Our issues, actions, and outcomes.
Teaching Health Center Graduate Medical Education Program (THCGME)
Issue: the teaching Health Center Graduate Medical Education Program needed re-authorization by US Congress. The THCGME program began in 2011 to train primary care residents in community-based health care settings. The THCGME program is vital to filling our nation’s primary care gaps in rural and underserved communities by training resident physicians in primary care fields – family medicine, internal medicine, OB/GYN, pediatrics, and dentistry.
Action: MPCC sent this letter to Representative Mike Bishop and Senators Gary Peters and Debbie Stabenow.
Outcome: On September 28, 2017 the THCGME was was extended for three months. The short-term extension was included in H.R. 3823, the Disaster Tax Relief and Airport and Airway Extension Act of 2017.
Michigan Physician Orders for Scope of Treatment (MI-POST) Bill Package
Issue: Michigan Physician Orders for Scope of Treatment (MI-POST) bill package scheduled reviewed on June 7, 2017 by the Michigan House of Representatives. MI-POST is an important component of caring for the whole person because the POST form requires shared decision-making between the health care professional signing the form and the patient, or his/her legally authorized health care representative. MI-POST represents an opportunity for seriously ill patients and their loved ones to make sure their conversations are recorded and communicated at the right time to the right individuals.
Action: MPCC sent this letter to Representative Hank Vaupel, Chair, Health Policy Committee.
Outcome: The bills were passed by the Michigan House of Representatives and Senate, and signed by Governor Snyder on November 8th. The measures are now Public Acts 154-157 of 2017. The Department of Health and Human Services will now establish a committee to determine the content of the POST form, rules and a follow up committee.
Michigan State University College of Human Medicine Family Medicine Exposure in Curriculum
Issue: Michigan State University College of Human Medicine was considering a proposal to reduce students’ exposure to family medicine during the third hear from eight weeks down to four weeks. Given the looming shortages in family medicine physicians, reducing the visibility of family medicine could negatively impact vulnerable populations and limit access to care.
Action: MPCC sent this letter to Norman J. Beauchamp, Jr. MD, MHS, Dean, College of Human Medicine, Michigan State University.
Outcome: Norman J. Beauchamp, Jr. MD, MHS, Dean, College of Human Medicine, Michigan State University sent this letter in response, and invited MPCC to meet with Senior Associate Dean Sousa.
Health Plans & Different PCMH Payments
Issue: The decision by some Medicaid Health Plans to financially reward practices at different levels based on Patient-Centered Medical Home designation impacts between 10,000 and 15,000 physicians in Michigan and forces practices to make a redundant misallocation of resources. Click here for more background.
Action: MPCC helped members meet with the Michigan Department of Health and Human Services on September 29, 2016 to discuss the decision by some health plans.
Outcome: United Health Plan decided to drop the NCQA-only requirement from their Patient-Centered Medical Home designation rewards. Meridian Health Plan increased the Physician Group Incentive Program Patient-Centered Medical Home designation payment from $0.25 per member per month to $1.50 per member per month.
W.W. Knight Family Medicine Residency Program Closure
Issue: ProMedica decided to close this family medicine residency program at Toledo Hospital at a time when not enough primary care clinicians are being trained to replace those that are retiring.
Action: MPCC sent this letter to Randy Oostra, ProMedica's President and CEO.
Outcome: This residency program moved to another hospital.
Michigan Medicaid Pharmacy Plan Reimbursement Changes
Issue: The proposed change requires that MTM service providers be affiliated with the billing NPI of a pharmacy, Federally Qualified Health Center (FQHC), Tribal Health Center (THC), or Rural Health Clinic (RHC) in order to get reimbursed for these services. Our interpretation is this policy precludes clinical pharmacists affiliated with a physician organization or ambulatory care clinic from being reimbursed for MTM services.
Action: MPCC sent this letter to Christ Priest, Director and Rita Subhedar, Policy Specialist of the MDHHS Bureau of Medicaid Care Management & Quality Assurance.
Outcome: At this time they have not changed their policy that requires pharmacists to affiliate with a pharmacy, FQHC, THC or RHC in the MTM provider enrollment process. However, they are taking our comments into consideration and are discussing them internally.