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

Abortion Ballot Measure Draws In Voters For The Win

Proposal 3, arguably the top driver for many voters who headed to the polls today, passed today.

The proposal inscribes the right to an abortion, and other reproductive issues, into the Michigan Constitution after the U.S. Supreme Court overturned the Roe v. Wade decision that legalized the practice nationally. It was projected by Mark Grebner of Practical Political Consultants to draw between 10,000 and 20,000 new young female voters.

“Michigan, we made it happen! Your votes helped #RestoreRoe and protect #ReproductiveFreedom for generations to co come. Thank you to everyone who volunteered, hosted a yard sign, and voted for #Proposal3 this election!” reads the tweet from Reproductive Freedom For All, the group that spearheaded Proposal 3.

Reproductive Freedom for All was already putting the ballot initiative together before the ruling in the Dobbs decision. Weeks later, the participation level in the drive to collect signatures for the proposal revealed a spike in interest after Roe v. Wade was overturned.

The ballot proposal effort collected the highest number of signatures in Michigan history.

The road to the finish line wasn’t easy, as a coalition spearheaded by the Catholic church and Right to Life spent nearly $25.6 in advertising to abort it at the ballot box.

Reproductive Freedom for All was able to nearly match the advertising spending with nearly $22 [Read More]

Sick Profit: Investigating Private Equity’s Stealthy Takeover of Healthcare

By FRED SCHULTE
Two-year-old Zion Gastelum died four days after receiving baby root canals and crowns at Kool Smiles, a private equity-affiliated dental clinic in Yuma, Arizona. In a lawsuit, which was settled in 2021, his parents accused the clinic and the investment firm of putting profits ahead of patient safety. The clinic and investment firm denied liability. The boy’s death was featured on ABC15 Arizona on Jan. 4, 2018.

Two-year-old Zion Gastelum died just days after dentists performed root canals and put crowns on six baby teeth at a clinic affiliated with a private equity firm.

His parents sued the Kool Smiles dental clinic in Yuma, Arizona, and its private equity investor, FFL Partners. They argued the procedures were done needlessly, in keeping with a corporate strategy to maximize profits by overtreating kids from lower-income families enrolled in Medicaid. Zion died after being diagnosed with “brain damage caused by a lack of oxygen,” according to the lawsuit.

Kool Smiles “overtreats, underperforms and overbills,” the family alleged in the suit, which was settled last year under confidential terms. FFL Partners and Kool Smiles had no comment but denied liability in court filings.

Private equity is rapidly moving to reshape health care in America, coming off a banner year in 2021, when [Read More]

The Gift Of Mentoring

By EWA MATUSZEWSKI
I was overwhelmed by the response to my October column on internships. It’s a topic that resonated with readers for varying reasons – whether they recalled fond memories of their own internship or saw the impact of internship programs, formal or informal, at their own organization. I want to continue in a similar vein this month by taking the logical jump from internships to mentoring. While I did include mentoring in the conversation last month, I didn’t really dissect it until someone recently asked me if I had a mentor in my early career.

It took me a split second to acknowledge one of my earliest mentors, Myra Lenard. Long deceased, Myra’s leadership example is very much alive in guiding my actions to this day. I was in my late teens and early twenties when I first worked with Myra. I was an intern of sorts for the Polish American Congress and Myra, a Polish immigrant like I am, was the Executive Director of the Washington, D.C. office of the Polish American Congress. I didn’t live in D.C. but flew in as part of the local grass roots activities I was spearheading in Detroit’s Polish community for a national presidential campaign.

It didn’t happen overnight, [Read More]

MDHHS Reinstates Provider Enrollment And Revalidation Requirements

By ROLF LOWE
Effective Dec. 1, 2023, the Michigan Department of Health and Human Services (MDHHS) announced in Medical Services Administration (MSA) Bulletin 22-38 that it will be eliminating the remaining temporary suspensions of certain provider enrollment and revalidation requirements issued in the spring of 2020, shortly after the COVID 19 pandemic and federal emergency disrupted the normal course of business for providers and MDHHS.  On April 30, 2020, MDHHS released MSA Bulletin 20-28, temporarily suspending certain Medicaid, Healthy Michigan, Maternity Outpatient Medical Services (MOMS), Children’s Special Health Care Services (CSHCS) and MI Health Link provider enrollment and revalidation requirements. The bulletin, which had an effective date of March 1, 2020, was intended to relax, and reduce potential administrative burdens on providers as they adapted to the challenges of the COVID 19 pandemic. MSA suspended the following federal provider enrollment requirements:

Community Health Automated Medicaid Processing System (CHAMPS) Enrollment Revalidations;

Site visits for prospective and current providers;

Fingerprint-based criminal background checks associated with providers in the high-risk level category; and

Payment of application fees – (Providers required to pay an application fee were able to request a postponement of the fee by declaring the payment a hardship during their CHAMPS enrollment or revalidation).

In the bulletin, MSA also described certain restrictions [Read More]

A New Interstate Compact Is In Town: The Interstate Compact For Counselor Licensure

By ERICA ERMAN
One interstate compact you may not have heard of yet that could be very helpful for the behavioral health field is the Interstate Compact for Counselor Licensure. As of August 4, 2022, the Counselor Compact now has 17 members – Alabama, Colorado, Delaware, Florida, Georgia (the first state to enact the Counseling Compact), Kentucky, Louisiana, Maine, Maryland, Mississippi, Nebraska, New Hampshire, North Carolina, Ohio, Tennessee, West Virginia, Utah – and The Compact became active when ten states passed it.

This month, the Compact Commission will convene for the first time in October of 2022! According to the Compact’s website, “The Commission will adopt initial bylaws and rules to carry out the Compact. The Commission will also provide for creating an interstate licensure data system allowing for rapid verification of practitioners’ good standing and sharing of disciplinary information among member states. This activation process generally takes up to a year or longer.”

This Compact is for Licensed Professional Counselors (LPCs) only. It specifically does not include licensed marriage and family therapists (LMFTs), licensed clinical social workers (LCSWs), or psychologists.

The Compact website FAQ page notes, “If your state uses a title different than but equivalent to LPC (e.g., LMHC, LPCC), and you are a counselor who can independently diagnose, assess, [Read More]

LANSING LINES

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

Hospitals In Low Population Counties Could Become Non-Profits Under Bill

A Sen. Wayne A. Schmidt (R-Traverse City) bill allowing qualifying county hospitals to convert to non-profit designations heard testimony before the House Health Policy Committee and was voted out unanimously.

SB 1055 , which passed the Senate unanimously in June, was passed out of committee 18-0 after Schmidt testified in favor.

The bill would amend the Municipal Health Facilities Corporations Act to allow Helen Newberry Joy Hospital and Healthcare Center in Luce County to restructure as a nonprofit.

The county hospital is a 25-bed critical access facility that has been providing ancillary out-patient and surgical services since 1965, in addition to operating four rural health clinics and a 39-bed long-term care unit.

In recent years, the hospital has struggled to respond to a changing healthcare landscape and seek certain forms of grant funding, said Hunter Nostrant, who testified in support of the bill on behalf of HNJH.

The change in designation would allow more seamless future affiliations and partnerships, he said.

HNJH isn’t the first hospital to change their designation in Michigan, with several 2016 amendments to the Act allowing public health corporations in Mecosta, Alpena and Branch counties to restructure and [Read More]

Abortion Bans Are Motivating Midterm Voters, Poll Shows

By EMMARIE HUETTEMAN
Half of voters say the Supreme Court’s decision overturning the constitutional right to an abortion has made them more motivated to vote in next month’s midterm elections, with enthusiasm growing especially among Democrats and those living in states with abortion bans, according to a new poll from Kaiser Family Foundation.

The survey also showed that most voters, whether they are Democrats or Republicans, do not think abortion should be prohibited in cases of rape or incest, nor do they support laws that set criminal punishments for abortion providers and women who have abortions.

The findings, collected in late September through KFF’s regular survey of public opinion on health care issues, highlight that even the majority of Republican voters oppose some of the laws that have strictly restrained abortion access — including for those who have been raped — that are now in effect in Republican-led states such as Texas and Missouri. However, states with such strict standards have so far authorized abortions to save the life of a mother.

Bottom of Form

With Democrats currently holding control of the House of Representatives and the Senate by narrow margins and several close races underway, control of Congress could hinge on voter turnout. And while voters are less likely to pick [Read More]

Pro-Life Democrats Make Their Case Against Prop 3

Abortion providers and medical providers are pushing to pass Proposal 3 next month to keep the money coming in the door and to shield themselves from potential legal action down the road, according to Democrats who opposed the constitutional amendment on the Capitol lawn.

A handful of speakers led by the “Democrats for Life” argued that passing the Reproductive Freedom for All initiative will mean abortions with no limitation or oversight.

The message coming out of the event was Proposal 3 will eventually eliminate all statutory regulations over abortion. The courts will have no choice but to side with the broad constitutional language that allows for abortion, regardless of age, up until a subjective point of fetal viability.

“We’re putting the decision not in the hands of women, but in the hands of providers who stand to make a profit,” said Kristen Day, executive director of the national organization Democrats for Life. “So, as Democrats, we never advocate for profits over the health and safety of people.”

Once the courts get done with overturning current statutory limitations on abortion, girls at any age will be able to seek an abortion without parental consent, said Monica Galloway, a former Flint City Councilmember.

“This proposition is going to destroy families,” she said. “It will [Read More]

Maximize The Power Of Internships—And Your Intern’s Future

By EWA MATUSZEWSKI
How does one build a 41-year-old organization? My response today is different than it would have been 15 or so years ago, largely due to my increased understanding of the value of internships. During this time, we’ve hired numerous interns of differing backgrounds and skill levels and the overwhelming majority have made meaningful contributions that ultimately helped us build a stronger organization.

I define ‘stronger’ in differing ways. One is our ability to take on new projects where we can lead with creativity and enthusiasm; another, our reputation for offering interns – and staff – both direction and independence in their careers with us – which in turn helps identify us as an employer of choice; and, yet another, the relationships we build with our internship schools that lead to partnerships and opportunities not easily available outside academia.

For example, through the years we have hired more than a dozen interns through neighboring Oakland University. From exercise specialists to dietitians and, since its first graduating class in 2015, masters of public health students who brought us deep data skills at a time when outcomes reporting took on greater significance for reimbursement by health plans. So valuable were these MPH interns that we hired five of [Read More]

Don’t Be Surprised: A No Surprises Act Primer

By JENNI COLAGIOVANNI & DANIEL AYYASH
Wachler & Associates, PC

Overview

Signed into law on Dec. 27, 2020, the No Surprises Act addresses surprise medical billing or “balance billing” at the federal level by protecting patients from receiving surprise medical bills resulting from gaps in coverage for emergency services and certain services provided by out-of-network clinicians at in-network facilities, including by air ambulances. Effective Jan. 1, 2022, healthcare providers, facilities, and providers of air ambulance services (hereinafter “providers”) are subject to new requirements that generally apply to items and services provided to individuals enrolled in group health plans, group or individual health insurance coverage, and Federal Employee Health Benefit plans. These requirements generally do not apply to beneficiaries or enrollees in federal programs such as Medicare, Medicaid, Indian Health Services, Veterans Affairs Health Care, or TRICARE.

Under the Act, patients are liable only for their in-network cost-sharing amount and are removed from payment disputes between a provider and their health plan, while providers and insurers are given an opportunity to negotiate reimbursement. The Act provides for an Independent Dispute Resolution (IDR) process in the event disputes arise over reimbursement between providers and insurers.

Independent Dispute Resolution Process Between Providers and Insurers

Under the Act, if a provider and insurance company cannot [Read More]

Telehealth Update: Telehealth Waivers Post-PHE and Fraud and Abuse

By KIMBERLY RUPPEL
The current Public Health Emergency expiration deadline is this month.  However, the Secretary of the Health and Human Services indicated he would provide a 60-day notice before ending the PHE in order to minimize disruptions and potential loss of government and private insurance coverage.  That notice has not yet occurred.  Therefore, we expect another 90 extension.  In the meantime, telehealth waivers remain in effect.

Moreover, once the PHE is finally over, the Consolidated Appropriations Act signed into law earlier in 2022 provides a 151 day extension period of the expiration of many of the Covid-related exceptions or waivers, to allow for a transition period.

CMS has provided some guidance as to what waivers and flexibilities might remain in place after the end of the PHE for the purposes of promoting innovation, maintaining or improving quality, advancing health equity, and expanding access to care.

Those relating to telehealth include:

(1) Continued expansion of access to telehealth services for the diagnosis, evaluation, or treatment of mental health disorders;

(2) Temporary continued waiver expanding the types of healthcare professionals who can furnish distant site telehealth services to include all providers who are eligible to bill Medicare for their professional services.  This will allow physical therapists, occupational therapists, speech language pathologists and [Read More]

LANSING LINES

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

Anti-Prop 3 Campaign Going On Air With ‘Puberty Blocker’ Argument

The latest anti-Proposal 3 TV ad is making the claim that “sterilization” language in the proposed constitutional amendment would legally allow gender-changing-seeking minors to receive puberty-blocking drugs without their parents’ consent.

The “conversation is going to take a turn” said anti-Prop 3 consultant Fred Wzsolek for an anti-Proposal 3 side that’s averaging about $2.25 million a week on broadcast media.

Proposal 3, the constitutional amendment to overturn the 1931 Michigan abortion ban, also includes extreme policies “hidden behind the words,” said Christen Pollo of Citizens to Support MI Women and Children, the group putting out the ad.

Pollo said it’s “no secret that some want to cash in on the booming market for gender change therapies.”

“That’s why Planned Parenthood started dispensing these drugs in Michigan this year,” he said. “But what few understand is that their business plan includes a dangerous constitutional amendment that would allow them to provide these drugs to kids without the knowledge or consent of their parents.”

The 30-second ad, titled “Blocker,” starts with shots of a drug called Triptorelin, which is used to treat accelerated bone growth in children and accelerated prostate cancer in adults, [Read More]

COVID Is Still Here

By PAUL NATINSKY
Despite perceptions to the contrary, the COVID 19 pandemic is not over. Notwithstanding the return of crowds, the diminishment of mask wearers and the back-page treatment of pandemic news, the virus continues to circulate and the risk of resurgence looms.

“We’re certainly not done with it. We still have nationally a few hundred people a day dying from COVID. If you look at the overall mortality numbers, it’s still multiple times the number of deaths we see, say, from influenza. So it certainly has not faded into the background,” said Dr. Justin Skrzynski, a hospitalist with BHSH System, who has worked with COVID patients since the pandemic began.

Dr. Dennis Cunningham looks at COVID numbers on a daily basis. He says cases per 100,000 population are up, but they are mostly outpatients. He is not seeing serious disease numbers rising. Very few are coming into intensive care.

VIRULENT VARIANTS?

“The big question in my mind is when is the next new variant going to come up because that could change things a lot. But right now, things are probably better than they’ve been in the last three years,” Cunningham said.

Cunningham, who is System Director of Infection Control and Prevention at Henry Ford Health System, said a new [Read More]

Doctors Criticize Dixon’s Abortion Stance

“If local prosecutors, guided by their political expediency, are planning to imprison board certified obstetricians like me, then who do they expect to safely deliver all these pregnancies?” asked Dr. Audrey Stryker, a Bay City obstetrician and gynecologist.

Stryker met with several other medical professionals as part of a Committee to Protect Health Care’s virtual panel to discuss gubernatorial candidate Tudor Dixon’s abortion ban policy, which they say will drive medical professionals out of the state and lead to additional staffing shortages.

Dixon’s senior advisor, Kyle Olson, criticized the Committee, calling the group’s founder, Dr. Rob Davidson, a “political hack who failed at running for Congress.”

“He’s trying to remain relevant,” Olsen said, adding that the Committee is on the side of the “radicals” who want to eliminate protections like parental notification that he says are widely supported by Michiganders.

Stryker, who has practiced since 1988, said a medical staffing shortage existed even before the U.S. Supreme Court overturned Roe v. Wade in June.

“Every day I receive multiple emails, texts and phone calls from hospitals in urgent need of obstetricians to cover their labor and delivery units, necessitating the closure of smaller labor and delivery units all over the state,” Stryker said. “Even prior to the overturning of Roe, in the state of Michigan, we were in dire need [Read More]

PMCH And The Collaborative Care Model: The Journey To Integrated, Whole Person Care

By EWA MATUSZEWSKI
Blue Cross Blue Shield of Michigan (BCBSM) recently announced the names of its Patient-Centered Medical Home (PCMH) designees – many receiving designation renewals, but others being PCMH designated for the first time. From my vantage point, these practices, whether multiple-year designees or newbies, represent the best of primary care and affirm the effectiveness of a healthcare approach that puts the patient in partnership with the physician or advanced care provider and their team to optimize outcomes in physical and mental health. I again must give recognition to my friend Tom Simmer, MD, who had the foresight to launch the PCMH practice program through the Physician Group Incentive Program (PGIP; now known as value partnerships) when he was the CMO at BCBSM.

I mention the PCMH program because, coincident with that announcement, BCBSM also

introduced the use of the Collaborative Care Model (CoCM) for physician group members. CoCM brings together both physical and behavioral health providers to a primary care setting to offer integrated care. I’ve long advocated for this model and have seen it in action at Judson Center Health, our joint venture integrated primary care clinic in Warren where our organization provides the clinical staff and Judson Center provides behavioral health. We also have [Read More]

HHS OIG Directs Medicare Contractors to Scrutinize Telehealth Services Billing

By STEPHEN SHAVER & CHRISTIAN IERACI
The COVID-19 pandemic created a newfound need for expansive telehealth services. As lockdowns, restrictions, and mandates left many without in-person access to healthcare, providers shifted to telehealth services to provide the care their patients needed, providing telehealth care to over 28 million Medicare beneficiaries in the first year of the pandemic. The Centers for Medicare and Medicaid Services (CMS) recognized the need for telehealth services and temporarily paused many audits and other medical reviews of claims in order to expand telemedicine access to Medicare beneficiaries. The increased need for telehealth services caused by the pandemic also led CMS to increase the types of services available via telehealth from 118 to 264 services. Now, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) has produced a review of telehealth service claims from the first year of the pandemic in an attempt to identify fraud, waste, and abuse related to telehealth. This review attempts to identify providers that performed the most telehealth services, scrutinizes their billing, and forecasts an increase in Medicare audit activity for telehealth providers.

OIG analyzed Medicare fee-for-service claims data and Medicare Advantage data for the first year of the pandemic, spanning from March 1, [Read More]

Michigan Medical Spas: Is The Wild West No More?

By JESSICA BUSCH
There’s a new sheriff in town, and they are looking to crack down on medical spas in Michigan.

Medical spas offering minimally invasive cosmetic medical services have enjoyed increasing popularity in the State of Michigan and across the United States. But with great success comes greater scrutiny of the so-called “Wild West” of the healthcare industry, particularly from lawmakers and government agencies. And with Michigan’s newly proposed legislation, lawmakers may be going after the bread and butter of many medical spas: Botox and dermal fillers.

New Michigan Legislation

Cosmetic medical services are 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. Since cosmetic medical services generally are not medically necessary and can be minimally invasive, it often leads to confusion as to the qualifications required to perform them.

Michigan lawmakers have answered with proposed legislation, which identifies, and significantly limits, who can perform cosmetic injectable services under Michigan law. On June 7, 2022, Michigan legislators introduced Senate Bill No. 1068, which proposes to permit only the following licensed persons to administer Botox and dermal fillers for cosmetic purposes: a physician; a physician’s assistant (“PA”) with a practice agreement with [Read More]

LANSING LINES

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

Hospital Association CEO: ‘Pipeline Issue’ Remains The Bottom Line For Healthcare

Although an economic report from the state’s hospital association discovered that healthcare maintains its place as Michigan’s largest private-sector employer, struggles with attracting and training newcomers has put a damper on things.

“There are some 1,700 fewer staff hospital beds throughout the state of Michigan than there were pre-pandemic,” said Brian Peters, chief executive officer of the Michigan Health and Hospital Association (MHA). “We have lost staff—both frontline (and) clinical staff, as well as non-clinical staff, who are so important to making a hospital operate on a 24-7-365 basis.”

Overall, Peters said the bottom line is “we have a pipeline issue.”

Peters spoke on the MIRS Monday Podcast , referencing a September report that found that healthcare in Michigan directly employed nearly 572,000 residents in 2020.

According to The Economic Impact of Healthcare in Michigan report, released earlier this month, direct healthcare workers in the state obtained $44.2 billion total in wages, salaries and benefits. Healthcare-affiliated workers additionally contributed $15.2 billion in local, state and federal taxes.

However, the American Hospital Association has also revealed occupied nursing and residential care jobs dropped by 11,000 while compensation hopped by $200 million.

Nationally, per-patient labor [Read More]

MAHP ‘Pleased’ Judge OK’s BCBSM $2.67B Antitrust Settlement

The Michigan Association of Health Plans is “hopeful” the recent $2.67 billion antitrust settlement with Blue Cross Blue Shield (BCBSM) will encourage “employers and individuals” to consider other plans.

MAHP Executive Director Dominick Pallone said its member health plan providers are “pleased that the court has finally accepted the terms” of the landmark settlement against Michigan’s largest insurer.

“For years, the American Medical Association (AMA) has consistently ranked Michigan as one of the least competitive states in the nation for health insurance,” he said in a statement. “We’re hopeful that this settlement will raise awareness of BCBS’ anti-competitive behavior and encourage all employers and individuals shopping for health insurance coverage to regularly evaluate their insurance provider options and consider other health plans offering more affordable policies.”

The settlement could affect more than 100 million class members, but how many are in Michigan was not immediately known. Class members were notified earlier of the proposal settlement via direct notice, a postcard or electronically.

A BCBS spokesperson said it is “premature for us to comment because the court’s approval of the settlement kicks off a 30-day window where parties may appeal, and the settlement won’t be final until that window closes, or until all appeals have been concluded.” She did not say [Read More]

Abortion Is Shaking Up Attorneys General Races and Exposing Limits to Their Powers

By LAUREN WEBER & SAM WHITEHEAD
As the country grapples with states’ newfound power to regulate abortion in the aftermath of this summer’s U.S. Supreme Court decision, state attorney general candidates are staking claims on what they’ll do to fight or defend access to abortion — and that’s attracting cash and votes.

“By pretty much every indicator there is in a campaign, the Dobbs decision has energized and supercharged our race,” said Kris Mayes, a Democrat running for attorney general in Arizona. “People are outraged about this, and you can feel it in the air.”

But they aren’t the only ones who may be testing the laws. The winners of local prosecutorial races will also shape the legal landscape, and, in many states, an attorney general’s ability to bring criminal abortion cases to court ends at a local prosecutor’s doorstep. Called district attorneys, prosecutors, and various other names across the country, these lawyers — not the attorneys general — would make the final decisions on whether criminal charges can be brought against people seeking abortion or the medical professionals that provide them.

The exceptions include states such as Delaware and Rhode Island, which have distinct attorney general and local prosecutorial structures, said David LaBahn, president and CEO of the Association of Prosecuting [Read More]

ON POINT WITH POs: Regionalizing #SDOH data tracking will help fill Michigan care gaps

By EWA MATUSZEWSKI
I mentioned in a recent column that teaching is one of my passions, which is why I’m so grateful to have this column as an educational platform to share what’s new in Michigan’s healthcare community. It’s not just news though; rather, an opportunity to learn what your local community is doing to promote better health outcomes – and encourage you to get involved. To that end, I’m excited about an initiative launched earlier this month by the Michigan Department of Health and Human Services addressing the social determinants of health (#SDOH) in the COVID era.

With funding from the CDC and Center for State, Tribal, Local and Territorial Support grants, and based on the concept of regional health exchanges for data, the state has created 11 regional Health Equity Advisory Councils, run by Backbone organizations (BBO), from the following regions:

  • Genesee County
  • Ingham County
  • Kent County
  • Oakland County
  • Ottawa County
  • Macomb County
  • Muskegon County
  • Saginaw County
  • Washtenaw County
  • Wayne County

Working with BBO community organizations such as ACCESS, Detroit Association of Black Organizations (DABO), Metropolitan Organizing Strategy Enabling Strength (MOSES) and Judson Center, the Councils will focus on capturing and sharing health disparities data in the manner best suited to their community’s needs. This will [Read More]

COMPLIANCE CORNER: OIG Special Fraud Alert Highlights Suspect Telemedicine Arrangements

By DUSTIN T. WACHLER
Following recent enforcement actions against a variety of telemedicine arrangements throughout the country, the U.S. Department of Health & Human Services (HHS) Office of Inspector General (OIG) published a Special Fraud Alert to notify practitioners to exercise caution when entering arrangements with purposed telemedicine companies.[1] The telehealth arrangements described in the OIG’s Alert implicate multiple federal laws including, but not limited to, the federal Anti-Kickback Statute, False Claims Act, criminal health care fraud statutes, as well as the OIG’s exclusion authorities related to kickbacks and Civil Monetary Penalties Laws provision for kickbacks. Additionally, such arrangements will also implicate state fraud and abuse laws related to kickbacks, fee-splitting, self-referral, false claims, and related issues.

The Special Fraud Alert explains that following dozens of investigations into telemedicine schemes, the OIG continues to target telehealth arrangements that may result in corruption of medical decision-making, harm to beneficiaries (including, for example, receiving medically unnecessary care, items that could harm the patient, or improperly delaying needed care), and increase in costs to the federal healthcare programs for medically unnecessary items and services. In several telehealth arrangements recently targeted by the OIG, telemedicine companies paid practitioners in exchange for ordering or prescribing items or services for purported [Read More]

LEGAL LEANINGS: Mitigating the Internal Risk – Revamping Employee Recruitment in Healthcare Practices

By WASIF KHAN
For many healthcare providers, their roles as business owner and employer tend to be overshadowed by their role as a healer.   While employees can be your greatest asset, they also tend to be one of the largest liabilities as well.  Hiring the right employees – properly – will help mitigate risk and ensure compliance within the complex regulatory landscape of the healthcare industry.

How and What to Ask Pre-Offer

 Employers have historically asked prospective employees about their salary history before making an offer; however, many jurisdictions[1] have enacted laws that ban employers from doing so. Pre-employment, employers should focus on establishing compensation models commensurate with prevailing market rates and if necessary, inquiries should be focused on applicants’ salary expectations for the position they applied for.

Let’s be honest, salary tends to be a defining factor in hiring activity, but there are a number of questions that tend to be stumbling blocks earlier in the process. Employers must be certain that a prospective employee can actually perform the job that you are seeking to fill. In thinking about whether a prospective employee will meet your expectations, you may be tempted to inquire about limitations or disabilities, children/sick family members that are being cared for, or [Read More]

LANSING LINES

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

Nurses Sue U-M Over Refusal To Bargain

A lawsuit filed in mid-August alleges the University of Michigan is breaking the law by refusing to bargain over nurses’ workloads in contract negotiations with the University of Michigan Professional Nurse Council (UMPNC).

Michigan Nurses Association, the labor organization that filed the suit in the Court of Claims, says the 6,200 UMPNC nurses have worked without a contract since July 1. The organization alleges the university is violating the Public Employment Relations Act, which designates workload and safety as mandatory subjects of bargaining, and it wants an order compelling U-M to bargain.

The “major stumbling block,” MNA claims, is the administration’s refusal to discuss workloads in terms of number of patients assigned per nurse, which is tied directly to patient safety concerns that nurses have raised for months.

“When nurses are forced to take care of too many people at once, patient care gets compromised and nurses are put in danger of injury or burnout, and that’s happening far too often at our hospital,” said Renee Curtis, a registered nurse and president of UMPNC. “Our union is fighting for patient safety, first and foremost. It’s absurd to think [Read More]

DHHS Budget Expands Mental Health Services, Opens Door To Dental Reform

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

The Department of Health and Human Services (DHHS) budget for Fiscal Year (FY) 2023 passed early this morning includes funds to expand adult and child mental health services and programs, and opens the door to a restructuring of dental benefits in the state, among a cornucopia of historic funding.

Rep. Mary Whitford (R-Casco Twp.), chair of the House DHHS Appropriations Subcommittee, and Michigan Association of Health Plans Executive Director Dominick Pallone hailed the funding as a great investment into the health of Michiganders.

“MDHHS is thankful for improvements in access to affordable, high-quality dental services for Michiganders, raising rates for foster, adoptive, and guardian providers and investments in community organizations that provide direct support to families. Congrats to Gov. Gretchen Whitmer and the Legislature for passing a balanced, bi-partisan budget,” MDHHS spokesperson Lynn Sutfin said.

Whiteford highlighted the $325 million in funding going toward the creation of a new psychiatric hospital, $41 million to add 56 beds and 87 full-time positions to the Hawthorn Center, and $223 million in funding being directed toward several private sector mental health facilities, such as Pine Rest, U of M Medicine and McLaren Northern Michigan, to help expand access for [Read More]

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