars, which is summarized in the latest MHA Annual Report. This work evolved around the ending of the COVID-19 public health emergency, a pandemic that tried our member organizations, and especially their healthcare workers, like nothing has before in most of our lifetimes. A large part of our success in making this transition and achieving so many significant outcomes was due to the MHA Board of Trustees, who I want to thank for their strong leadership and commitment to advancing the health of individuals and communities. I particularly want to express my gratitude to our outgoing Chair, T. Anthony Denton, for his steadfast leadership throughout this year.

Key to our efforts to safeguard the financial viability of hospitals is our continued focus on the state budget. Not only were we successful in continuing existing supplemental payment pools such as for Disproportionate Share Hospitals, Graduate Medical Education, Rural Access and Obstetrical Stabilization, but we also secured a Medicaid outpatient hospital rate increase. Collectively, these victories generated hundreds of millions in funding for Michigan hospitals. Long a priority of our association, the MHA also successfully advocated to ensure the Healthy Michigan Plan (our Medicaid expansion program) is fully funded. Our advocacy team continues to be one of the most respected in Lansing, as we saw several MHA-supported bills signed into law while experiencing a 100% success rate in making sure none of the 10 bills we opposed became statute.

Each of the four pillars are equally important to our membership, but it is hard to overstate just how important workforce restoration and well-being is to our healthcare leaders. This is the issue that keeps each of them up at night, whether it is finding new staff or protecting and retaining their existing workers. Our advocacy efforts secured an additional $75 million in funding to support the hospital workforce while also securing $56 million in funding to support partnerships to offer Bachelor of Science in Nursing programs at community colleges. We also continue to advocate for increased penalties for those who verbally or physically harm healthcare workers, providing them with protections they deserve as front-line caregivers, much like emergency responders receive. The MHA Keystone Center has been active in offering well-being resources, trainings, safety and security risk assessments and other offerings, continuing their long history as a leader in safety and quality not just here in Michigan, but nationally and internationally. Lastly, we recently launched a statewide healthcare career awareness campaign to entice students to pursue health career pathways.

Our work on behavioral health continues, as there remains a need to expand the number of behavioral health professionals and facilities to provide better access to care. The MHA secured both $50 million in the fiscal year 2023 state budget for expanding pediatric inpatient capacity, while adding an additional $10 million to create Psychiatric Residential Treatment Facilities to alleviate state hospital capacity issues. Much of the feedback we have received is the need to add quantitative data to the conversation to demonstrate to lawmakers and stakeholders the degree of the crisis. For several months, our team has been collecting data weekly on the number of patients waiting for a behavioral health bed in Michigan hospitals. This demonstrates the degree to which patients are having difficulty finding care, while also showing how many patients are utilizing hospital resources while the facility receives no reimbursement due to not having an acute care diagnosis billing code.

Lastly, we will not rest as our members continue to address health disparities to ensure health equity. The MHA Keystone Center works closely with the Michigan Alliance for Innovation on Maternal Health (MI AIM) to help address disparities and reduce the risk of maternal death. This past program year, their efforts resulted in 77% of Michigan birthing hospitals participating in MI AIM, 94% of which are compliant with the pre-partum assessment and 89% are compliant with the post-partum assessment. Our work with the MHA Public Health Task Force also continues as they explore strategies for collaboration that can improve data collection and public health initiatives.

Of course, there are always other items that come up that require MHA attention and effort that are not always known during the development of the strategic action plan. Responding to the shortages of chemotherapy drugs cisplatin and carboplatin and working with Michigan’s Congressional delegation is just one example of the value of association membership and how quickly we can mobilize our relationships in a time of crisis. Other wildcards include our work on licensing Rural Emergency Hospitals, tracking and increasing awareness of candida auris infections and expanding hospital bed capacity.

As we concluded our program year during our Annual Meeting on Mackinac Island, we were able to honor a true healthcare champion with our Meritorious Service Award in U.S. Sen. Debbie Stabenow. She announced earlier this year she will not seek an additional term in office and this award is the highest honor our association can bestow on an individual for their years of work towards enabling the health and wellness of individuals and communities. We have worked closely with Sen. Stabenow from her time in elected office in the Michigan Legislature to Congress and she will leave an extraordinary legacy for which the MHA family will be eternally grateful. We also had an opportunity to honor a number of other outstanding individuals for their contributions to Michigan healthcare.

Above all else, I want to take this opportunity to thank all MHA staff for their many contributions which made it another successful program year. The challenges we confront in healthcare are daunting and constantly evolving, but my confidence in our team at the MHA has never wavered, as they continue to display their exceptional commitment to their work and embody the MHA culture of member service and value creation every single day.

Now as we formally begin our 2023-24 program year on July 1, I am excited for the leadership of our new Chair Shannon Striebich. We offer our congratulations to her and look forward to working closely together. A year from now, I am confident we will once again be able to report on the successful outcomes we were able to achieve through our unity, collaboration and plain old fashioned hard work.

As always, I welcome your thoughts.

Legislative Fiscal Year 2024 State Budget Renews Commitment to Healthcare

Brian Peters

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

Brian PetersThe fiscal year 2024 state budget approved by the Michigan Legislature renews a longstanding commitment lawmakers have made to the health and wellness of Michigan’s hospitals, health systems and communities.

We are extremely pleased to see the inclusion of new funding to support trauma centers and inpatient psychiatric services that will provide a net benefit of $92 million. Trauma centers at hospitals provide lifesaving treatment to people with the most severe injuries, ready at a moment’s notice for mass casualty events and catastrophic accidents with a vital network of EMS services. This added funding makes Michigan a national leader in recognizing the importance of access to trauma services and makes sure trauma centers can continue to be equipped with the resources needed to staff these services 24/7, year-round.

Michigan is also in the middle of a behavioral health crisis where the demand of patients needing inpatient care continues to increase. We commend the Legislature for recognizing this need and increasing rates to inpatient psychiatric facilities based on patient acuity to help hospitals afford the staffing, security and facilities necessary to accept patients with more severe illness.

In addition, the budget continues to support long-standing programs crucial to access to healthcare services throughout Michigan. These include funding for rural and critical access hospitals, obstetrical services, graduate medical education, the Healthy Michigan Plan and Michigan’s Medicaid population.

We look forward to a signed budget that provides hospitals with the needed support to continue to provide high-quality care to every patient.

Policy Committees Continue Work Amid Budget Negotiations

capitol building

capitol buildingSeveral MHA-tracked bills were reported the week of June 19 from their respective policy committees. The bills address violence against healthcare workers, scope of practice for pharmacists, dietician licensure, behavioral health and the Healthy Michigan Plan.

In the House Criminal Justice Committee, House Bills (HBs) 4520 and 4521, introduced by Reps. Kelly Breen (D-Novi) and Mike Mueller (R-Linden), were voted out of the committee unanimously. 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. Addressing violence against healthcare workers and deterring potential attacks continues to be an MHA priority. HBs 4520 and 4521 now move to the House Floor for a full chamber vote.

In the House Health Policy Committee, a vote was held on a bill introduced by Sen. Sylvia Santana (D-Detroit) that would increase access to vaccines and certain laboratory tests. Senate Bill (SB) 219 would allow pharmacists to order and administer immunizations and certain diagnostic tests for their patients without physician supervision. Under the current language, pharmacists wishing to provide these services must also complete some additional training courses as part of their licensure process. The MHA is supportive of SB 219, which now heads to the House Floor for further consideration.

Legislation to create a licensure process for Michigan dieticians also saw action in House Health Policy. HB 4608, introduced by Rep. Laurie Pohutsky (D-Livonia), would create a new license for individuals seeking to provide medical nutrition therapy in Michigan. Establishing the new license will help ensure access for Michigan patients by increasing opportunities for dieticians to be reimbursed for the services they provide. The MHA is supportive of the bill, which was reported to the House Floor with recommendation that it pass.

In the House Committee on Insurance and Financial Services, a vote was held to report legislation intended to increase insurance coverage for mental health and substance abuse disorder services. HB 4707, introduced by Rep. Felicia Brabec (D-Pittsfield Township), would require coverage of medically necessary behavioral health and substance use disorder treatment, with the intent to encourage expanded access to much needed services. More specifically, the bill would require coverage for out-of-network and emergency services and set limitations to prior authorization and utilization review requirements. The MHA has been closely monitoring HB 4707, working with proponents and stakeholders alike. The bill now awaits a full House Floor vote.

In the Senate Healthy Policy Committee, a vote was taken in support of legislation to improve the Healthy Michigan Plan. HBs 4495 and 4496, introduced by Reps. Graham Filler (R-St. Johns) and Will Snyder (D-Muskegon), would eliminate unnecessary provisions in the Healthy Michigan Plan and make changes to help ensure its long-term success. The package would remove requirements that certain beneficiaries maintain Health Savings Accounts and pay co-pays or deductibles. Additionally, the bill removes the provision that a future administration could repeal the program if state savings are reduced. The MHA is supportive of both bills, which now await action on the Senate Floor.

Members with questions about state legislative action may contact Adam Carlson at the MHA for more information.

Bills on Healthy Michigan Plan Improvements and Tax Credit for Clinical Preceptors See Action

capitol building

capitol buildingAction was taken the week of May 22 on a variety of bills that would make improvements to the Healthy Michigan Plan, require adult changing tables be included in future construction or renovation projects and provide new tax credits for clinical preceptors.

In the House Health Policy Committee, a bipartisan vote was taken in support of legislation to improve the Healthy Michigan Plan. House Bill (HB) 4496, introduced by Rep. Graham Filler (R-St. Johns), would eliminate unnecessary provisions in the Healthy Michigan Plan and make changes to help ensure its long-term success. The bill is part of a two-bill package with HB 4495, which was introduced by Rep. Will Snyder (D-Muskegon) and approved last week by the committee. The package would remove requirements that certain beneficiaries maintain Health Savings Accounts and pay co-pays or deductibles. Additionally, the bill removes the provision that a future administration could repeal the program if state savings are reduced. The MHA is supportive of both bills and will continue to monitor any future action.

Also in the House, a new bill to increase access to adult changing tables was introduced by Rep. Lori Stone (D-Warren). HB 4649 would require that future construction or renovation projects over $10,000 include one adult-sized changing table for the facility. Hospitals and rehabilitation facilities with 10 or more employees are included directly in the language. The MHA is reviewing the legislation to ensure that any existing patient rooms with adequate accommodations would satisfy the requirement under the language. The bill was referred to the Committee on Regulatory Reform for further consideration.

On the Senate side, an MHA-supported package to provide new tax credits for clinical preceptors was reintroduced. Senate Bills 360 and 361 were introduced by Sen Jeff Irwin (D-Ann Arbor) and Sue Shink (D-Ann Arbor) and would provide up to $5,000 in state income tax credit for individuals who agree to work in Michigan as a physician, physician assistant or advanced practice nursing program clinical preceptor. The language allows for $1,000 to be credited for every 250 hours completed during a tax year. The MHA sees this as a unique solution to encourage individuals to assist in growing the healthcare talent pipeline and could increase Michigan’s capacity for clinical rotation slots.

Members with questions about state legislative action may contact Adam Carlson at the MHA for more information.

MHA Enrollment Data Analysis Expansion

The MHA recently expanded its analysis of enrollment data to reflect Medicare and Medicaid enrollment as a percentage of each county’s total population and the split for Medicare and Medicaid between fee-for-service and managed care organizations. Statewide, nearly 22% of the total population is enrolled in Medicare and 32% enrolled in Medicaid.

Total Medicaid enrollment, including the Healthy Michigan Plan, is 3.2 million as of April 2023, with 71% of beneficiaries enrolled in one of nine managed care plans. The MHA will update this data monthly as we monitor the impact of the Medicaid redetermination process that requires eligibility be redetermined for all enrollees over the next 12 months. The Michigan Department of Health and Human Services began the process April 1, with some enrollees expected to lose coverage July 1.

Total Medicare enrollment is 2.17 million with 59% of beneficiaries enrolled in a Medicaid Advantage (MA) plan. April enrollment is spread across 48 MA plans with up to 28 plans covering beneficiaries in several Michigan counties. The MHA will also update this data monthly as Michigan’s population continues to age and MA enrollment continues to grow.

Members are encouraged to review the MHA’s COVID-19 PHE webpage for information about the end of the PHE and additional resources.

Members with enrollment questions should contact Health Finance at the MHA.

MHA Monday Report May 15, 2023

MHA Monday Report

capitol buildingHarmful Nurse Staffing Legislation Introduced in Michigan Legislature

Harmful nurse staffing legislation was introduced May 11 in the Michigan Legislature that would mandate nurse staffing ratios, require public disclosure of the ratios and restrict mandatory overtime for nurses. The bill package is pushed by the Michigan Nurses Association and was ….

Behavioral Health ED Boarding Data Available

Behavioral health emergency department (ED) boarding data the MHA has been collecting on a weekly basis from acute care hospitals across Michigan since March 2023 is now available on the Health Data webpage of the …

Annual Meeting iconMHA Annual Membership Meeting Includes Ways to Support Michigan Hospitals

The MHA membership will convene in person for the MHA Annual Membership Meeting June 28 through 30 at Grand Hotel on Mackinac Island. The annual meeting will feature an outstanding lineup of speakers, the family …

DEA Issues Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications

After delaying the final rule for ending COVID-19 telehealth prescribing rules, the Drug Enforcement Agency (DEA) has issued a temporary rule to allow the following: The full set of telemedicine flexibilities regarding prescription of controlled …

Upcoming Webinars on Medicare FFS Quality-based Programs

The MHA is partnering with DataGen to host two free webinars focused on Medicare fee-for-service (FFS) quality-based programs, which can reduce hospital inpatient FFS payments by up to 6%, depending upon hospital performance. The webinars …

Webinar Outlines Practices to Re-engage Patients and Families in Care

Fractured social contracts in today’s world have changed the healthcare landscape and culture. There is a convergence of patient consumerism and digital transformation happening, and those who focus on patient-centered care and person and family …

MHA Keystone Center PSO Safe Table – Health IT & Risk Safety

The MHA Keystone Center PSO is hosting a Health IT & Risk Safety Safe Table from 12:30 to 3 p.m. June 14. The event will be held at Goshen Health, located at 200 High Park …

Direct Care and Behavioral Health Workforce Assessment: Regional Feedback Sessions

Public Sector Consultants and Health Management Associates are partnering with the Michigan Department of Health and Human Services to gather the perspectives of people impacted by the direct care worker and behavioral health workforce …

MHA Webinar Focuses on Building Trust and Relationships for Trustees

When stakeholders gather to discuss community vitality, the health and wellbeing of the community is not only about access to safe, affordable healthcare, but about non-medical health influences that have an impact on the community. …

MDHHS Releases Beginner Guide for Doula Providers

Michigan Medicaid began reimbursing doula services provided to individuals covered by or eligible for Medicaid as of Jan. 1, 2023. Doula providers are required to be on the Michigan Department of Health and Human Services …

The Keckley ReportPaul Keckley

The End of the Pandemic Health Emergency is Ill-timed and Short-sighted: The Impact will further Destabilize the Health Industry

“The national spotlight this week will be on the debt ceiling stand-off in Congress, the end of Title 42 that enables immigrants’ legal access to the U.S., the April CPI report from the Department of Labor and the aftermath of the nation’s 199th mass shooting this year in Allen TX.

The official end of the Pandemic Health Emergency (PHE) Thursday will also be noted but its impact on the health industry will be immediate and under-estimated. …

In the weeks ahead as the debt ceiling is debated, the Federal FY 2024 budget finalized and campaign 2024 launches, the societal value of the entire health system and speculation about its preparedness for the next pandemic will be top of mind. …“

Paul Keckley, May 8, 2023

News to Know

  • Upon the end of the COVID-19 Public Health Emergency, the Health Resources & Services Administration will end a 2020 policy allowing hospitals to use 340B drugs for eligible patients in new hospital locations, even if they have not yet appeared on a filed Medicare cost report.
  • The MHA is hosting the webinar MHA Programs of All-Inclusive Care for the Elderly (PACE): An Alternative to Traditional Nursing Home care from 8:30 to 9:30 a.m. May 23.
  • Completed 2022 occupational mix surveys must be submitted by acute care hospitals paid under the Medicare prospective payment system to the Medicare Administrative Contractor by June 30, 2023.

Brian PetersMHA in the News

The MHA received media coverage the week of May 8 regarding nurse staffing legislation, healthcare worker shortages, the ending of the COVID-19 public health emergency and more. A joint media statement was published May 11 …