Page 14 - Volume 69 Number 3
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Legislative News By, Dr. Brad Uren
With all of the focus on the healthcare debate in Washington DC it is easy to miss that important legislative issues are playing out at home in Michigan that have the potential to impact your everyday practice and your patients. Currently being discussed in Lansing, outlined below are some of these most important issues.
Medicaid expansion:
Related to the conversation in Washington, the ACHA was passed by the House which would make changes to the Medicaid program, especially as it relates to the patients covered by the Healthy Michigan Medicaid expansion. Under the ACHA, the enhanced matching rate for states to expand Medicaid would be phased out by 2020. Under the current ACA, the enhanced FMAP provides 90% of the funding for the program, whereas the standard FMAP rate for Michigan is 64.7%. Many Republican Senators, particularly those in states that have expanded Medicaid, have objected to the three- year phase out for Medicaid expansion funding. This decreased match would significantly increase the state’s share of the Healthy Michigan program and would place its future at risk.
Premium Subsidies:
The ACHA moved away from need based subsidies, which were effectively a sliding scale based on income, in favor of flat-rate tax credits based on age. The consequence of this policy would be that an older individual with pre-existing conditions would see significantly higher premiums, and would be capped at a much lower tax credit, increasing the likelihood that such an individual would not be able to afford insurance. The Senate has undertaken efforts to try to specifically address this policy issue by adjusting the credits available to older individuals, to smooth over the transition of the ACA to the AHCA. At this time, it is not clear what the exact amounts will be, or what the anticipated costs to these individuals will be.
Opioid Legislation Update:
Now that the upgrades to the Michigan Automated Prescription System have been completed, the legislature has turned their attention to policies related to prescription drug diversion. This is now a priority for the administration and the legislature. MSMS has been actively working with other stakeholders to ensure that these proposals do not disrupt physician decision making and the doctor-patient relationship, while also fitting in with physician workflow. Many hours have been spent working toward this goal. MSMS has successfully worked to gain amendments that help us achieve these goals, but more work will be required. Several bills have passed one chamber and MSMS will spend the summer recess working with the legislature to make further
changes to the bills. See the MSMS website for further details and updates on these bills as they progress through the legislature.
No fault:
The Michigan Supreme Court recently ruled in a landmark decision to prevent medical providers from filing suit against insurance companies for care provided to the victims of auto accidents. The decision in the Covenant Medical Center v State Farm Mutual Auto Insurance case will prevent hospitals and medical providers from filing suit against insurance companies directly on behalf of accident victims. This ruling will likely have a significant impact by leaving patients responsible for ensuring payment, potentially forcing providers to sue their own patients, who must then sue their insurance companies for payment. This is the type of scenario that no fault was intended to prevent. A legislative solution to this problem is being sought currently.
Immunization Waiver Law:
Michigan has successfully implemented a law requiring a meeting with a healthcare professional prior to being granted an immunization waiver to attend school. This has increased the immunization rate in Michigan and helps to protect the medically susceptible from preventable illness. Bills have now been proposed that would decrease the impact of these recent laws, likely decreasing the immun- ization rate at the same time. See the MSMS website for the action alert. Ask your lawmaker to vote “NO” on HB 4425, 4426, and SB 300.
The Michigan State Medical Society is actively working on these and many other issues on your behalf. The position of MSMS is determined by resolutions passed by the House of Delegates as well as positions taken by the board of directors with input from the Committee on Legislation and Regulation. If you are interested in joining this committee, please contact the Washtenaw County Medical Society office for more information.
The Washtenaw County Medical Society Legislative Committee meets regularly to discuss legislative issues. Dr. James Mitchiner, past president of WCMS, chairs these meetings:
2017 WCMS Legislative Update Meetings:
All WCMS members are welcome to attend these very informative meetings with our local legislators. Discussions relate to current proposed legislation and how it will impact physicians, practices, and patients.
For information and or registration contact Dolores Nixon at dnixon@wcms-mi.org.
Monday, September 11, 2017 and November 6, 2017 7:30 a.m. – 8:45 a.m.
Location: WCMS office located at 5 Research Drive, Suite C, Ann Arbor, MI 48103.
14 Washtenaw County Medical Society BULLETIN JULY / AUGUST / SEPTEMBER 2017














































































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