Critics of Medicaid work requirements say that a U.S. district judge’s ruling disapproving work requirements for Medicaid recipients in Kentucky and Arkansas could lead to a similar ruling in Michigan.

Judge James Boaasberg in Washington, D.C., recently ruled work requirements to receive Medicaid in Kentucky and Arkansas are “arbitrary and capricious.” That may also affect states with similar laws, according to Families USA, a nonprofit health care organization.

Michigan is one of those. Republican lawmakers pursued work requirements for Medicaid recipients enrolled in the Healthy Michigan Plan last year. They take effect next year.

Sen. Mike Shirkey (R-Clarklake) sponsored the bill that added the work requirements after President Donald Trump approved states to [Read More]

By EWA MATUSZEWSKI
Because my column is due a few weeks prior to publication, I can only hope that the ugliness of the Wayne State University Board of Governors schism has diminished by the time you are reading this. Still, I am compelled to comment on what has disintegrated into personal name calling and the appearance of grandstanding by some board members. Lost in all this seems to be an understanding of the mission and values of a university and the role of its board of governors.

While I don’t want to get involved here in the discussion on whether University boards of governors should be appointed or elected, the fact of [Read More]

The Authority Health Board of Directors has named Loretta V. Bush, MSA, president and CEO of Authority Health, effective May 1, announced Gail Warden, Chairman of the Authority Health Board. Ms. Bush will replace Chris Allen, who has served as president of Authority Health since its inception in 2004, who will retire on April 30.

“I am pleased to announce that Loretta Bush will be our new president and CEO,” Gail Warden said. “Her extensive experience in public health practice and administration makes her an excellent candidate to lead our organization in the next phase of its history. She has impressive background addressing the complex health issues of the uninsured, underinsured [Read More]

By JESSE ADAM MARKOS, ESQ.
The National Practitioner Data Bank (Data Bank) has published an article in the April 2019 issue of NPDB Insights that urges reporting entities to include a detailed narrative when submitting an Adverse Action Report. The Data Bank’s stated purpose for requesting detailed information is to give organizations a more complete picture of what occurred to assist in making critical hiring and credentialing decisions. However, it will also result in healthcare providers being saddled with a career-damaging Data Bank report that contain inaccurate details and contested facts. Importantly, options are available to these providers to help minimize the damage. More specifically, healthcare providers have the right [Read More]

GOP Lawmakers Think DHHS Caro Study A Sham
Two Republicans representing Tuscola County say the state has already made up its mind about moving the replacement Caro Center, based on emails published by a TV station.

ABC 12 got its hands on emails from Gov. Gretchen Whitmer administration officials discussing the future of the proposed replacement for the psychiatric facility, including messages from Robert Gordon, director of the Michigan Department of Health and Human Services.

According to the report, Gordon in January “increasingly believes that closing Caro entirely is the correct path forward.”

In another email “within weeks,” Gordon suggested the idea of forming a commission “that would help us get the right answer, [Read More]

By ALLAN DOBZYNIAK, MD
Economics is apolitical. Economists can and often do have biases. But there are basic economic principles that are accepted. There are empiric data that provide the proof for their reliability. Trying to plough through healthcare and arrive at logical economic conclusions for a non-economist is not that easy. But hang in there if you can, and follow along as an attempt is made to do just that.

Healthcare is, like most everything, a scarce resource. Besides that, it is so complex that no single person or any limited group of persons is capable of completely planning and supervising the goods and services included in healthcare. It requires elaborate [Read More]

The head-spinning experience of navigating the pharmaceutical pricing world came to town Feb. 28, leaving lawmakers and laypeople alike with no greater understanding of why the entire scheme leaves consumers light in the pocket.

The basics are clear. Drug companies set the price for their drugs, but rarely does anyone pay it, Peter Fotos, PhRMA’s Chicago-based regional director for state advocacy told the House Health Policy Committee.

Generally, health insurers go through this relatively new layer of bureaucracy called Pharmacy Benefit Management (PBM) companies to negotiate cheaper rates based on bulk purchases. Then there are other assorted rebates and discounts patients can score. When the smoke clears, about 33 percent of the [Read More]

By JAY HANCOCK
Large majorities of Americans from both major parties support steps to control prescription drug costs such as showing prices in ads, removing barriers to generics and letting patients get less expensive drugs from Canada, a new poll shows.

By a 9-to-1 ratio, Republicans, Democrats and independents favor making drug companies show list prices in their advertising, says a new survey from the Kaiser Family Foundation. Highly advertised medicines such as Humira, for arthritis, cost tens of thousands of dollars a year, even after discounts.

Although Republicans tend to frown on government control over commerce, 8 in 10 Republican respondents said they support giving negotiating power to the $700 billion Medicare [Read More]

By EWA MATUSZEWSKI
What’s in a name? Sometimes, limitations. A physicians’ organization, for example, is the name given to organizations originally designed to help private practice physicians build and maintain an independent practice. Broadly speaking, the PO handled the foundational business aspects and insurance provider contracts of the practice, while the physicians tended to the needs of their patients and day-to-day operations. The role of POs in the past 10 years, however, has changed dramatically. Yes, we still negotiate contracts, trouble shoot patient registries and implement EHRs, but we also provide in-office care teams and care managers to support the 21st century model of medicine; and we introduce quality initiatives and [Read More]

By JESSE MARKOS
The National Practitioner Data Bank has published an article in a recent version of NPDB Insights to help clarify when a hospital privileging action is reportable to the Data Bank. Since a Data Bank report can have significant professional and economic ramifications, it is important for all healthcare providers to understand when a report is required and when one can be avoided.

By way of background, the Data Bank is an alert system that collects and discloses certain adverse information about physicians and other healthcare providers. An adverse report to the Data Bank can significantly impact a health care provider’s reputation and career. State licensing authorities, hospitals and [Read More]