Earlier this week, the Michigan State Medical Society (MSMS) Board of Directors met to address the Flint water crisis, upcoming meetings and conferences, the upcoming House of Delegates, and more. Below are some of the highlights:

• 2016 House of Delegates: The 151st meeting of the MSMS House of Delegates will continue a two-day format, beginning on Saturday, April 30. Resolutions are due no later than 5:00 p.m. on March 1, 2016. Resolutions debated during the annual MSMS House of Delegates are the vehicles by which MSMS policies, priorities, and direction are determined. The Annual House of Delegates will convene at The Henry in Dearborn.
• Flint water crisis: The Partnership for Michigan's Health regarding the Flint water crisis issued the following statement: The first priority of Michigan's health systems, hospitals and physicians is the health of our communities. As the citizens of Flint find themselves in the midst of a crisis to ensure they have access to safe, clean water, the healthcare community stands ready to assist. The MHA, the MSMS, the MOA and their member healthcare providers across Michigan are reviewing the action steps put forth by the Snyder administration to determine how to best engage hospitals and physicians in a coordinated effort to guarantee Flint residents have access to the health-related services and education they need.
• Maintenance of Certification: MSMS has sought legislation to limit the ability of insurers and health systems to use Maintenance of Certification (MOC) as a criterion for participation. MOC has grown onerous for many physician specialties with very no evidence that such requirements benefit the patient. The time and costs associated with MOC have become increasingly burdensome largely because certifying boards know physicians need board certification to participate in a health plan. MOC should be voluntary based on the quality of the program and not because physicians are captive to their specialty board.
• End-of-Life Care: MSMS is offering a conference titled "Supporting End-of-Life Care" on Wednesday, March 16, at MSMS Headquarters. This conference will help practitioners overcome barriers and equip physicians with a core base of knowledge on discussing end-of-life care with their patients; palliative care; Michigan Orders for Scope of Treatment (MI-POST); advance care planning models; and ethical and legal challenges.
• Pain Management and Prescription Drugs: MSMS received an additional grant to hold two "ER/LA Opioid REMS: Opioid Prescribing: Safe Practice, Changing Lives" sessions. The first session planned in collaboration with the Saginaw County Medical Society and the Michigan Dental Association attracted nearly 100 attendees last week in Saginaw. A November session will be held in Novi in collaboration with the Beaumont Hospital-Farmington Hills, Botsford Campus.
• MSMS Membership: Active paid memberships and most other membership categories have increased over this time last year.
• Auto No-fault: Efforts to find a legislative package to reform the auto no-fault laws in Michigan continues to be a priority for the House and Senate. Thus far, the key issues appear to be creation of a fraud authority, reconfiguration of the Michigan Catastrophic Claims Association, and reforming how family provided attendant care costs are calculated. It is unclear at this time if fee schedule language will be added to the package. To date, legislation containing fee schedules has been unable to gain traction in the House.
• HCD: The Health Care Delivery Committee met with staff from the Department of Insurance and Financial Services (DIFS) to discuss its role and received an update on the Michigan Marketplace. Highlights from the presentation include:
  • DIFS regulates private health insurance including both group and individual coverage and insurance agencies.
  • They have many consumer resources that are free to physician offices. Content includes how to shop for coverage, how benefits can coordinate, how to use your health coverage, and glossary of health insurance terms.
  • DIFS staff is available to present on health literacy type topics to physician and consumer groups.
  • They do field consumer complaints and facilitate arbitration with payers. The most common submissions are cancelled coverage, misrepresentation of coverage, and rating issues.
  • DIFS oversees the Michigan clean claims process. Physicians may file a complaint against a payer for violating the clean claim law.
  • The number of products offered on the Marketplace has exploded in the last two years. IN 2014, there were 75 individual and 69 group products available. This year, there are 192 individual and 52 group products.
  • As of January 23, there were 327,674 enrolled. 85% of enrollees received tax subsidies. 68% selected silver plans, and 24% chose bronze plans.
  • The average rate increase was 6.5% in the individual market and 1% for the small group market.
  • Drivers of the rate changes include growth in expenditures like prescription drugs, unexpected composition of risk pool, change in provider networks.
  • Future issues may emerge based on the political landscape, evolving definition of preventative services, legislative changes, push for more benefits without rate increases and consumers lack of understanding of cost sharing and narrow networks.
  • New this year, the Marketplace now allows consumers to search for their physician and prescription drugs as they shop by product.
• Prescription Drug Abuse: The Governor's Prescription Drug Task Force has concluded meeting and has published several recommendations. This task force was convened in response to the growing number of prescription drug overdoses as well as an increased prevalence of heroin use. MSMS is supportive of efforts to improve the electronic prescription drug monitoring program in Michigan (MAPS) as well as increased access to the Naloxone to help patients at risk of overdose. MSMS will be engaging the governor to assure that policies are balanced in order to assure that appropriate access to pain treatments remain, while also recognizing that prescription drug overdoses are reaching epidemic levels.