Legislative Update January 2024

In the upcoming election year of 2024, the entire Michigan State House faces re-election. However, prior to reaching this stage, special elections are required to fill two open House seats left vacant by Representatives who were elected Mayors of their respective cities. Adding a layer of complexity, the House districts affected by a recent court decision deeming them unconstitutional must undergo redrawing before any elections can proceed.

Presently, the Michigan House maintains a delicate 54-54 split between Democrats and Republicans. Despite this even distribution, Democrats still hold control, and Speaker Tate still holds the office of Speaker of the House. However, the 54-54 split means that neither party has the votes to pass legislation without a member of the opposite side joining them to form the needed 55 votes for passage of a bill. This intricacy adds a dynamic dimension to the political landscape, which will shape the trajectory of legislative proceedings until special elections are held and the open seats are filled.

All that being said, the following is an extensive but not completely exhaustive list of current priorities that we will be monitoring for the next year. 

Prior Authorization and Step Therapy:

  • Governor Whitmer signed legislation in 2022 to regulate the prior authorization process.
  • The reform establishes uniform timelines and procedures for insurance companies, effective in summer 2022.
  • Efforts also focus on reforming step therapy processes, with specific provisions outlined in House Bill 5339.

Scope of Practice:

  • Continued opposition to Senate Bill 279, allowing nurse practitioners to practice independently without physician supervision.
  • Support for House Bill 4472, promoting physician-led healthcare teams, outlining specific responsibilities and collaboration.
  • Opposition to House Bill 5116, which attempts to change titles for physician assistants and addresses several other issues in the behavioral health space.
  • Advocating for health care professional title transparency legislation modeled after Indiana’s recently passed law in this area.

Reimbursement Efforts:

  • Engaging in discussions to address stagnant physician reimbursement in Medicaid, Worker’s Compensation Insurance, and No-Fault Auto Insurance.
  • Successful advocacy led to a 7.5% increase in Medicaid payments for primary care services in 2022/2023.
  • MSMS supports Senate Bills 530 and 531 to address flaws in the 2019 Auto No-Fault law and advocates for fair reimbursement rates (see below for further detail.)

Liability Reforms:

  • Actively working to preserve existing tort reforms and retain long standing legislative intent.
  • Monitoring challenges to tort laws in the Michigan court system, including a case before the Michigan Supreme Court (Daher v. Prime Healthcare Services-Garden City, LLC).

Corporate Practice of Medicine (CPOM):

  • MSMS Board actively addresses violations of Michigan law banning CPOM.
  • MSMS, along with a number of physician groups crafted a letter to the Attorney General urging enforcement of the CPOM Doctrine to protect physicians, medical team members, and patients.
  • We will continue to emphasize the importance of transparency in private equity and investment in medical care to ensure healthcare is provided in the best interest of patients.

Prescription Drug Affordability Board (PDAB) Legislation:

  • Senate Bills 483, 484, and 485 create the “Prescription Drug Cost and Affordability Review Act” in Michigan.
  • The bills establish a board to review and set upper price limits for high-cost prescription drugs in Michigan, as well as a stakeholder council to serve in an advisory role to the PDAB.
  • MSMS submitted a card of support for all three bills during the committee process.
  • The bills were approved by the Senate and sent to the House, where they were referred to the House Committee on Insurance and Financial Services and await further action.

Auto No-Fault

  • Senate Bills 530 and 531 would make adjustments to the limits on attendant care, a fee schedule at 250 percent of Medicare, reform the utilization review requirements, and create a new fee schedule for services that do not have a Medicare code.
  • MSMS provided written testimony in support of these bills during the Senate committee process.
  • The bills were approved in the Senate and transmitted to the House, where they have been referred to the Committee on Insurance and Financial Services and await further action.

Health Data Utility

  • House Bill 5283 would facilitate the creation of a health data utility in Michigan to enhance patient care, support public health initiatives, and realize cost savings for Michigan residents.
  • House Bill 5284 would utilize the Insurance Provider Assessment Act (IPAA) as a long-term, durable funding source, rather than the MDHHS General Fund budget.
  • MSMS is in support of the bills and has offered suggestions to further improve them. We are in talks with the sponsors and will continue to monitor.