Legislative Meeting Minutes
December 12, 2011


No legislators in attendance.

AGENDA

1)  Auto No-Fault/ Helmet Law:  MSMS feels that this bill does not have the votes to pass.  There have been several different proposals generated on this bill such as 1) Study for several years 2) Make the data public.  Currently, Michigan has the best coverage and does not have the highest rates (Michigan rates 19th in the states regarding rates).  Proponents of No-Fault don’t have concrete data to support the claims.  The auto insurance industry is showing a surplus this year which they base on the use of seat belts and less drunk driving.  Regarding the proposed helmet law, there have been several versions which have passed the house and senate.  Currently, the Governor has no intentions to sign this bill because “it doesn’t make financial sense” however, if the bill does go to the Governor’s desk, he will be forced to make a decision.

2)  Bullying:  The Kent County Medical Society Alliance has been strong in   supporting this issue over many years.  This was a comprehensive bill which requires schools to create policies pertinent to bullying.  This law has been passed and signed by the Governor (HB4163).  This law has no exceptions (there are no guidelines contained in the law).


3) GME funding:  The state has restored 60% of funding to a 9% cut in graduate medical education funding. Federal funding for graduate medical education comes primarily from Medicare.  There is a proposed 60% cut in federal funding for medical education.  Currently, there are 300 residents in 19 medical programs throughout the state. The federal funding cut will trickle down to the residencies thus cutting the number of residents to 120 in our state.  This will have a nation-wide impact.  The only way to make up the difference in funding would be to rely on our two major hospitals to fund $20 million per year or except the cuts as they are and be forced to hire PA’s and NP’s to cover for the loss in medical residents to provide care.  However, this measure would aggregately increase costs as residents are considered “cheap” labor in comparison.  MSMS doesn’t have a role in the federal issues.  Sen. Stabenow is an advocate and doesn’t support cuts in medical education.  AMA is concentrating on the immediate issue of SGR cuts which is planned for a 6% cut to Medicare in addition to the cuts slated for medical education.  MSMS feels that SGR will be patched again versus a permanent fix. (Hospitals and pharmacies would be excluded from cuts.)  There is great concern regarding where medical students will be trained if the cuts pass.  We are seeing more medical schools because universities receive more in federal funding if they are a “research university”, therefore an addition of a medical school fits the definition for increase in federal funding

4)  2012 Legislative Topics:  MSMS reports there will be scope of practice issues.  Non-nurse midwives are looking for licensure.  They will have a pathway to bill however, no oversight or accountability.  They are seeking legitimacy as they are not a universally recognized group.  They have no formal training.  The push is from rural legislators who state that there are not enough health care providers to provide care and other states have allowed non-nurse midwives to practice with licensure.  Dr. Barr offered that PA’s  will promote legislation which will allow them medical degrees after specified number of years working as a PA with some additional classes.  He believes this will be at the national level.


5)  Other Issues:  Dr. Condit addressed legislation regarding Worker’s Compensation which will affect the doctor patient relationship.  This version was specified at 45 days of control versus 28 days as well as, physicians will be responsible for attorney fees with disputes.  MSMS commented that they were aware of this bill; however their focus has been the auto no-fault bill.


6)  Adjournment:  Dr. Wise proposed that legislators be on record for their positions with specific health care issues and comments published.  This would enable membership to be current with a legislator’s position on issues to make informed decisions when choosing legislators.

No January meeting.



Respectfully Submitted,


Deborah M. Droste, RN, BSN

On behalf of Karen Maupin and the KCMSA

 

October 10, 2011 

No legislators were present. 

Agenda: 

1. Auto No-Fault:  Senate Bill 293, Senate Bill 294, Senate Bill 295, and House Bill 4936 are considered concert bills meaning that when passed, they are passed together and therefore signed together; all of which are tied to the vote on Thursday.  The Auto No Fault Bill is not supported by the Chamber of Commerce or trial lawyers.  House Democrats and 4 Republicans do not support the proposed changes in the insurance code. Most republicans support these bills in part because of the money/lobbing received from insurance companies.  MSMS does not support any bill connected to this no-fault bill.  The bill would make numerous amendments to the No-Fault Auto Insurance statute: it would no longer automatically cover unlimited lifetime medical and rehabilitation benefits.  There would be changes to the personal insurance protection (PIP) coverage, a worker’s compensation fee schedule would be applied to payments, there will be provisions as to when a person could sue, specifics regarding motorcycle injuries and coverage, and specific limits would be placed on attendant or nursing care.  Furthermore, the issue of whether a person has suffered a serious impairment of body function will be determined by a jury or trier of fact.  This bill is to encourage those that have no insurance to purchase insurance.

This bill will not provide sufficient coverage in the event of a catastrophic incident.  The coverage is limited and the savings for citizens is not significant considering the limited coverage.  With this bill, the coverage can be selected with insurance premiums based on selected coverage.  When coverage is exhausted, health insurance (if available) will kick in and when those benefits are exhausted it will then be the state’s Medicaid system that will need to provide further coverage.  Our Medicaid system is taxed at present.  Auto injuries that cause significant life long care cost significantly more than what will be covered based on premium selections. Rehab facilities will be in jeopardy if these bills pass.  It is hoped by MSMS that this bill will be discharged.  The governor is refraining from commenting on this bill. 

2. Helmet Law- This bill is taking a back seat to the No-Fault bills.  There is no time line for this bill.
    

3. Advanced Directive Registry-This registry will confidentially contain end of life needs information such as Do Not Resuscitate (DNR) statements state wide and electronically.  Dr Dean stated that it should be mandatory that the information is real time and that EMT’s should have real time electronic access to the information enroute to their call.  It was also addressed that people are always changing that information and there needs to be real time way that attorneys and patients can update and change their information.
    

4. Health Exchange:  Senate Bill 693 aka Michigan Health Market bill.  This will set up health insurance exchanges in the state of Michigan.  This bill does not address coverage.  This bill was necessary as part of the federal government requirements.  Federal dollars are tied to the set-up and start up; if this isn’t done the federal government would take control of the health care market.  MSMS supports this bill.  It is important to recognize that the state is looking forward and proactive.
    

5. Other issues:  30% Medicare Part B decrease in physician payments will occur.  5.8% decrease per year for specialty physicians.  Senator Stabenow has been a supporter in preventing Medicare cuts to physicians and fight against SGR (Sustainable Growth Rate).  The leverage will be access of care for Medicare recipients.  SGR situation needs to be rectified.
    

There was discussion regarding the claims tax passed earlier this year.  This tax is on all health care claims. Currently a 1% tax on insurers; previously the tax was on HMO’s that took Medicaid patients to supplement the Medicaid program.  CMS said it was unfair to tax 6% on HMO’s and they would fine and tax if changes were not made to include all insurers.  This tax funds the 1.2 billion short fall in the Medicaid program.   

Respectfully submitted, 
 Deborah Droste
Karin Maupin
KCMSA Legislative Committee