Be Heard Urgent: Tell Congress to pass H.R. 879 ! As you know, late last year Congressional inaction led to another round of physician payment cuts, this time to the tune of 2.83% that went into effect on January 1, 2025, marking the fifth consecutive year that Medicare physician payment has been cut. Kicking the can down the road has long been a favorite tactic of Congress, but the end of that road is fast approaching – the current government funding package is set to expire on March 14 and this may be the last, best opportunity to include much needed payment relief to help stabilize physician practices and ensure access to high quality care their patients deserve. Urgent action needed – please join the thousands of physicians from across the country who have already taken action by contacting your members of Congress today and urging them to include the "Medicare Patient Access and Practice Stabilization Act" (H.R. 879) in the next spending package! Last month, Reps. Greg Murphy, MD (R-NC) and Jimmy Panetta (D-CA), along with a bipartisan group of legislators, re-introduced the "Medicare Patient Access and Practice Stabilization Act" (H.R. 879). This legislation, if passed, would, effective April 1st, prospectively cancel the 2.83% payment cut that went into effect on January 1, while also providing a 2.0% payment update, helping to stabilize physician practices and protect patients' access to care. Momentum is building – H.R. 879 already has over 100 bipartisan cosponsors and the Congressional Doc Caucus recently announced its endorsement of the bill. Everyone, including Congress, agrees that the Medicare physician payment model is hopelessly broken, and these yearly cuts are having a negative impact on physician practices while leaving patients' access to care at risk. It's time they finally do something about it! The clock is ticking – please contact your members of Congress today and urge them to support including H.R. 879 in the next spending package before it's too late! America's patients are counting on Congress to provide this much needed relief and work toward achieving long-term Medicare physician payment reform. |
Michigan MGMA State Chapter Legislative Update
Prepared By: Sandra Holdorf, Michigan MGMA State Chapter Legislative Liaison
Date: February 10, 2025
1. 2024 Legislative Updates
• New Legislation: Laws or policies passed in 2024 that impact medical group
management.
o House Bill 4608 – Licensure of dietitian nutritionist.
▪ An individual that engages in the practice of medical nutrition
therapy must be licensed under this Act.
o Senate Bill 27 – Equitable coverage for mental health and substance
disorder treatment.
▪ Coverage cannot be more restrictive than any other
medical/surgical benefits.
▪ There must be no separate cumulative financial requirement
o House Bills 4579 and 4580 – Telemedicine coverage
▪ The insurer shall provide the same coverage for the service as if
the service was face-to-face.
o House Bill 4131 – Telemedicine
▪ An insurer shall not require a healthcare professional to provide
telemedicine unless their services are contractually required per the
terms of the contract.
o House Bill 4580 – Telehealth reimbursement
▪ Telehealth services provided under the medical assistance program
shall provide the same coverage as face-to-face service.
o Senate Bills 449 and 450 – Complex Rehabilitation
▪ DME that is individually configured for an individual
▪ Designated HCPCS codes
▪ Maintain adequate payment policies
o Senate Bill 482 – Medical Waste
▪ Amends Public Health Code to require medical facilities to store
sharps in a sharps container for up to 18 months or until the
container is 75% full.
o Senate Bills 790 and 791 – Home Help Program caregivers
▪ Created the home help caregiver council
• Regulatory Changes: Updates to existing regulations or new compliance requirements.
o Senate Bill 249 – Amends the Public Act Code to change the examination
requirements for a person to be licensed as a paramedic.
o House Bill 4101 – Amends the Public Act Code to extend from 12 months
to 24 months for a temporary license for speech-language pathologists.
o House Bill 4613 – Extends temporary license for medical first responders
to one year.
2. Legislation Effective January 1, 2025
o House Bill 5435 – Contraception
▪ Insurer must provide coverage for path, self-administered
contraception, and vaginal ring. Effective date 04.02.25
o House Bill 5436 – Contraception
▪ Allows a pharmacist to issue a prescription for and dispense
hormonal contraception. Effective date 04.02.25
o House Bill 5166 – The Department to maintain a perinatal quality
collaborative. Effective date 04.02.25
o House Bill 5167 – Blood pressure monitor coverage under medical
assistance during pregnancy and postpartum period.
o House Bill 5169 and 5170 – Mental health screening
▪ A health professional shall offer the mental health screening to an
individual who has given birth at a follow-up appointment or well-
child visit during the postpartum period.
▪ Insurers must provide coverage for mental health screening.
Effective date 04.02.25
o House Bill 5172 - Establish a program to register levels for perinatal
facilities. Effective 04.02.25
o House Bill 5173 – Informational document on insurance enrollment
▪ The Department of Insurance and Financial Services shall develop
a form for hospitals to provide guardians when a live child who is
not covered under insurance is born. Effective 04.02.25
o House Bill 5636 – Freestanding Birthing Centers to be licensed. Effective
04.02.25
o House Bill 6046 – Community Violence services. Effective 10.01.25
3. What to Watch for 2025
• New or Pending Legislation: Bills under consideration or policies expected to roll out later in 2025.
o Senate Bill 279 – Nurse Practitioner; Modify Schedule II-V Controlled
Substances.
▪ Allow controlled substance license to NP
▪ Allow prescribing for Schedule 11-V controlled substances without
delegation
▪ NP could supervise RN, LPN, and other health professionals.
o Senate Bill 44 – Medical Students Performing Invasive Bodily Exams.
Invasive bodily exam: Pelvic, vaginal, rectal, prostate
▪ Prohibits on unconscious patient or anesthetized patient.
o Senate Bill 28 – Restrain and Seclusion
▪ Reserved for immediate physical safety.
▪ Discontinued at the earliest possible time.
▪ Cannot be a standing order or on an as-needed basis
▪ Only used when less restrictive means are determined to be
ineffective.
o House Bill 5620 – Employees Wage Sharing
▪ Employers cannot seek information on past wages, benefits, credit
score, or credit history
▪ Job description required
▪ Civil penalties for violating law $500-$25,000
o House Bill 5616 – Patient Eye Drops
▪ Unused eye drops must be offered to the patient post-procedure.
o House Bill 5526 – Reviewing Patient’s Driver’s License
▪ Patient can decide whether or not to allow a copy or scan
▪ Care cannot be refused.
o House Bill 1130 – Pediatric
▪ Patient liability restrictions
▪ Prior authorization is subject to urgent standard
▪ Appeal guidelines
o Senate Bill 1128- Group Prenatal Care Services
▪ Visits provided in a group setting
▪ Evidence-based model that includes health assessments, social
and clinical support, and educational activities in a family-centered
environment.
o Senate Bills 774 and 775 – Hair Prosthesis (Cranial hair prosthesis for patients 19 years and under).
▪ Cranial hair loss due to a medical condition or treatment for a
medical condition.
▪ Coverage is not subject to dollar limits, deductibles, and
coinsurance provisions.
o Senate Bill 685 – Pharmacy 90-Day Supply
▪ Covered maintenance prescription drugs.
o House Bill 6154 – Brain Injury
▪ Must provide coverage for acquired brain injury
▪ Not impose any lifetime limitation or unreasonable annual limitation.
o Senate Bill 530 – PIP Reimbursement
▪ 250% reimbursement of the amount payable under Medicare.
o Senate Bills 1182 and 952 – Treatment of infertility
▪ Must include fertility diagnostic care, fertility treatment, standard
fertility preservation services, four complete oocyte retrievals, and
medical costs related to embryo transfer.
o Senate Bill 1088 – Prompt Pay Interest Rate
▪ 1-30 Days Late – 1.5% per month
▪ 31-90 Days Late – 2% per month
▪ >90 Days Late – 4% per month
▪ Clean Claim – Paid within 30 days of receipt.
o Senate Bill 988 – IUDs Immediate Postpartum
▪ Must provide coverage
o Senate Bill 833 – Inpatient Psych Coverage
▪ Cannot limit coverage based on duration of time
o Senate Bill 3 – Cost and Affordability for Certain Drugs
▪ Create a prescription drug pricing board and prescription drug
affordability stakeholder council
▪ Establish upper payment limits for certain prescription drug
products.
o Senate Bill 915 – Mental Health Code
▪ If the psychiatrist certifies that the patient requires outpatient
treatment, the referral must be made to community mental health.
▪ A second order of hospitalization must not exceed 90 days.
▪ A second order of assisted outpatient treatment must not exceed 1
year.
o Senate Bill 103 – Psychologist supervision
▪ Required supervision by a psychologist who has a license other than a limited license.
o Senate Bill 105 – Dental insurers reimbursement
▪ Must offer a method of payment that does not require the dental
provider to incur a fee to access reimbursement.
o Senate Bill 107 – Insurer to cover services by pharmacist
▪ Certain laboratory tests ordered by the pharmacist
▪ Immunizations
4. Resources and Next Steps
• State government or regulatory agency websites.