One of the most effective ways of letting elected officials know an organization’s views on issues is through personal meetings. In political terms, this is called lobbying. The MSMS Government Relations team provides elected officials with the information they need to make the best decisions for their constituencies.
We also try to connect legislators directly with their constituents. Elected officials pay attention to mass numbers. When a group of people from a lawmaker’s district request a meeting, email, or call about a particular issue, the lawmaker wants to hear their point of view. As experts in their field, physicians in mass numbers can truly help officials understand the benefits or pitfalls of a piece of legislation.
Who Are We?
The MSMS Government Relations team together has well over 20 years of bi-partisan and bi-cameral experience. This allows for better relationships with lawmakers and the ability to more effectively advocate for the needs of Michigan’s patients. The team includes:
Josiah Kissling, Senior Director of State and Federal Government Relations
Josiah Kissling worked as the Legislative Director for former House Speakers Tom Leonard and Lee Chatfield, was the Budget Director for Speaker Kevin Cotter, and Policy Adviser for the House Republican Caucus.
Scott Kempa, Manager of State and Federal Government Relations
Prior to serving as Legislative Director for Representative Mike Mueller, Scott Kempa spent time on staff in both the House and Senate.
Kate Dorsey, Manager of State and Federal Government Relations
Kate Dorsey worked for former Representative Lisa Brown before joining the Government Relations team for the Oakland County Intermediate School District.
What Are We Working On?
Prior Authorization
As you know, the prior authorization process regularly delays the start or continuation of necessary medical treatment, directs resources away from patient care, and can negatively impact patient health outcomes. On April 29, 2021, the Michigan Senate unanimously passed Senate Bill 247 by a vote of 35 yeas, 0 nays, and one member absent.
Senate Bill 247 would reform the prior authorization process to do the following:
- Require an insurer to make available, by January 1, 2023, a standardized electronic prior authorization request transaction process.
- Require prior authorization requirements to be based on peer-reviewed clinical review criteria.
- Require an insurer to post on its website if it implemented a new prior authorization requirement or restriction or amended an existing requirement or restriction, with respect to any benefit under a health benefit plan.
- Require an insurer or its designee utilization review organization to notify, on issuing a medical benefit denial, the health professional and insured or enrollee of certain information, including the right to appeal the adverse determination, and require an appeal of the denial to be reviewed by a health professional.
- Prohibit an insurer or its designee utilization review organization from affirming the denial of an appeal unless the appeal was reviewed by a licensed physician.
- Prescribe procedures for granting a prior authorization request that had or had not been certified as urgent by a health care provider. For urgent requests, the prior authorization is considered granted if the insurer fails to act within 72 hours of the original submission. For non-urgent requests, the prior authorization is considered granted if the insurer fails to act within 7 business days of the original submission.
- Require an insurer to adopt a program that promoted the modification of prior authorization requirements of certain prescription drugs, medical care, or related benefits, based on the performance of the health care providers with respect to adherence to nationally recognized evidence-based medical guidelines and other quality criteria.
The bill was transmitted to the House and referred to the House Health Policy Committee for action. We continue to advocate for this and other legislation that will promote transparency, appropriate clinical decision-making, and timely processing of requests.
Telehealth
During the COVID-19 pandemic, physicians of all kinds had to pivot toward telehealth services. This has proven to be an incredibly effective care delivery method that ensures patients can access care in a convenient and timely manner. While payers did temporarily remove some of the regulatory and administrative obstacles during the height of the pandemic, those policies are now reverting to pre-pandemic times. For physicians, the standard of care remains the same, regardless of the care delivery method. For this reason, we are working to achieve parity for payment and services whether in person or virtual.
Unfortunately, the relevant bill introduced thus far this term is House Bill 4355, which allows out-of-state practitioners to treat patients without any licensing or regulation. MSMS is opposed to this bill as currently written, but hopeful that improvements and changes to the bill could offer the opportunity to create model legislation for other states to follow.
Scope of Practice
Our goal is to protect the health and safety of patients by opposing efforts of health care practitioners to seek licensure or recognition to perform tasks or procedures for which they lack the education, training, or experience. Attention so far this term has been focused on House Bill 4359, which would have allowed Certified Registered Nurse Anesthetists (CRNAs) to provide anesthesia care without any supervision, input, or collaboration with a physician and had no minimum requirements for training or education.
Through four months of diligent effort, MSMS secured significant changes. Most noteworthy was ensuring a doctor is not only part of a patient care team, but also must be immediately available when a procedure is taking place. Additionally, the new language requires training, prohibits a CRNA from practicing without physician supervision at a pain clinic, and clarifies that CRNAs are not allowed to practice independently.
We are also preparing for potential similar issues with regards to Physician’s Assistants and Nurse Practitioners, as well as others. We continue to proactively promote physician-led, team-based care efforts, including holistic approaches to scope of practice and licensure that meaningfully address care.
For regularly updated information, be sure to visit MSMS.org/Engage, where you can see all our tracked legislation and learn how to take action!
