The Pulse Newsletter | Michigan Osteopathic Association, April 6, 2018                   
Gov. Rick Snyder makes appointment to the Pharmacy and Therapeutics Committee
Adair, Andrew

Gov. Rick Snyder today announced the appointment of Andrew Adair of Ferndale to the Michigan Pharmacy and Therapeutics Committee.

Housed within the Michigan Department of Health and Human Services, the 11-member board advises the department on issues affecting prescription drug coverage for its various health care programs.

"I thank Andrew for his commitment to this committee and the Michiganders it serves," Snyder said.

Adair will serve the remainder of a two-year term expiring Oct. 1, 2019.

Gov. Snyder appoints Richard Bryce, DO, to
Michigan Board of Occupational Therapists

Gov. Rick Snyder appointments Richard Bryce, DO, of Royal Oak, to the Michigan Board of Occupational Therapists.

The nine-member board assists the Michigan Department of Licensing and Regulatory Affairs in overseeing the licensure and practice of Michigan's occupational therapists and occupational therapy assistants.
"I thank these individuals for overseeing those in the occupational therapy field," Snyder said.
Bryce is the chief medical officer and a family medicine physician for Community Health and Social Services in Detroit. He also serves as clinical faculty for Henry Ford Health System, the medical director for Street Medicine Detroit at Wayne State University School of Medicine, and a faculty advisor for Detroit Street Care at Michigan State College of Osteopathic Medicine. He holds a bachelor's degree in secondary education and a Doctor of Osteopathic Medicine from Michigan State University. He will represent the general public as a physician and replaces Michael Moutsatson.

Dr. Bryce will serve the remainder of a four-year term expiring Dec. 31, 2019.

MDHHS alerts public about uncontrolled bleeding due to synthetic marijuana products containing brodifacoum
70 cases reported in neighboring Illinois
The Michigan Department of Health and Human Services (MDHHS) is alerting health care providers and Michigan residents about numerous cases of individuals in Illinois suffering from persistent and severe bleeding due to the suspected use of synthetic marijuana containing brodifacoum.

Brodifacoum has been identified as the cause of 70 cases of uncontrolled bleeding reported between March 7 and April 2 being investigated by the Illinois Department of Public Health. This has included 60 hospitalizations and two deaths.

Brodifacoum is an off-white, odorless powder poison. It was first introduced in 1975 to eliminate rodents that had become resistant to existing poisons. It is one of the most widely used pesticides around the world.

To date, the illnesses have been associated with the use of synthetic marijuana products. Synthetic marijuana is a humanmade, mind-altering chemical that is either sprayed on dried, shredded plant material to be smoked or sold as liquids to be vaporized and inhaled in e-cigarettes and other devices. Also known as fake weed, it is sold for recreational drug use under brand names such as K2, Spice, Black Mamba, Bombay Blue, Genie, Zohai and others. 

"While public health officials in Michigan have not been made aware of any cases to date, the fact Illinois is a neighboring state gives us cause for concern," said Dr. Eden Wells, MDHHS chief medical executive. "We are urging anyone who has a reaction to synthetic marijuana, such as severe bleeding, to call 911 or have someone take them to the emergency department immediately."

When correctly identified, cases can be treated with doses of vitamin K.

MDHHS CONTACT: Lynn Sutfin, 517-241-2112 | Email:

Physicians targeted in extortion scam by criminals posing as DEA agents

Criminals are calling physicians, demanding money, and threatening to suspend their target's DEA registration.

The U.S. Drug Enforcement Agency reports that physicians and the public have been targeted by criminals posing as DEA agents.

Criminals mask their telephone number on caller ID, instead displaying a DEA support number, then demand money or threaten to terminate their target's DEA registration.

The DEA urges physicians who receive such calls to report the information to the DEA on a form they have created on the DEA website (see below).

DEA Extortion Scam Online Reporting: Report Incident form
Join us for the  119th Annual Spring Scientific Convention   as the MOA will offer educational opportunities with compelling sessions and information on issues affecting your practice and profession.
Thursday, May 17 - Sunday, May 20, 2018  
The Westin Southfield Detroit - 1500 Town Center, Southfield, MI 48075

Spring Convention Session Highlight:

Early Bird Registration | Save $80 off registration fees  

LARA requirement for prescribing delayed

The Michigan Department of Licensing and Regulatory Affairs (LARA) requirement to establish a "bona fide prescriber-patient relationship" prior to prescribing any controlled substances, which was part of the recently enacted opioid and prescribing legislative package, will be delayed pending the Governor's signature. As passed by the Legislature, House Bill 5678, sponsored by Rep. Bronna Kahle (R-Adrian), extends the effective date to March 31, 2019 or upon the promulgation of rules if prior to March 31, 2019. This requirement was originally slated to take effect at the end of this month.

Delaying the effective date gives the Michigan Osteopathic Association (MOA) and a coalition of stakeholders the opportunity to work with LARA through the rules promulgation process to address several concerns with the definition of "bona fide prescriber-patient relationship." The current definition severely restricts the ability to provide quality care to established patients in emergent situations, when another prescriber is providing care when the primary prescriber is unavailable, when another licensed member of the health care team has been delegated to provide care, and during transitions of care such as from a hospital to a nursing home or hospice.

The MOA met with leadership within LARA in making sure this requirement did not take effect without appropriately addressing these unintended consequences. MOA appreciates Rep. Kahle for agreeing to use her bill as the vehicle to accomplish this and Sen. Mike Shirkey (R-Clarklake), Chair of the Senate Health Policy Committee, for shepherding the final compromise through to its resolution.

MOA Opioid Alert page (MOA member login)
Includes Opioid legislative FAQs, analysis of the new regulations and a list of the original bills with their legislative history. 
Governmental Affairs
Petition for part-time Michigan Legislature Falls Short

Backers of a plan to move Michigan to a part-time legislature appear ready to pack it in and try again in 2020.

Norman Kammeraad, an organizer with Clean Michigan Government, said the petition fell about 20,000 signatures short of the minimum.

"We were beginning to have signatures going stale faster than we could collect them," Mr. Kammeraad said of signatures collected more than six months ago.

He said the group is logging the signatures collected to date and will be mailing new petitions to begin the process again in 2019.
Report Shows Healthcare is Michigan's Largest Private-sector Employer

A new report from the Partnership for Michigan's Health shows that healthcare directly employed more than 603,000 Michigan residents in 2016, making healthcare the largest private-sector employer in the state. 

The 2018 edition of  The Economic Impact of Healthcare in Michigan  indicates that hospitals alone employ nearly 240,000 individuals in the state. Direct healthcare workers in Michigan earned more than $58 billion that year in wages, salaries and benefits.

Because direct healthcare employment results in additional jobs that are indirectly related to or induced by healthcare, the state's healthcare sector supports about 458,000 additional people who earned more than $21 billion in 2016 in wages, salaries and benefits. Together with their employers, those working in the healthcare sector contributed more than $17 billion that year in local, state and federal taxes. These taxes include Social Security, income, motor vehicle, sales, property, corporate and more.

The report was compiled by the Partnership for Michigan's Health, which consists of the Michigan Health & Hospital Association, the Michigan State Medical Society and the Michigan Osteopathic Association, all based in the greater Lansing area.
Economic Impact Report

From the AOA:

Congress is in recess, another big win in Tennessee, CMS Extends the MIPS 2017 Data Submission Deadline, and the Trump Administration adds some new members to their health care team. But first, the government avoids yet another shutdown.

Ballin' on a Budget: On March 23, 2018, President Trump signed H.R. 1625 into law, the Consolidated Appropriations Act of 2018, which will fund the government through September 30, 2018. The $1.3 trillion spending bill funds several key AOA priorities programs including a $3 billion increase for the National Institutes of Health, a $10 billion increase for the Department of Health and Human Services, and nearly $ 4 billion to fight the opioid addiction crisis.

Ch-ch-ch-ch-Changes to Key Health Care Positions:  On March 28, 2018, President Trump announced the nomination of Rear Admiral Ronny Jackson as Secretary of the U.S. Department of Veterans Affairs. Rear Admiral Jackson would replace former V.A. Secretary David Shulkin who also served during the Obama Administration. Prior to his nomination to the VA, Rear Admiral Jackson served as the Physician to the President.

Three Part Thing: On April 11, 2018, the Energy and Commerce Committee will hold its third and final hearing on its legislative actions to address the opioid crisis. The committee plans to bring a legislative package to the floor of the House of Representatives before the Memorial Day recess. The AOA has endorsed, H.R. 5102, the Substance Use Disorder Workforce Loan Repayment Act of 2018, which would create a loan repayment program for individuals who complete a period of service in a substance use disorder treatment job in a mental health professional shortage area or a county where the drug overdose death rate is higher than the national average.

Take Action! Tell Congress to cosponsor the Substance Use Disorder Workforce Loan Forgiveness Act.

This bill expands upon one of the central issues that DO Day participants lobbied for on March 7, 2018. Let's continue the momentum. Tell Congress to cosponsor The Substance Use Disorder Workforce Loan Forgiveness Act. This act addresses:
  1. Physician Shortages in Rural Areas
  2. Opioid Abuse
  3. Student Loan Forgiveness
The Doctors Company Announces $19 Million Member Dividend

Over $415 Million in Dividends Paid to Members Since 1976

The Doctors Company announced that it has declared a 2018 premium dividend of approximately $19 million. The company has paid out more than $415 million in dividends since the program started in 1976. "For thirteen consecutive years, we have recognized and rewarded our members by paying a dividend," said Richard E. Anderson, MD, FACP, chairman and CEO of The Doctors Company. "Unlike commercial insurers that reward shareholders, we reward our members through our generous dividend program and with the TributeĀ® Plan, an unrivaled career benefit that recognizes members for their loyalty and their commitment to the practice of good medicine."

 News and Resources

Michigan Health Market Review 2017-2018
For the second year, Detroit area hospitals added more than $100 million to their operating income in 2016. Based on an analysis of Medicare cost report data for 2016 operations, Detroit hospitals, now consolidated into six health systems, had net income of $655.5 million in 2016, which was 5.5% of net patient revenues of almost $12 billion. That is up more than 20% from 2015 net income of $535.5 million. They improved their operating income from $133.7 million in 2015 to $238.6 million in 2016. The Beaumont Health system, now with 32% of the market, improved its net income for the third straight year, from $301.6 million in 2015 to $360.5 million in 2016.
Link: Michigan Health Market Review report

Crain's: Hospitals adjust staffing to payment changes
Beaumont, Henry Ford, McLaren and St. Joseph's don't anticipate layoffs this year 
Hospital systems in Southeast Michigan are taking another look at the size of their workforce and how they manage clinical care as government and private payers ratchet down reimbursements and patients seek lower-cost outpatient services.
Link: Crain's Detroit Business report 

Michigan Health Departments Get Money to Fight Hepatitis A
Health departments around Michigan are getting a share of $500,000 in grants to help combat Michigan's hepatitis A outbreak
The Michigan Department of Health and Human Services says the funding includes $20,000 each to 25 county health departments toward increasing vaccination outreach to high-risk populations. Hundreds of cases have been reported.
Link: US News & World Report article 

January 26, 2018, saw the passing of Henry F. Marcus, DO
Click here for a local obituary

January 23, 2018, saw the passing of Edward A. Loniewski, DO, FACOS, FAOAO
Click here for a local obituary

January 9, 2018, saw the passing of David A. Kellam, DO
December 26, 2017, saw the passing of Lawrence "Larry" Abramson, DO 
September 3, 2017, saw the passing of Roy Vomastek, DO
Click here for a local obituary 
Click here for a local news story  
August 30, 2017, saw the passing of Donald "Doc" R. Barbachym, DO 
Click here for local obituary
June 3, 2017, saw the passing of Charles Alan Slagle, DO 
Join us on social media:
The MOA Pulse connects our DO family with our partners, followers and the healthcare communities of Michigan. If you have any news or events you would like to us share, or if you have any questions or concerns, please feel free to contact:
Todd Ross
Manager of Communications
Michigan Osteopathic Association
Michigan Osteopathic Association | 800.657.1556 |