Home2018-12-19T19:55:43+00:00

McCain’s Complicated Health Care Legacy: He Hated the ACA. He Also Saved It.

By EMMARIE HUETTEMAN
There are many lawmakers who made their names in health care, seeking to usher through historic changes to a broken system.

John McCain was not one of them.

And yet, the six-term senator from Arizona and decorated military veteran leaves behind his own health care legacy, seemingly driven less by his interest in health care policy than his disdain for bullies trampling the “little guy.”

He was not always successful. While McCain was instrumental in the passage of the Americans with Disabilities Act in 1990, most of the health initiatives he undertook failed after running afoul of traditional Republican priorities. His prescriptions often involved more government regulation and increased taxes.

In 2008, as the Republican nominee for president, he ran on a health care platform that dumbfounded many in his party who worried it would raise taxes on top of overhauling the U.S. tradition of workplace insurance.

Many will remember McCain as the incidental savior of the Affordable Care Act, whose late-night thumbs-down vote halted his party’s most promising effort to overturn a major Democratic achievement — the signature achievement, in fact, of the Democrat who beat him to become president. It was a vote that earned him regular — and biting — admonishments from President Donald Trump.
McCain […]

How Rival Opioid Makers Sought To Cash In On Alarm Over OxyContin’s Dangers

By FRED SCHULTE
As Purdue Pharma faced mounting criticism over deaths linked to OxyContin, rival drugmakers saw a chance to boost sales by stepping up marketing of similarly dangerous painkillers, such as fentanyl, morphine and methadone, Purdue internal documents reveal.

Purdue’s 1996-2002 marketing plans for OxyContin, which Kaiser Health News made public this year for the first time, offer an unprecedented look at how that company spent millions of dollars to push opioids for growing legions of pain sufferers. A wave of lawsuits demanding reimbursement and accountability for the opioid crisis now ravaging communities has heightened awareness about how and when drug makers realized the potential dangers of their products.

The Purdue documents lay out how the company and its biggest competitors were jockeying for market share. Some of those drugmakers’ sales promotions downplayed or ignored the risks of taking opioids, or made false claims about their safety, federal regulators have asserted in warning letters to the companies.

Purdue first offered OxyContin as a remedy for moderate to severe cancer pain in 1996. Within three years, the company viewed the cancer market as too limited, with $261 million in potential annual sales versus $1.3 billion for a broader range of chronic pain care, the company’s marketing reports said.

“That was […]

No One Knows How Many Lose Coverage From Healthy MI Work Reqs

The state still doesn’t have an exact figure on the number of Healthy Michigan recipients who could lose health coverage because of the work requirements recently enacted by the Legislature.

However, the Michigan Department of Health and Human Services said it doesn’t expect more than 400,000 of the roughly 680,000 Healthy Michigan recipients to be affected by the 80 hours-per-month requirement that came with Sen. Mike Shirkey’s (R-Clarklake) SB 0897, signed into law by Gov. Rick Snyder in June.

That 400,000 number is based on subtracting from the total program population the number of people who are already meeting those hours, or are exempt from other work requirements posed by food assistance and cash assistance programs, DHHS spokesperson Bob Wheaton said.

Yet, Wheaton said the number impacted by the requirements could still be less than 400,000, because some may be exempt from the work requirements and some may already be working.

But the DHHS hasn’t been able to calculate how many people might be kicked off their health coverage for not complying with work requirements, a question posed to the state by House Minority Leader Sam Singh (D-East Lansing) July 31 during a public hearing on the DHHS’ proposed Healthy Michigan waiver.

Singh argued that because the state doesn’t have […]

Physician Practices Should Incubate Future Physicians

By EWA MATUSZEWSKI
In the waning days of summer, I allow myself to meander at bit, including in my columns.

First off is an issue that has a bit of a back to school connection, and that is that primary care physician practices and their teams should be incubators for future physicians. While training in an ambulatory setting is preferable to a hospital setting, such an environment generally doesn’t reflect the value of the ongoing relationship that is developed between the PCP and patient—a relationship that can reinforce healthy behaviors and provide health strategies that help prevent or manage chronic conditions and co-morbidities.

When residents are trained day in and day out in this setting, they are also afforded a unique mentoring experience, with “teacher” and “student” not only jointly providing care, but with the resident learning communication (listening) skills with the patient and the patient’s family from the physician mentor. Such practice-based training is also imperative for population health, with residents seeing patients in their medical home, rather than in acute situations in a hospital setting.

Now I want to revisit a training approach that does not take place in a physician’s office, or even a traditional health setting, but is primary care training, nonetheless. I think it […]

COMPLIANCE CORNER: Private Equity In MI Healthcare Entities

By REESA N. BENKOFF & DUSTIN WACHLER
Michigan healthcare providers contemplating a relationship with private equity investors must be aware of various legal considerations relative to such arrangements. Increasingly, private equity investors are becoming more interested in investing in healthcare entities. Such investments often present lucrative opportunities for healthcare providers, yet these arrangements implicate a myriad of legal issues. This article will focus on health law issues, however other legal issues including, without limitation, corporate, tax and real estate matters, must be considered when evaluating private equity investment in healthcare entities.

Michigan laws include a legal doctrine commonly referred to as the corporate practice of medicine (CPOM) doctrine. CPOM laws restrict who can own and control certain healthcare entities and employ certain healthcare providers. Specifically, Michigan law requires entities that provide professional medical services to be organized as professional corporations (PCs) or professional limited liability companies (PLLCs). Michigan PCs and PLLCs engaged in the practice of medicine may only be owned by individuals licensed to provide the professional medical services rendered by the entity, or by entities directly or indirectly solely owned by such licensed individuals (1). Further, all officers of PCs and managers of PLLCs must be licensed to provide the professional medical services […]

LEGAL LEANINGS: HIPAA And The Opioid Crisis

By KIMBERLY J. RUPPEL
With the ever-growing opioid crisis and the president’s call to action to address that crisis, primary care, pain management and behavioral health providers in particular may be faced with privacy issues dealing with a patient’s family, friends or others in relation to treatment for opioid abuse. What can a provider disclose to others in the aftermath of an overdose in order to assist a patient’s recovery efforts and prevent future incidents? What information can a provider share about a patient’s condition and treatment in such a situation?

The Health Insurance Portability and Accountability Act (HIPAA) prohibits disclosure of a person’s protected health information (PHI) to family members, friends or others involved in the patient’s care (or payment for care) without patient consent except for certain defined situations.

In the event an individual is disoriented, unconscious or otherwise incapacitated, a medical provider may provide information to others without the patient’s permission so long as sharing that information is: (1) in the best interest of the patient; and (2) the information shared is directly related to the patient’s care. Thus, a provider may exercise his or her judgment to advise family or others that an opioid overdose occurred, describe the patient’s condition and how the […]

LANSING LINES

Health Org: Prosecuting Lyon Could Cause ‘Threat’ Nationwide
A non-profit organization representing health agencies and public health professionals says holding state Department of Health and Human Services Director Nick Lyon criminally responsible for actions done in his professional responsibility could “cause a threat to public health nationwide.”

A second nonprofit organization disagreed with criticism of criminal accountability for the Flint water crisis.

The two statements came in amicus curiae briefs filed by the Association of State and Territorial Health Officials (ASTHO) and Community Based Organizing Partners (CBOP), respectively, just two days before Lyon learns if he will head to trial on felony criminal charges for decisions he made during Flint’s Legionnaires’ disease outbreaks in 2014 and 2015.

“This prosecution greatly concerns ASTHO and its members, who fear that the criminalization of professional, discretionary decision making will harm, not help, public health,” ASTHO’s attorney Jeffrey Muth, of Grand Rapids, says in a court filing. “. . . In seeking to punish public health officials for their administration of their professional responsibilities, this case could cause a threat to public health nationwide.”

Flint-based CBOP’s brief from East Lansing Attorney Mark A. Totten stated: “Several voices—the well-connected, who neither live in Flint nor experienced this horror—have publicly criticized the idea of criminal accountability […]

ON MEDICINE: The Death Of Private Practice, Maybe Not

By ALLAN DOBZYNIAK, MD
Is there any life remaining in the longstanding and cherished method of healthcare delivery by staunchly independent, patient-centric physician entrepreneurs? Do those physicians relishing the autonomy of small businesses aligned around patient care still exist? Are the market and political forces evolving in ways not permitting independence for such physicians, and is their demise inevitable?

When examining the history of healthcare in the United States, at some point predicting that the private practice of medicine would be in peril now seems inevitable. Tax-exempt policy toward employer-based health insurance, the expensive cost-plus Medicare and Medicaid payment policy at the outset of those programs in the 1960s and first-dollar (no deductible) health insurance policies could not help but result in healthcare cost inflation. These are symptoms of what Justice Louis Brandeis dubbed the problem of “Other People’s Money.” With advances in technology and an aging demographic added to the mix, the seeds of healthcare inflation have long been sown.

Of course as these myriad poor decisions stoked inflation, action by the same decision makers who created the problems was deemed necessary. The result was pricing controls disguised within various schemes, a regulatory onslaught, burgeoning numbers of mandates and the two programs delivering the coup de gras, […]

Trump Loosens Restrictions On Short-Term Health Plans

By JULIE APPLEBY
Insurers will again be able to sell short-term health insurance good for up to 12 months under final rules released Aug. 1 by the Trump administration.

This action overturns an Obama administration directive that limited such plans to 90 days. It also adds a new twist: If they wish, insurers can make the short-term plans renewable for up to three years.

The rule will “help increase choices for Americans faced with escalating premiums and dwindling options in the individual market, said James Parker, a senior adviser to Health and Human Services Secretary Alex Azar.

But the plans could also raise premiums for those who remain in the Affordable Care Act marketplace — and the short-term coverage is far more limited.
“We make no representation that it’s equivalent coverage,” Parker said.

The Trump administration’s approach is expected to please brokers and the insurers that offer the coverage.

“To restore these to 364 days — as originally drafted — is exactly what we are looking for,” said Jan Dubauskas, general counsel for the IHC Group, speaking before the final rule was released. The IHC Group is an organization of insurance carriers headquartered in Stamford, Conn.

She said she expects IHC to offer 12-month versions as soon as the rule goes into effect, […]

Medicaid Work Requirement Bill Signed

Able-bodied, adult Healthy Michigan recipients would need to work 80 hours a month or be in a job training program after Jan. 1, 2020 in order to keep their Medicaid coverage unless they fall under a handful of exemptions, under legislation Gov. Rick Snyder signed June 22.

Sen. Mike Shirkey’s (R-Clarklake) SB 0897 also strips Healthy Michigan recipients who chronically lie on their monthly work reports to lose their coverage for a year. The Department of Health and Human Services would receive an extra $5 million a year under the bill for the additional auditors needed to track these recipients.

The bill also restates in law a provision that legislative Republicans didn’t get in the original Healthy Michigan waiver to the federal government. It allows people to stay on Healthy Michigan for 48 months, after which they need to set aside 5 percent of their income for healthcare while also pledging to engage in healthy behaviors to stay in the program.

If the President Donald Trump administration doesn’t approve the federal waiver that would be needed to implement these policies, Healthy Michigan would end.

Snyder framed the bill signing as the preservation of his Healthy Michigan program, which has enrolled 670,000 Michiganders as of the most recent numbers.

“I am committed […]

New Mental Health Parity Proposal

There should be no “discrimination of coverage” between mental health benefits and those paid out by insurance companies for physical health, says Rep. Martin Howrylak (R-Troy).

He introduced two bills in mid June,HB6109, and HB 6191, calling the mental health parity, requiring insurers to offer the same coverage for mental health services as traditional medical care.

“The big picture is that mental health treatment should be not subordinated to physical health because they are inextricably linked,” Howrylak explained. “They both represent heath care needs of individuals.”

He used the example of disorders like bulimia and anorexia. Left untreated, they obviously can lead to very significant health problems later on.

“If I were an insurance company, I would rather nip it in the bud because I would know that I might have to spend a little more money today but in the long run I’m going to save money,” he said. “If people are doing well mentally, they are most likely going to be doing better than they would otherwise physically. It is very antiquated to treat them separately and it is something that is not consistent with modern science.”

The issue is not new in Michigan.

Wendy Block of the Michigan Chamber of Commerce, which has opposed previous such proposals, said […]

ON POINT…WITH POs: Certification Overload

By EWA MATUSZEWSKI
In last month’s column, I asked the question, “Why do physicians with a career history of providing high quality care have to continue to take board re-certification examinations every six years?” I guess the topic of certifications in general has me in a bit of a huff these days. Not physician certifications, necessarily; rather, the plethora of certifications that have sprouted in recent years for healthcare roles not directly related to personal, clinical care.

I recently came across a post on LinkedIn that noted 149 patient advocates were now certified through a board I won’t name, following the inaugural national certification exam for professionals working as patient advocates. I’m an advocate for advocacy in most forms, and certainly for patient advocates. Yet does an examination make them more qualified or effective than their non-certified patient advocate colleagues in the field? I use this only as an example, not to highlight the legitimacy of this particular board and/or certification.

In general, I believe there is mission creep when it comes to board certifications for professionals who work in the healthcare community yet are not providing direct clinical care. Is the goal of having an educated healthcare workforce being hijacked by non-profit or for-profit companies set up […]

COMPLIANCE CORNER: Medicaid Work Requirements

By SARAH HILLEGONDS, ESQ
In June, a controversial bill that would impose work requirements on Medicaid recipients in the state’s expanded Healthy Michigan Plan made its way through the Legislature. It is expected that Gov. Rick Snyder will sign this bill into law, which could affect hundreds of thousands of individuals enrolled in the Healthy Michigan Plan. The House Fiscal Agency estimates that 540,000 of 670,000 individuals in the Healthy Michigan Plan would be subject to the new work requirements, and 5 percent to 10 percent of those individuals could lose coverage.

As background, the Healthy Michigan Plan was approved by the Legislature in 2013. It provides health coverage to individuals between ages 19 and 64 with income at or below 133 percent of the federal poverty line that do not qualify for Medicaid or Medicare.

Under the proposed bill, beginning in 2020, able-bodied adults ages 18 to 62 would have to show workforce engagement averaging 80 hours per month to be eligible for the Healthy Michigan Plan, unless an exemption applies. Qualifying work activities include employment or self-employment, education, job training, vocational training, internships, participation in substance abuse treatment, and community service. An individual is exempt from the workforce engagement requirements in the following circumstances:  pregnant; […]

LEGAL LEANINGS: When Hospital Systems Crash

By Tim Gary
Electronic medical records have become vital to both hospitals and physician’s practices. They are a secure, electronic version of a patients’ medical history and often include all of the clinical data relevant to a patient’s care, including demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports. The EMR automates access to information and streamlines the healthcare provider’s workflow. When a hospital EMR crashes or is breached it can be catastrophic. There is a real risk of liability exposure if the clinical staff’s access to patient records is cut off and the clinician proceeds with treatment without having access to all of the relevant data. Having assisted a number of hospitals in acquiring, implementing and maintaining electronic healthcare record systems, I have witnessed some of the best and worst practices. Here are some guidelines on how to prepare for a crash, or loss of data, and what to do after it happens.

No Such Thing As A Failure-proof System
Normally there are several redundancies built into hospital computer systems and most Software as a Service (SAS) physician office EMRs in order to either prevent a crash or bring the system back up quickly. These include recovery programs and […]

LANSING LINES: Killing Legalized Pot

There are some high-rollers out there who are being asked to kick in some big bucks to bankroll what could be a $4-$5 million ad campaign to defeat legalized pot on the statewide ballot in November.

At an unannounced and closed door meeting during the week of June 11, the Senate Majority Leader asked the lobby shops in town that have a piece of this pot issue to meet to discuss the anti-pot strategy.

The unanswered question on the table was simple: Are these interests willing to shell out the money to run an effective vote no campaign?

No one around the table had the answer, but the pledge was made to make the contacts with the various entities to get an answer. Everyone agreed to meet in another week or so.

Recall that Senate Majority Leader Arlan Meekhof (R-Holland) was unable to pass the pot petition drive language with the hopes of regulating the smaller “microbrew”-type shops that come away with weakened state regulation under this proposal. He also wanted to address amounts and dosages, among other things.

Hence, when the lobbyists discuss this issue, a critical question will likely be why would these major donors wanted to fund the no vote campaign and toward what end?

If they were […]

Three Waterborne Outbreaks In Detroit

By GEORGE GAINES, MSW, MPH
The morbidity data from Michigan Community Health and the Detroit Department of Health show several disease outbreaks during the last two years. Here, I offer a description of the increases and a viewpoint on the causes involved.

A theory and hypothesis are derived from data from the study by Ford Hospital1 and the morbidity data from the City Health Department 2012 thru 2017. The supporting theory is the lack of household water will affect household sanitation increasing the risk for disease.

Given the fact of thousands of water-service shuts offs, sanitation is compromised increasing risk of disease. The hypothesis is outbreaks of waterborne disease in Detroit are caustically related to the massive number of shut offs in 2016-2017. The three waterborne diseases are proof of outbreaks: First, shigellosis an acute dysentery. Second, giardiasis is a protozoan infection. Third, campylobacter an acute enteric that attacks the intestines. Children are infected more by water contaminated water sources than adults. For shigellosis “most of the deaths, are in children under 10 years of age.”2

GI outbreaks annually averaged 10.2 from 2012 thru 2015 years. However, 2016 had 45 and 2017 had 87 out breaks of group clusters (individual cases are not required reportable).

Data are arranged in two […]

IndyCar Driver Kimball Races Past Diabetes

By PAUL NATINSKY
IndyCar driver Charlie Kimball says he is the first diabetic to start and finish the Indy 500. Legally, that is. Diabetic racer Howdy Wilcox II competed in the Indianapolis 500, finishing second in 1932, but he was disqualified before the 1933 race when diabetic symptoms revealed his secret.

Today’s racecar drivers travel much faster—in excess of 225 mph on oval tracks—than their compatriots of yesteryear. Consequently, the slowed reactions, vision issues and decision-making deficits characteristic of unmanaged diabetes are much more dangerous.

“Charlie needs to consistently keep track of before getting on the racetrack,” Michigan State University kinesiologist David Ferguson told MSU Today in 2017. “If his blood sugar is too low, it may take him too long to make the right decision. If his sugar is too high, his reaction time may be fine, but the likelihood of him making the wrong choice increases.” Ferguson works with Kimball to manage his diabetes and authored a study using data from his work with Kimball.

“Technically, since Charlie doesn’t have a functioning pancreas, all the other drivers have had an advantage over him,” Ferguson said. “We simply put him on a level playing field.”

Kimball, 33, thinks his heightened consciousness regarding his health and fitness gives him an […]

OUR VIEW: An Attack On ACA Protections

Setting a building on fire and then “rescuing” its inhabitants does not make one a hero—quite the opposite.

Thwarting the intent of a law by refusing to enforce it and then using that action to further undermine the law does not make one a skilled policymaker representing the will of the people—quite the opposite.

But that is what the president and his attorney general have done in supporting a lawsuit that would eliminate the Affordable Care Act’s requirement to cover pre-existing medical conditions, leaving those who are sick and uninsured without coverage options. The suit was filed by several conservative states and the ACA is being defended against by a group of heavily Democratic states.

Actually, the administration is going much further, endorsing the declaration of the entire ACA as unconstitutional because the health insurance mandate (upheld famously by the Supreme Court in 2012) is so central to the law.

The conservative states’ lawsuit argues that if the there are no penalties connected to the mandate (a provision Republicans included in the recently passed tax bill), then there is no incentive for people to seek insurance until they are already sick—an unfair and expensive situation for insurers.

The lawsuit and the attorney general’s brief in support of it is the […]

ON POINT…WITH POs: Alternatives To Board Exams

By EWA MATUSZEWSKI
Several DO and MD primary care physicians recently noted to me the grueling commitment of preparing for their respective medical boards. These exemplary practice leaders have been physicians for several decades—and plan to continue working for the foreseeable future. Each of the physicians I spoke with is a PCMH champion with an outstanding reputation for serving their patients and the surrounding Macomb, Oakland and Wayne County communities.

Why do physicians with a career history of providing high quality care have to continue to take board re-examinations every six years? I’m looking for a reasonable answer, but the response currently seems to be, “so they don’t get kicked out of a health plan.” At the same time, I can’t help but ponder the big business behind board certifications. Consider the cost of the board examinations and the prep programs including pre-tests, times the number of physicians taking them and it’s hard to deny the financial implications/advantages of keeping the status quo.

At a time when we aggressively aim to attract and retain primary care physicians, we need to remove barriers that prevent senior physicians in the field from staying. This problem is of notable concern in underserved areas where primary care physicians may be opting out […]

‘Exposure’ & ‘Poisoning’ Toxic When It Comes To Lead

(Editor’s Note: The following is a statement issued by the Genesee County Medical Society, June 4)
The Genesee County Medical Society has reviewed the position taken by the Medical Staff of the Hurley Medical Center regarding the term “lead poisoned.” It’s very important to recognize there are no strict guidelines that would allow us to state that using the term “exposed” is different than using the term “poisoned” in regard to physiologic disruption caused by the toxic metal lead. It is vital to emphasize that there is no safe amount of lead when ingested by children, pregnant women, or any person daily for 15 months without any risk to health and/or development.

While there are still some who must see organ failure, seizures or altered consciousness to use the word poisoned, many medical and scientific experts along with the federal Centers for Disease Control have recognized the more subtle effects of lead poisoning and have repeatedly lowered the level of concern from 40 to 5 ug/ml starting in the 1970s. This has happened in part because the methods to measure blood levels have improved as well as the tools to evaluate brain function. Additionally, screening with blood lead levels does not measure the lead storage in other […]

COMPLIANCE CORNER: CMS Changes Home Health Policy

By KEVIN R. MISEREZ, ESQ.
Wachler & Associates, P.C.
On May 29, the Centers for Medicare & Medicaid Services published its 60-day notice to allow interested stakeholders the opportunity to comment on CMS’s proposed Review Choice Demonstration for Home Health Services (revised demonstration). The Review Choice Demonstration is a revised version of the CMS’s previous Pre-Claim Review Demonstration for Home Health Services, which was paused by CMS on April 1, 2017. According to CMS, the revised demonstration will “offer more flexibility and choice for providers.”

Under the revised demonstration, home health agency providers subject to the demonstration have the choice of participating in either a 100 percent pre-claim review or 100 percent post-payment review. These HHAs will remain under the chosen review method until the HHA reaches the target affirmation (for pre-claim reviews) or claim approval rate (for post-payment reviews). At this time, CMS has not provided any specific benchmarks with respect to the requisite “target affirmation” or “claim approval rate” HHAs will need to satisfy. However, once the target affirmation or claim approval rate has been met, HHAs may choose to be relieved from claim reviews with the exception of a “spot check” of their claims to ensure continued compliance.

Under the pre-claim-review option, CMS will review […]

ON MEDICINE: Leaders Or Followers

By ALLAN DOBZYNIAK, MD
The solution to healthcare’s costs and access problems is quite obvious. It has been repeatedly suggested that what is needed is a plethora of doctors. Of course this would lower cost and increase access. “Overpayment” of U.S. doctors would disappear as the market becomes oversaturated. Access to care would no longer be an issue as doctors compete for patients.

Only a few minor adjustments would be needed. Time and cost as barriers to manufacturing legions of new doctors could be rectified by eliminating the non-essential four years of college and the extraneous liberal arts courses. A year or so of several science courses in the local community college should suffice. Once in medical school, students could be indoctrinated to give up their rights and self-determination for the general good. Compromise as an approach to regulatory serfdom could be declared one of the most laudable qualities. The chorus of righteousness and the PR mumbo-jumbo of “openness,” “caring,” “sharing,” “community,” and “compassion” could be further integrated into the curriculum. Being taught to think like thinking machines would be pursued. Following the protocols and checking boxes in the myriad screens in the EMR to satisfy the masters of the very “moral” RVU invention would relegate thinking […]

LEGAL LEANINGS: Opioid Litigation Comes To Michigan

By: KERRY B. HARVEY & ANDREW L. SPARKS
Michigan, like the rest of the country, suffers from an opioid epidemic. Every day, more than 100 Americans die from an opioid overdose. Some economists estimate that the opioid crisis has cost the U.S. economy more than $1 trillion since 2001 and is on pace to cost an additional $500 billion through 2020.

The profligate use of opioid pain relievers has contributed mightily to the epidemic. A few data points tell the story:

• About a quarter of patients prescribed opioids for chronic pain do not use them as directed.

• Roughly 4 out of 5 heroin users first abused prescription opioids.

• United States citizens consume about 80 percent of the world supply of oxycodone and almost all of the supply of hydrocodone

Predictably, lawyers and their clients have engaged the legal system to assign responsibility for the opioid epidemic. The wave of opioid litigation has reached Michigan. Opioid litigation, modeled largely on the tobacco lawsuits of the 1990s, has grown exponentially over the last few years. State and local governments initially targeted pharmaceutical manufacturers. Now, distributors such as McKesson and Cardinal have been sued. In 2017, more than 250 state and local governments sued organizations throughout the opioid supply […]

LANSING LINES

Legalized Pot Goes To Ballot, House Opts Not To Vote
Not only did the House Republican caucus not have the votes to legislatively adopt and amend a citizen initiative to legalize recreational use of marijuana, House Speaker Tom Leonard (R-DeWitt) said June 5 he’s not convinced the state Senate really did either.

Senate Majority Leader Arlan Meekhof (R-West Olive), presented with polling showing recreational marijuana passing this fall, said he had 20 votes in the Senate to pass the marijuana legalization citizens initiative.

Had the House passed it June 5, the last day of the 40-day constitutional deadline, Meekhof pledged he would have, too, giving Republican lawmakers an easier shot at amending the proposal to better regulate “home-brew” marijuana businesses, potency restriction and possession amounts.

But the House didn’t have the votes. Inside sources project the chamber had about 40 and likely weren’t going to get any more. Democrats had presented a united front against the proposal and hardline conservatives philosophically opposed legalizing pot.

And Leonard questioned whether the Senate had the 20 votes to pass it anyway, despite Meekhof’s claims.

“I have to believe that if they had the votes to pass this, if they were serious, that they would have taken the vote. And they have yet to take […]

Pediatrician Says Wells’ Action Helped State ‘Change Course’ In Water Crisis

A Flint doctor whose research helped expose the lead contamination crisis in Flint’s drinking water said it was the chief medical executive’s work that moved state officials “to change course” in the water crisis.

Dr. Mona Hanna-Attisha, a pediatrician with Hurley Medical Center and Michigan State University, said Dr. Eden Wells’ phone call to her in October 2015 got the state to relook at its results—which contradicted the doctor’s research—of lead blood levels in Flint’s children.

“It was her phone call and I think what she did at the state level to re-look at the data . . . that really got them to change course,” the doctor testified April 24 at day 15 of Wells’ preliminary examination. “I’m grateful she was able to look at the data and to realize we did have a problem. If not for her action, I think it, the attacks and denials, would have gone on much longer.”

Hanna-Attisha summed up Flint’s situation rather succinctly: “Flint had no democracy; money was the bottom line.”

Wells is charged with involuntary manslaughter, lying to a special police agent and obstruction of justice in connection with the legionnaires’ disease outbreaks that killed 12 people and sickened nearly 80 more.

Special Prosecutor Todd Flood called the state’s last […]