Michigan Legislators Act on Healthcare Bills

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capitol buildingSeveral bills impacting hospitals were acted upon during the week of May 9. Bills to plan for new funding from the national opioid settlement and to allow for certain out-of-state prescriptions were sent to the governor. In the Senate, testimony was taken on a bill to create a new license for dieticians and nutritionists and a bill to register certain medical labs in Michigan, and legislation to allow for certain visitors in healthcare facilities was reported to the House for further consideration.

On the House floor, the final votes were held on legislation to help guide Michigan’s use of new funding from the $26 billion national opioid settlement. Senate Bills (SBs) 993, 994 and 995 would create a new restricted fund for the state to house the settlement dollars, establish a new advisory commission appointed by the Legislature and governor to oversee spending, and prohibit future civil lawsuits related to claims covered by this fund. The bills now head to the governor’s desk for signature into law.

The Senate passed an MHA-supported bill related to out-of-state prescriptions. SB 166, introduced by Sen. Curt VanderWall (R-Ludington), would allow pharmacies to fill noncontrolled substance prescriptions written by licensed, out-of-state physician assistants and advanced practice registered nurses. SB 166 was also sent to the governor for signature.

The full Senate approved and reported to the House SB 450, which would ensure that visitors of cognitively impaired patients are permitted in healthcare facilities. Introduced by Sen. Jim Stamas (R-Midland), the bill would prohibit the director of the Michigan Department of Health and Human Services (MDHHS) 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 and will continue to monitor any action taken in the House.

Further testimony was held in the Senate Health Policy and Human Services Committee on SB 614, which would create a new license for both dieticians and nutritionists in Michigan. Under the current language, a single license would be used for both professions. There was no vote held on SB 614, as the bill sponsor Sen. Michael MacDonald (R-Macomb Township) is working to address concerns from the Michigan Department of Licensing and Regulatory Affairs on the implementation of the dual licensure. The MHA supports SB 614 and looks forward to working with the stakeholders on potential improvements.

Questions on these issues or other state legislation related to healthcare can be directed to Adam Carlson at the MHA.

State Legislature Discusses Multiple Bills Affecting Healthcare

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capitol buildingThe Michigan Legislature returned from its spring recess during the week of April 11, taking up several bills impacting hospitals. In the House, the state’s higher education budget was advanced to the appropriations committee and testimony was held on legislation to regulate the sale of the opiate-like substance kratom. In the Senate, legislation was introduced to provide for new tax credits for medical school and advanced practice nursing program preceptors. Additionally, both the House and Senate held hearings on identical bills intended to help prepare the state for incoming funding from the recently finalized national opioid settlement.

The MHA successfully advocated for the inclusion of $4.7 million dollars in House Bill (HB) 5785, the state’s Higher Education budget, which is now before the House appropriations committee. Introduced by Rep. Ben Frederick (R-Owosso), this funding will allow for the creation of a healthcare workforce collaborative between the MHA and the state’s public and private post-secondary educational intuitions. HB 5785 will support a better understanding of statewide graduates in health professions as well as current employment opportunities in healthcare throughout the state. Funding and creating a searchable, accessible repository allows healthcare employers to understand current educational trends in the state and provides prospective employees easy access to healthcare positions throughout the state.

The House Rules and Competitiveness Committee took testimony on HB 5477, which would regulate the sale of kratom in Michigan. Kratom is a substance of concern with opiate-like effects that has no approved medical use in the United States. The MHA’s Legislative Policy Panel has previously taken a position supporting the identification of kratom as a Schedule I narcotic. HB 5477 would create a license for kratom sales and manufacturing, require testing of products and require new safety warnings on kratom substances sold in Michigan. The MHA has not yet taken a position on the bill.

In the Senate, legislation was introduced to provide new tax credits for medical school and advanced practice nursing program preceptors. Senate Bills (SBs) 998 and 999 were introduced by Sens. Jeff Irwin (D-Ann Arbor) and Curt VanderWall (R-Ludington) and would create a new tax credit for individuals who agree to work as a preceptor for required clinical rotations. A $1,000 tax credit would be provided for every 250 hours they serve in that capacity through December 2026, capped at $5,000 per year. The MHA supports the bills, which could help increase the capacity for clinical rotations at hospitals across the state.

In both the House and Senate, work began on identical packages of bills to help guide Michigan’s use of new funding from the $26 billion national opioid settlement. The legislation was introduced as HBs 5968, 5969 and 5970 in the House and SBs 993, 994 and 995 in the Senate. Michigan is estimated to receive $776 million from the settlement, and these legislative packages are intended to plan and prepare for the state to spend those funds wisely. The packages would create a new restricted fund for the state to house the settlement dollars, establish a new advisory commission appointed by the Legislature and governor to oversee spending, and prohibit future civil lawsuits related to claims covered by this fund. The MHA is currently working to identify treatment and prevention priorities for feedback on the legislation and will continue to monitor the legislation as it progresses.

Questions on these issues or other state legislation related to healthcare can be directed to Adam Carlson at the MHA.

Prior Authorization Bill Signed into Law

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capitol buildingLegislation to decrease wait times for commercial insurance prior authorization requests was signed into law by Gov. Gretchen Whitmer April 7. Senate Bill (SB) 247, introduced by Sen. Curt VanderWall (R-Ludington), will shorten the timeline for approval to seven calendar days or 72 hours for urgent requests, as well as ensure that emergency care can be provided without prior approval.

Shortening wait times for prior authorization requests has been an MHA priority for several legislative sessions. The MHA provided testimony in support of SB 247 in both chambers and shared a letter with the governor encouraging her to sign the bill. The legislation will take effect June 1, 2023.

Members with questions about SB 247 or other state legislation regarding healthcare should contact Adam Carlson at the MHA.

Healthcare Bills Progress Prior to State Legislative Summer Break

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Michigan CapitolThe Michigan Legislature continued work on bills impacting Michigan hospitals as it goes into the final week before its summer break. Action was taken during the week of June 21 on issues regarding certified registered nurse anesthetists (CRNAs), the fiscal year (FY) 2022 budget, pharmacy benefit managers (PBMs), requirements for Canadian health professionals in Michigan and allowing certain health professionals to train nurse aides. In addition, the Michigan Department of Health and Human Services held a news conference on legislation related to treatment for opioid use disorder (OUD), and the governor signed legislation related to the Certificate of Need (CON) program.

Both the House and Senate took action on House Bill (HB) 4359, voting to support the important legislation that would modernize the scope of practice for CRNAs. The bill was introduced by Rep. Mary Whiteford (R-Casco Township) and will now go to the governor’s desk for signature. The legislation would bring Michigan in line with 42 other states and the U.S. military, all of which provide flexibility regarding physician supervision of CRNAs delivering anesthesia care. The MHA has supported HB 4359 with testimony in both chambers and will continue to advocate for the bill to be signed into law.

Representatives in the House approved House Bill (HB) 4410, which would provide for all funding for the FY 2022 budget year, aside from community colleges and higher education. HB 4410 would protect key hospital priorities, including graduate medical education, disproportionate share hospital funding, rural and obstetrics stabilization pools, critical access hospital funding and Medicaid rate increases. The bill includes new provisions that would make changes to streamline prior authorization timeframes for Medicaid health plans and boilerplate that would prohibit the use of any funds for vaccinations under a mandatory vaccination program. Due to concerns that the vaccine mandate provision could hinder state vaccination efforts, the MHA will work closely with the administration to address potential issues. HB 4410 will now be sent to the Senate for consideration.

The House Health Policy Committee reported Senate Bill (SB) 416 to the floor. The bill was introduced by Sen. Wayne Schmidt (R-Traverse City) and would ensure that Canadian health professionals who have previously taken relevant medical exams could apply for Michigan licensure. SB 416 clarifies legislation supported by the MHA during the last session that provided licensure reciprocity to Canadian health professionals who want to work in Michigan. It will now be sent to the full House for a vote.

The House Health Policy Committee also took testimony on HB 5089, which was introduced by Rep. Ann Bollin (R-Brighton Township) and would allow a registered professional nurse to train nurse aides without a permit for up to four months after the end of the COVID-19 declared state of emergency. The MHA has not taken a position on HB 5089 and no vote was held.

In the Senate Health Policy and Human Services Committee, further testimony was held on HB 4348, which would regulate and establish licensure for PBMs in Michigan. The legislation was introduced by Rep. Julie Calley (R-Portland) and is supported by the MHA to help slow the rising cost of prescription medications. No vote was held in committee on HB 4348.

Dr. Daniel Roper participated in the June 23 event that announced legislation to increase access to lifesaving treatment for opioid use disorder.A news conference was held June 23 to announce the introduction of a bill that would provide funding for a grant program for hospitals to increase access to medication assisted treatment for OUD in the emergency department (ED). The MHA Legislative Policy Panel supports the bill, which is intended to increase access to lifesaving treatment for OUD. Daniel Roper, MD, chief of emergency services and medical director of the ED at Mercy Health Saint Mary’s in Grand Rapids, represented one of 19 Michigan hospitals currently providing medications for OUD in EDs during the event, noting that the proposed bill would remove barriers for other providers to offer the treatment. The bill is expected to be introduced before the legislative summer break, and the MHA will keep members apprised of its movement.

Lastly, the governor signed SB 440 into law June 24 as Public Act 35 of 2021. SB 440 was introduced by Sen. Winnie Brinks (D-Grand Rapids) and would remove full-body PET scanner services from CON oversight.

Members with questions on these or other state legislative issues should contact Adam Carlson at the MHA.