By EWA MATUSZEWSKI
How does one build a 41-year-old organization? My response today is different than it would have been 15 or so years ago, largely due to my increased understanding of the value of internships. During this time, we’ve hired numerous interns of differing backgrounds and skill levels and the overwhelming majority have made meaningful contributions that ultimately helped us build a stronger organization.

I define ‘stronger’ in differing ways. One is our ability to take on new projects where we can lead with creativity and enthusiasm; another, our reputation for offering interns – and staff – both direction and independence in their careers with us – which in turn helps identify us as an employer of choice; and, yet another, the relationships we build with our internship schools that lead to partnerships and opportunities not easily available outside academia.

For example, through the years we have hired more than a dozen interns through neighboring Oakland University. From exercise specialists to dietitians and, since its first graduating class in 2015, masters of public health students who brought us deep data skills at a time when outcomes reporting took on greater significance for reimbursement by health plans. So valuable were these MPH interns that we hired five of [Read More]

By JENNI COLAGIOVANNI & DANIEL AYYASH
Wachler & Associates, PC

Overview

Signed into law on Dec. 27, 2020, the No Surprises Act addresses surprise medical billing or “balance billing” at the federal level by protecting patients from receiving surprise medical bills resulting from gaps in coverage for emergency services and certain services provided by out-of-network clinicians at in-network facilities, including by air ambulances. Effective Jan. 1, 2022, healthcare providers, facilities, and providers of air ambulance services (hereinafter “providers”) are subject to new requirements that generally apply to items and services provided to individuals enrolled in group health plans, group or individual health insurance coverage, and Federal Employee Health Benefit plans. These requirements generally do not apply to beneficiaries or enrollees in federal programs such as Medicare, Medicaid, Indian Health Services, Veterans Affairs Health Care, or TRICARE.

Under the Act, patients are liable only for their in-network cost-sharing amount and are removed from payment disputes between a provider and their health plan, while providers and insurers are given an opportunity to negotiate reimbursement. The Act provides for an Independent Dispute Resolution (IDR) process in the event disputes arise over reimbursement between providers and insurers.

Independent Dispute Resolution Process Between Providers and Insurers

Under the Act, if a provider and insurance company cannot [Read More]

By KIMBERLY RUPPEL
The current Public Health Emergency expiration deadline is this month.  However, the Secretary of the Health and Human Services indicated he would provide a 60-day notice before ending the PHE in order to minimize disruptions and potential loss of government and private insurance coverage.  That notice has not yet occurred.  Therefore, we expect another 90 extension.  In the meantime, telehealth waivers remain in effect.

Moreover, once the PHE is finally over, the Consolidated Appropriations Act signed into law earlier in 2022 provides a 151 day extension period of the expiration of many of the Covid-related exceptions or waivers, to allow for a transition period.

CMS has provided some guidance as to what waivers and flexibilities might remain in place after the end of the PHE for the purposes of promoting innovation, maintaining or improving quality, advancing health equity, and expanding access to care.

Those relating to telehealth include:

(1) Continued expansion of access to telehealth services for the diagnosis, evaluation, or treatment of mental health disorders;

(2) Temporary continued waiver expanding the types of healthcare professionals who can furnish distant site telehealth services to include all providers who are eligible to bill Medicare for their professional services.  This will allow physical therapists, occupational therapists, speech language pathologists and [Read More]

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

Anti-Prop 3 Campaign Going On Air With ‘Puberty Blocker’ Argument

The latest anti-Proposal 3 TV ad is making the claim that “sterilization” language in the proposed constitutional amendment would legally allow gender-changing-seeking minors to receive puberty-blocking drugs without their parents’ consent.

The “conversation is going to take a turn” said anti-Prop 3 consultant Fred Wzsolek for an anti-Proposal 3 side that’s averaging about $2.25 million a week on broadcast media.

Proposal 3, the constitutional amendment to overturn the 1931 Michigan abortion ban, also includes extreme policies “hidden behind the words,” said Christen Pollo of Citizens to Support MI Women and Children, the group putting out the ad.

Pollo said it’s “no secret that some want to cash in on the booming market for gender change therapies.”

“That’s why Planned Parenthood started dispensing these drugs in Michigan this year,” he said. “But what few understand is that their business plan includes a dangerous constitutional amendment that would allow them to provide these drugs to kids without the knowledge or consent of their parents.”

The 30-second ad, titled “Blocker,” starts with shots of a drug called Triptorelin, which is used to treat accelerated bone growth in children and accelerated prostate cancer in adults, [Read More]

By PAUL NATINSKY
Despite perceptions to the contrary, the COVID 19 pandemic is not over. Notwithstanding the return of crowds, the diminishment of mask wearers and the back-page treatment of pandemic news, the virus continues to circulate and the risk of resurgence looms.

“We’re certainly not done with it. We still have nationally a few hundred people a day dying from COVID. If you look at the overall mortality numbers, it’s still multiple times the number of deaths we see, say, from influenza. So it certainly has not faded into the background,” said Dr. Justin Skrzynski, a hospitalist with BHSH System, who has worked with COVID patients since the pandemic began.

Dr. Dennis Cunningham looks at COVID numbers on a daily basis. He says cases per 100,000 population are up, but they are mostly outpatients. He is not seeing serious disease numbers rising. Very few are coming into intensive care.

VIRULENT VARIANTS?

“The big question in my mind is when is the next new variant going to come up because that could change things a lot. But right now, things are probably better than they’ve been in the last three years,” Cunningham said.

Cunningham, who is System Director of Infection Control and Prevention at Henry Ford Health System, said a new [Read More]

“If local prosecutors, guided by their political expediency, are planning to imprison board certified obstetricians like me, then who do they expect to safely deliver all these pregnancies?” asked Dr. Audrey Stryker, a Bay City obstetrician and gynecologist.

Stryker met with several other medical professionals as part of a Committee to Protect Health Care’s virtual panel to discuss gubernatorial candidate Tudor Dixon’s abortion ban policy, which they say will drive medical professionals out of the state and lead to additional staffing shortages.

Dixon’s senior advisor, Kyle Olson, criticized the Committee, calling the group’s founder, Dr. Rob Davidson, a “political hack who failed at running for Congress.”

“He’s trying to remain relevant,” Olsen said, adding that the Committee is on the side of the “radicals” who want to eliminate protections like parental notification that he says are widely supported by Michiganders.

Stryker, who has practiced since 1988, said a medical staffing shortage existed even before the U.S. Supreme Court overturned Roe v. Wade in June.

“Every day I receive multiple emails, texts and phone calls from hospitals in urgent need of obstetricians to cover their labor and delivery units, necessitating the closure of smaller labor and delivery units all over the state,” Stryker said. “Even prior to the overturning of Roe, in the state of Michigan, we were in dire need [Read More]

By EWA MATUSZEWSKI
Blue Cross Blue Shield of Michigan (BCBSM) recently announced the names of its Patient-Centered Medical Home (PCMH) designees – many receiving designation renewals, but others being PCMH designated for the first time. From my vantage point, these practices, whether multiple-year designees or newbies, represent the best of primary care and affirm the effectiveness of a healthcare approach that puts the patient in partnership with the physician or advanced care provider and their team to optimize outcomes in physical and mental health. I again must give recognition to my friend Tom Simmer, MD, who had the foresight to launch the PCMH practice program through the Physician Group Incentive Program (PGIP; now known as value partnerships) when he was the CMO at BCBSM.

I mention the PCMH program because, coincident with that announcement, BCBSM also

introduced the use of the Collaborative Care Model (CoCM) for physician group members. CoCM brings together both physical and behavioral health providers to a primary care setting to offer integrated care. I’ve long advocated for this model and have seen it in action at Judson Center Health, our joint venture integrated primary care clinic in Warren where our organization provides the clinical staff and Judson Center provides behavioral health. We also have [Read More]

By STEPHEN SHAVER & CHRISTIAN IERACI
The COVID-19 pandemic created a newfound need for expansive telehealth services. As lockdowns, restrictions, and mandates left many without in-person access to healthcare, providers shifted to telehealth services to provide the care their patients needed, providing telehealth care to over 28 million Medicare beneficiaries in the first year of the pandemic. The Centers for Medicare and Medicaid Services (CMS) recognized the need for telehealth services and temporarily paused many audits and other medical reviews of claims in order to expand telemedicine access to Medicare beneficiaries. The increased need for telehealth services caused by the pandemic also led CMS to increase the types of services available via telehealth from 118 to 264 services. Now, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) has produced a review of telehealth service claims from the first year of the pandemic in an attempt to identify fraud, waste, and abuse related to telehealth. This review attempts to identify providers that performed the most telehealth services, scrutinizes their billing, and forecasts an increase in Medicare audit activity for telehealth providers.

OIG analyzed Medicare fee-for-service claims data and Medicare Advantage data for the first year of the pandemic, spanning from March 1, [Read More]

By JESSICA BUSCH
There’s a new sheriff in town, and they are looking to crack down on medical spas in Michigan.

Medical spas offering minimally invasive cosmetic medical services have enjoyed increasing popularity in the State of Michigan and across the United States. But with great success comes greater scrutiny of the so-called “Wild West” of the healthcare industry, particularly from lawmakers and government agencies. And with Michigan’s newly proposed legislation, lawmakers may be going after the bread and butter of many medical spas: Botox and dermal fillers.

New Michigan Legislation

Cosmetic medical services are medical-grade skin care and aesthetic services that constitute the practice of medicine and may only be performed by, or under the supervision of, a licensed physician. Since cosmetic medical services generally are not medically necessary and can be minimally invasive, it often leads to confusion as to the qualifications required to perform them.

Michigan lawmakers have answered with proposed legislation, which identifies, and significantly limits, who can perform cosmetic injectable services under Michigan law. On June 7, 2022, Michigan legislators introduced Senate Bill No. 1068, which proposes to permit only the following licensed persons to administer Botox and dermal fillers for cosmetic purposes: a physician; a physician’s assistant (“PA”) with a practice agreement with [Read More]

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

Hospital Association CEO: ‘Pipeline Issue’ Remains The Bottom Line For Healthcare

Although an economic report from the state’s hospital association discovered that healthcare maintains its place as Michigan’s largest private-sector employer, struggles with attracting and training newcomers has put a damper on things.

“There are some 1,700 fewer staff hospital beds throughout the state of Michigan than there were pre-pandemic,” said Brian Peters, chief executive officer of the Michigan Health and Hospital Association (MHA). “We have lost staff—both frontline (and) clinical staff, as well as non-clinical staff, who are so important to making a hospital operate on a 24-7-365 basis.”

Overall, Peters said the bottom line is “we have a pipeline issue.”

Peters spoke on the MIRS Monday Podcast , referencing a September report that found that healthcare in Michigan directly employed nearly 572,000 residents in 2020.

According to The Economic Impact of Healthcare in Michigan report, released earlier this month, direct healthcare workers in the state obtained $44.2 billion total in wages, salaries and benefits. Healthcare-affiliated workers additionally contributed $15.2 billion in local, state and federal taxes.

However, the American Hospital Association has also revealed occupied nursing and residential care jobs dropped by 11,000 while compensation hopped by $200 million.

Nationally, per-patient labor [Read More]

The Michigan Association of Health Plans is “hopeful” the recent $2.67 billion antitrust settlement with Blue Cross Blue Shield (BCBSM) will encourage “employers and individuals” to consider other plans.

MAHP Executive Director Dominick Pallone said its member health plan providers are “pleased that the court has finally accepted the terms” of the landmark settlement against Michigan’s largest insurer.

“For years, the American Medical Association (AMA) has consistently ranked Michigan as one of the least competitive states in the nation for health insurance,” he said in a statement. “We’re hopeful that this settlement will raise awareness of BCBS’ anti-competitive behavior and encourage all employers and individuals shopping for health insurance coverage to regularly evaluate their insurance provider options and consider other health plans offering more affordable policies.”

The settlement could affect more than 100 million class members, but how many are in Michigan was not immediately known. Class members were notified earlier of the proposal settlement via direct notice, a postcard or electronically.

A BCBS spokesperson said it is “premature for us to comment because the court’s approval of the settlement kicks off a 30-day window where parties may appeal, and the settlement won’t be final until that window closes, or until all appeals have been concluded.” She did not say [Read More]

By LAUREN WEBER & SAM WHITEHEAD
As the country grapples with states’ newfound power to regulate abortion in the aftermath of this summer’s U.S. Supreme Court decision, state attorney general candidates are staking claims on what they’ll do to fight or defend access to abortion — and that’s attracting cash and votes.

“By pretty much every indicator there is in a campaign, the Dobbs decision has energized and supercharged our race,” said Kris Mayes, a Democrat running for attorney general in Arizona. “People are outraged about this, and you can feel it in the air.”

But they aren’t the only ones who may be testing the laws. The winners of local prosecutorial races will also shape the legal landscape, and, in many states, an attorney general’s ability to bring criminal abortion cases to court ends at a local prosecutor’s doorstep. Called district attorneys, prosecutors, and various other names across the country, these lawyers — not the attorneys general — would make the final decisions on whether criminal charges can be brought against people seeking abortion or the medical professionals that provide them.

The exceptions include states such as Delaware and Rhode Island, which have distinct attorney general and local prosecutorial structures, said David LaBahn, president and CEO of the Association of Prosecuting [Read More]

By EWA MATUSZEWSKI
I mentioned in a recent column that teaching is one of my passions, which is why I’m so grateful to have this column as an educational platform to share what’s new in Michigan’s healthcare community. It’s not just news though; rather, an opportunity to learn what your local community is doing to promote better health outcomes – and encourage you to get involved. To that end, I’m excited about an initiative launched earlier this month by the Michigan Department of Health and Human Services addressing the social determinants of health (#SDOH) in the COVID era.

With funding from the CDC and Center for State, Tribal, Local and Territorial Support grants, and based on the concept of regional health exchanges for data, the state has created 11 regional Health Equity Advisory Councils, run by Backbone organizations (BBO), from the following regions:

• Genesee County
• Ingham County
• Kent County
• Oakland County
• Ottawa County
• Macomb County
• Muskegon County
• Saginaw County
• Washtenaw County
• Wayne County

Working with BBO community organizations such as ACCESS, Detroit Association of Black Organizations (DABO), Metropolitan Organizing Strategy Enabling Strength (MOSES) and Judson Center, the Councils will focus on capturing and sharing health disparities data in the manner best suited to their community’s needs. This will [Read More]

By DUSTIN T. WACHLER
Following recent enforcement actions against a variety of telemedicine arrangements throughout the country, the U.S. Department of Health & Human Services (HHS) Office of Inspector General (OIG) published a Special Fraud Alert to notify practitioners to exercise caution when entering arrangements with purposed telemedicine companies.[1] The telehealth arrangements described in the OIG’s Alert implicate multiple federal laws including, but not limited to, the federal Anti-Kickback Statute, False Claims Act, criminal health care fraud statutes, as well as the OIG’s exclusion authorities related to kickbacks and Civil Monetary Penalties Laws provision for kickbacks. Additionally, such arrangements will also implicate state fraud and abuse laws related to kickbacks, fee-splitting, self-referral, false claims, and related issues.

The Special Fraud Alert explains that following dozens of investigations into telemedicine schemes, the OIG continues to target telehealth arrangements that may result in corruption of medical decision-making, harm to beneficiaries (including, for example, receiving medically unnecessary care, items that could harm the patient, or improperly delaying needed care), and increase in costs to the federal healthcare programs for medically unnecessary items and services. In several telehealth arrangements recently targeted by the OIG, telemedicine companies paid practitioners in exchange for ordering or prescribing items or services for purported [Read More]

By WASIF KHAN
For many healthcare providers, their roles as business owner and employer tend to be overshadowed by their role as a healer.   While employees can be your greatest asset, they also tend to be one of the largest liabilities as well.  Hiring the right employees – properly – will help mitigate risk and ensure compliance within the complex regulatory landscape of the healthcare industry.

How and What to Ask Pre-Offer

 Employers have historically asked prospective employees about their salary history before making an offer; however, many jurisdictions[1] have enacted laws that ban employers from doing so. Pre-employment, employers should focus on establishing compensation models commensurate with prevailing market rates and if necessary, inquiries should be focused on applicants’ salary expectations for the position they applied for.

Let’s be honest, salary tends to be a defining factor in hiring activity, but there are a number of questions that tend to be stumbling blocks earlier in the process. Employers must be certain that a prospective employee can actually perform the job that you are seeking to fill. In thinking about whether a prospective employee will meet your expectations, you may be tempted to inquire about limitations or disabilities, children/sick family members that are being cared for, or [Read More]

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

Nurses Sue U-M Over Refusal To Bargain

A lawsuit filed in mid-August alleges the University of Michigan is breaking the law by refusing to bargain over nurses’ workloads in contract negotiations with the University of Michigan Professional Nurse Council (UMPNC).

Michigan Nurses Association, the labor organization that filed the suit in the Court of Claims, says the 6,200 UMPNC nurses have worked without a contract since July 1. The organization alleges the university is violating the Public Employment Relations Act, which designates workload and safety as mandatory subjects of bargaining, and it wants an order compelling U-M to bargain.

The “major stumbling block,” MNA claims, is the administration’s refusal to discuss workloads in terms of number of patients assigned per nurse, which is tied directly to patient safety concerns that nurses have raised for months.

“When nurses are forced to take care of too many people at once, patient care gets compromised and nurses are put in danger of injury or burnout, and that’s happening far too often at our hospital,” said Renee Curtis, a registered nurse and president of UMPNC. “Our union is fighting for patient safety, first and foremost. It’s absurd to think [Read More]

This story appears courtesy of MIRS, a Lansing-based news and information service.

The Department of Health and Human Services (DHHS) budget for Fiscal Year (FY) 2023 passed early this morning includes funds to expand adult and child mental health services and programs, and opens the door to a restructuring of dental benefits in the state, among a cornucopia of historic funding.

Rep. Mary Whitford (R-Casco Twp.), chair of the House DHHS Appropriations Subcommittee, and Michigan Association of Health Plans Executive Director Dominick Pallone hailed the funding as a great investment into the health of Michiganders.

“MDHHS is thankful for improvements in access to affordable, high-quality dental services for Michiganders, raising rates for foster, adoptive, and guardian providers and investments in community organizations that provide direct support to families. Congrats to Gov. Gretchen Whitmer and the Legislature for passing a balanced, bi-partisan budget,” MDHHS spokesperson Lynn Sutfin said.

Whiteford highlighted the $325 million in funding going toward the creation of a new psychiatric hospital, $41 million to add 56 beds and 87 full-time positions to the Hawthorn Center, and $223 million in funding being directed toward several private sector mental health facilities, such as Pine Rest, U of M Medicine and McLaren Northern Michigan, to help expand access for [Read More]

This story appears courtesy of MIRS, a Lansing-based news and information service.

More than 60 Ascension Michigan health care workers filed a federal lawsuit seeking to recover wages lost when they were suspended for not getting mandatory COVID vaccines and not complying with the health system’s 2021 policy.

The proposed class-action suit, filed in U.S. District Court Western District, alleges violations of the Civil Rights Act of 1964 when hospital leaders placed employees on “involuntary, indefinite, unpaid leave of absence” in November 2021 after denying their religious exemptions requests.

According to the suit, Ascension required its employees – but not independent contractors, vendors, temporary staff, patients or visitors – to be vaccinated by 5 p.m. Nov. 12, 2021. Failure to do so would be “deemed voluntary resignation,” the suit claimed.

The plaintiffs submitted religious accommodation requests, but Ascension denied the requests while approving some based on “pure favoritism,” the suit alleges.

When the November deadline hit, the plaintiffs were placed on unpaid suspensions, but after five weeks, some slowly returned to work when hospital leaders faced “legal challenges” and “staffing challenges,” the suit claims.

The plaintiffs allege they were told the vaccine suspension had been recalled, but many employees denied religious accommodations were not recalled to work, which the suit [Read More]

By EWE MATUSZEWSKI
Anniversaries can be wonderful – or emotionally difficult. I just celebrated a milestone wedding anniversary – a joyous occasion. Yet, the first anniversary of my brother’s passing as a result of suicide is looming and brings back feelings of shock, disbelief and the lingering question, “Is there anything I could have done?” My brother and I were, sadly, neither geographically nor emotionally close as adults (his choice on both.) Yet the raw feelings remain, the helplessness, the abiding sense of loss.

In my head, I know there truly was nothing I could have done. But I choose to do something now. And that is to be open about death by suicide in this platform and any others I may have in order to spread a message of prevention; to advocate for mental health check-ups and encourage primary care physicians and Advanced Practice Providers to include mental health wellness checks in patient visits; and to share three easy digits that can save a life: 988.

988 was established to improve access to crisis services in a way that meets our country’s growing suicide and mental health-related crisis care needs. 988 will provide easier access to the Lifeline Network and related crisis resources, which are distinct from [Read More]

By JESSE ADAM MARKOS, ESQ.
Wachler & Associates

On June 27, 2022, three days after the U.S. Supreme Court overturned nearly 50 years of settled law in a direct assault on women’s rights and reproductive freedom, the Court issued an important decision for physician autonomy in a consolidated case ruling in Ruan v. United States. In that case, the Court raised the burden of proof for federal prosecutors seeking to hold physicians accountable under the Controlled Substances Act for the rise in addiction and death during the opioid crisis. While many of these prosecutions have certainly been laudable, others have involved treatment that was not so clearly egregious, treating what, at worst, could have been medical malpractice or standard of care violations, as criminal matters.

In each of the consolidated cases, the defendants were physicians licensed to prescribe controlled substances. Each was charged with violating 21 U.S.C. § 841, which makes it a federal crime to distribute or dispense controlled substances “except as authorized.” A federal regulation authorizes registered doctors to dispense controlled substances via prescription, but only if the prescription is “issued for a legitimate medical purpose by an individual practitioner acting in the usual course of his professional practice.” 21 CFR §1306.04(a).

At issue was the [Read More]

By KATHLEEN CAMPBELL WALKER
Dickinson Wright

On Feb. 12, 2022, the Subcommittee on Immigration and Citizenship of the House Committee on the Judiciary held a very informative hearing regarding the relevance of foreign physicians in the healthcare system of the United States. The hearing was titled, “Is There a Doctor in the House? The Role of Immigrant Physicians in the U.S. Healthcare System.” The testimony provided underscores the ridiculous labyrinth of immigration rules set to complicate and cause ongoing unpredictability for foreign physicians trying to obtain approval to serve the U.S. public – even when desperately needed.

Dr. David J. Skorton, the President and Chief Executive Office of the Association of American Medical Colleges (AAMC), which is a nonprofit comprised of members of all 155 accredited U.S. and 16 accredited Canadian medical schools, outlined the following critical points:

• Based on the AAMC’s review of American Medical Association (AMA) data in 2020 for physician practices, approximately 23% of active physicians practicing in the U.S. identified as foreign born. Many of whom are now U.S. citizens or legal permanent residents.
• AAMC projects that the overall physician shortage will grow to a total of between 37,800 to 124,000 physicians by 2034. This projection includes shortages of primary care physicians between [Read More]

Legislature Says Planned Parenthood’s Abortion-Ban Challenge ‘Premature’

Lansing Lines appears with cooperation from MIRS, a Lansing-based news and information service.

The Michigan Legislature asked a Court of Claims judge to dismiss Planned Parenthood’s lawsuit challenging the state’s abortion-ban law.

The filing says Planned Parenthood’s claims are “premature” because they “are based on a series of hypotheticals” and the relevant statute, MCL 750.14, “is not being enforced, and plaintiffs do not claim that there are any concrete threats of enforcement.”

“No state authority has sought to enforce the statute at issue here, making plaintiffs’ claims unripe,” the court brief from Nicholas Miller, of Washington, D.C.-based Schaeer-Jaffe LLP, reads on behalf of the Legislature. “First, Michigan’s statute cannot be used to prosecute pregnant women. … Second, there are … no pending prosecutions or threatened prosecutions of any abortion provider under MCL 750.14.”

The Legislature also argues Planned Parenthood lacks standing.

Some prosecutors have said they will prosecute the law if violated, which the Legislature argues is irrelevant to Planned Parenthood’s lawsuit, in part, because the prosecutors are not parties to the lawsuit.

The only prosecutor – and only defendant – on the case, Attorney General Dana Nessel, has repeatedly said she will not prosecute Michigan’s abortion-ban law.

Planned Parenthood filed its suit in April, [Read More]

A package of four Senate bills that modify the requirements for health facilities wishing to expand, including those increasing psychiatric bed numbers or purchasing an air ambulance, received a hearing in the House Health Policy Committee.

SB 181, sponsored by Sen. Curtis VanderWall (R-Ludington), would allow health facilities to bypass certificates of need in order to expand their number of psychiatric beds. It would also increase the threshold on expenditures requiring certificates of need to $10 million.

Currently, health facilities wishing to increase in size or spend more than $2.5 million on upgrades need a certificate.

SB 182, sponsored by Sen. Lana Theis (R-Brighton), would increase Certificate of Need Commission members from 11 to 13, and require one of the new additions to be from a county with 40,000 people or less.

Both bills are necessary to speed up outdated processes which hinder hospitals’ “ability to upgrade and expand efficiently,” said Jordan Jorritsma, VanderWall’s legislative director, in testimony before the House Health Policy committee.

“When we have places that want to expand current beds or build a new facility, I don’t believe we need this extra bureaucratic burden,” Jorritsma said, “which slows down the process of getting those beds online and operable.”

But trying to increase expansion could lead to more [Read More]

By SAM WHITEHEAD
Until last year, Georgia’s Medicaid coverage for new moms with low incomes lasted 60 days.

That meant the Medicaid benefits of many women expired before they could be referred to other medical providers for help with serious health problems, said Dr. Keila Brown, an OB-GYN in Atlanta. “If they needed other postpartum issues followed up, it was rather difficult to get them in within that finite period of time,” said Brown, who works at the Family Health Centers of Georgia, a group of community health centers.

Georgia lawmakers, recognizing the state’s high rate of pregnancy-related deaths, have taken action. In 2021, Georgia extended the Medicaid coverage window to six months postpartum. And, now, the state plans to broaden that benefits period to a year.

Georgia is one of a dozen states that have opted not to fully expand Medicaid — the federal-state health insurance program for people with low incomes or disabilities — under the Affordable Care Act. But nine of those states, mostly in the South, have sought or plan to seek an extension of postpartum Medicaid coverage, in many cases to a full year after a birth.

Some took advantage of a provision of the American Rescue Plan Act that allows states to extend coverage [Read More]

Maximize Your Learning Events With These Best Practices

By EWA MATUSZEWSKI
I will admit to being taken aback by how many positive comments I received on my last column: Don’t Get Trained – Learn! I appreciate all of the feedback and your interest. I hope I’m not wearing out my welcome by staying on this topic for June as well.

While it may be unusual for a healthcare executive to spend so much time in curricula development, it is a significant part of my work life. I attribute that not only to my love of learning but the sheer volume of new information coming out daily on health and well-being (and the billing codes to charge for them!) For better or for worse – but mainly for better, because it keeps things fresh and focused on patient care– those of us who work in health care administration or leadership are inundated with the latest news, trends, and research. But we can’t disseminate it all ourselves – or understand the nuances. We need to engage with colleagues, experts and authorities from respected organizations to gain additional perspectives and digest what it all means.

To that end, I think it helps to keep in mind some best practices prior to organizing [Read More]