The state wants to end an agreement with the local public entity responsible for administering mental health services in West Michigan and instead go directly through a private health provider, sparking concern of the “privatization overnight” of mental health care.

The Michigan Department of Health and Human Services announced June 28 it plans to end its contract with Lakeshore Regional Entity, the pre-paid inpatient plan (PIHP) covering the region containing Allegan, Ottawa, Kent, Muskegon, Oceana, Mason and Lake counties.

In mental health service delivery, the state contracts with regional, locally controlled public entities known as PIHPs to administer behavioral health care services. The PIHPs in turn contract with the local community mental [Read More]

By EWA MATUSZEWSKI
Collaboration is a favorite topic of mine, but one offshoot of collaboration I haven’t touched on much is learning collaboratives. A learning collaborative takes collaboration into a more formal, but still relaxed, learning environment, bringing together practice teams to share ideas and find solutions to existing challenges.

Some may recall the Mackinac Learning Collaborative (MLC), which was launched in Detroit in 2009-2010 with the goal of transforming primary care physicians’ offices into patient-centric practices. While our Patient Care Organization championed and led the effort, its success was due to the commitment of primary care practices and family residency training programs throughout SE Michigan who not only participated but did [Read More]

By EMMARIE HUETTEMAN
A draft plan spearheaded by House Speaker Nancy Pelosi would allow the federal government for the first time to negotiate prices for 250 drugs for Medicare and apply those prices to all payers, including employers and insurers.

As House Democrats hash out a proposal empowering the federal government’s top health official to negotiate lower drug prices, House Speaker Nancy Pelosi is taking it a step further and pushing a plan that could benefit even those Americans with private health insurance.

A draft plan spearheaded, but not yet released, by Pelosi and other House Democratic leaders would ensure that prices negotiated on the most expensive drugs would apply not only to [Read More]

Budget Office Projecting $45M Shortfall In DHHS’ IT Spending
The Michigan Department of Health and Human Services (DHHS) could be as much as $45 million in the hole by the end of the fiscal year if “major adjustments” are not made to address the agency’s IT budget shortfall, according to the State Budget Office.

On May 31, the SBO informed the legislative appropriations chairs that DHHS is the only agency at risk of spending more than it’s allotted to spend this fiscal year, which ends Sept. 30.

While no appropriations have been overspent, according to Budget Director Chris Kolb in the letter, the shortfall could result in overspending by the end of [Read More]

By PAUL NATINSKY
A famous catcher and left fielder once reportedly said: “It’s like déjà vu all over again.” This is precisely the case with medical coverage under Michigan’s new no-fault auto insurance law.

The new law ends the unlimited medical benefits provision contained in the original 1973 no-fault law and replaces it with tiered premium discounts that allow drivers to pay less for less medical coverage. The law guarantees no premium increases for eight years on the medical portion of insurance premiums and imposes a fee schedule for healthcare providers that begins at about double what Medicare pays.

Michigan’s auto insurance premiums are the highest in the country, with Detroiters often paying [Read More]

Calling the bill “destructive,” “a sell-out of Michigan citizens” and “a total gift to the insurance industry,” the Coalition Protecting Auto No-Fault (CPAN) was among several groups that didn’t hold back opposition to the auto insurance bill approved by the Legislature and signed by Gov. Gretchen Whitmer.

CPAN, the Michigan Brain Injury Provider Council (MBIPC), the Michigan Association of Justice (MAJ), Michigan Health & Hospital Association (MHA) and the Insurance Alliance of Michigan (IAM) all criticized SB 0001.

About the only outside entity that shared in the Legislature’s enthusiasm was Detroit developer Dan Gilbert, whose promise of a citizens’ initiative absent legislative action helped push the issue for a pre-Memorial Day deal.

“Today [Read More]

By EWA MATUSZEWSKI
While my recent columns have put me on the defensive regarding primary care trends, I’m thrilled to see CMS not only acknowledge but reinforce the important role of primary care in achieving optimal overall health and well-being through the recent introduction of its Primary Care Initiative Medicare payment models. At the heart of the introduction is a threefold goal: reduce administrative burdens, empower PCPs to spend more quality time with patients, and reduce overall healthcare costs. I’m not the only one applauding. The Patient Centered Primary Care Collaborative (PCPCC) cites the CMS move as reinforcement of the role primary care plays not only in health, but healthcare value.

There [Read More]

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

The National Practitioner Data Bank (Data Bank) published an article in the May 2019 issue of NPDB Insights that provides significant guidance regarding when proctoring is reportable. Proctoring can come in many different forms and has several different names depending on the hospital, such as monitoring, mentoring, or preceptoring. Regardless of the name, hospital-assigned proctorship agreements can be a useful tool to help evaluate a practitioner when a hospital has concerns about clinical competence. This is especially true because certain proctorships can be structured to avoid a report to the Data Bank. When that is accomplished, hospitals are able strike a [Read More]

By FEDERICO MARIONA, MD
Last Nov. 6, in lieu of a legislative decision that never took place, the Michigan voters approved the legalization of marijuana for recreational use by adults. That made our state the first in the Midwest to have such policy, complementing the previous implementation of the medical marijuana use. The statute included the proviso that recreational marijuana was to be allowed on persons of 21 years old and above, and that certain rules and regulations were to be developed via legislation to organize the cultivation, process, distribution and sales of the approved substance by a state certified system.

As of May 6, six months after the approval, a rather [Read More]

State Medicaid Official Placed On Leave Following Negligence Accusation

Michigan’s chief medical director for Medicaid was placed on administrative leave May 9 after accusations of negligence and deficiencies in patient care.

Dr. David Neff, who had been recognized for helping combat the state’s opioid crisis, is accused of failing to meet minimal standards and violating his general duty as a health care provider, according to an administrative complaint filed by the Michigan Department of Licensing and Regulatory Affairs (LARA) that MIRS received via a Freedom of Information Act request May 31.

LARA spokesperson David Harns said the department is not commenting outside the administrative complaint.

Lynn Suftin, spokesperson with the Michigan Department of Health [Read More]