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So far Paul Natinsky has created 205 blog entries.

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 [Read More]

New DHHS Order Reinstates COVID Mask Requirements, Gathering Sizes2020-10-13T19:17:18+00:00

Distrusting Trump, States Plan To Vet COVID Vaccines Themselves

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 [Read More]

Distrusting Trump, States Plan To Vet COVID Vaccines Themselves2020-10-13T19:15:09+00:00

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

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 [Read More]

ON POINT WITH POs: Let’s Get PCPs Off The Endangered Species List2020-10-13T19:13:27+00:00


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 [Read More]

COMPLIANCE CORNER: EOs Take Aim At RX Prices2020-10-13T18:48:55+00:00


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 [Read More]

LANSING LINES2020-10-13T17:51:24+00:00

LEGAL LEANINGS: Regulatory Issues And Practice Entity Structure

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” [Read More]

LEGAL LEANINGS: Regulatory Issues And Practice Entity Structure2020-10-13T19:20:15+00:00

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 [Read More]

Community Colleges Could Offer Bachelor of Science Nursing Under Bill2020-09-24T18:59:29+00:00

Public Health: What To Do About Racism

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 [Read More]

Public Health: What To Do About Racism2020-09-24T18:57:43+00:00

A Model Made For A Pandemic

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 [Read More]

A Model Made For A Pandemic2020-09-24T18:54:29+00:00

Compliance Corner: Providers & Private Payor Audits

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 [Read More]

Compliance Corner: Providers & Private Payor Audits2020-09-24T18:50:21+00:00