Home2019-01-17T20:58:16-05:00

State Of State: Family Leave And Drug Cost Lowering Proposals Left Out

Missing from the Gretchen Whitmer’s State of the State address late last month were her calls for paid family leave and prescription drug affordability – both items she wanted to see get done before the end of last year.

Whitmer’s August 2023 “What’s Next?” Address highlighted proposals she wanted moved in Lansing during the first year of a Democratic-led House, Senate and executive office in 40 years.

The “clean energy” by 2040 proposal and the elimination of numerous state abortion regulations were both endorsed by the governor in her August speech and passed before mid-November. Whitmer’s priorities for paid family leave and a prescription drug affordability board were left behind, and didn’t make her vision for 2024 either.

Instead, she prioritized things like a $5,000 debut “Caring for MI Family Tax Credit” for a family’s caregiver expenses, two years of tuition free community college for high school graduates and a revamped pot of business incentive tools.

For economic development, Whitmer wants more renaissance zones – where businesses and entrepreneurs are awarded a period of tax exemptions – and a new “Innovation Fund” to deploy state investment into “high-growth startups” projected to boost significant career attraction and retention in the state.

Whitmer didn’t say anything about a prescription drug affordability board [Read More]

Health Plans Can’t Dodge Paying For Expensive New Cancer Treatments, Says Michigan’s Top Insurance Regulator

By ROBIN FIELDS & MAYA MILLER
ProPublica/Co-published with The Capitol Forum

In a victory for many cancer patients in Michigan, the state’s top insurance regulator told health plans last month that they cannot deny coverage for clinically proven cancer treatments, and she made it clear for the first time that this includes cutting-edge genetic and biologic therapies.

The move follows weeks of questions from ProPublica and pressure from state lawmakers after the news organization reported in November that an insurer there refused to pay for the only treatment that could save the life of Forrest VanPatten, a 50-year-old father of two, even though a state law requires insurers to pay for proven cancer drugs.

Internal emails obtained by ProPublica showed that executives at Priority Health, the second-largest insurer in Michigan, had argued that the expensive treatment VanPatten needed was a gene therapy, not a drug, so the state’s mandate didn’t apply. VanPatten died in February 2020, still fighting for access to treatment. Priority Health’s associate chief medical officer had tried fruitlessly to convince his bosses that the company was required to cover the treatment, known as CAR T-cell therapy. He later told ProPublica: “We crossed the line.”

Forrest VanPatten’s widow, Betty, and their two adult children said they hoped the historic [Read More]

ADELMAN’S ANALYSIS: TikTok Challenges Present Health Risk

By SUSAN ADELMAN, MD
We all have heard that Tik Tok should be banned, but usually for political reasons. Few in the medical community realize the medical and public health dangers that kids are exposed to when they go on this platform. Along with alluring dance routines are enticing challenges to do completely ridiculous, unbelievably dangerous pranks—dangerous to the self and to others. Does anyone older than a teenager know what these challenges are? Let us go through some of them.

One is so dangerous and has caused so many deaths that Tik Tok has put up a warning message on their platform – the Blackout Challenge.  In this one, the child holds his breath, then a companion presses him against a wall until he passes out. The purpose is to attain a brief state of euphoria. Next, there is the Challenge to Tape the Mouth shut during sleep, supposedly because sleeping with the mouth open is hazardous. This can result in the child becoming hypoxic, even to the point of a cardiac arrest.

In the Skull Breaker Challenge, three people stand in a row, facing the camera. The two on the outside convince the one in the middle to jump, but when he does, they sweep his [Read More]

COMPLIANCE CORNER: LARA Ramps Up Efforts To Remove Obstacles Preventing Foreign-Trained Healthcare Providers From Practicing In Michigan

By: Jesse Adam Markos, Esq.
Wachler & Associates, P.C

Michigan is currently facing a shortage of healthcare providers that has escalated to unprecedented levels.  In response, Michigan’s Department of Licensing and Regulatory Affairs (“LARA”) has taken steps to enhance efforts to recruit and retain providers.  One such step is the formation of a task force to identify obstacles that prevent Foreign Trained Medical Professionals (“FTMPs”) from practicing in Michigan and to create recommendations to improve the efficiency and effectiveness of the licensing process.  The resulting Michigan Task Force on Foreign Trained Medical Professional Licensing (“Task Force”) has done just that in its recently released Final Report.

As background, the Task Force was created pursuant to Public Act 166 of 2022, and representatives from state government, higher education, hospitals, and other professional associations were invited to meet with LARA to help identify the issues confronting FTMPs.  Michigan is following in the footsteps of a number of states that have been actively turning to FTMPs, who were trained in other countries and have the experience and skills necessary to deliver healthcare services, to address provider shortages.

LARA believes that there are approximately 6,000 FTMPs in Michigan with sufficient training and degrees, who are ready and able to help alleviate the provider [Read More]

LEGAL LEANINGS: 6 Key Steps to Respond to a Health Care Investigation

By SETH WAXMAN
Dickinson Wright

The United States Department of Justice (“DOJ”) and state law enforcement agencies have robust teams investigating and prosecuting health care fraud. Law enforcement often uses advanced data analytics and algorithmic methods to identify newly emerging health care fraud schemes. DOJ also employs nine regional strike forces located throughout the country to bring together groups of prosecutors, FBI agents, and key administrative agencies to combat health care fraud. Critical time will be lost, and important steps may be missed if an organization waits until an investigation is underway to decide how to respond to a government investigation.

6 Steps for Responding to a Search Warrant

  1. Company policy

Health care companies should implement a written policy on how to handle government investigations. Attempting to put together a response on the fly is fraught with danger and will likely put the company at risk. For search warrants, the policy should include designating a lead person within the company, such as an experienced attorney or trained manager, to oversee the company’s response. There should also be a designated manager at each health care facility who is responsible for initially engaging with law enforcement and notifying the lead corporate official (these corporate leaders and managers are collectively referred [Read More]

LANSING LINES

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

Abortion Provider, Student Group Challenge Access Restrictions

A Michigan abortion provider and a pro-abortion rights student group filed a Michigan Court of Claims case challenging three abortion restrictions, including Michigan’s 24-hour waiting period.

Northland Family Planning Centers and Medical Students for Choice also challenge the dissemination of certain information to a patient before an abortion and prohibitions on the ability of advanced practice clinicians to perform abortions, according to the lawsuit filed recently.

“Through the RFFA, Michigan voters overwhelmingly declared that they will not tolerate paternalistic and medically baseless restrictions on abortion like those we are challenging in this case,” said Rabia Muqaddam, senior staff attorney at the Center for Reproductive Rights. “With this lawsuit, we hope to eliminate these harmful restrictions and ensure the state’s laws reflect the will of Michigan voters.”

The RFFA – Reproductive Freedom for All – is a constitutional amendment passed on Nov. 8, 2022.

Renee Chelian, executive director of Northland Family Planning Centers added: “Every day, and especially since Roe (v. Wade) was overturned, our providers and clinic staff work tirelessly to meet the needs of both Michigan residents and out-of-state patients.

“Despite our win with Proposal 3, patients continue to [Read More]

There’s A New COVID-19 Variant And Cases Are Ticking Up. What Do You Need To Know?

By JULIE APPLEBY
It’s winter, that cozy season that brings crackling fireplaces, indoor gatherings — and a wave of respiratory illness. Nearly four years since the pandemic emerged, people are growing weary of dealing with it, but the virus is not done with us.

Nationally, a sharp uptick in emergency room visits and hospitalizations for COVID-19, influenza, and respiratory syncytial virus, or RSV, began in mid-December and appears to be gaining momentum.

Here are a few things to know this time around:

What’s Circulating Now?

The COVID virus is continually changing, and a recent version is rapidly climbing the charts. Even though it appeared only in September, the variant known as JN.1, a descendant of omicron, is rapidly spreading, representing between 39% to half of the cases, according to pre-holiday stats from the Centers for Disease Control and Prevention.

Lab data indicates that the updated vaccines, as well as existing COVID rapid tests and medical treatments, are effective with this latest iteration. More good news is that it “does not appear to pose additional risks to public health beyond that of other recent variants,” according to the CDC. Even so, new COVID hospitalizations — 34,798 for the week that ended Dec. 30 — are trending upward, although rates are still substantially [Read More]

Michigan 10 Percent Behind Last Year’s Flu Shot Numbers

As of Dec. 2, Michigan was trailing behind last year’s administered flu shot numbers by more than 10 percent, which is a setback that’s caught the attention of the Michigan State Medical Society.

“The biggest risk would be to have a very severe flu season, with many severe illnesses requiring (hospitalization),” said Dr. M. Salim Siddiqui, MSMS president. “I think we all have a sense of what happens when our hospitals get overwhelmed by respiratory illness. For older patients and younger patients, there (would) be (concerns) about severe permanent complications and even death.”

During a recent roundtable discussion, lasting around 20 minutes, Siddiqui described the influenza vaccine as a way to avoid respiratory illness-related hospitalizations, preventing facilities from tapping out their capacities.

According to the state’s official Flu Dashboard, influenza vaccine coverage for youths – from six months through 4-years-old – has fallen from 41.4 percent and 31.6 percent during the 2021-22 and 2022-23 flu seasons, respectively, to 21.4 percent in the ongoing season.

As for those 65-years-old and older, vaccine coverage has dropped from 62.6 percent in the last season to 51.9 percent in the present-day 2023-24 influenza season – declining from more than 1.1 million vaccinated residents to 936,330.

Siddiqui said a survey found 27 percent of non-vaccinated individuals [Read More]

IN OUR VIEW: Keep The Momentum For Mental Health

By PAUL NATINSKY
Until recently, I never gave much serious thought to mental health. As a member of that latch-key, seat-beltless, hose-hydrating generation born in the late ‘60s, I thought of mental health as a refuge of the weak and excuse-seeking. Worse, at times I thought of those with severe mental health issues as hopeless institution dwellers beyond the help of healthcare professionals. Even as I gained experience as a healthcare reporter and health policy professional in the state legislature, I hated working on mental health issues.

That’s a tough truth to admit to for a healthcare publication editor and I’ll probably pay a price for that. But it is important to illustrate how far attention to mental health has come in public and professional consciousness.

We see the quarterback of the national champion Michigan Wolverines meditating cross-legged, eyes closed, with his back against the goal post. We later see him consulting with the team psychologist on the sideline during the championship game (imagine that tableau during the Schembechler era!).

We see the suicides of beloved public figures such as actor and comedian Robin Williams used to draw attention to the horribly painful and self-negating effects of depression.

We see concern about the effects of “triggering” events on our fellow [Read More]

ADELMAN’S ANALYSIS: COVID Boosters And Vaccines: Let Science Prevail!

By SUSAN ADELMAN, MD
Since the beginning of the COVID epidemic, most physicians have been struggling to do the right thing when it comes to treatment and prevention. Part of this was because, in the beginning, a terrifying complex of symptoms hit our patients fast, with high lethality, high transmissibility and distressing urgency. We worked hard, under pressure, to diagnose, to figure out immediate treatments, to devise prevention strategies, to understand new vaccines, and, eventually, boosters. Now we have a great deal of information, but most of us in the medical profession still are hard-pressed to be confident in our recommendations about vaccines and boosters for all age groups. Meanwhile, some politicians, schools and employers still are trying to protect their constituents and employees with well-meaning but scientifically shaky mandates.

It is now time for the medical profession to stop, take a deep breath, and begin addressing COVID as it would address any other diagnostic or therapeutic dilemma, using evidence-based medicine. This is a systematized method of grading evidence to assess, say, the effect of an intervention or the results of clinical trials, usually using meta analysis of multiple studies. The quality of the evidence then is rated High, Moderate, Low or Very low. As an example, moderate [Read More]

ON POINT WITH POs: A Much Needed Checklist Of Steps To Take When A Practicing Physician Dies

By EWA MATUSZEWSKI
When a practicing physician dies, there is not only intense grief, but an entire gamut of professional details that require immediate attention. I recently faced this personal challenge and was admittedly adrift in confronting first and subsequent steps. Perhaps I should have known them already—but some of the medical associations and health plans I reached out to didn’t either. The question? Where is the checklist to guide me through the “un-credentialing” of a physician?

With the risk of identity theft high, it is imperative that no enterprising thief access physician credentials for nefarious purposes. Here is what I learned by creating my own checklist for steps that must be taken when a physician dies. (Note that information to “disenroll” applies to a retiring physician as well.) The following provide time-sensitive basics:

  • Meet with the practice manager to create an action plan for the first 15 days.
  • Assemble current employees to communicate pending changes in the practice and how their support is needed for a smooth transition.
  • Send an announcement via the patient portal to active patients. Draft and send a letter via US mail to the patients as well. This is not necessary for a fully retired physician unless the successor practice leaders want to [Read More]

COMPLIANCE CORNER: Medicaid Coverage Expanded By MDHHS To Include Community Health Worker Services

By SHEA MACE
Wachler & Associates, P.C.

On December 7, 2023, MDHHS announced that community health worker services now will be covered by Medicaid. The new policy is effective January 1, 2024, and chiefly applicable to the Medicaid Fee-for-Service (FFS) program. Medicaid Health Plans (MHPs) and Integrated Care Organizations (ICOs) must also comply by offering the full range of services described within the policy, although they may provide additional services beyond those specified and may develop review and prior authorization criteria different than Medicaid requirements.

CHW Overview

Community health workers (CHWs) are non-licensed but trained public health providers who have distinct knowledge and appreciation of the community they serve. They function as a liaison between community members, healthcare providers, and social services. CHW services must be delivered face-to-face and broadly include assistance with health system navigation, resource coordination, health promotion and education, and the use of screening and assessment tools.

Beneficiary need for CHW services must be recommended by a licensed healthcare provider, including but not limited to a physician, physician assistant, nurse practitioner, registered nurse, licensed master social worker, dentist, or psychologist. Necessity must be assessed and established by using a health risk or social determinant of health (SDOH) screening tool. Conditions that endorse the need for CHW services [Read More]

LEGAL LEANINGS: A State-Based Cure – Interested Government Agency J-1 Waivers For Physicians

By KATHLEEN CAMPBELL WALKER
Recently, the president of the American Medical Association, Jesse M. Ehrenfeld, MD, stated in a national address that the physician shortage long-feared is here and that “It’s an urgent crisis…hitting every corner of this country—urban and rural—with the most direct impacting hitting families with high needs and limited means… Ninety percent of counties in the U.S. are without a pediatric ophthalmologist. Eighty percent are without an infectious disease specialist.”

All areas of the country rely in part on foreign medical graduate (FMG) physicians, who may be required to serve in qualifying health professional shortage areas (HPSAs) or medically underserved areas (MUAs) to transition to a career as a health professional in the United States. These FMG physicians are often admitted to the U.S. to engage in their medical graduate studies in J-1 nonimmigrant status and are subject to a requirement to return to their home country for two years before transitioning to a pathway to legal permanent residence (LPR) in U.S. (Some refer to his process as obtaining a “green card”)

For those J-1 FMG physicians who wish to transition to a pathway to LPR, they must determine if they can be approved for a waiver of this two-year obligation to return to [Read More]

LANSING LINES

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

Passive Renewals Helping Medicaid Redetermination Process

With Michigan’s post-pandemic Medicaid redetermination process well underway, the Department of Health and Human Services has stayed busy contacting Medicaid recipients to inform them of their redetermination requirement. But, in some cases, an automatic or passive renewal is easing DHHS’ workload.

Nicole Hudson, DHHS senior advisor on special projects, explained the redetermination process that started after three years of pandemic-prompted auto-renewals for Medicaid. It was accompanied by a significant increase in the state’s Medicaid population and an almost 35% increase in Michiganders on Medicaid.

Over 3.2 million Michiganders were covered by Medicaid in May 2023, Hudson said.

Starting in June, those Michiganders are being notified in monthly-grouped cohorts that their Medicaid is up for redetermination. They’re first sent a letter, then a packet in the mail, which is pre-populated with all information on file and must be completed within approximately 30-days to determine their continued eligibility.

Hudson said it can be returned as physical paperwork, completed via the state’s online system or called in via a renewal phone line, but is then processed through a caseworker. If information isn’t returned, DHHS will follow up and contact recipients by text, phone or [Read More]

What Would A Nikki Haley Presidency Look Like For Healthcare?

By LAUREN SAUSSER
CHARLESTON, S.C. — Republican presidential hopeful Nikki Haley will learn how her campaign is resonating with voters after the Jan. 15 Iowa caucuses, the first presidential nominating contest of this election year.

Already, the former South Carolina governor — who became well known as one of the Affordable Care Act’s loudest critics during her tenure in office from 2011 to 2017 — has raised questions about what her presidency could mean for the nation’s health care policy.

She has criticized the Biden administration for high federal spending on COVID relief and for the number of people on Medicaid, a program she has argued the federal government should give states more flexibility in funding and administering.

She has also emphasized the need to find consensus on banning abortions late in pregnancy. And on Jan. 10, during her heated sound-off with Florida Gov. Ron DeSantis in the final debate before the Iowa caucuses, she reiterated her critical stance on gender-affirming care.

Former South Carolina Medicaid Director Anthony Keck pointed out that one of her early achievements as governor was fixing a $228 million Medicaid deficit.

“People forget what dire straits the Medicaid program was in when she came into office and how it took us a couple years to right the [Read More]

We’re Losing Our Most Experienced Physicians

By PAUL NATINSKY
I understand very clearly the deep concern about the future of medicine and the frustrations attached to that concern. Other professionals with similar levels of academic and practical credentials and similar licensing requirements practice much more autonomously and with much more freedom than physicians.

As a patient and healthcare writer, I have exposure to the sense of defeat physicians increasingly feel toward their careers, particularly those who are near end of their practicing years, a career phase that arguably makes them among the most valuable of practitioners. Experience and the wisdom that comes from decades of practice cannot be replaced.

Several years ago, my family’s terrific pediatrician retired early. She is an intelligent, vibrant woman with children of her own who had a joyful, warm greeting for us at each visit. She had the low-key self-assuredness of a very accomplished professional who enjoyed plying her craft. She was in her early sixties and told me she would have liked to work another 10 years. Changes such as required computer entries on a rolling cart after each patient visit took the joy out of practicing for her. She didn’t need the money, but her patients and the medical profession would have benefitted from 10 more years [Read More]

ADELMAN’S ANALYSIS: Is Medicine Still a Profession?

By SUSAN ADELMAN, MD
What is a profession? The on-line Oxford Dictionary defines a profession as “a paid occupation, especially one that involves prolonged training and a formal qualification.” What is a guild? The same dictionary defines a guild as “a medieval association of craftsmen or merchants, often having considerable power…[or] an association of people for mutual aid or the pursuit of a common goal.” What are proletariat? This dictionary defines proletariat as “workers or working-class people, regarded collectively. (often used with reference to Marxism)” also, “the lowest class of citizens in ancient Rome.”

What attributes characterize a profession? According to the Association of Accredited Public Policy Advocates to the European Union, these are “great responsibility, accountability, based on specialized, theoretical knowledge, institutional preparation, autonomy, clients rather than customers, direct working relationships, ethical constraints, merit-based, and morality.” Further, “A profession makes deliberate choices where others have choices made for them or they simply react to what comes their way.”

Remember, Karl Marx defined the proletariat as “the social class having no significant ownership of the means of production (factories, machines, land, mines, buildings, vehicles) and whose only means of subsistence is to sell their labor power for a wage or salary.”

Which one sounds more like medicine today? When I entered the medical [Read More]

LETTER: A Profession at the Precipice?

Certainly, this is not a formal survey, but those physicians that I have recently interacted with have been sadly and regrettably consistent. The new mantra seems; “I will put in the next four or five years and get out of the agony as soon as I can.” This defines a profession that has lost. Without the visibility or even the hope of any significant action steps, surrender becomes the final chapter. All of the professional organizations, the AMA and reinvented and reinvigorated state and local medical societies must acknowledge reality and get proverbially “their heads out of the sand.”

Medical students must be prepared for the realities of practicing medicine in an environment where their burnout is to be anticipated. Optimally, they would be equipped with the understanding and tools needed to rescue this great profession from the politicos, bureaucrats, insurance companies and myriad corporate entities that have attached themselves to the financial opportunity represented by this huge one fifth of GDP.

But medical educators are failing our future doctors. All of these including the inappropriate mandate of expensive useless technology poison the physician-to-patient relationship which is foundational to the enjoyment of practicing medicine and the survival of the profession. A model of subservience to the paymasters [Read More]

Issue Of Physician-Assisted Deaths To Be Resurrected In Legislature For ’24

Terminally ill patients in Michigan, determined to have up to six months left to live, could request life-ending medication under bills the Legislature could likely take up next year.

“We wanted to make sure to introduce it before this holiday season in order to continue to work with stakeholders, for (it), against (it)…or even people that might have questions,” said Sen. Mary CAVANAGH (D-Redford Twp.), the lead sponsor behind this term’s “Death with Dignity” bill package, to MIRS. “But, it is not my intent to shove anything down that we haven’t had full vetting and full conversations of what is the best thing for Michigan, and who might be utilizing some of these new access points in end-of-life care.”

On the last day of regular session activities for 2023, Cavanagh and Sens. Kevin Hertel (D-St. Clair Shores), Veronica Klinefelt (D-Eastpointe) and Sam Singh (D-East Lansing) introduced SB 678 , SB 679 , SB 680 and SB 681 . In order to access the end-of-life care established through the legislation, a patient must be specifically diagnosed as terminally ill and cannot have more than six months remaining to live, based on medical judgements.

Life-ending medication must be prescribed by an attending physician and a consulting physician under the bills, and the patient must be evaluated to ensure they’re capable of decision making and rational [Read More]

Gov Signs Tougher Penalties For Healthcare Worker Assault

Gov. Gretchen Whitmer signed a bipartisan legislative package at Sparrow Hospital last month that would increase the punishment leveled against people, excluding patients, that assault health care workers.

As she signed HB 4520 and HB 4521 , sponsored by Reps. Mike Mueller (R-Linden) and Kelly Breen (D-Novi), Whitmer was surrounded by nurses and doctors, who she said were facing an increase of violence, even as they faced a shortage of workers. Her response was signing this legislation into law, which could help stem the tide.

“We owe a debt of gratitude to the doctors, nurses, and health care workers who routinely step up to protect our communities and save lives,” Whitmer said. “Unfortunately, health care workers face rising rates of bullying, viciousness, and violence.”

The new law increases assault and battery to a 93-day misdemeanor and $1,000 fine, aggravated assault to a one-year misdemeanor and $2,000 fine, and felonious assault to a four-year felony and a $5,000 fine.

An exemption for patients was carved out in the legislation.

Jessica Lannon, a nurse at Sparrow, told stories before the bill signing about assaults on colleagues and her own experience with a man who pulled a large plumber’s wrench and threatened all the workers, saying  if his baby “did not come out perfect, we would all pay.”

“Too many workers are forced [Read More]

ON POINT WITH POs: Trepidation – but hope – in the new era of healthcare

By EWA MATUSZEWSKI
Healthcare is not for the faint of heart. I’m not speaking of exposure to blood, trauma, distress, violence, and death – but there’s that, too.  Rather, I’m playing my violin for the healthcare warriors who are dealing with a new era of healthcare in a post-pandemic world. These are frontline nurses, physicians, phlebotomists, clerks, medical assistants, x-ray, ultrasound and med techs, midwives, social workers and behavioral health specialists. But they are also administrators, hiring managers and recruiters, payors, financial personnel and office managers.

This is not an exhaustive list; the healthcare world is simply too massive to capture every role in this column. The overarching commonality, though, is that healthcare professionals are facing a crisis of societal despair that is exhibited in increasing mental health problems in doctor’s offices, hospitals, community agencies, and school and university health clinics.

In speaking with a colleague recently, I opened up about some troubling statistics from our PO’s patient population regarding Emergency Department (ED) visits from January 2023 through September 2023. Out of 1,208 ED visits, 469 were due to substance use disorder and depression: alcohol (329), opioids (28), cocaine (29), general substance misuse (96) and depression (107). These numbers, significantly higher in most categories than pre-pandemic numbers, represent [Read More]

COMPLIANCE CORNER: MSMS Urges AG Action to Enforce Corporate Practice of Medicine Laws

By KAITLYN DELBENE
Wachler & Associates, PC
The Michigan State Medical Society and various specialty organizations are urging the Michigan Attorney General to investigate the role of private equity in healthcare and to enforce Michigan’s corporate practice of medicine (CPOM) doctrine against apparent violations. In an October 23, 2023 letter, MSMS expressed concern that “a series of deceptive legal loopholes and shell corporations” has allowed private equity groups to effectively circumvent Michigan’s CPOM laws. While physician practice management companies and medical staffing companies are common in the healthcare industry, physician groups and management companies must be aware of the legal and regulatory challenges presented by these arrangements.

CPOM Primer: Michigan’s 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. All officers of PCs and managers of PLLCs must be licensed to provide the professional medical services rendered [Read More]

LEGAL LEANINGS: Top Issues in Negotiating Physician Employment Agreements

By RALPH Z. LEVY & BRIAN S. FLEETHAM

Successful negotiation of physician employment agreements requires a careful balance of the objectives of the prospective employer with those of the prospective employee while ensuring that the negotiated agreement complies with the federal and state laws that apply to agreements of this type.  The prospective employer wants to make certain it has enough professionals to handle the needs of its patients, and the prospective employee wants to be paid adequately and fairly for services provided while preserving a work-personal life balance.  If the agreement “blows up,” the prospective employer wants protection against the physician “stealing” its patients, and the prospective employee wants to practice medicine without relocating.

Impact of Federal and State Laws That Apply to Physician Employment Agreements

Written physician employment agreements should comply with the regulatory safe harbors for agreements of this type under federal and state anti-kickback statutes (“AKS”) and the exceptions to the laws that restrict referrals by physicians to entities in which the physician has a financial interest for certain types of ancillary services under applicable state and federal laws, such as the Stark Law.  In addition, federal and state laws require preservation of the privacy of patient records (such as HIPAA and [Read More]

LANSING LINES

Michigan’s Unique Drug Immunity Statute Is No More

(FLINT) A Gov. John Engler-era law that shields drug manufacturers from liability if their medicine received U.S. Food and Drug Administration approval was flushed down the toilet late last month.

With Gov. Gretchen Whitmer’s signature, Sen. Jeff Irwin (D-Ann Arbor)’s SB 410 ends the 1995 Michigan Product Liability Act, a statute House Democrats and Democrats et al. used with some success on the campaign trail about 15 years ago.

The bill, which received bipartisan support in both the House and Senate, will end Michigan’s status as the only state with what Whitmer called an “immunity shield in place.”

Joined by bill sponsor Irwin, who Whitmer said has been working to overturn immunity for two decades, and Attorney General Dana Nessel, Whitmer told the story of Leslie Richter, whose husband lost his life after taking a prescription drug.

Richter became the public face of the statewide attempt to repeal the 1995 law after her husband, Richard Richter, died from a stroke, allegedly from taking the pain medication Vioxx for his arthritis

Richter’s name appeared on a New Jersey court’s case list as having filed a claim there against the company that manufactured Vioxx, Merck, which would have made her potentially eligible to receive a portion of a $4.85 billion settlement.

“Had they lived in [Read More]

Ohio Voted On Abortion. Next Year, 11 More States Might, Too

By BRAM SABLE-SMITH

UNIVERSITY CITY, Mo. — As activists parse the results of a Nov. 8 vote to protect abortion rights in Ohio, Jamie Corley is already well on her way to putting a similar measure in front of Missouri voters next year.

Corley, a former Republican congressional staffer, filed not one, but six potential ballot measures in August to roll back her state’s near-total ban on abortion, triggered by the U.S. Supreme Court’s June 2022 decision to end federal protections for terminating pregnancies.

“I can’t emphasize enough how dangerous it is to be pregnant in Missouri right now,” Corley said at a restaurant near her home in this St. Louis suburb. “There is a real urgency to pass something to change the abortion law.”

Missouri is one of at least 11 states considering abortion-related ballot measures for next year, part of the wave of such actions since the Supreme Court’s decision on Dobbs v. Jackson Women’s Health Organization. And while November 2024 is still a year away, the groundwork for those campaigns has been in motion for months, sometimes years.

In Iowa, for example, efforts to pass a state constitutional amendment declaring no right to abortion began in 2021, although the legislature has yet to finish the process. In Colorado, competing [Read More]

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