Lansing Lines is presented in cooperation with MIRS, a Lansing-based news and information service.
Implicit Bias Training Removed From Health License Requirements Under Bill
The Department of Licensing and Regulatory Affairs (LARA) couldn’t require a health professional to complete an implicit bias training to obtain or renew a license under Rep. Matt Maddock (R-Milford)’s HB 4915 .
“Picture this, every state is like a large swimming pool. Some states have warm water, clear water, like Florida, some states like New York and California have murky water, cold water. And every state has to attract people and businesses, right? So everyone wants to jump into a nice, warm swimming pool with clear water. Unfortunately, Michigan has cold water with sharks in it. No one wants to go to Michigan. I think we should name this committee, the shark removal committee, removing the sharks in the swimming pool to make Michigan great again,” Maddock said in front of the House Economic Competitiveness Committee today.
Kurt Miceli, medical director of Do No Harm Action, testified that an implicit bias training takes about 2 to 3 hours to complete and must be re-taken for each new licensing period, which lasts about 2 to 3 years.
Miceli said the mandate stemmed from “the belief that such biases lead to disparities in health care delivery.”
“While disparities do exist, attributing them to implicit bias ignores the impact of other factors like genetics, medical comorbidities, access to care, and individual choices,” Miceli said.
He added that implicit bias training assumes health care professionals harbor unconscious prejudices, and suggests that a provider is treating them less equally or with inferior care.
Maddock asked Miceli if it was fair to say that 200 doctors a year in Michigan would choose to walk away from their profession entirely over the implicit bias training requirement, and Miceli said he didn’t know a definitive number, but he thinks “that’s completely within reason.”
Miceli said he sees doctors that are on the brink of determining whether they should continue to practice medicine or not. Based on what he said about the frequency at which implicit training must be retaken and how long each session takes, Rep. Kristian Grant (D-Grand Rapids) asked if there really are 200 doctors per year that believe three hours of training is worth them leaving the profession.
Miceli said he believes it is a factor, but not the only factor. He said there are disparities in health care and a bigger emphasis should be placed on things like diabetes, hypertension and other illnesses.
In her written opposition to the bill, Grant wrote that it’s a false premise that bias is a matter of opinion that can be eliminated by refusing to name it, and implicit bias is a well-documented reality of human cognition and experience.
“Human biases are not a moral failing or a product of malice; rather, they are the result of how the brain, under complexity and pressure, relies on mental shortcuts that can lead to unconscious assumptions. In the context of healthcare, those assumptions can cost lives,” Grant wrote.
Rep. Julie BRIXIE (D-Okemos) asked Chair Mike Hoadley (R-Au Gres) for another hearing on the bill since not all of her questions were answered, and Mueller said it was noted.
The Committee also took up HB 4927 from Rep. Parker FAIRBAIRN (R-Harbor Springs), which reduces the number of hours a barber student would have to complete to qualify for a license from 1,800 to 1,500 hours.
Rep. Karl Bohnak (R-Negaunee) and Rep. Pat Outman (R-Six Lakes)’s HB 4913 and HB 4914 were taken up as well. The former would allow someone to be licensed as an architect if they have completed the equivalent of a professional degree and the latter to remove the requirement that at least 2/3 of a firm’s principles would have to be licensed as architects, engineers or surveys to be able to practice architecture, engineering or surveying.
LARA Neglects Hospice Home Complaints, Licensing Surveys, According To Audit
The Department of Licensing and Regulatory Affairs (LARA) has been falling short in its oversight of hospice facilities, according to an Auditor General report released last month.
The audit reviewed 51 facility surveys conducted by the Bureau of Community and Health Systems, which is responsible for licensing and inspecting hospice homes. In 49% of those cases, there was little to no documentation to justify whether a facility should remain licensed.
Although the Bureau told auditors that administrative rules guide what inspectors must review, the audit found that surveyors often didn’t follow those procedures.
One hospice facility, for example, was found to be in full compliance in 2021. However, during a follow-up inspection in 2024, it had 29 violations — some of which should have been caught in the earlier survey.
The report recommends that LARA standardize survey procedures and ensure proper documentation is reviewed. LARA agreed and said it would revise its inspection protocols.
The audit also flagged serious problems in how the Bureau handles complaints about hospice facilities. Of 16 complaints reviewed, 10 were never investigated, and six of those had missing allegations in the records. In three cases, inspectors left out allegations in their written summaries. One complaint, which should have triggered an investigation, was instead referred back to the facility.
Auditors said three of the complaints that were dismissed may have deserved further review, depending on interpretation. Two complaints were about the same facility.
In addition, 14 out of the 16 complaints took between three and 98 days to be addressed, even though procedures require a response within two days.
LARA officials blamed the delays on staffing shortages and a backlog. They also said that many of the errors were linked to a nurse who no longer works for the state.
In response, LARA said it has begun requiring standardized training for all new employees. It also said the complaint intake unit manager will begin monitoring complaint handling more closely and conducting random audits to ensure procedures are followed.
What’s The Deal With Provider Taxes In FY ’26 Budget?
The Citizens Research Council (CRC) reports that the state’s current budget is worth $84 billion when money from provider taxes is considered. The taxes are assessed on health insurers, ambulance services and hospitals, later returned to them as larger Medicaid payments.
Without the Medicaid-related taxes in the mix, the Fiscal Year (FY) 2026 budget, which was created behind schedule because of negotiation challenges between the Democratic-controlled Senate and Republican-led House, the budget is worth $74.6 million.
“We get revenue from that tax. We use that revenue to draw federal funds, probably better than $2 federal to every $1 state…there’s a big multiplier effect when we bring revenue into the Medicaid program,” said Bob Schneider, the senior research associate of the Citizens Research Council of Michigan. “Then most of that money gets passed back to those providers in the form of an enhanced Medicaid reimbursement.”
Schneider spoke this morning as part of the CRC’s virtual presentation on the recent budget.
Previously, Schneider served as the State Budget Office’s director of the health and human services office, as well as the Michigan House Fiscal Agency’s associate director.
In early July, President Donald Trump’s One Big Beautiful Bill Act (OBBBA) tightens up federal Medicaid costs, solidifies tax cuts from his first term and ramps up funding for immigration enforcement. One of OBBBA’s goals was to limit states’ potential misuse of provider taxes, with critics viewing them as a type of “money laundering” scheme that inflates Medicaid matching funds from Washington, D.C.
Schneider said the most immediate pressure from OBBBA’s Medicaid reforms was on insurance provider assessments (IPAs), affecting the state’s health plans overseeing Medicaid benefits.
“We were going to lose the insurance provider assessment . . . we would lose $450 million in current revenue that helps draw federal funds to support Medicaid, and we would have either needed to absorb that Medicaid cut, or we would have needed to find other revenue somewhere else.”
Among budget implantation bills was HB 4968 . Schneider explained the legislation instructs Michigan’s Department of Health and Human Services to restructure the assessments, no longer imposing the largest tax on Medicaid health plans – which would have directly violated OBBBA’s latest restrictions.
He described DHHS as submitting a waiver to the federal government, detailing how Medicaid health plans will have parity with private insurers through the provider tax system, dodging a termination of $450 million in healthcare revenue.
“I don’t know if it’ll happen next week or in a month or in six months, but when the federal government says, ‘look, this tax needs to end,’ the legislation says ‘DHHS, you have the authority now to . . . tax everybody the same, submit a new waiver that says we’re going to change our tax structure, and this structure will comply with your strict rules.'”
In the current fiscal year, Michigan is aligned to oversee $6 billion in provider tax reimbursements linked to hospitals and $3.3 billion to insurers.