Supreme Court Justices & Lt. Governor Urge Physicians Support of ‘Pivotal’ Elections GME Slots, Licensing & Technology Drive Board Discussion

The MSMS Board of Directors met on March 14 in East Lansing to drive MSMS Future of Medicine (FOM) strategic objectives forward. Following are highlights:

2012 Supreme Court Race – Michigan Lt. Governor Brian Calley joined incumbent Supreme Court Justices Steven Markman and Brian Zahra to stress the importance of the upcoming elections and urge Board members—and their colleagues—to participate in the grassroots political process by supporting the re-election of Justices Markman and Zahra in what is expected to be a “critically important” race, according to Lt. Gov. Calley. The make-up of the high court can (and has) greatly impacted Michigan’s tort reform laws, which continue to face challenges. Under the current court majority of rule of law justices like Justices Markman and Zahra, who strictly follow what the law is instead of what the law should do, tort reform laws have fared well. However, under the activist majority that took over last year, the laws were weakened.

“This election is extremely pivotal. For 26 years, the court didn’t have an incumbent lose until 2008. This has happened two election cycles in a row,” explained Justice Zahra. “There needs to be education of physicians about the importance of this race and of their participation.”

For more information about grassroots political action, contact Joshua Richmond at 517-336-5788 or jrichmond@msms.org. Also, visit www.mdpac.org.

GME Slots The Board voted to recommend to the 2012 MSMS House of Delegates not to adopt Resolution 87-11, “State Funding for GME Slots for Resident Physicians Committed to Staying in Michigan.” The resolved portion of the resolution asks “that the Michigan Department of Community Health fund GME slots for physicians committed to staying in Michigan to alleviate the physician shortage.” The Board is interested in finding ways to better recruit physicians and get physicians to locate in underserved areas, but believes that offsetting medical student debt was a preferred route as opposed to using GME as the vehicle for incentivizing physicians to locate in Michigan. The Board offered feedback and encouraged the author to resubmit an alternative proposal to the House of Delegates next month.

As legislators debate the state budget, MSMS is fighting the governor’s proposed $40 million cut to GME funding from the Medicaid budget for FY 2012 that was carried forward into 2013. Last year, MSMS advocacy efforts were successful in restoring the majority of that cut to the FY 2012 budget.

Lay Midwife Licensure – The Board voted to oppose House Bill 5070, which would create a new class of licensure for lay midwives (not Certified Nurse Midwives). This legislation seeks to provide midwives with a new classification of licensure by the state with title protections and a scope of practice that would be limited although very similar to that of a Certified Nurse Midwife. MSMS believes this is too risky for patients, who could easily be misled about midwife qualifications.

For more information about legislative advocacy issues, contact Colin Ford at 517-336-5737 or cford@msms.org. Also, visit www.msms.org/advocacy.

MiHIN, Health Insurance Exchanges – The Board heard an update about the Michigan Health Information Network (MiHIN) and Michigan’s sub-state health information exchanges (HIEs). Tim Pletcher, MiHIN Executive Director, indicated that initial HIE data services will be security and messaging services, which will allow secure transaction-based routing among HIEs, and establishing a health provider directory that will provide an entity and individual level identification. In addition, MiHIN is focusing on two general use cases: electronic public health reporting by pushing immunization records into the Michigan Care Improvement Registry and reportable labs into the Michigan Disease Surveillance System and pushing of structured data (lab results and care summaries).

Michigan currently has six sub-state HIEs. Carol Parker, Executive Director of the Great Lakes Health Information Exchange, explained that a fully functioning sub-state HIE makes clinical data available to physicians. The goal is to provide benefits such as efficiencies in workflow through reduced time spent looking for information or tracking down faxed reports; improved care coordination by sharing patient medical data like labs, radiology services, immunizations and medications; and, positive fiscal impact through reductions in duplicative testing, more efficient use of staff time, and more success in achieving various payer performance incentives. Ms. Parker noted that each of the sub-state HIEs have a slightly different business model. Several are geographically based, while at least two have expanded state-wide. It was noted by Mr. Pletcher that Michigan has made a significant investment in HIE as evidenced by the participation of 61 hospitals and more than 4,400 providers with at least one of the sub-state HIEs.

Computerized Athletic Form - Finally, the Board voted to recommend the adoption of the Resolution 10-11 by the 2012 House of Delegates. Resolution 10-11 asks that MSMS work with the Michigan Department of Community Health to develop a computerized version of the Michigan High School Athletic Association health form that can be used by standard word processing programs or be interfaced with common EMR programs. One of the key functionalities needed in an electronic version of the form is the ability to save the form in a way that it can populate automatically as needed.

For more information about HIT issues, contact Stacey Hettiger at 517-336-5766 or shettiger@msms.org. Also, visit www.msms.org/hit.

Tramadol As a Scheduled Substance – The Board voted to recommend that the 2012 House of Delegates adopt as amended Resolution 65-11 “Move Tramadol to Schedule 2 Drug Designation.” Tramadol is not currently a drug scheduled by the DEA. In lieu of addressing the classification of Tramadol on a state level, the Board believes that this investigation should be addressed federally, due to the variability among states in its classification, in an effort to avoid duplicating resources. Therefore, the resolved portion of the measure was amended to read: “that the Michigan Delegation to the AMA ask the AMA to support efforts to study and potentially reclassify Tramadol as a scheduled substance.”

For more information, contact Brenda Marenich at 517-336-7580 or bmarenich@msms.org.

Legal Counsel Report – MSMS Legal Counsel Daniel J. Schulte, JD, of Kerr Russell, updated the Board about several pending cases of interest, including Myriam Velez v. Martin Tuma, MD, involving the Non-economic Damages Cap, and Rodney Hanna v. Dario Merlos, DDS, involving the “serendipitous” filing of an Affidavit of Merit. MSMS has filed amicus briefs on behalf of the plaintiffs in both cases. Read the complete report at www.msms.org/reports.

For more information about MSMS leadership, contact MSMS Executive Director Julie L. Novak at 517-336-5735 or jnovak@msms.org.