Lame Duck Session Begins in Senate

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capitol buildingThe 2022 lame-duck session in the legislature got off to a slow start in the Senate during the week of Nov. 28. Several bills impacting hospitals saw unsuccessful votes on the floor, including legislation to make changes to the operation of the 340B drug pricing program and a package to integrate behavioral and physical health for state regulated insurance plans.

The 340B legislation, Senate Bill (SB) 1088, threatened to strike important protectionist language that was secured in Public Act 12 of 2022. That bill signed into law in February prohibits a pharmaceutical manufacturer from requiring the use of a modifier on non-Medicaid claims, protecting 340B entities from industry implemented administrative hurdles. Removing this language would negatively impact the communities served by Michigan 340B hospitals. The MHA and its member hospitals have been working hard to advocate to elected officials the importance of the program. SB 1088 was introduced as a vehicle bill by Sen. Curt VanderWall (R-Ludington) and was discharged and substituted on the floor before voting. The vote on SB 1088 on Nov. 29 ultimately failed twice on the floor and it is not clear if the legislation will be considered again.  The MHA will continue to oppose SB 1088 and other threats to the 340B program.

SB 597 and 598, the Senate’s behavioral health integration package, also did not find the votes to pass on the floor. Introduced by Sen. Majority Leader Mike Shirkey (R-Jackson) and Sen. John Bizon (R-Battle Creek), the package would create new specialty integrated plans (SIPs) that would replace the current prepaid inpatient health plans (PIHPs) and contract with each community mental health (CMH) services program to deliver physical and behavioral health services to Michigan’s Medicaid population. The bills would also eliminate language requiring CMH entities to coordinate substance use disorder (SUD) and school based behavioral health services and create a new statewide ombudsman.

The Senate’s Health Policy and Human Services Committee also met to advance several bills to the floor for a potential vote in the final days of session. Among those bills was House Bill (HB) 6086, introduced by Rep. Jeff Yaroch (R-Richmond). HB 6086 would establish an alternate licensure process for paramedics in Michigan. HB 6086 would require the state to develop a new Michigan-specific certification course, separate from the currently required course from the National Registry of Emergency Medical Technicians. The MHA is opposed to HB 6086, which could have implications for a paramedic’s ability to work in multiple states. The National Registry of Emergency Medical Technicians certification is currently used in 48 states and is required for all newly licensed paramedics in Michigan.

The MHA will continue to monitor all these bills for any further action in the coming weeks. Members with questions about these issues or other state legislation related to healthcare can be directed to Adam Carlson at the MHA.

MHA Hospital Priorities Fully Funded in Legislative Budget Proposals

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The state House of Representatives and Senate advanced budget proposals May 13 for both the current year and the upcoming fiscal year that fully fund hospital priorities, including new MHA Board of Trustees’ priorities from its April meeting.

During that meeting, board members discussed several possible funding items that could be used to address the ongoing and worsening behavioral health crisis in Michigan and its significant impact on hospitals and patients. The board directed the MHA to focus on funding to address these issues and work toward better patient care. The House budget proposal approved May 13 includes $125 million to add pediatric psychiatric patient beds at hospitals, improve care of behavioral health patients in the emergency department and add additional settings of care for behavioral health cases.

In addition, the House and Senate included a separate MHA priority of $160 million in COVID-19 relief funding for hospitals as they continue to respond to the pandemic. The payments are allocated proportionate to statewide Medicaid inpatient volume over the previous 12 months and will assist hospitals in maintaining the resources they need to improve the health of Michigan citizens.

The Michigan House and Senate also advanced their respective budget proposals for state fiscal year 2022, beginning Oct. 1, 2021. Both the House and Senate proposals protect key hospital priorities, including full funding for:

  • 21% increase in hospital Medicaid outpatient rates that took effect Oct. 1, 2020.
  • Critical access hospital-specific Medicaid outpatient rate increase that took effect Jan. 1, 2020.
  • Graduate medical education.
  • Disproportionate share hospital payments.
  • Healthy Michigan Plan.
  • Rural access pool.
  • Obstetrical stabilization fund.

On the legislative side, a proposal from the House includes new provisions that would streamline the prior authorization process for Medicaid managed care and reduce the timeframes for prior authorization approvals. In addition, language was added in the House proposal that would prohibit the use of any Michigan Department of Health and Human Services funds for vaccinations under a mandatory vaccination program. The MHA is concerned that this provision could hinder state vaccination efforts and will work closely with legislators to understand the impact of this language and address potential issues.

The proposals are now likely to be negotiated between the House and Senate before advancing to the governor’s desk for approval or veto. The negotiations are likely to last several more weeks. Members with questions may contact Adam Carlson at the MHA.

Senate Reintroduces Certificate of Need Legislation

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A package of Certificate of Need (CON) bills originally considered during the 2019-2020 legislative session was reintroduced in the Senate during the week of Feb. 22. Senate Bills (SBs) 181, 182 and 183 would implement the CON reforms that the governor pocket vetoed during the last lame-duck session. The bills were introduced by Sens. Curt VanderWall (R-Ludington), Lana Theis (R-Brighton) and Michael MacDonald (R-Macomb Township).

The proposed reforms would increase the threshold for capital expenditures, increase the number of members on the CON Commission, remove air ambulance services from CON and remove psychiatric beds from CON oversight in certain situations.

The MHA does not anticipate taking a position on the package as introduced. Members with questions can contact Adam Carlson at the MHA.