Michigan Panels Take Up Maternal Mortality Reporting, Maintenance of Certification, and Prescription Drug and Opioid Abuse Legislation

Legislation brought before the Michigan House Health Policy Committee and the Senate Health Policy Committee on May 17 focused on several issues that MAFP has been closely monitoring in Lansing on behalf of members—requirements for reporting maternal deaths, changes to maintenance of certification, and prescription drug and opioid abuse.

Maternal Death Reporting Requirements

The House Health Policy Committee considered and passed legislation that would create a new requirement in the state for reporting maternal deaths. House Bill 4235, introduced by Representative George Darany (D-Dearborn), would require a physician, or any individual in charge of a health facility who was present for or aware of a maternal death, to submit to the Department of Health and Human Services information to be included in the Michigan Health Information Network Shared Services (MiHIN).

Whether the bill will see further consideration on the House floor is yet to be determined.

Maintenance of Certification

The House Health Policy Committee also heard extensive testimony from physician groups on a package of bills addressing maintenance of certification. House Bills (HB) 5090 and 5091 would prohibit the Michigan Department of Health and Human Services, and the Boards of Medicine and Osteopathic Medicine, from promulgating rules requiring a physician applying for licensure, or a licensed physician, to maintain national or regional certification that is not otherwise specifically required by the state. These bills would also prohibit a physician's hospital admitting privileges from being solely contingent on that physician maintaining national or regional certification, and they would further prohibit an insurer or health maintenance organization from requiring a physician to maintain certification as a condition of obtaining payment or reimbursement for an insurance claim.

HB 5090 and HB 5091 were introduced late last year by Representative Ed Canfield (R-Sebewaing), largely due to physicians’ continued frustration with the burdensome maintenance of certification process and the growing evidence suggesting the process does little to improve a physician’s ability to practice medicine. The MAFP Board of Directors communicated these frustrations to the American Board of Family Medicine in a letter sent earlier this year, highlighting the emergence of the bills as indicative of the growing skepticism and impatience with the process percolating within the physician community.

While the House Health Policy Commmittee heard much supporting testimony during the May 17th hearing, the opposition was also vocal. Blue Cross Blue Shield of Michigan and the Michigan Hospital Association were among the more prominent groups opposing the bill, requesting that lawmakers allow them to retain their flexibility in setting standards that their physicians must meet in order to practice in their facility.

MAFP was among the groups that registered a supporting position in committee. It is currently undetermined whether the bills will see further consideration and/or a vote in committee.

Prescription Drug and Opioid Abuse

Meanwhile, the Senate Health Policy Committee heard a presentation on May 17 from state officials regarding Michigan's prescription drug and opioid abuse epidemic. In what may be the first of consecutive weeks of testimony on the issue, Elizabeth Hertel of the Michigan Department of Health and Human Services (MDHHS) and Tom Clement from the Michigan Attorney General’s Office spoke about the Governor Task Force’s recommendations and some of the underlying issues that have inspired various pieces of proposed legislation.

Perhaps the most prominent issue discussed was the state’s prescription drug monitoring system—the Michigan Automated Prescription System (MAPS)—and the improvements that need to be made to support the desired increase in usage and functionality. The Governor’s proposed budget for fiscal year 2016-2017 includes $4.5 million to upgrade or replace MAPS, and much of the testimony before the Committee centered on what a new system would look like and whether the prescriber community had been and/or will be consulted as technological changes are considered. Although funding hasn’t been appropriated and the state is still in the process of identifying companies to administer the system, Mr. Clement testified that once decisions are made, it is anticipated that MAPS would be updated or replaced within six months.

It is estimated that only 30% of prescribers are currently consulting MAPS—a fact that has also sparked legislative action to expand access and usage among the prescriber community. Legislative proposals, such as making MAPS consultation a requirement for prescribers seeing new patients, are currently on the table and may see further consideration in the Senate Health Policy Committee in the coming weeks.