Page 20 - Volume 69, Number 4
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WCMS Legislative Update By Brad Uren, MD
The current legislative session in the Michigan has seen bills introduced with regard to two topics of interest to Washtenaw County Medical Society (WCMS) members. The first is Michigan’s Auto No-Fault insurance; the second is the opioid epidemic.
Below are summaries of these two important topics.
If you have additional questions regarding any legislative issues affecting physicians in Washtenaw County and Michigan, please feel free to reach out to WCMS staff at for more information.
Auto No-fault
The issue of auto no-fault has reemerged as a key issue for the last quarter of 2017. While the dynamics have not changed in terms of the positions of various interest groups, or the substance of the legislation, there has been a renewed interest in the House to tackle the issue once again. Specifically, the House Insurance Committee is attempting to pass legislation that is intended to achieve a dramatic reduction of premiums by aggres- sively seeking to find savings within the personal injury protection portion of the current policy. These changes are all contained within House Bill 5013, introduced by Representative Lana Theis (R-Brighton). Highly relevant to physicians is the significant reduction in medical care coverage for accident victims as well as the imposition
of a fee schedule set at 125% of Medicare. This provision would be highly detrimental to trauma centers and medical specialties that serve crash survivors.
A new twist this year is that the mayor of Detroit and several prominent business leaders within the city of Detroit have endorsed the changes, feeling that the high auto insurance costs for Detroit residents is a barrier to the city’s recovery. As of this moment, there does not appear to be sufficient support for this proposal for it to move forward. However, it is anticipated that the vote total will increase, as House leadership and the Michigan Chamber of Commerce begin to exert pressure on the House Republican Caucus. MSMS is working in close concert with Coalition Protecting Auto No-fault to assure that House Bill 5013 does not pass as currently worded while pressing for a comprehensive package to reform no-fault that is not at the sole expense of medical providers, accident victims, or ratepayers.
Opioid Epidemic/ Prescription Drug Diversion
The Governor’s Drug Diversion Task Force in its report outlined a sequence of steps to deal with the opioid crisis. Initially, legislative efforts focused on eliminating barriers to the access of naloxone to treat overdose; this was largely accomplished via a statewide standing order issued by the Chief Medical Officer within the Department of Health and Human Services. The next step was to update the MAPS system to provide a more useful clinical tool for physicians seeking patient and prescriber prescription histories. This was accomplished via an appropriation made in 2016 as
well as the use of a reciprocity agreement that allowed state government to circumvent the customary require- ments for state procurement contracts. Consequently, what would normally take 18-48 months was completed in less than a year. The final phase of legislative enactment of the Task Force Recommendations focused on enforcement of opioid prescribing policy, including mandatory enrollment in MAPS and quarterly review of MAPS patient information by physicians and other prescribers. Unfortunately, legislative proposals to enact this task force recommenda- tion have gone far beyond the specifics of the recommen- dation. Senate Bill 166 would require that a physician conduct a MAPS query prior to the prescribing of any controlled substance. This language is overly broad and likely to create hardship for prescribers in excess of any benefit that might be realized in terms of reduced drug diversion. Senate Bill 274 places limits on the duration of prescriptions physicians can prescribe for acute pain. While Senate Bill 274 would have the effect of potentially reducing the excess supply of opioids in medicine cabi- nets, the rigid framework of the bill is likely to create unintended consequences for patients. Under the bill as written, for example, there is no possible exception for a doctor prescribing medications to a patient even if the drug were lost or stolen. MSMS is working with the House Health Policy Committee to further amend these bills to be consistent with the objectives of MSMS to reduce diversion while minimizing disruption of physician workflow.
Dr. Uren was recently appointed by Gov. Snyder to the Pharmacy and Therapeutics Committee, an 11-member board that advises the Michigan Department of Health and Human Services on issues affecting prescription drug coverage for its various health care programs.
The Michigan State Medical Society (MSMS) and WCMS is actively working on these and many other issues on your behalf. The position of MSMS and WCMS 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. WCMS also holds Legislative Update Meetings regularly with the local legislators: for information and or registration contact Dolores Nixon at dnixon@wcms-mi.org.
2018 Legislative Update Meetings: 7:30 a.m.-8:45 a.m. Monday, February 19, 2018
Monday, May 14, 2018
Monday, September 10, 2018
Monday, November 12, 2018
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