By PAUL NATINSKY

As Robert F. Kennedy eases into the Health and Human Services director’s chair, his flashpoints and shortcomings are widely publicized, but lightly opposed.

Kennedy’s skeptical views on vaccine effectiveness and safety, fondness for fringe conspiracy theories and likely embrace of deep Medicaid cuts have the healthcare community and many policymakers concerned about the new secretary’s public health stewardship.

Kennedy’s lack of administrative acumen looms large as he assumes control over a department that employs 80,000 and oversees a $3 trillion annual expenditure representing 22.8% of the U.S. federal budget.

Kennedy lacks managerial experience at organizations even a small fraction of that size. HHS is responsible for the care of 140 million [Read More]

By PHIL GALEWITZ

Medicaid is under threat — again.

Republicans, who narrowly control Congress, are pushing proposals that could sharply cut funding to the government health insurance program for poor and disabled Americans, as a way to finance President Donald Trump’s agenda for tax cuts and border security.

Democrats, hoping to block the GOP’s plans and preserve Medicaid funding, are rallying support from hospitals, governors, and consumer advocates.

At stake is coverage for roughly 79 million people enrolled in Medicaid and its related Children’s Health Insurance Program. So, too, is the financial health of thousands of hospitals and community health centers — and a huge revenue source to all states.

On Feb. 13, the House [Read More]

By AMY MAXMEN

Some private schools have shut down because of a rapidly escalating measles outbreak in West Texas. Local health departments are overstretched, pausing other important work as they race to limit the spread of this highly contagious virus.

Since the outbreak emerged three weeks ago, the Texas health department has confirmed 90 cases with 16 hospitalizations, as of Feb. 21. Most of those infected are under age 18. Officials suspect that nine additional measles cases reported in New Mexico, across the border from the epicenter of the Texas outbreak in Gaines County, are linked to the Texas outbreak. Ongoing investigations seek to confirm that connection.

Health officials worry they’re missing cases. [Read More]

By STEPHEN SHAVER
Consultant, Wachler & Associates PC

Nearly every third-party payor of claims for healthcare services – Medicare, Medicaid plans, commercial insurers, etc. – will at some point request that the billing provider submit copies of the documentation and medical records that support the services billed. In these circumstances, an ounce of prevention is often worth a pound of cure. The payor will often make decisions regarding coverage and overpayment allegations based on the records submitted by the provider. The provider can proactively address or even prevent many disputes by careful attention to their response to the medical records request.

First, a provider should be aware of what entity issued the request, [Read More]

By ERICA ERMAN
Dickinson Wright

Can you remember healthcare security 20+ years ago? It seems like a different world from now. Believe it or not, the HIPAA Security Rule has barely changed since it was first enacted in 2003[1]and has been long overdue for a significant remodel. Read on for highlights of the proposed new Security Rule and action items.

A Very Brief HIPAA History

 As a quick background, the HIPAA Security Rule was first penned in large part to create minimum security standards for electronic protected health information (ePHI) and to protect patients’ rights over their healthcare data. The Health Information Technology for Economic and Clinical Health Act (HITECH) of [Read More]

Richardville Urges Leadership, Bi-Partisan Cooperation To Address ‘Mental Health Crisis’

Back in 2014, then-Senate Majority Leader Randy Richardville put together a $1.5 billion road funding plan with higher fuel taxes, among other things. He said the incentive at the time was what he was hearing in his district.

“I think the most common phrase I’m hearing from back home is ‘just fix the roads. In fact, they say ’just fix the damn roads,” Richardville is quoted in an MLive article as saying.

Richardville was before his time in coining that catchphrase. His counterpart in the Senate at the time, Democratic Leader Gretchen Whitmer, used the slogan during her gubernatorial campaign with success.

But like Whitmer, Richardville [Read More]

By STEPHANIE ARMOUR

Former President Donald Trump’s return to the White House will likely bring changes that scale back the nation’s public health insurance programs — increasing the uninsured rate, while imposing new barriers to abortion and other reproductive care.

The reverberations will be felt far beyond Washington, D.C., and could include an erosion of the Affordable Care Act’s consumer protections, the imposition of work requirements in Medicaid and funding cuts to the safety net insurance, and challenges to federal agencies that safeguard public health. Abortion restrictions may tighten nationwide with a possible effort to restrict the mailing of abortion medications.

And with the elevation of vaccine skeptic Robert F. Kennedy Jr. to [Read More]

This year, Michigan hospitals will continue pushing legislators to ban drug manufacturers from creating restrictions and limited-access conditions around their “340B Drug” products, which they say will preserve discounted drug access for rural hospitals.

The federal 340B Drug Pricing Program was established in 1993. According to the federal Health Resources and Services Administration, drug manufacturers participating in the Medicaid insurance program must supply outpatient drugs to 340B facilities at “significantly reduced prices.” Becoming a 340B facility depends on the number of Medicaid recipients and considerably “underserved” individuals that a hospital serves.

In a recent interview with MIRS, Laura Appel – the Michigan Health and Hospital Association’s executive vice president – said 87 hospitals in the [Read More]

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

Whitmer Signs Maternal Health Package, Pharmacist Birth Control Bills, Other Insurance Changes

Gov. Gretchen Whitmer signed 16 bills this month, many surrounding women’s reproductive health care, including two that let pharmacists prescribe birth control, a nine-bill package putting pregnancy on Medicaid, and two on birthing centers and doulas.

Whitmer was slated to sign HB 5435 and HB 5436 in Flint today, but the event was canceled because of the snow and freezing weather. Whitmer posted the signing on social media, where she thanked Reps. Stephanie Young (D-Detroit) and Kara Hope (D-Holt) for sponsoring the bills.

“Today, I’m signing commonsense bills to further protect everyone’s fundamental [Read More]

By ROLF LOWE
Wachler & Associates

On Dec. 18, 2024, the Center for Medicare and Medicaid Services, announced that Michigan, along with New York, Oklahoma and South Carolina were selected to participate in the Innovation in Behavioral Health (IBH) Model. The IBH Model is another step forward by CMS in integrating health care services and improving outcomes for Medicare and Medicaid beneficiaries. The IBH Model was announced in January of 2024 with CMS providing funding opportunities for state Medicaid agencies willing to participate in the IBH Model. The Implementation of the IBH Model started on January 1, 2025, and is scheduled to be in effect for eight years.

The IBH Model in [Read More]