MSMS Efforts on the Primary Care Uplifts for Medicaid > Michigan State Medical Society

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MSMS Efforts on the Primary Care Uplifts for Medicaid

Due to the efforts of MSMS, the challenges of administering the primary care uplift in Medicaid were elevated within the Michigan Department of Community Health. There have been many questions regarding the accuracy of payments made through the managed care plans, and the timing of such payments. As a result, MSMS submitted a Freedom of Information Act request that provided the amount of funds MDCH distributed to the health plans and the amount of funds the health plans had distributed to physicians.

The MSMS Board of Directors discussed this issue in detail on October 22. MSMS discovered that the increases in payments to primary care physicians were held up by a number of issues including system issues that delayed payments as well as missing data from Medicaid health plans. Medicaid officials have met with health plan representatives and are committed to working with the plans to prioritize resolution of communication, data, and logistical problems, according to a report to the Board.

"This wouldn't have happened without the efforts of MSMS,” said MSMS President James D. Grant, MD. "Freeing up this money for those members to whom it is owed is a tangible benefit of MSMS membership. It also benefits non-members who are not paying MSMS dues. We need all Michigan physicians to join MSMS so we can do even more advocacy like this in the future.”

Other highlights from the MSMS Board meeting include:

  • continuing MSMS efforts to educate physicians and patients about end-of-life care issues and the need for a durable power of attorney for health care. Patient Advocate forms are available through MSMS. The annual Conference on Bioethics on Nov.7-8 in Ann Arbor will focus on end-of-life care issues.
     
  • initiating a pilot membership program that will allow individual members of physician organizations that have engaged in a service agreement with MSMS to get a five percent discount on MSMS dues.
     
  • supporting Senate Bill 1033 that would assure that a set of Direct Primary Care services offered by a physician are not improperly characterized as insurance. While the pros and cons of offering prepaid DPC services were discussed at length, the Board agreed that the scope of SB 1033 is only to clarify that this innovation is not insurance and, therefore, removed from various burdensome regulatory hurdles.
 

 

Posted in: Medicaid, Board of Directors News

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