By Jay Schripsema, Legislative Chair
MAHU Legislative Report
The 2015-2016 Michigan legislative cycle came to end this December with a less than tumultuous lame duck session. Many major reform initiatives including addressing local municipal retiree pension and health care obligations fell by the way side and will likely be brought back up next session. There are over 40 new State Representatives taking office in January along with new leadership in the House that was detailed in post-election memorandums. New committee chairmanships have yet to be named but I will let MAHU's membership know as soon as the information is released. There was little left on MAHU's legislative watch list that had a chance of moving lame duck but I've pulled several issues that have bills that waiting to be signed by the Governor or will likely be hot topics going into next year.
I hope everyone has had a safe and enjoyable holiday season.
Kandler, Reed, Khoury and Muchmore
HICA Reform Part 2
After Governor Snyder had vetoed a package of bills (SB 987-990) the legislature still needed to repeal the current Use Tax mechanism otherwise Medicaid health plans would have been assessed a tax that they were previously being reimbursed for. In light of the November election that ushered in President-elect Donald Trump, SB 1172 aims to try and skirt the issue. The Medicaid HMO Use Tax will be repealed as of December 31
st, 2106 however if the Federal government allows for that mechanism to be used for Medicaid matching funds then the tax would be reinstated and HICA would be repealed. The bill has yet to be signed by the Governor and potentially may be vetoed.
Scope of Practice and Licensure
There was a compromise reached between the physician and advanced practice nurse groups over APRN scope of practice. HB 5400 officially gives state licensure and limited prescribing rights to APRNs under the supervision and delegation of a physician. HB 5533 modifies how Physician Assistants operate under supervision of a physician and limits the number of PA's that can be supervised. SB 1015/1016 license Applied Behavior Analysts in Michigan, practitioners that focus mainly on treating autism. HB 4598 gives licensure to certified midwives and gives them a limited scope of practice. All these bills have either been signed or are believed to be signed into law.
Everything Else That Didn't Make It
Most notable was a push for a compromise on auto no-fault reform. The hospital group tried to negotiate a deal that would have left fee schedules for medical care out of a reform package in exchange for limits in other areas. This fell apart in the wee hours of the morning but has splintered the group defending no-fault as they promptly expelled the hospitals from their organization. Speaker-elect Leonard is a major proponent of no-fault reform and this legislation will be a major issue next year.
HB 4437 and HB 4812 would have allowed for pharmacists to substitute a biosimilar for a biologic medication. There was significant fighting between PHARMA and Health Plans over what would be required for making the substitution. This legislation is likely to move next year as more and more biosimilar products come on the market and the ability to substitute for the cheaper version becomes more important to health insurers.
SB 625 would require oral chemotherapy medications to be covered by insurance companies. This bill passed the Senate with near unanimous consent before dying in the House Insurance committee. This has been a contentious issue for several years between cancer patient advocates saying that oral drugs are better for patients and insurance companies trying to keep costs down. It's likely to be reintroduced next cycle.