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On September 30, 2020, the Michigan Senate voted to pass Surprise Billing legislation (House Bills  445944604990, and 4991). These bills were concurred by the House of Representatives last week. The MCEP Executive Committee delivered a letter of concern and opposition to the Governor and asked if she chose to sign this legislation, that the Department of Insurance and Financial Services (DIFS) be asked to monitor these changes for any adverse impact on physicians in Michigan. We opposed these original bills because they did not hold our patients harmless from unanticipated out-of-network bills, did not provide an avenue for the physicians to negotiate in good faith, did not create a practical dispute resolution process, or support the use of a fair and sustainable payment standard.

After discussion and questions from the Governor, the request to have DIFS monitor these changes was granted, and the Governor signed the bills yesterday afternoon.

When the bills were introduced in 2019, they banned balance billing and forced physicians and other health care providers to accept payment equal to 125% of Medicare. As a result of your advocacy efforts, these bills include a fairer fee schedule (150 percent of Medicare or the median in-network rate, whichever is greater), and the patient is removed from the middle and out-of-network providers receive direct payments from the patient’s insurer.

The MCEP Executive Committee would like to thank all the members who emailed, called, or texted their representatives.
We have been assured that we will meet with DIFS and be included in their monitoring process in 2021.

2019


MCEP leadership was on the Hill in October to represent you at the House Committee for the Health Policy Hearing. Because there was so much testimony before the Committee, we expect to be heard in fight against legislators deciding what your reimbursement should be on October 31st. A substitute bill, raising the cap from 125% to 150% of Medicare, was accepted for consideration. Please call your legislators in the House and educate them on why they should oppose House Bill 4459 as substituted.

This newly substituted bill attempts to address surprise billing by capping all out-of-network reimbursement at the average in-network rate for the  insurer or 150% of local Medicare rates, whichever is greater. This proposed substituted bill:

  1. Does not solve the problem, which instead lies with the insurance industry, ever-increasing out-of-pocket costs, and high deductible plans;
  2. Would create a significant financial burden for many emergency departments, particularly rural ones;
  3. Ultimately limit access to care; and
  4. Effectively eliminate any contract negotiating power that physicians and emergency medicine provider groups have.

This is a critical issue. Call your House Representative today.  Thank you!

Find Your Legislator Here

House Bill Number 4459

House Bill Number 4460

Health Policy Committee Members

Emergency Department Assaults – MCEP is helping push SB 33, sponsored by Senator Ken Horn of Saginaw, which makes assaulting health care professionals in the emergency department a felony punishable by up to 15 years and a major fine for injuries causing severe bodily harm to those professionals trying to fulfill their duties.  There are several other increased penalties in the bill but the main deterrent is the ability for prosecutors to pursue felony charges against individuals assaulting health care professionals.  The bill is currently on the Senate floor and MCEP is pushing for passage this spring.

Opioid Crisis – MCEP has been monitoring and following legislative proposals pertaining to the epidemic griping our state in recent years.  MCEP was invited to testify at the House Health Policy Committee on Wednesday, April 19, 2017.  This day coincided with the College’s Leadership Development Program Day in Lansing event.  There were eight cohorts of the LDP class in attendance for the day and they got to witness first hand Dr. Rami Khoury, Dr. Jake Manteuffel, and Dr. Melissa Barton speaking before the committee.

Dr. Khoury led the discussion by introducing the College to the legislature and talking about the history of emergency medicine in the state.  He spent thirty minutes walking through the College’s feelings on various opioid proposals and the MAPS system.  He talked about the potential unintended consequences of mandating all physicians to check MAPS and warned of the potential of driving more patients to the ED setting.  A link to Dr. Khoury’s presentation is on the homepage of MCEP website (www.mcep.org) and I would suggest all MCEP members use the powerpoint when talking to your state representative or state senator.

Please feel free to reach out to Dr. Rami Khoury, Chair of MCEP’s Legislative Committee, or Bret Marr with any questions you may have on state legislative or regulatory issues.