More than 2.6 million Michiganders were enrolled in Medicaid in May 2024 after the year-long redetermination, which means the state added more than 400,000 people since before the 2020 COVID-19 pandemic and dropped 500,000 people since the end.

No one had to reapply during the COVID-19 pandemic emergency orders and by May 2023, when the emergency orders ended, 3.1 million residents were enrolled in Medicaid. Redeterminations for the medical program restarted and after the year-long “unwind” there were more people enrolled than prior to the pandemic .

“This was the largest renewal process our state has ever conducted, with 1.8 million beneficiaries renewing their coverage during the past year. MDHHS employed numerous successful strategies to help ensure those families continued to have health care coverage,” said Michigan Department of Health and Human Services (MDHHS) Director Elizabeth HERTEL.

The MDHHS reported 12,402 people in May were dropped from Medicaid and Healthy Michigan Plan and 1,954 people were found ineligible because of procedural reasons. There were 141,992 people up for renewal during the month.

The MDHHS said there were several tactics used to help the renewal process, which reduced the number of people dropped from the program.

Some of the strategies, which the MDHHS said were approved by the federal Centers for [Read More]

By CHRISTINE SPOLAR

PHILADELPHIA — Zarinah Lomax is an uncommon documentarian of our times. She has designed dresses from yellow crime-scene tape and styled jackets with hand-painted demands like “Don’t Shoot” in purple, black, and gold script. Every few months, she hauls dozens of portraits of Philadelphians — vibrant, bold, bigger-than-life faces — to pop-up galleries to raise an alarm about gun violence in her hometown and America.

In a storage unit, Lomax has a thousand canvasses, she estimates, mostly of young people who died from gunfire, and others of the mothers, sisters, friends, and mourners left to ask why.

“The purpose is not to make people cry,” said Lomax, a Philadelphia native who has traveled to New York, Atlanta, and Miami to collaborate on similar exhibitions on trauma. “It is for families and for people who have gone through this to know that they are not forgotten.”

Each person “is not a number. This is somebody’s child. Somebody’s son, somebody’s daughter who was working toward something,” she said. “The portraits are not just portraits. They are telling us what the consequences are for what’s happening in our cities.”

Firearms in 2020 became the No. 1 cause of death for children and teens under 18 — from both suicides [Read More]

By SUSAN ADELMAN, MD
I just got off the phone after talking to a distant cousin and his wife, who recited a frustrating list of the medical and surgical problems that dominate their lives. They are my age, but neither can walk without a walker. My cousin is in a nursing home. I am active and traveling. Why? It is not clear.  Some of their conditions obviously are not preventable. Some, I am not sure. Of limited means, they are trying not to spend more than their insurance will cover. In today’s environment, that may mean rushed 15-minute appointments, which make it hard for their doctors to deal in a calm, unhurried manner with complicated issues, prioritize them, and go over their treatments in detail.

They both have back problems. One of them received a series of steroid shots in the spine every three months until they no longer were effective. What about physical therapy? An effective course of therapy would have been good, but their benefits have run out. Do they go to the type of doctor we used to call general practitioners? I doubt it. If they really went to doctors with whom they could sit down and talk about their problems, they would not [Read More]

 By JESSE ADAM MARKOS, ESQ.
Wachler & Associates, P.C.

Healthcare providers employed by a hospital or on staff at one, who believe that they will be terminated, may try to get ahead of that decision by resigning in lieu of termination.  At first glance, a resignation under such circumstances may appear to be an option that offers greater dignity and minimizes professional harm. However, in today’s highly regulated environment, there is often very little benefit to resigning. In fact, a resignation can, on its own, create significant problems for providers as it can trigger the filing of a report to the National Practitioner Data Bank or Michigan’s Department of Licensing and Regulatory Affairs regarding termination, peer review actions or other reportable events.

While a resignation in lieu of termination always has the potential to damage a provider’s reputation, it can have a disproportionately adverse impact on providers employed by or on staff at a hospital as hospitals are required to report certain actions. For example, pursuant to the Michigan Public Health Code, a hospital that employs, contracts with, or grants privileges to a provider must report certain actions to LARA, including disciplinary action that results in a change of employment status or a case in which a [Read More]

By KATHLEEN CAMPBELL WALKER
Dickinson Wright

A recent commentary offers a stark glimpse into future healthcare demands (Harris & Marshall, 2024). During the first two years of the pandemic, the U.S. economy saw a loss of 400,000 workers in residential care facilities and nursing. Presently, there remains a shortage of approximately 130,000 workers compared to pre-pandemic levels (U.S. Bureau of Labor Statistics). With the last cohort of baby boomers turning 65 by 2030, the U.S. Census Bureau estimates that 73 million seniors will soon constitute about one-fifth of the population, outnumbering children (Vespa, Medina & Armstrong, 2020).

In 2017, immigrants made up 18.2% of healthcare workers and 23.5% of long-term care workers, both formal and non-formal. Additionally, immigrants comprised 27.5% of direct care workers and 30.3% of nursing home housekeeping and maintenance staff (Zallman et al., 2019). Given these figures, it seems logical to streamline processes for employers seeking foreign nationals to fill staffing shortages in the healthcare industry. Unfortunately, healthcare-based immigration options are minimal at best. This article will not delve into physician-based alternatives due to space constraints.

Paths for Healthcare Workers

Immigration is plagued by bureaucratic complexity, often obscuring potential game-changing steps. For instance, employers must navigate employment-based immigrant (permanent residence/green cards) visa options alongside nonimmigrant (temporary [Read More]

By DUAA ELDEIB
This story was originally published by ProPublica
The U.S. has not prioritized stillbirth prevention, and American parents are losing babies even as other countries make larger strides to reduce deaths late in pregnancy.

The Senate on Tuesday passed legislation that, for the first time, expressly permits states to spend millions of federal dollars on stillbirth prevention.

The Maternal and Child Health Stillbirth Prevention Act, which passed the House in mid-May, now goes to President Joe Biden, who is expected to sign the measure into law.

ProPublica has spent the past two years reporting on the crisis around stillbirth, the death of an expected child at 20 weeks of pregnancy or more. Every year in the U.S., more than 20,000 pregnancies end in stillbirth. Research shows as many as 1 in 4 stillbirths may be preventable.

The bipartisan bill, which does not allocate any new money, amends the Social Security Act to add stillbirth prevention and research to the programs that can use existing Title V funds dedicated to improving the health of mothers and children.

Bottom of Form

“This bill is the first step to preventing stillbirths across America, and I will keep pushing to deliver the federal resources needed to bring down the shockingly high rate of [Read More]

Supremes’ Ruling Allows Medical Malpractice Suit To Continue

An Oakland County woman who sued her doctor for medical malpractice will get a second chance to advance her lawsuit.

In a 5-2 decision, the Michigan Supreme Court held the trial court improperly dismissed Lynda Danhoff’s lawsuit.

At issue was whether an expert is required to support their standard-of-care opinion with scientific literature.

“Consistently with precedent, we hold once again that scientific literature is not always required to support an expert’s standard-of-care opinion, but that scientific literature is one of the factors that a trial court should consider when determining whether the opinion is reliable,” the majority’s opinion from Justice Kyra Bolden reads.

” … Determining that the expert is unreliable and granting summary disposition without first considering all such applicable factors, as the trial court did here, is an abuse of discretion,” she noted.

Justice Richard Bernstein concurred, but wrote separately to say he’s open to revisiting the two prior cases the court used in its opinion.

Justice Brian Zahra, joined by Justice David Viviano, disagreed that the trial court improperly applied the rules of evidence, statute and prior court decisions.

Zahra believes the trial court excluded the expert’s opinion because it was based only on the expert’s opinion, background and experience.

” … The [Read More]

By SAMANTHA YOUNG

The White House is calling on hospital executives, doctors, and other health care leaders to take bolder steps to prevent gun violence by gathering more data about gunshot injuries and routinely counseling patients about safe use of firearms.

Biden administration officials are hosting back-to-back events Thursday and Friday at the White House for about 160 health care officials, calling gun violence a “public health crisis” that requires them to act.

The strategy also reflects a stark political reality: Congress has been deadlocked on most gun-related legislation for years, with a deep divide between Republicans and Democrats. If Democratic President Joe Biden wants to get anything done quickly, he will need to look outside the Capitol. He has already enlisted educators to talk to parents about safe gun storage and community workers to help at-risk youth.

“The president has been clear: This is a public health crisis. So, to solve it, we need the leaders from the health care sector,” Rob Wilcox, a deputy director of the White House Office of Gun Violence Prevention, told KFF Health News. “Those are the leaders that run the health systems and hospitals that we go to for treatment, and it’s those doctors, nurses, practitioners on the front lines.”

Health experts have long described [Read More]

A Rep. Alabas A. Farhat (D-Dearborn) bill prohibiting pharmaceutical manufacturers from denying access to drugs based on participation in a drug pricing program for low-income patients received a first day of testimony in a House committee.

Farhat said the legislation would address skyrocketing prescription drug prices, but pharmaceutical industry stakeholders said they feel the bill, and the “340B” program as a whole, gives an unfair advantage to hospital and chain pharmacies that don’t pass the savings onto their patients.

The 340B Drug Pricing Program is a 32-year-old, federal program to get pharmaceutical manufacturers to discount some of their most expensive prescription drugs, Farhat said, and requires these manufacturers to sell outpatient drugs to organizations that care for uninsured or low-income patients.

The program requires discounts be provided specifically to cancer hospitals, children’s hospitals, hospitals serving a high percentage of Medicaid patients, rural referral centers and sole community hospitals.

There are just under 90 340B hospitals in Michigan now, according to a handout from the Michigan Health and Hospital Association.

Farhat’s HB 5350 would prohibit manufacturers from denying or discriminating against 340B entities purchasing drugs, including those to be dispensed or administered under a contract pharmacy arrangement.

He said during testimony before the House Insurance and Financial Services Committee that the bill will expand [Read More]

By SUSAN ADELMAN, MD
Tricia Keith has just been appointed CEO of Blue Cross Blue Shield of Michigan, becoming the first woman to attain that position since 1929, the year the company was first organized. She comes to this position after a career of steadily rising through the ranks of the organization since she joined in 2006. Her last appointment was as Chief Operating Officer and President of the Emerging Markets Division. In 2018, a profile of her in Detroit Business gave her titles as executive vice president, chief of staff, and corporate secretary of Blue Cross Blue Shield of Michigan in Detroit. In these positions, Tricia Keith oversaw 300 employees, a managed care subsidiary called Blue Cross Complete, the Blues Medicare business, and a $110 million budget. In this new position, she oversees 9,000 employees.

Keith is a Michigan native who grew up just outside of Ludington and graduated from Central Michigan University. Her rise to prominence must not have been what her family might have expected of their little girl as they worked the farm that had been in the family for three generations, but times have changed.

Early on, Keith decided that life in agriculture was not for her. When she went off to college, [Read More]

JENNI COLAGIOVANNI
Wachler & Associates, P.C.

On April 26, 2024, the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) published a Final Rule introducing modifications to the HIPAA Privacy Rule that limit the use or disclosure of reproductive healthcare information (RHI) for certain non-health care purposes.[1] Titled the “HIPAA Privacy Rule to Support Reproductive Health Care Privacy,” the Final Rule prohibits disclosure of protected health information (PHI) related to lawful reproductive health care under certain circumstances. The Final Rule incorporates several changes for HIPAA-covered entities and business associates including a requirement for entities to obtain an attestation in connection with certain requests for reproductive healthcare information, updates to business associate agreements and HIPAA policies and training, and updates to Notices of Privacy Practices (NPPs).

The Final Rule was issued in response to the changing legal landscape, in particular the U.S. Supreme Court’s 2022 decision in Dobbs v Jackson Women’s Health Organization[2], which overturned the precedent protecting a constitutional right to abortion.  In the wake of Dobbs, the Final Rule describes an increase in the likelihood that an individual’s PHI may be disclosed in ways that cause harm to the interests that HIPAA seek to protect, including the trust [Read More]

By L.PAHL ZINN & PATRICK MASTERSON
Dickinson Wright

It has been a rapid-fire start to 2024 with antitrust enforcers within the Biden administration ramping up regulatory scrutiny across the U.S.—and healthcare is at the center of it.

These efforts started in December 2023 when the Federal Trade Commission (the “FTC” or “Commission”) and Antitrust Division of the Department of Justice (the “DOJ”) released the final 2023 Merger Guidelines, which drastically restructured the framework used to evaluate mergers. Notably, several new guidelines are aimed squarely at healthcare. The new Merger Guidelines significantly lowered thresholds applied to assess whether a merger is presumptively anticompetitive and introduced novel guidelines, including a special interest in “roll-up” acquisitions and unique theories of competitive harm. Soon to follow was the FTC and DOJ embarking on broader enforcement efforts; some of which directly target the healthcare sector. Such trends and developments warrant continued assessment from healthcare organizations and participants.

Enforcement Agencies Show Signs of Increased Scrutiny on Private Equity’s Growing Presence in Healthcare

On February 29, 2024—less than two months after releasing the new Merger guidelines—the FTC, DOJ, and the U.S. Department of Health and Human Services jointly launched a cross-government public inquiry into private equity and other corporations’ increasing control over healthcare. The cross-government inquiry [Read More]

By AMY MAXMEN & ARTHUR ALLEN

Stanford University infectious disease doctor Abraar Karan has seen a lot of patients with runny noses, fevers, and irritated eyes lately. Such symptoms could signal allergies, COVID, or a cold. This year, there’s another suspect, bird flu — but there’s no way for most doctors to know.

If the government doesn’t prepare to ramp up H5N1 bird flu testing, he and other researchers warn, the United States could be caught off guard again by a pandemic.

“We’re making the same mistakes today that we made with COVID,” Deborah Birx, who served as former President Donald Trump’s coronavirus response coordinator, said June 4 on CNN.

To become a pandemic, the H5N1 bird flu virus would need to spread from person to person. The best way to keep tabs on that possibility is by testing people.

Scientifically speaking, many diagnostic laboratories could detect the virus. However, red tape, billing issues, and minimal investment are barriers to quickly ramping up widespread availability of testing. At the moment, the Food and Drug Administration has authorized only the Centers for Disease Control and Prevention’s bird flu test, which is used only for people who work closely with livestock.

State and federal authorities have detected bird flu in dairy cattle in 12 [Read More]

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

Whitmer Signs Telemedicine Parity, Asbestos, Teacher Licenses, And Mental Health

Gov. Gretchen Whitmer signed nine bills recently with several directed at insurance and telehealth, along with asbestos abatement, licensing for teachers and children’s mental health intervention policy.

Whitmer signed HB 4579 , HB 4580 , HB 4213 , and HB 4131 , which all add up to requiring health insurance companies, Medicaid and Healthy Michigan to cover telemedicine services at the same rate as going to physically see the doctor.

Republicans said the bills would drive up health care costs, while Reps. Natalie Price (D-Berkley), Felicia Brabec (D-Ann Arbor), Christine Morse (D-Kalamazoo), and Tullio Liberati, JR. (D-Allen Park) said they make sure that everyone has access to health care services.

“The pandemic exposed accessibility concerns in our health care system. With more providers now offering telehealth options, it only makes sense to keep the reimbursement rates the same for telehealth appointments and in-person visits,” Brabec said.

Two of the bills, HB 4186 and HB 4188 , were part of the package that would heighten standards set for the removal of asbestos.

Reps. Donavan McKinney (D-Detroit) and Abraham Aiyash (D-Hamtramck) said the safety legislation surrounding asbestos was a win for the environment and communities.

“Asbestos is a killer; there [Read More]

The Senate wants more than $194.9 million in Medicaid reimbursement rate increases in next year’s budget, based on a Fiscal Year (FY) 2025 spending bill that moved out of subcommittee late last month.

The plan also boosts Michigan’s health and human services spending by more than $1.97 billion.

“Uplifting the Medicaid reimbursement payments was a top priority in this budget cycle,” said Sen. Sylvia Santana (D-Detroit), chair of the Senate Department of Health and Human Services Appropriations Subcommittee. “We looked at the top five billing codes in the state, and allocated values accordingly. That was a priority for me.”

Under the $37.7 billion DHHS budget in SB 767, $54.66 million ($14.5 million from the General Fund) went to raise rates for outpatient facilities that accept Medicaid and Medicare patients. In 2021, according to a July 2023 study by Health Management Associates (HMA), the average total cost per visit to these facilities was $267.74 while payment rates were $171.55.

Other reimbursement rate increases will go toward autism applied behavioral analysts, boosting available reimbursements to up to $70 per hour.

Also receiving higher Medicaid reimbursement rates are office visits, some dental care, certain anesthesia services, private duty nursing and speech therapy services.

For new patient visits, including 30-minute visits where there’s a low [Read More]

By JULIE APPLEBY

President Joe Biden counts among his accomplishments the record-high number of people, more than 21 million, who enrolled in Obamacare plans this year. Behind the scenes, however, federal regulators are contending with a problem that affects people’s coverage: rogue brokers who have signed people up for Affordable Care Act plans, or switched them into new ones, without their permission.

Fighting the problem presents tension for the administration: how to thwart the bad actors without affecting ACA sign-ups.

Complaints about these unauthorized changes — which can cause affected policyholders to lose access to medical care, pay higher deductibles, or even incur surprise tax bills — rose sharply in recent months, according to brokers who contacted KFF Health News and federal workers who asked not to be identified.

Ronnell Nolan, president and CEO of the trade association Health Agents for America, said her group has suggested to the Centers for Medicare & Medicaid Services that it add two-factor authentication to healthcare.gov or send text alerts to consumers if an agent tries to access their accounts. But the agency told her it doesn’t always have up-to-date contact information.

“We’ve given them a whole host of ideas,” she said. “They say, ‘Be careful what you wish for.’ But we don’t mind going an [Read More]

By SUSAN ADELMAN, MD
When I entered the medical profession 50 years ago, those were the good old days for doctors. Physicians enjoyed a windfall when Medicare and Medicaid were passed, then the appearance of new pharmaceuticals and surgical techniques enabled doctors to cure more conditions, which meant they had more lucrative business. Once regarded as poor, now doctors had the image of fat cats, rich targets to be taken down.

In 1993 the Clinton Healthcare Reform Task Force was in full throttle, and I had the dubious privilege of representing the AMA on a Healthcare Professionals Review Committee—not part of the Task Force, an afterthought.  The committee was created after I asked the AMA about joining the Task Force, and the AMA Executive mentioned at a Washington conference that the AMA did not have representation on it. Newspapers across the country gleefully heehawed that the AMA had not been invited. The rest is history.

Members of this committee included doctors, nurses, social workers, physician assistants, pharmacists, a healthcare administrator, and other professionals involved with healthcare. Neither name nor place tags indicated who practiced what profession, certainly not who was a doctor.  No such elitism would contaminate this group!

In those days the AMA Council on Medical Service, on [Read More]

By KAITLYN DELBENE
Wachler & Associates, PC

The authority to revoke the Medicare billing privileges of enrolled providers is one of many program integrity tools used by the Centers for Medicare & Medicaid Services (“CMS”) to curb fraud, waste, and abuse in the federal healthcare programs. While CMS has generally stated that its revocation authority is intended to protect the Medicare program and its beneficiaries from overt abuse, ongoing expansions to the grounds for revocation have swept many well-intentioned providers into CMS’s crosshairs. Increasingly, relatively very small audit findings, e.g., amounting to $5,000 or less in alleged overpayments, if left un-appealed by the provider, are leading CMS contractors to pursue disproportionately severe revocation actions based on alleged abuse of billing privileges. Providers faced with audit findings should be cognizant of CMS’s revocation authority and should make it a standard practice to seriously engage in the appeals process when faced with audit findings by CMS or its contractors.

CMS Expands Revocation Authority for Abuse of Billing Privileges under Section (a)(8)(ii)

CMS’s revocation authority is set forth at 42 CFR § 424.535, pursuant to which CMS may revoke a currently enrolled provider’s Medicare billing privileges and any corresponding provider agreement (or supplier agreement) for any of a list of ever-expanding [Read More]

By RALPH Z. LEVY, JR.
Dickinson Wright

My prior article addressed tax issues in repurchasing equity in physicians and other practice groups. This article provides information about drafting buy-sell agreements for practice entities that include provisions for repurchasing equity from owners. These agreements limit an owner’s ability to transfer equity and require its sale if employment terminates or the owner retires, becomes disabled, or dies. Buy-sell agreements also help the practice entity comply with state law requirements that only active practicing professionals can own equity in the entity.

Topic 1:  Structuring the buy-sell agreement

Since buy-sell agreements require its owners to transfer equity in the practice group upon termination of employment, death, disability, or retirement (each, a “Trigger Event”), the practice group should identify its desired purchaser if a Trigger Event takes place. If the entity is the purchaser, the agreement will be a redemption agreement; if the other practice owners are the purchasers upon a Trigger Event, a cross-purchase agreement should be used. Regardless of which type of agreement is used, the agreement should specify how the purchase price for the equity is determined (fixed, formula value, etc.).

If the entity has many owners, it will be simpler to use a redemption buy-sell agreement and for the practice [Read More]

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

Cannabis Redo Could Open Up Michigan Industry

U.S. Attorney General Merrick Garland put forth a proposal to reclassify cannabis from a schedule I drug, along with heroin, to a schedule III drug, with some codeine combinations, which could change some rules in the Michigan industry.

Department of Justice Director of Public Affairs Xochitil Hinojosa said the proposal would need to be published by the federal register, which would then initiate the formal rule-making process. The Drug Enforcement Administration and DOJ had no further comment about a timeframe for the process or how long it could take.

Cannabis Regulatory Agency Director Brian Hanna said rescheduling would make research easier and make it easier for consumers to access.

He said businesses would also have access to more banking and the tax burden would be reduced.

“We will continue to monitor the situation and look forward to our part to keep Michigan as a national leader in the cannabis industry,” Hanna said.

Michigan Cannabis Industry Association Executive Director Robin Schneider said the rule promulgation process could take three years or longer and the Michigan industry would be participating in that process.

“This is likely one of the most overdue polices that [Read More]

NOTE: The letter below appears partly in response to a story that appeared in the April 2024 edition of Healthcare Michigan.

EDITOR:

Any discussion of gun issues should begin with the reasons for and wisdom of the Second Amendment. The founders were quite clear on the rationale for this, so much so, that it was memorialized in the Constitution itself. Also rarely mentioned is the violence and even deaths prevented by armed law-abiding citizens.

Long lists of statistical data in a debate so immersed in political rhetoric, demagoguery and ideology should not be accepted as the final word. COVID has taught us that there are now two phrases that should evoke skepticism. They are “studies show” and “experts say.” That experts cannot solve the problem leads to several questions. Is it that they cannot or are unwilling or even apprehensive about stating objective truth because of the predictable political consequences? Perhaps they are looking at the wrong problem altogether.

One can wonder why scrutiny of our own U.S. culture and social factors might not provide objective easily observable insights even to those of us labeled as non-experts. The rule of law has moved from “equal and blind justice” to a politicized and ideologically progressive system that can hardly, if [Read More]

This story was originally published by ProPublica.

By ROBIN FIELDS
A new study challenged the accuracy of public health data on deaths related to pregnancy and childbirth — and the narrative of high and rising U.S. maternal mortality rates. An unusual public dispute has ensued.

Series: Lost Mothers: Maternal Care and Preventable Deaths

The U.S. has the highest rate of deaths related to pregnancy and childbirth in the developed world. Half of the deaths are preventable, victimizing women from a variety of races, backgrounds, educations and income levels.

An unusual public dispute has erupted among leading maternal health experts over whether the striking rise of U.S. maternal mortality rates over the past two decades was the real deal — or a statistical mirage.

The challenge to what has been a long-held view among public health officials came from researchers behind a new study published in the American Journal of Obstetrics & Gynecology.

The study concluded that maternal death rates put out by the Centers for Disease Control and Prevention have been substantially inflated by misclassified data. Using an alternate way of counting deaths related to pregnancy and childbirth, the study found, U.S. maternal mortality rates would be far lower than have been reported. And they’d be stable, not rising.

The pushback followed soon after.

The [Read More]

By CHRISTINE SPOLAR

Gun violence has exploded across the U.S. in recent years — from mass shootings at concerts and supermarkets to school fights settled with a bullet after the last bell.

Nearly every day of 2024 so far has brought more violence. On Feb. 14, gunfire broke out at the Super Bowl parade in Kansas City, killing one woman and injuring 22 others. Most events draw little attention — while the injuries and toll pile up.

Gun violence is among America’s most deadly and costly public health crises. But unlike other big killers — diseases like cancer and HIV or dangers like automobile crashes and cigarettes — sparse federal money goes to studying gun violence or preventing it.

That’s because of a one-sentence amendment tucked into the 1996 congressional budget bill: “None of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control.”

Its author was Jay Dickey, an Arkansas Republican who called himself the “point man” for the National Rifle Association on Capitol Hill. And for nearly 25 years the amendment was perceived as a threat and all but paralyzed the CDC’s support and study of gun violence.

Even so, a small group of [Read More]

By SUSAN ADELMAN, MD
When I was a surgery resident at Henry Ford Hospital, we greeted each patient on morning rounds in the same way. Good morning, Mr. Jones. Good morning, Mrs. Smith. How are you today? Or something like that. At least it was courteous and respectful. It did not matter if Mr. Jones was black or white, poor or rich. On our rounds, and in discussion of patients, staff doctors modeled color-blind treatment of their patients when they trained the residents. They even would call a child Mr. Jones, out of habit, then laugh, realizing it sounded silly. And Diversity, Equity, Inclusion training (DEI) had not been invented yet.

We learned at the bedside exactly what our parents had taught us. “Do unto others as you would have them do unto you.”  This comes from the Bible: the Golden Rule.

We knew that some medical conditions were commoner in certain ethnic groups. That is part of medicine. Children have children’s diseases. Older people have geriatric conditions. Those with some black heritage have a higher risk of sickle cell anemia, thalassemia, or prostate cancer.  The government Office of Minority Health elaborates that they also are more prone to “heart diseases, stroke, cancer, asthma, influenza and pneumonia, diabetes, [Read More]

By DANIEL AYYASH & SHEA MACE
Wachler & Associates, P.C.

Overview

In response to the enormous economic challenges faced by healthcare providers during the COVID-19 public health emergency (PHE), the Coronavirus Aid, Relief, and Economic Security (CARES) Act established the Provider Relief Fund (PRF) in an effort to provide financial support to providers across the nation. Congress allocated $178 billion to the PRF program, which was then disbursed to providers in multiple phases through general and targeted distributions. The Health Resources & Services Administration (HRSA), a subagency of the Department of Health and Human Services (HHS), was tasked with administering PRF disbursements and overseeing compliance with the program’s terms and conditions.

The primary compliance requirements attached to PRF distributions mandated that the funds only be used to prevent, prepare for, and respond to COVID-19, and that providers submit reports to HRSA regarding use of the funds. The reporting requirements, including the timeline for reporting, changed multiple times throughout the years following the program’s inception, creating significant confusion amongst providers.

Furthermore, while HRSA stated that providers who received PRF funds were required to accept a corresponding set of terms and conditions, all providers who retained those funds for longer than 90 days without contacting HHS or returning the funds were [Read More]