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Michigan Healthcare Reform Update


Email Alert

January 4, 2010

By Cami Pendell*


Update on the Speaker's Public Employee Healthcare Reform Package

The Speaker of the House has introduced additional bills to accompany House Bill (HB) 5345, which is the main bill to create the public pooling plan. These bills (HBs 5688-5697) would require the newly proposed public employee health benefit system to harmonize with the various existing public employee healthcare retirement and healthcare systems.

In addition to the bill introductions, the Chair of the House Public Employee Healthcare Reform Committee recently created workgroups on the following topic areas: (1) administrative cost efficiencies;
(2) prescription drug purchasing; (3) plan elements and opt-out; and
(4) retiree plans. The intent was to have each workgroup examine their issue area and provide a report back to the committee by December 31, 2009.

In one final action before the holiday break, and in an effort to obtain more information on the cost of public health plans, the committee reported out HB 5671 . This bill requires public employers to file information on the health benefits it provides to employees with the Department of Management of Budget (DMB). The DMB then has forty-five days to compile the information and present it to the legislature. This bill is currently on the House floor awaiting passage.

OFIR Begins Hearing on Blue Care Network Purchase of Physicians Health Plan

The Office of Financial and Insurance Regulation held a public hearing on whether Blue Care Network (BCN) should be allowed to acquire the Physicians Health Plan of Mid-Michigan (PHP). Blue Care Network is a wholly owned health maintenance organization (HMO) subsidiary of Blue Cross Blue Shield of Michigan (BCBSM), and the Physicians Health Plan of Mid-Michigan is a HMO that is currently owned by the Sparrow Health System. During the hearing, the Michigan Association of Health Plans shared its concerns that if the purchase is allowed to proceed, it would result in a significant decrease of competition in mid-Michigan and effectively give Blue Cross a regional monopoly. Blue Care Network responded that there would be competition in the area and that because it is a subsidiary of BCBSM, the parent company is actually one of its competitors. They also added that they would purchase PHP out of their own funds. The Insurance Commissioner is now reviewing BCN's purchase application and will issue a decision in the near future.

Scope of Practice Expansion for Chiropractors

The legislature passed a bipartisan and bicameral package of bills to expand the scope of practice for chiropractors licensed in the state of Michigan. This package is made up of Senate Bills (SBs) 968, 970, 971, 972, 973, and HBs 5091 and 5105 . SB 968 amends the Public Health Code by changing the definition of "practice of chiropractic" to include the diagnosis of human conditions and disorders of the human musculoskeletal and nervous systems as they relate to subluxations, misalignments, and joint dysfunctions. It continues on to further explain these various terms and concepts. The definition also contains a list of practices that are not considered to be part of the practice of chiropractic, including procedures that cut or puncture the skin, dispending or prescribing medicine, certain uses of x-rays, treating fractures or dislocation, and various invasive procedures unless allowed by promulgated rules and are limited to the ears, nose, and throat. HB 5091 amends the Public Health Code to allow for certain rule promulgations, establish certain educational requirements, and modify license renewal standards. SBs 970-973 and HB 5105 amend various statutes that pertain to reimbursement or coverage for chiropractic services.

Under the new legislation, coverage or reimbursement for these services is required if the service is included in the definition of "practice of chiropractic" in the Public Health code as of January 1, 2009. Opponents of this expansion of coverage have argued that it would increase the cost of healthcare due to increased utilization of imagining technology.

The SBs were presented to Governor Jennifer Granholm on December 28, 2009; however, the two HBs have not yet been transmitted to Granholm. She is likely to sign the bills once all of them arrive on her desk.

Upcoming Schedule of the Michigan Legislature

The legislature convened on December 30, 2009, to adjourn Sine Die , as required by the Michigan Constitution. The legislature remains on break until the second Wednesday in January when it is required by the Michigan Constitution to reconvene. Just two days prior to that date, the January Revenue Estimating Conference is scheduled to occur. This will allow legislators to know what fiscal situation they will face for the upcoming year. At this point in time, the budget deficit is expected to be nearly $1.8 billon. Other events that will take place in the upcoming new year include Granholm's State of the State address, which has not been officially scheduled but normally occurs at the end of January or the beginning of February. Shortly after that address, Granholm will present her budget to the legislature.

*We would like to thank Cami M. Pendell, JD (BL Government Affairs LLC, Lansing, MI), for providing this email alert.

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