Health departments, both state and local, learned many lessons from going through the COVID-19 pandemic. Communications, making friends and funding stood out as top of mind.

Michigan Association of Local Public Health Executive Director Norm Hess said the group was having a “high-level review” to look at the pandemic response and would release it in June or July.  He said there was one lesson that all areas of health quickly had to learn.

“The communication aspect is definitely something that we want to delve into and make sure that in the future we have really good processes for that,” Hess said.

He said in the beginning, the federal Centers for Disease Control had to get messages out to the states.

Each state had to integrate them into their own state health laws and then communicate that to the local health departments.

The health officers then had to adjust those to local ordinances and communicate that to residents.  The process was slow.

“All of this is happening while the news is reporting on it every day and social media is 24/7,” he said.

He said all the players needed to be in the loop and not be surprised by new information emerging daily, forcing everyone to adjust the strategy and confusing the residents who were [Read More]

A nationwide shortage of cancer drugs cisplatin and carboplatin has Michigan hospitals asking state and federal government leaders for help.

Manufacturing delays at several pharmaceutical companies are causing the nationwide shortages of the two critical chemotherapy medications, which are used to treat several types of cancer, including bladder, lung, ovarian and testicular cancers.

As a result, Michigan hospitals and health systems are forced to find alternative treatments for patients, some of which may be less effective, the Michigan Health & Hospital Association said.

“The MHA is in communication with our members of Congress to make them aware of the extent of the drug shortage and any potential solutions,” said John Karasinski, MHA’s senior director of communications, who noted that the MHA would like to see both the state and federal governments implement strategies to help ease the crisis.

The Michigan State Medical Society also called for urgent action to address the shortage, saying the “escalating scarcity” of the two drugs “is reaching a tipping point with each passing day.”

Dr. M. Salim Siddiqui, president of the Society who has personally witnessed the devastating effect on cancer, said the Society is urging Michigan officials to “meticulously assess regions within the state that are most susceptible to chemotherapy shortages and the subsequent impact on [Read More]

By EWA MATUSZEWSKI

I get the sense I have written this column before. If I have, I approach this version with more vim and vigor and, admittedly, a bit of annoyance. The topic is physicians organizations, what they do, who they serve and what they are – and are not.

What they definitely are not, is new. I begin with this, because a respected Michigan business publication recently published an article about a physicians’ organization that formed to counter the efforts of large health systems trying to control their anesthesia specialty. Perhaps it was a beat unfamiliar to the reporter, but the article was written as if physician organizations were a new concept. Well, our organization has been around for more than 40 years, and I can attest that we were not the first. As a matter of fact, one of the reasons for founding our PO was because primary and specialty care physicians who immigrated to the U.S., and ultimately Michigan, were having a difficult time getting into other POs. We saw a need to help foreign-trained physicians blend in and set up and grow their medical practices. Today, our organization and other POs in Michigan – there are more than 40 – continue that mission [Read More]

By STEPHEN SHAVER, Wachler & Associates, P.C.

The US Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently released a report outlining the results of a review it conducted of claims for physician and other practitioner services provided to Medicare patients during Medicare Part A covered skilled nursing facility (SNF) and hospital stays. OIG asserted that physicians were miscoding the location where these services were provided, leading Medicare to make tens of millions of dollars in overpayments. This report is likely to lead to overpayment demands, further audits of providers, and increased scrutiny of place of service (POS) codes.

Each time a physician or other fee-for-service (FFS) healthcare practitioner submits a claim for reimbursement, the provider includes a two-digit POS code indicating where the services were provided. For example, POS code 11 means “office.” Although the codes themselves are a claims submission standard under the Health Insurance Portability and Accountability Act (HIPAA), the code list and rules are maintained by the Centers for Medicare & Medicaid Services (CMS). Regarding Medicare Part B reimbursement for physician and other practitioner services, CMS reimburses some (such as those with POS codes for hospitals and SNFs) at the “facility” rate, and others (such as those with the [Read More]

By SARA JODKA

Introduction

As the intersection of technology and healthcare becomes increasingly nuanced, the field of genomic medicine is rapidly evolving and expanding. Genomic medicine, or personalized medicine focusing on the data holding information on base sequence in an individual’s genome, uses an individual’s genetic information to guide healthcare decisions. This revolutionary medical field promises immense benefits to patients, researchers, and healthcare providers. Nevertheless, it brings with it a number of complex privacy concerns that must be adequately addressed in law to ensure that patient data remains confidential and secure.

This article examines the current legal landscape, identifies the unique challenges genomic data privacy poses, and explores the opportunities for developing legal frameworks for genomic medicine.

Genomic Data and Privacy Concerns

Genomic data is sensitive personal information that can reveal not just an individual’s current health status but also potential future health risks, including predispositions to specific genetic conditions. It can also reveal information about an individual’s family members, which extends privacy considerations beyond the individual.

These issues present unique challenges inherent in the privacy of genomic data – including the highly predictive nature and permanency of this data. Unlike other health data, which can change and be modified by lifestyle and environmental factors, genomic data does not change over [Read More]

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

Conversion Therapy Ban Moves Again, Less than 24 Hours Later

Bills that ban conversion therapy for minors were voted out of the House Health Policy Committee after being voted out of a subcommittee less than 24 hours prior.

Conversion therapy, the practice of attempting to change an individual’s sexual orientation, gender identity or gender expression to align with heterosexual or cisgender norms, is not therapy at all, said Rep. Felicia Brabec (D-Ann Arbor), chair of the Behavioral Health subcommittee.

The bills are an explicit ban on “saying to someone, ‘who you are is not OK, and it’s wrong.’ That’s not what we do in therapy,” Brabec said.

Rep. Graham Filler (R-St. Johns) asked about how the ban would affect an individual seeking therapy to rid themselves of homosexual or transgender feelings.

Brabec said therapy is client-led and affirming to allow a “safe, welcoming space” for clients to explore their identities.

Rep. Jamie Thompson (R-Brownstown) asked if a conversion therapy ban would mean a 6-year-old having transgender thoughts or feelings would have their suspicions “affirmed,” and Brabec said the affirming environment of therapy is “one of trust and it’s affirming no matter what folks are coming in for.”

Testimony during a recent Behavioral Health [Read More]

By DARIUS TAHIR

What use could health care have for someone who makes things up, can’t keep a secret, doesn’t really know anything, and, when speaking, simply fills in the next word based on what’s come before? Lots, if that individual is the newest form of artificial intelligence, according to some of the biggest companies out there.

Companies pushing the latest AI technology — known as “generative AI” — are piling on: Google and Microsoft want to bring types of so-called large language models to health care. Big firms that are familiar to folks in white coats — but maybe less so to your average Joe and Jane — are equally enthusiastic: Electronic medical records giants Epic and Oracle Cerner aren’t far behind. The space is crowded with startups, too.

The companies want their AI to take notes for physicians and give them second opinions — assuming they can keep the intelligence from “hallucinating” or, for that matter, divulging patients’ private information.

“There’s something afoot that’s pretty exciting,” said Eric Topol, director of the Scripps Research Translational Institute in San Diego. “Its capabilities will ultimately have a big impact.” Topol, like many other observers, wonders how many problems it might cause — like leaking patient data — and how often. “We’re going to find [Read More]

The number of patients assigned to nurses would be limited and nurses’ mandatory overtime reduced, under legislation reintroduced in the House and Senate with Michigan Nurses Association (MNA) support.

The package, called the Safe Patient Care Act, was intended to improve nursing retention. It was immediately opposed by the Michigan Health and Hospital Association.

Sen. Sylvia Santana (D-Detroit)’s SB 334 , and Rep. Stephanie Young (D-Detroit)’S HB 4550 limit the number of patients a nurse can be assigned.

The bills establish a one-to-one ratio in intensive care units, during trauma or critical care for triage duties, in operating rooms, during conscious sedation and post-anesthesia, during active labor and birth, immediately postpartum and in cases of an unstable newborn.

In pregnancy cases before labor, the ratio would be one nurse to three pregnant patients, not including cases of continuous fetal monitoring.

Non-trauma emergency departments and pediatrics would each be required to staff one nurse for every three patients, while postpartum care, behavioral health and acute rehabilitation cases would require one nurse for every four patients.

Sen. Stephanie Chang (D-Detroit)’s SB 335 and Rep. Betsy Coffia (D-Traverse City)’s HB 4551  prohibit hospitals from punishing nurses who refuse to accept overtime requests outside of a declared state of emergency, with a $1,000 fine for violation.

Sen. Jeremy Moss (D-Southfield)’s SB 336 and Rep. Carrie A. Rheingans (D-Ann Arbor)’ HB 4552 require hospitals to [Read More]

By EWA MATUSZEWSKI
I wrote in February that we are entering the era of the community health worker (CHW). I reiterate that today, but fear that I spoke too soon on one aspect of the CHW movement. Unsurprisingly, it’s reimbursement. Here’s what I said then:

“Many insurers are also beginning to recognize the community health worker as the new, must-have care team member for an efficient connector between clinician and community…Some services of a CHW are reimbursable to the provider; however, they must be connected to a clinical organization.”

While I was accurate in noting the existence of reimbursable services, I believe I was too optimistic in how I presented the information. The reality is, as our learning organization, Practice Transformation Institute, welcomed several freshly minted Community Health Workers following a commencement celebration earlier this month, reimbursement for billable services they are prepared to provide are in limbo.

Data continues to affirm that CHWs are critical members of the public health workforce who connect individuals with resources, advocate for communities of all socioeconomic backgrounds – but especially those facing health and racial inequities – and, on net, contribute to improving the quality of healthcare. Yet, at this relatively early stage of true integration of CHWs into clinical practice teams, [Read More]

By ROLF LOWE
Over the last thirty years the transition from handwritten and dictated patient notes to electronic health records (EHR) has created efficiencies for providers. While EHRs were introduced with the idea of better patient care and less administrative burdens, they have also created issues that didn’t exist when the norm was to create a contemporaneous handwritten note in a patient’s chart. One of these issues is the “cloning” of a procedure or a SOAP note in a patient’s chart. The Centers for Medicare and Medicaid Services in its EHR Provider Fact Sheet defines cloning as the practice of copying and pasting previously recorded information from a prior note into a new note. The practice may also be referred to as copy and paste, carrying forward or same as last time (SALT). CMS, as well as other payers, see this as a problem in health care institutions and settings that is not being addressed.

One of the ways CMS is addressing this issue is through its various audit programs. Uniform Program Integrity Contractors (UPICs), who perform audit work for Medicare and Medicaid programs, rely heavily on Section 1888 of the Social Security Act, Payment for Benefits, when auditing a provider’s chart to deny a payment for [Read More]

By RALPH LEVY, JR.
In prior articles in this publication, this author addressed a federal tax issue faced by practice entities- the possible attack by the Internal Revenue Service (IRS) on a common practice of incorporated medical and other types of practice groups.  By use of the “zero out” technique to pay compensation to the practice group’s owners as salaries during the year and year-end bonuses, practice groups organized as ‘C’ corporations (set up as a professional corporation or professional association under local law) will pay little or no federal income taxes.  The potential tax risk to this compensation method is that depending on the facts and circumstances of each situation, the IRS could disallow the compensation deduction for the “salary” and bonuses paid and treat these payments as non-deductible dividends made by the practice entity to its shareholders.  In such case, the practice entity would be liable for federal income taxes on the disallowed compensation deductions.

However, the care and feeding of practice groups to avoid adverse federal income tax issues involves more than maintaining the recommended compensation practices as outlined in more detail in these prior articles.  This article will discuss two other areas that could result in federal tax indigestion for practice entities.

Area #1           [Read More]

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

Homeless Youth Could Receive Health Care Under Bill

Homeless youth would be able to access health care without parental consent under a bill sponsored by Rep. Amos Oneal (D-Saginaw) that is part of a bill package sponsored by Rep. Lori Stone (D-Warren)  and Rep. John Roth (R-Interlochen).

Under HB 4085 , HB 4086 and HB 4087 , homeless or runaway youth between the ages of 16 and 21 would have to establish with the child care institutions’ staff that they do not have access to a safe living environment with their parent and have no other safe alternative living arrangement besides a homeless youth shelter in order to qualify for health care and supervision.

The bills would not apply to individuals involved in juvenile justice or foster care systems.

“Prior to becoming a homeless youth, I hadn’t been to the doctor in years. Within days of joining the transitional living program, I was seen by a doctor,” said Spencer Calhoun, board member at Comprehensive Youth Services and former homeless youth.

The bill would allow the youth to receive medical, dental or behavioral health examinations, care or treatment.

The bill would not provide access to abortion for homeless or runaway youth without parental consent.

Another bill in the package extends the [Read More]

By PAUL NATINSKY
Regardless of the state of science or prejudices of politics, the common cultural vibe is that the COVID-19 pandemic is over. I saw convincing evidence on a trip to visit a friend recovering from a stroke at a Southeast Michigan hospital. The nurses staffing the desk on his floor either had their masks at half-mast (below the nose) or completely furled.

In mid-April the official lowering of sails was announced. May 11 will be the date on which the national emergency initiated by then-President Trump and renewed twice by President Biden is set to expire. The end of required fabric face filters is mostly a symbolic end to COVID precautions, as businesses and social gatherings have long been barefaced and stickers forbidding use of every other stadium seat or restaurant booth have begun to fade and peel as patrons slide into those spots.

As is often the case, the real story is a case of following the money. In this instance money for testing, vaccines and treatments will shift from government subsidies to the realm or private insurance and standard government programs such as Medicaid.

As many as 3 percent of Americans are estimated to be immunocompromised, which translates to about 10 million people who [Read More]

The Biden administration’s decision to end the COVID-19 public health emergency in May will institute sweeping changes across the health care system that go far beyond many people having to pay more for COVID tests.

In response to the pandemic, the federal government in 2020 suspended many of its rules on how care is delivered. That transformed essentially every corner of American health care — from hospitals and nursing homes to public health and treatment for people recovering from addiction.

Now, as the government prepares to reverse some of those steps, here’s a glimpse at ways patients will be affected:

Training Rules for Nursing Home Staff Get Stricter

The end of the emergency means nursing homes will have to meet higher standards for training workers.

Advocates for nursing home residents are eager to see the old, tougher training requirements reinstated, but the industry says that move could worsen staffing shortages plaguing facilities nationwide.

In the early days of the pandemic, to help nursing homes function under the virus’s onslaught, the federal government relaxed training requirements. The Centers for Medicare & Medicaid Services instituted a national policy saying nursing homes needn’t follow regulations requiring nurse aides to undergo at least 75 hours of state-approved training. Normally, a nursing home couldn’t employ aides for [Read More]

By EWA MATUSZEWSKI

Are you among the LEP? Likely not, because you’re reading this. But as someone in the healthcare sector, it’s an acronym you should not only know, but understand, particularly as it relates to health literacy and equity. LEP is Limited English Proficient, and the U.S. Census Bureau describes it as individuals over age 5 who report speaking English less than “very well”. It reports that number as over 25 million –  9% of the United States population in 2015, the year the report originates.

Flash forward to today in a heightened era of health literacy, DEI and social determinants of health and LEP takes on new significance. It’s not just race, ethnicity, gender identification and socio-economics. We need to expand the conversation to include those that, literally, can’t join in – at least not without assistance. Regardless of one’s views on immigration, we must acknowledge and deal with the reality that we are not necessarily a nation of native English speakers.

But interpreters are expensive – isn’t that why insurers include them as part of general overhead? Yes, but…aren’t hospital admissions and readmissions even more expensive. Medical consumers want to have a relationship with a primary care provider who speaks their language. When that’s [Read More]

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

Pursuant to a plea agreement filed in federal court in Grand Rapids on April 6^th, the former chairman of Michigan’s Medical Marijuana Licensing Board, Rick Johnson, has admitted to accepting bribes while serving in his official capacity. Federal prosecutors allege that, over a two-year period, Johnson accepted cash payments and other benefits, such as private chartered flights, in excess of $100,000.00 in return for giving preferential treatment during the medical marijuana licensing process.

Michigan’s now-defunct Medical Marijuana Licensing Board was created by the Michigan Legislature in 2016 to issue licenses for various medical marijuana facilities.  It operated within the Michigan Department of Licensing and Regulatory Affairs (“LARA”) and was tasked with approving or denying applications for licenses for medical marijuana businesses. The 5-member Medical Marijuana Licensing Board was made up of political appointees chosen by the Governor and its process for granting medical marijuana licenses was patterned after the regulatory scheme used for liquor licenses.

In May 2017, Johnson was appointed as Chairman by then-Governor Snyder.  Johnson had previously served as a republican legislator in the Michigan House from 1999-2004, where he was House Speaker from 2001-2004. After leaving office, Johnson worked as a lobbyist and led a prominent Lansing [Read More]

By ALEXANDRA CRANDALL

J-1 status is a favorite for foreign nationals attending medical resident training programs in the United States. While there are many advantages to the J-1 visa category, one major obstacle remains for J-1 physicians who wish to continue working in the United States—the home residence requirement.

Because the J-1 physician visa is considered an “exchange visitor visa,” foreign nationals who enter in that status must return to their home country for two years before being granted H/L non-immigrant status or permanent residency. This is a discouraging reality, particularly within an industry that desperately needs to retain the talent it works so hard to train. Luckily, there are four options to waive the home residency requirement, though each requires careful timing and expertise.

Option One: Conrad 30 Waivers

Conrad 30 waivers are available to a limited number of physicians each year based on the J-1 physician’s commitment to work in underserved communities. While there are a few federally-mandated requirements for this waiver, each state runs its own program and dictates eligibility of applicants. Each physician must, at a minimum: (1) agree to work full-time for three years in a qualifying location; (2) begin work within 90 days of the waiver being granted; and (3) work in an [Read More]

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

Lucido Can’t Connect Dots On Nursing Home Deaths

In the midst of the back and forth between the Gov. Gretchen Whitmer administration and the then-GOP-controlled Legislature over COVID-19 nursing home deaths, the Macomb County prosecutor launched an investigation into that issue within his jurisdiction.

Pete Lucido went so far as to create a countywide protocol for residents reporting COVID-19-related deaths connected to involuntary transfers to nursing homes, potentially based on the Whitmer administration’s directives.

Lucido even asked each of the police departments in Macomb to gather whatever information they could on the issue.

The Governor’s office at the time issued a statement suggesting that the Prosecutor was engaged in a “shameful political attack based on neither facts nor reality.”

Now, some two years later, the investigation continues as complaints from constituents who lost loved ones in nursing homes still trickle into his office, but Lucido told MIRS, “there is no way to determine that the deaths were caused by the nursing home protocols” related to COVID patients.

A frustrated Lucido says that without any “medical police” to look into the reasons behind the deaths, “proof” of a linkage between policy and fatalities “is a problem.”

He reported that many of the family members met [Read More]

By LIZ SZABO

Diego never imagined he’d carry a gun.

Not as a child, when shots were fired outside his Chicago-area home. Not at age 12, when one of his friends was gunned down.

Diego’s mind changed at 14, when he and his friends were getting ready to walk to midnight Mass for the feast of Our Lady of Guadalupe. But instead of hymns, Diego heard gunfire, and then screaming. A gang member shot two people, including one of Diego’s friends, who was hit nine times.

“My friend was bleeding out,” said Diego, who asked KHN not to use his last name to protect his safety and privacy. As his friend lay on the ground, “he was choking on his own blood.”

The attack left Diego’s friend paralyzed from the waist down. And it left Diego, one of a growing number of teens who witness gun violence, traumatized and afraid to go outside without a gun.

Research shows that adolescents exposed to gun violence are twice as likely as others to perpetrate a serious violent crime within two years, perpetuating a cycle that can be hard to interrupt.

Diego asked his friends for help finding a handgun and — in a country supersaturated with firearms — they had no trouble procuring one, which they gave him free.

“I felt safer [Read More]

The state Department of Health and Human Services (DHHS) will be restarting annual redeterminations for Medicaid recipients, and ending extra benefits for those on the Supplemental Nutrition Assistance Program (SNAP) to comply with what DHHS Director Elizabeth Hertel called a “COVID-19 Public Health Emergency Unwind.”

Hertel, who spoke before the House Appropriations Subcommittee on Health and Human Services, said the necessary unwind is a result of federal pandemic emergency assistance that was provided to SNAP beneficiaries and Medicaid recipients and is now ending.

She said additional SNAP assistance increased benefit levels to the maximum amount allowable per eligible group regardless of income, with an additional $95 for groups already receiving the maximum benefit. For Medicaid recipients, Medicaid agencies were required to continue health care coverage for all programs, even if someone’s eligibility changed.

During that time, DHHS data found Michigan’s Medicaid caseload grew by more than 700,000 people.

But with the passage of the federal Consolidated Appropriations Act of 2023, the Medicaid requirement and extra assistance ended yesterday, Hertel said.

Hertel said regular benefit amounts will resume in March, and DHHS will soon restart the process of making Medicaid redeterminations, which means some who were made eligible during the pandemic could no longer qualify for assistance.

Hertel said the Department has been [Read More]

By EWA MATUSZEWSKI
With the President’s Emergency Declaration – Public Health Emergency related to COVID-19 slated to end on May 11, I have some observations to share on this and other matters that somehow feel related. My first observation is that I don’t want to see telehealth and its many benefits languish should government support ebb.

The pandemic didn’t launch telehealth, it was re-introduced after a years-long wobbly start where payers didn’t want to reimburse for it so providers didn’t want to offer it. Suddenly, in the early desperate days of the pandemic, telehealth was the rage, with unsecured channels like Facetime or Google Meet serving as makeshift portals for frightened patients and frazzled physicians needing to make a connection. As COVID-19 raged on, behavioral health took center stage as a telehealth beneficiary.  The toll of chronic illness – its cost in lives lost, isolation, disconnected friends and family, and ultimately cultural and societal cracks that created a dark cloud over the country – manifested in a behavioral health crisis that was long brewing but could no longer be contained.

While I’ve been vocal about the shortcomings of virtual healthcare for both physical and behavioral health (chiefly the absence of physical touch and interpretation of body language), I [Read More]

By JENNIFER COLAGIOVANNI & CHRISTIAN IERACI, Wachler & Associates, P.C.

Michigan recently revised its Corporate Practice of Medicine laws to allow for multidisciplinary practices amongst physicians (licensed MDs and DOs), podiatrists, and chiropractors. Prior to 2022, Michigan’s Corporate Practice of Medicine laws prohibited chiropractors from forming professional corporations with physicians and podiatrists. As a result of these recent changes, chiropractors are now generally permitted to form professional corporations (PC) and professional limited liability companies (PLLC) with physicians and podiatrists without violating Michigan’s Corporate Practice of Medicine laws.

Corporate Practice of Medicine

In general, Corporate Practice of Medicine occurs when a corporate entity practices medicine, as opposed to an individual licensed practitioner. In this arrangement, the corporate entity employs physicians, and the physician provides the medical services. Since corporate entities generally exercise some level of control over how their employees perform their roles and many states believe that medical decision making should solely be done by physicians and not be influenced by non-physician employers, many states prohibit or regulate the corporate practice of medicine.

While states vary as to the degree in which they restrict the Corporate Practice of Medicine, these prohibitions are often rooted in the “learned profession doctrine.”  The “learned profession doctrine,” as outlined by in a [Read More]

By BILLEE WARD, ESQ.

As the year 2020 began, it would have been difficult for most Americans to imagine how life as we knew it at that time would change in the coming months and years. You likely recall generally, if not specifically, that on January 31, 2020, the Secretary of the U.S. Department of Health and Human Services (HHS) declared the novel coronavirus (COVID-19) a Public Health Emergency (PHE) under Section 319 of the Public Health Services Act. Approximately six weeks later, by Proclamation 9994 on March 13, 2020, Former President Trump declared a National Emergency (NE) concerning COVID-19. These actions set the stage for a variety of measures being taken at various levels of state and federal government to address the emergency circumstances that existed at that time. Such measures included new policies, emergency pathways, waivers, and other measures providing for flexibility in relation to health and other benefits, access to care and treatment, development and availability of COVID-19 countermeasures, enforcement of fraud and abuse and other laws, and the list goes on and on.

After having been extended, the PHE and NE are currently set to expire on March 1, 2023 and April 11, 2023, respectively. Acknowledging that we are at a very different [Read More]

Court Says Muskegon Co. Can’t Recoup $12.2M Medicaid Funding Deficit From State

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

Muskegon County and its mental health provider, HealthWest, cannot recoup a $12.2 million deficit from the state for Medicaid-funded services provided in 2018 and 2019, an appeal panel ruled.

In a unanimous opinion from Court of Appeals Judge Christopher Yates, the three-judge panel agreed with the Michigan Department of Health and Human Services’ analysis that it bore no responsibility to pay HealthWest, who had to seek payment from its prepaid inpatient health plan, Lakeshore Regional Entity.

“The State of Michigan and the DHHS channeled Medicaid funds at the same level to PIHPs in spite of their concerns about LRE, but LRE failed to compensate HealthWest for its Medicaid-funded services at the traditional rates and pace,” the published opinion reads. “Thus, plaintiffs have failed to show that they were the victims of any constitutional violation committed by either the State of Michigan or the DHHS.”

Judges Kathleen Jansen and James Robert Redford concurred.

Muskegon County filed its suit in the Court of Claims in March 2020, alleging LRE “failed to pay” because the state had “failed to provide sufficient and timely funding to Lakeshore” as statutorily mandated. The suit alleged that underfunding could be traced to a contract issue [Read More]

A Rep. Samantha Steckloff (D-Farmington Hills) bill providing parity for cancer patients who take treatments orally at home was introduced in the House on early this month.

Currently, chemotherapy received intravenously at a hospital or clinic is covered by insurance, and is cheaper because it’s billed as a service. Oral chemotherapies, however, are only covered if an IV form is not available, and they have a more expensive out-of-pocket cost because they’re billed as a drug.

Steckloff said the types of chemotherapy available in both forms are “staggering”, leading Michiganders who want to take treatments orally to pay completely out-of-pocket.

Her own oral chemotherapy medication is only covered because there isn’t an IV alternative available, but Steckloff said the ability to take an oral drug has allowed her to live a higher quality of life and continue working as a legislator.

She explained the process of traveling to a clinic for chemotherapy, which can take all day long, every few weeks. You have to take a day off work to receive the therapy and a day after to recover, she said, and it feels like you’re “constantly battling a diagnosis you can’t seem to get out from underneath.”

Approximately 640,000 Michiganders have used chemotherapy, Steckloff said.

Providing an oral version of the same [Read More]