Home2019-01-17T20:58:16+00:00

New DHHS Order Reinstates COVID Mask Requirements, Gathering Sizes

This story presented in cooperation with MIRS, a Lansing-based news and information service.

The Michigan Department of Health and Human Services largely reinstated aspects of Gov. Gretchen Whitmer’s COVID-19 emergency orders Oct. 5, including mask requirements, gathering size limitations, and bar restrictions.

With the Michigan Supreme Court majority invalidating Whitmer’s previous orders that rested on a law the court deemed unconstitutional, DHHS Director Robert Gordon said the order relies on a different law that wasn’t at issue in the case from Friday.

He said under MCL 333.2253, if the DHHS director determines that controlling an epidemic is necessary to protect the public health, he or she can prohibit public gatherings, among other actions geared toward protecting public health.

Gordon, who said he once was a law clerk for the U.S. Supreme Court, said the MSC decision from Friday used what he called the “non-delegation doctrine,” which Gordon said had not been used to invalidate a Michigan law until now.

He said when he clerked for SCOTUS, the nation’s high court turned away a non-delegation challenge in an 8-1 vote in an opinion authored by the late GOP-nominated Justice Antonin Scalia.

But, Gordon said, that doctrine “has become popular on the anti-government right” and the MSC majority used it to invalidate [Read More]

Distrusting Trump, States Plan To Vet COVID Vaccines Themselves

By JONEL ALECCIA & LIZ SZABO
As trust in the Food and Drug Administration wavers, several states, including Michigan, have vowed to conduct independent reviews of any COVID-19 vaccine the federal agency authorizes.

But top health experts say such vetting may be misguided, even if it reflects a well-founded lack of confidence in the Trump administration — especially now that the FDA has held firm with rules that make a risky preelection vaccine release highly unlikely.

At least six states and the District of Columbia have indicated they intend to review the scientific data for any vaccine approved to fight COVID-19, with some citing concern over political interference by President Donald Trump and his appointees. Officials in New York and California said they are convening expert panels expressly for that purpose.

“Frankly, I’m not going to trust the federal government’s opinion and I wouldn’t recommend [vaccines] to New Yorkers based on the federal government’s opinion,” New York Gov. Andrew Cuomo said last month.

“We want to make sure — despite the urge and interest in having a useful vaccine — that we do it with the utmost safety of Californians in mind,” Dr. Mark Ghaly, California’s health and human services secretary, said at a recent news conference.

The District of Columbia, [Read More]

ON POINT WITH POs: Let’s Get PCPs Off The Endangered Species List

By EWA MATUSZEWSKI
Be afraid. Be very afraid. That’s one option for independent primary care physicians—but not one I would advocate if my livelihood were at stake. And make no mistake, community physicians are in danger of becoming extinct in the next decade.

It was recently announced that Village MD will be setting up primary care clinics in Walgreens. Around the same time, Aurora Health announced its intent to take good care of Beaumont physicians—in part by recommending they become employees of the health system. This is not new—but it’s an accelerating trend. These mega health organizations (and private equity groups who see dollar signs but not patients) are courting suitors quickly—as if to get a bargain on a Tiffany ring—while the world reels from a global pandemic. Their typical method of operation historically is to marry into the community full of promises to be good corporate citizens and stewards of care; then, after taking over a health system, spread their web to self-employed physicians, offering them solar systems as yet undiscovered. If you ever want to see an unhappy physician, speak with one who sold their practice to a health system long before they were ready to retire.

While this is a national trend, Michigan physicians are [Read More]

COMPLIANCE CORNER: EOs Take Aim At RX Prices

By STEPHEN SHAVER
This summer, President Donald Trump issued four orders targeting prescription drug prices. Three issued on July 24, 2020 with a fourth being signed, but not issued at that time. The fourth order appeared Sept. 13, 2020. All of the orders seek to lower prescription drug prices by directing the Department of Health and Human to exercise its regulatory authority. However, as each order requires significant legwork by HHS, it is unclear when, if ever, the effects of the orders will be seen.

The most recent order, issued Sept. 13, 2020 and titled “Executive Order on Lowering Drug Prices by Putting Americans First,” outlines a policy that Medicare should not pay more for Part B or Part D prescription drugs than the “most-favored-nation price.” The order defines the “most-favored-nation price” as the lowest price, adjusting for volume and differences in GDP, for a drug that the manufacturer sells to an Organization for Economic Co-operation and Development (OECD) member country with a comparable GDP per capita. For reference, Norway, Austria, and the Netherlands are all OECD member countries with GDPs per capita similar to the United States.

The order directs HHS to “immediately” implement a test payment model. The test model would apply the new policy [Read More]

LANSING LINES

Lansing Lines is presented in cooperation with MIRS, a Lansing-based news and information service.

DHHS Issues More COVID Orders; Mac Center Questions Validity
The Michigan Department of Health and Human Services issued more emergency orders Oct. 6 in reaction to the Supreme Court ruling Oct. 2 that struck the law on which the governor had issued similar executive orders.

DHHS Director Robert Gordon signed one order that maintains protections for people in residential and congregate care as well as juvenile justice facilities. Another one requires K-12 schools to provide public notice about probable and confirmed cases of COVID-19 within 24 hours.

The order on residential care continues restrictions on visitation to residential care facilities, which include nursing homes, homes for the aged, adult foster care, assisted living, and independent living, according to the state.

Outdoor visits are permitted with precautions, such as allowing for at least six feet separation between all people, and communal dining is permitted under the order at all facilities consistent with the Center for Medicare and Medicaid Services and DHHS guidance.

The order also covers notification requirements involving COVID-19 cases for these facilities.

There are different visitation rules for child caring facilities and juvenile justice facilities. In those cases, the facilities may allow visitors as long as [Read More]

LEGAL LEANINGS: Regulatory Issues And Practice Entity Structure

By ROSE WILLIS
Healthcare providers have additional regulatory restrictions related to the structure of their practice entities (Practice Entities), which are not applicable to those operating in other industries. Such restrictions include but are not limited to ownership and control by licensed professionals and limitations on the number of Practice Entities that a licensed professional may own or become employed by. The purpose of this article is to summarize certain regulatory restrictions placed on Practice Entities, which, if violated, could result in significant monetary penalties.

Many state laws prohibit the ownership or control of a Practice Entity by non-licensed individuals. This rule is referred to as the “Corporate Practice of Medicine” rule (CPOM Rule). Michigan law requires that for-profit Practice Entities form as “professional” entities, such as a professional corporations or professional limited liability companies. Michigan law prohibits the ownership of such a Practice Entity by anyone other than someone licensed in the service provided by the Practice Entity. This applies to physicians, physical therapists, chiropractors, dentists, among others.

Additionally, the CPOM Rule prohibits a non-licensed person from “controlling” the Practice Entity. For example, if the Practice Entity enters into a management services arrangement with a third party who is unlicensed, such an arrangement would need to [Read More]

Community Colleges Could Offer Bachelor of Science Nursing Under Bill

Community colleges would be allowed to offer four-year bachelors of science nursing degrees, under legislation a Senate committee began taking testimony Sept. 15.

Sen. Aric Nesbitt’s (R-Lawton) SB 1055 would re-open legislation passed in 2012 that first allowed limited baccalaureate offerings by community colleges.

“This was a policy that I was supportive of before I even came to the House,” Nesbitt said. “A simple change to the statute that will have far-reaching impact across our state. Adding the BSN to community colleges will increase the geographic access to this degree.”

Nesbitt said that the original legislation expanding baccalaureate offerings was introduced by then-Rep. John Walsh. That legislation, which covered some technical fields including maritime and cement management among others, had originally included the offering of BSN degrees by two-year community colleges.

“The House passed it fairly solidly on a bipartisan vote,” Nesbitt said. “In the Senate, the BSN was stripped out of it. What was signed into law was the compromise.”

The legislation brought out support from community colleges, particularly rural community colleges, as well as rural health care facilities. Opposing the expansion were the state’s public universities and independent universities.

Dr. Trevor Kubatzke, president of Lake Michigan College, testified that his community is rural enough that he cannot get a [Read More]

Public Health: What To Do About Racism

By SUSAN ADELMAN, MD
Physicians are used to seeking practical answers to definable problems. We do this in our clinical work and in our research. Perhaps this physician might suggest a useful approach in a time of worldwide demonstrations over racism. Normally in medicine, we try to break down a larger problem into its component parts, which need to be definable issues that can be addressed effectively to create real change.

Just as occurred in Detroit after the 1967 riots, we need civic leaders to join with leaders of affected neighborhoods, identify the issues that would be the most productive to work on, seek the people who need to come together for each project and prioritize the efforts. Working groups need to figure out what possible solutions would be realistic and would solve more problems than they will create. Then they need to coordinate with the political establishment and with sources of funding, in order to move forward.

The enthusiasm is here. The timing is now. We need to turn all of this turmoil into real change, change that will help. We understand that there are police who need more discipline. Then we need to work on this, not blow up the whole police force, which would have [Read More]

A Model Made For A Pandemic

By EWA MATUSZEWSKI
Today I revisit a topic I have written about many times: The Patient-Centered Medical Home Neighborhood (PCMH-N). Yet now I address it with a fresh perspective in the context of the pandemic.

The PCMH-N, with its connectivity to the broader healthcare community, encompasses primary care, health systems, nursing homes and rehabilitation centers, pharmacies, human service agencies and other organizations that seek to promote health, wellness, and healing within a community. Never before have the benefits of the PCMH been as clear as they have become during the pandemic. Starting with the immediate and wide-scale need for personal protective equipment (PPE) for those caring for community members, to the gathering of resources such as food, clothing and shelter, to sharing best practices to re-opening, the PCMH neighborhood was ready to respond as it was designed to do.

I am not saying it was designed specifically for a pandemic, but when the pandemic hit, it certainly seemed like it was. Such collaboration! Such teamwork! To have a network of resources at the ready—even if we may not have considered ourselves to be so networked previously—was a light in a very dark and scary place. We are not over this, but despite the remaining uncertainty, I’d like to [Read More]

Compliance Corner: Providers & Private Payor Audits

By KAITLIN A. NUCCI, ESQ.
Wachler & Associates, P.C

Regardless of the fact that the United States is still in the midst of a public health emergency battling the spread of COVID-19, the Center for Program Integrity encouraged the Centers for Medicare and Medicaid Services to resume both Recovery Audit Contractor (RAC) and Medicare Administrative Contractor (MAC) audits. For now, these audits will focus on claims submitted prior to March 1, 2020. CMS has not yet stated when they will be auditing claims submitted after March 1, 2020 and through the duration of the current public health crisis, but professionals in the field expect these audits to begin in the coming months. Providers are encouraged by CMS to discuss any COVID-19 related hardships that may affect audit response times.

While it is not clear when audits for claims submitted after March 1, 2020 will begin, providers should be prepared for post-payment reviews, particularly with regards to COVID-19 claim submissions. In fact, CMS has announced a new requirement to obtain reimbursement for COVID-19 patients. Beginning Sept. 1, 2020, a provider will receive a 20 percent Medicare reimbursement add-on payment for a COVID-19 patient only if the provider documents a positive test in the patient’s chart. This new guidance [Read More]

LANSING LINES

Ombudsman Defends Nursing Home Decisions During Pandemic
Michigan’s Long-Term Care Ombudsman, Salli Pung, says she believes the “best decisions” were made about the placement of COVID-19 patients in nursing homes given the information and resources that were available at the time.

“If we had the opportunity to create nursing homes that were isolated simply for residents with COVID-19, we would all pick that,” Pung told the House Joint Select Committee on the COVID-19 Pandemic Sept. 15. “We would want that for them because that would be the safest, but I don’t know that we had that opportunity to do that and staff it and meet residents’ needs because staffing is critical at this time. There are not people beating down the doors to work in nursing homes, unfortunately.”

She also had reservations about the field hospitals that the state set up, like the one established in the TCF Center in Detroit.

“I was concerned that it wouldn’t meet the residents’ needs for safety and access to services and supports that they needed. Things as simple as utilizing the restroom might have been really challenging in that type of a setting. But at the same time, I, of course, had concerns that we wouldn’t want to be introducing COVID-19 into [Read More]

Medical Spas: Common Legal Pitfalls To Avoid

By JESSICA BUSCH
Minimally invasive cosmetic medical services are on the rise and in high demand. With their recent popularity, many licensed cosmetologists and estheticians are looking to offer these cosmetic medical services to their existing customers. Midlevel medical providers, such as registered nurses, advanced practice nurses, or physician assistants often desire to leverage their medical experience to start cosmetic medical businesses of their own. These businesses can yield significant profits and present an enticing investment opportunity for licensed physicians.

However, there are numerous legal pitfalls associated with offering cosmetic medical services that must be considered and avoided. Most significantly, cosmetology and medical spa businesses (collectively referred to herein as “medical spas”) are often unaware that they are illegally engaging in the unauthorized practice of medicine. Without the proper legal structure, partnering physicians also expose themselves to potential civil and criminal liability and put their medical licenses at risk.

What are Cosmetic Medical Services?

The term “cosmetic medical services” is intended to refer to a subset of medical-grade skin care and aesthetic services that constitute the practice of medicine and may only be performed by, or under the supervision of, a licensed physician. Cosmetic medical services generally are not medically necessary and can be minimally invasive, which often [Read More]

COVID-19 Puts Michigan Hospitals In The Hole $1.1B

Michigan hospitals have lost a combined $1.1 billion during the recent pandemic, and that’s even after factoring in $2.1 billion in emergency federal aid, according to a Michigan Health and Hospital Association report released July 30.

The loss of patients, canceled and delayed medical procedures, staffing changes and the need to buy additional personal protective equipment has cost the hospitals a combined $2.7 billion, according to the report. The addition cost of treating COVID-19 patients has added $440 million in emergency expenses for a total of $3.2 billion in combined financial losses.

MHA noted that MidMichigan Health lost 24 percent of its impatient volume between March and June compared to the same time period in 2019.

This comes at a time when hospitals muscle through nearly $2.6 billion in uncompensated care they typically expect during normal circumstances.

“Responding to the COVID-19 pandemic has come at a steep price,” said MHA CEO Brian Peters. “Now more than ever, support is needed for the hospitals and health care providers that have been serving on the front lines of the pandemic.”

Back in April, the financial losses for the states’ 134 hospitals was at $600 million.

Meanwhile, nursing homes also are on the financial ropes due to the COVID-19 pandemic, according to the American [Read More]

Scientists Rely On Unproven Methods For Vaccine Research

By LIZ SZABO
With millions of lives on the line, researchers have been working at an unprecedented pace to develop a COVID-19 vaccine.

But that speed — and some widely touted breakthroughs — belie the enormous complexity and potential risks involved. Researchers have an incomplete understanding of the coronavirus and are using technology that’s largely unproven.

Among many worries: A handful of studies on COVID-19 survivors suggest that antibodies — key immune system proteins that fight infection — begin to disappear within months. That’s led scientists to worry that the protection provided by vaccines could fade quickly as well. Some even question whether vaccines will really end the pandemic. If vaccines produce limited protection against infection, experts note, people will need to continue wearing masks and social distancing even after vaccines roll out.

Yet in an interview with Kaiser Health News, the country’s top infectious disease expert, Dr. Anthony Fauci, said he’s “cautiously optimistic” that researchers will overcome such obstacles.

“We know the body can make an adequate response against this virus” after two shots of a vaccine being tested, Fauci said. “There’s no reason to believe that we won’t be able to develop a vaccine against it.”

Because early-stage trials began just a few months ago, doctors don’t know how [Read More]

What’s On My Mind: PPE, Physician Communications And Publicly Traded Primary Care

By EWA MATUSZEWSKI
“I have often depended on the kindness of strangers.” Thus, wrote Tennessee Williams in his famous Streetcar Named Desire. We, too, looked to the kindness of strangers in the early days of the pandemic, particularly for personal protection equipment. It was an all-in, humanitarian effort to keep our colleagues and patients safe. Because there were more stringent demands for the wearing of PPE for longer durations, and for more frequent changing of PPE than in our halcyon pre-pandemic days, the need to quickly source PPE for immediate use was paramount.

I wrote in a previous column of the need for keeping a 30-day inventory of PPE. I want to reiterate that, but also stress that depending on strangers to step in and restock PPE inventory as the pandemic continues is a foolish and fraught strategy. Poor planning on your part does not constitute a crisis on my part. A colleague shared this adage with me years ago, and it’s a perfect fit for this situation. If you need more stable channels for reliable PPE supplies, look to your physician organization for referrals, talk to your existing office and cleaning suppliers or consider joining an association that offers PPE resources as a member benefit. I [Read More]

Wisconsin Court Ruling Creates New Threshold For Medicaid Recovery Efforts

By ROLF LOWE
In July of 2020 the Wisconsin Supreme Court issued an opinion addressing the scope of the Wisconsin Department of Health Services authority to recoup payments to Medicaid service providers. Plaintiffs Kathleen Papa and Professional Homecare Providers (PHP) challenged WDHS’s recordkeeping policies, which included identifying things such as paperwork mistakes, that resulted in significant overpayment obligations from the state’s independent private duty nurses. In seeking an overpayment WDHS didn’t challenge whether the nurses provided a Medicaid patient with a covered service or that the payment for the claim was inappropriate or inaccurate, but instead based its right to seek recoupment of Medicaid funds because of inadequate documentation. The policy at issue covering the documentation requirements was affectionately identified by the Court as the “Perfection Policy.”

While the Court reviewed several issues on appeal, some of them procedural, the substantive issue decided in PHP’s favor was whether the Perfection Policy exceeds WDHS’s recoupment authority. In one of its previous filings in a lower court PHP provided an affidavit from one of the nurses that characterizes the scrutiny of the Perfection Policy reiterated by the Court in its opinion, stating that WDHS’s Office of Inspector General’s recoupment efforts were based on “noncorrelation between the medication record, the [Read More]

Applying The Health Information Blocking Rule To Healthcare Providers

By ROSE WILLIS
In the world of health information technology, “information blocking” generally refers to actions that discourage the interoperability of electronic health information except when necessary to comply with law (e.g. HIPAA). The concept applies to a range of problematic activities from charging patients unreasonable fees for copies of their electronic medical record to a software system’s inability to transfer records to a healthcare provider’s new electronic medical record system. Ultimately, information blocking hinders the desired full interoperability and exchange of electronic healthcare information (EHI).

The Federal Department of Health and Human Services, Office of the National Coordinator for Health Information Technology (ONC) released a Final Rule on May 1, 2020 (the Final Rule), which implements the information blocking provision of the 21st Century Cures Act, enacted in 2016. The information blocking provision applies to health care providers, health IT (HIT) developers and health information exchanges/networks (HIEs).
The Final Rule defines information blocking broadly as any practice that is likely to interfere with, prevent or materially discourage access, exchange or use of EHI when the actor knows it is likely to do so. Under this definition, information blocking is an “intent based” action that can take many forms, such as:

• A healthcare provider charging an unreasonable fee [Read More]

LANSING LINES

A Run On Tests For Senators After One Member Positive For COVID

Word that Sen. Tom Barrett (R-Charlotte) tested positive for COVID-19 on July 31 has led to a run on tests in the upper chamber.

Five days earlier, Barrett was with Sen. Adam Hollier (D-Detroit), on a district exchange program that included a student-less Pershing High School as part of their Motown visit. Hollier then visited Barrett’s district. Barrett says they both wore masks the entire time.

Hollier, whose wife is pregnant, tested negative for the virus Aug 3.

Others who have reportedly been tested include Sen. Jeremy Moss (D-Southfield), Sen. Betty Jean Alexander (D-Detroit) and Sen. Erika Geiss (D-Taylor).

Sen. Peter Lulido (R-Shelby Twp.), at the urging of his wife, was slated for a test Aug. 4. During last week’s Judiciary and Public Safety Committee hearing on July 30, Lucido sat two seats away from Barrett.

“Sen. Curt VanderWall (R-Ludington) sat between us and that’s a pretty big buffer to have,” Lucido joked.

VanderWall said he had already been tested Aug. 3 and he expected to have the results back Aug. 4.

Sen. Ruth Johnson (R-Holly) had just got off the phone with her doctor when MIRS called. She will be tested as soon as possible. Several senators who were in [Read More]

COVID-19: Behind The Numbers

By SUSAN ADELMAN, MD
Anyone who follows the supposed official numbers of people dying of coronavirus will find inexplicable discrepancies in the numbers from country to country. For example, the data for June 6 on the Worldometers website record 111,636 deaths in the United States and 4,634 in China, the country in which the virus originated. China? A country of 1.4 billion people? Really? India, a country with 1.3 billion people, reports only 6,933 deaths, as contrasted with Belgium, a country of 11.5 million people, which had 9,580 deaths. Seriously?

What about Germany, population 83.7 million, with 8,766 deaths, as contrasted with Spain, population 46.7 million, with 27,135 deaths, or Italy, population 60 million, with 33,846 deaths? How can this be? How do they count these deaths? Do they have political agendas?

Of course the website’s data collection methods could be faulty, and some have accused it of numerous discrepancies, but other websites have similar numbers. The key question is whether these are a potpourri of deaths from coronavirus, deaths among people who also have coronavirus, deaths of people who are assumed to have coronavirus, or even whether the deaths were of people proven by accurate tests actually to have coronavirus. We will come back to the various [Read More]

New Frontiers Await During Coronavirus Crisis

Those days are gone forever. I should just let them go…
—Don Henley

By PAUL NATINSKY
Irrevocable changes are here and more are to come. COVID-19 will change small things as well as large.

We might finally be seeing the end of currency. Bills and coins are some of the dirtiest things we encounter in the course of our daily lives. Gone for good, likely, is the handshake, possibly the casual greeting kiss or hug. I vote for the bow to replace these conventions—elegant and regal, safe and sanitary.

Big things will change, too. Social distancing and reduced capacities for indoor businesses, restaurants, bars, concert halls and movie theaters are likely to stick in some form. The same is true for public transportation and ride services. Masks? The nonsensical controversy there looks like it too, will continue for years, not months.

Distance learning for schools and remote working for businesses—already established by some institutions, pre-COVID, likely will continue to develop.

As scientists struggle to learn more about the virus amid a hostile political environment, solid answers on how to slow its spread and treat its ravages remain elusive.
Much hope is being pinned on finding a vaccine. If one is developed, would enough people vaccinate to slow or stop the virus? Would anti-vaxxers [Read More]

A Trained Response: Health And Safety Protocols Demand Full, Informed Implementation

By EWA MATUSZEWSKI
This column was not supposed to be about COVID-19—yet it must be. Not only because the virus continues to thrive in various parts of the country as I write this on the cusp of the 4th of July holiday weekend, but because in many ways the hard part has just begun.

I do not mean to minimize the extreme sickness and loss of life during the pandemic’s peak. That was a tremendously frightening and heartrending time not only in our nation but globally, and healthcare professionals at all levels used heroic measures to tame a fearsome, unknown enemy that was – and is – the virus. Their work continues, while ours has begun in fits and starts.

By “ours,” I refer to those of us in the healthcare community who are not treating patients in the hospital or rehabilitation facilities. I also refer to leaders beyond healthcare – business owners, managers and supervisors who must convey through their actions the seriousness of the virus and its easy spread. The standard has been set, with an array of health and safety protocols such as screening questions for potential COVID-19 symptoms or exposure, temperature screening, masks, physical distancing, hand washing, and reduced capacity. Some mandated, some strongly [Read More]

Maintaining Coverage For Services During The Pandemic

By ROLF LOWE
The COVID 19 pandemic has had a significant impact on health care providers of all sizes and practice areas. While non-essential services came to a halt during the early part of the pandemic creating a sudden income loss, the loss of insurance coverage for existing and potential patients due to a job loss, reduction in income or reduction in hours worked could have a lingering effect on patient visits for routine care and serious health conditions. Fortunately, the Health Insurance Marketplace created by the Affordable Care Act and the Medicaid program allow individuals who have lost their health insurance to find low or no cost options for health care coverage.

Providers typically verify insurance coverage when a patient shows up in the office for a scheduled visit. In the wake of the COVID 19 pandemic that practice needs to evolve. Providers need to be proactive and reach out to patients and inform them of potential alternatives for health care coverage in the event they do lose coverage. While there were significant job losses resulting in a loss of health care coverage early on in the pandemic, many employers took advantage of the Payroll Protection Program in the CARES Act to keep staff on [Read More]

Special Immigration Considerations For Medical Professionals During The COVID-19 Pandemic

By ALEXANDRA CRANDALL
The COVID-19 National Emergency has now been effective in the United States for three months. During this time, guidance from federal agencies has been dynamic as the government adapts to the “new normal.”

But even as the global health crisis halts nonessential travel and disrupts visa issuance to many foreign nationals, federal agencies have published additional guidance and announced special consideration for medical professionals. To be sure, these carve-outs are critical, as 17 percent of medical professionals—and 28 percent of all physicians—in the United States were born outside of the United States.

Medical Professionals Present in the United States:

USCIS has implemented a temporary policy change for former J-1 medical graduate physicians who (1) were granted a waiver of the two-year foreign residence requirement; and (2) currently practice in the United States as H-1B nonimmigrant physicians based on interest from a government agency.

Typically, in order to maintain their waiver, these former J-1 medical graduate physicians must work full-time (40 hours a week) and administer healthcare to a population in a “shortage area” (as defined by the U.S. Department of Health and Human Services). In a policy memo dated May 11, 2020, USCIS provided the following “flexibilities” for these medical graduates who “are assisting in the [Read More]

LANSING LINES

Gov Mulls How To Enforce Mask-Wearing
Gov. Gretchen Whitmer said July 9 she is reviewing the state’s current mask-wearing requirements to consider “whether or not we need to take this a step further to strengthen compliance.”

The governor led off her COVID-19 update press event with a picture from the Diamond Lake sandbar party from the over the weekend and said she wanted to make it “very clear” the law still requires people to wear masks in enclosed places of accommodation.

“Make the mask. Make the mask with a political statement saying ‘I hate masks’ if you want. But just wear it,” the governor said toward the end of the press conference.

Whitmer said “we do actually have penalties under the law,” but it comes down to enforcement, which she said comes at the local level. She said “we have the ability for a misdemeanor and a fine” but she said she is considering what’s going to be the “most helpful to encourage compliance.”

She added that “the last thing I want to do is be doling out lots of penalties.”

Meanwhile, Chief Medical Executive Dr. Joneigh Khaldun said statewide COVID-19 data trends “is not looking so good” and while Michigan is not in the “extreme situation we were in this [Read More]

Civil Immunity For COVID Care Stalls Amid Tough Questions

(This story courtesy of MIRS, a Lansing-based news and information service.)

House Judiciary Committee members had some hard questions May 19 about legislation that would give immunity to hospitals, nursing homes, and health care providers from civil suits related to the COVID-19 pandemic.

In the end, the bill designed to tie up a loose end caused by the Legislature not extending the governor’s original emergency declaration didn’t move out of committee.

“If this bill passes, if it actually gets signed in its current form, which is incredibly unlikely, then plaintiffs would be unable to bring a suit or a theory saying that there was a failure to exercise appropriate care under the circumstances?” Rep. Brian Elder (D-Bay City) asked of Amy Barkholz of the Michigan Health and Hospital Association. She testified in support of SB 0899, sponsored by Sen. Michael MacDonald (R-Sterling Heights).

Elder contended that under current law, “a regime of Michigan tort reform, it is already incredibly difficult to bring medical malpractice cases.” In court, the judge would have to consider the circumstances, which would necessarily include the fact that the state is under a pandemic.

“You are saying that a person, if they can find a lawyer, if they can actually get all of the experts [Read More]