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MSMS Board Addresses Upcoming House of Delegates, Human Trafficking

Posted on March 23, 2017 12:02

Earlier this week, the Michigan State Medical Society (MSMS) Board of Directors met to address the upcoming House of Delegates, health care delivery, human trafficking and more. Below are some of the highlights:

  • 2017 House of Delegates: The 152nd meeting of the MSMS House of Delegates will continue a two-day format, beginning on Saturday, May 6. 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 Amway Grand Plaza in Grand Rapids. Delegates: Please visit www.MSMS.org/HOD and complete the form indicating your attendance.
     
  • Health Care Delivery: The Health Care Delivery committee discussed the Provider Directory, BCBSM New Precertification Program, BCBSM Quality Initiative on C-Section Rates and Economic Study for SNAF:
    • Provider Directory: CMS has mandated that health plans provide accurate information regarding physicians who are available to new patients/enrollees in their online and printed directories. Plans must communicate with physicians at least quarterly to verify the physician's location and availability. An BCBSM audit found their error rate was between 30-50 percent . This has led to efforts to correct the provider directory data to be compliant with the CMS mandate.
       
      BCBSM contracted with a vendor to collect physician information online. BCBSM has also developed an electronic file exchange with POs to submit their roster directly. Enforcement actions for physicians who are non-compliant will include suppression from the provider directory, suppression of applicable value-based reimbursement for PGIP physicians, and ultimately, termination from BCBSM and BCN networks if compliance issues are not resolved. MSMS is assisting in communicating this messaging through all MSMS communication vehicles. MSMS has also requested monthly updates from BCBSM to assist in monitoring compliance.
    • BCBSM New Precertification Program: BCBSM has three new precertification programs (or prior authorization) for radiation therapy, lumbar spine fusion, and interventional pain. MSMS continues to advocate that BCBSM's history of collaborative quality initiatives to improve quality is a better model than the more short-term and perhaps short-sighted utilization management program like pre¬ authorization. MSMS has facilitated several meetings between specialty societies and BCBSM to share similar concerns. After a temporary postponement of the lumbar fusion program, BCBSM allowed several practices with high quality and favorable outcomes data to opt-out of the program.
    • BCBSM Quality Initiative on C-Section Rates: BCBSM has indicated a strong interest in addressing (-section rates in the stat e. A meeting with representatives from MSMS, MHA, Ml-ACOG and BCBSM took place in January. All organizations concurred that the most appropriate and effective means of implementing a comprehensive, multidisciplinary approach to (-sections rates would be through a Coordinating Quality Initiative (CQI). BCBSM is considering the request.
    • Economic Study for SNAF: Through matching federal funds, Michigan Medicaid offers commercial reimbursement rates to providers affiliated with the six medical schools and Hurley Hospital. This program is referred to as the Specialty Network Access Fee (SNAF). MSMS is working with SNAF facilities to prepare advocacy resources to maintain this special financing. Through the federal managed care plan rules and any pending national health care reform, this funding mechanism is at risk. MSMS is acting as the fiduciary in contracting an economic assessment of the SNAF program. The intent is to gather data regarding access, financial impact, and community benefit to assist in messaging the importance of the program to legislators.
           
  • Human Trafficking: Dena Nazer, MD, Children's Hospital of Michigan and Associate Professor, Pediatrics, Wayne State University gave a presentation on human trafficking highlighting: 1) the types of avenues in human trafficking in Michigan and the United States; 2) how to identify warning signs and victims on human trafficking in the health care seeting; and 3) resources for reporting suspected victims of child and adult human trafficking. Doctor Nazer's "Human Trafficking Overview", an MSMS On-Demand webinar, is available at http://MSMS.org/OnDemandWebinars. This webinar does meet Michigan's new human trafficking one-time training requirement from the Michigan Department of Licensing and Regulatory Affairs.
     
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AMA
As part of CCB, and having become known in the HOD as a trusted and respected parliamentarian and advisor, he has been actively sought out by sections and delegations for his expertise and counsel, to ensure their concerns are met and can be adopted by the House. His commitment to open, fair and unbiased discussion and debate empowers colleagues wherever he leads, including in our House of Delegates.

ACEP
In addition to his commitments to MSMS, the AMA and CCB, Pino participates in the American College of Emergency Physicians (ACEP) Section Council. This allows him to stay informed about the latest issues facing their specialty and the broader medical landscape across the country. The council comprises representatives from all over the US, who bring unique perspectives and experiences to the table, and gain a better understanding of the challenges and opportunities facing emergency medicine in different regions, and work collaboratively to develop solutions and best practices. This also allows him to build relationships across the country, which are key to getting the House to “yes.”

MSMS
Dr. Colone has been an active member of the AMA since his first year of medical school. He served as Chair of the Medical Student Section, Resident and Fellows Section, and the Young Physician Section of the Michigan State Medical Society, as well as representing each of those sections as delegate from MSMS to the AMA. He has served on the Michigan Delegation to the AMA for almost 30 years, and on the MSMS Board of Directors for 11 years during that time. He is also a recipient of the AMA Foundation Leadership Award.

In addition to influencing the national debate, Dr. Colone served as president of his county and state medical societies during times of crisis. He led his county medical society during the Flint water crisis and MSMS during the COVID pandemic from 2021-2022, standing up to outside efforts by lay persons and legislators and standing by science for the safety and betterment of the public. During his presidency he led a coalition of 50 patient and health care organizations to achieve comprehensive prior authorization reform removing barriers and improving the health of all Michiganders.

President of MSMS: Pino took the helm of MSMS as President during a tumultuous time. The COVID pandemic was entering its second year. Effective and, more importantly, ineffective treatments, were becoming better known, better understood, as physicians were learning every day how to best save lives. He stood by science and resisted pressures and endorsed science based treatments based on what we’d learned, over unproven, and even dangerous, treatments.

Health Can’t Wait Initiative: Pino advanced the Health Can’t Wait Initiative as President of MSMS, a coalition of over 50 health-focused groups that saw the successful passage of comprehensive prior authorization reform into law.

Read more about the coalition here

Organizations involved in the coalition 

PA Reform Signed into Law

“Today is a wonderful day for Michigan patients who can now rest easy knowing insurance company prior authorization practices will no longer prove to be an impassable roadblock between them and the timely care and treatment they too often desperately need," said MSMS President Pino Colone, MD. “Speaking on behalf of providers, patient advocacy groups and patients across the state, I want to thank Governor Whitmer and Michigan’s lawmakers for recognizing the need for reform in this area and then working to craft and enact legislation that delivers. In signing SB 247, Governor Whitmer has ushered in a new era where transparency, clinical validity and fairness to patients will all be factored into the prior authorization process, protecting Michigan patients from costly and dangerous delays in access to health care. Officially signing this bill into law is a tremendous—and much needed—win for countless Michigan patients and the providers who serve them.”

Scope of Practice: He has testified on scope of practice helping legislators understand that nonphysician practitioners (NPPs) do not have the training or education to safely care for our families, and that medical school matters. (include the graphic from the article) and link the article: https://www.mha.org/newsroom/tag/pino-colone/

Pino spent six years as chair of the MSMS Task Force on Opioid Stewardship, advocating for naloxone to be available to residents of Michigan without a prescription, collaborating with colleagues and state officials, and disseminating timely and accurate information to MSMS members. In this role, he was pivotal in shaping MSMS’s strategic plan to reduce opioid-related overdose, eliminate stigma, and support harm reduction efforts by fighting to make naloxone available over the counter.

He was also a member of the MSMS Executive Task Force on Health Care Disparities. 

Genesee County Medical Society
Pino was also president of the GCMS during the water crisis of its largest city, Flint. He led efforts by the Society to disseminate accurate information about lead in drinking water and its effects on health. With the city and state in the national spotlight, Pino stood firm against pressure from government officials to endorse what would later prove to be flawed information, putting the expertise of his physician colleagues and the safety of local residents first.
Read more about Pino’s service as county medical society president below: 

§  November 2020 GCMS Bulletin 

§  December 2020 GCMS Bulletin

§  January 2020 GCMS Bulletin

§  February 2020 GCMS Bulletin

§  March 2020 GCMS Bulletin 

§  April 2020 GCMS Bulletin

§  May 2020 GCMS Bulletin

§  June 2020 GCMS Bulletin

§  July 2020 GCMS Bulletin

§  August 2020 GCMS Bulletin

§  September 2020 GCMS Bulletin

§  October 2020 GCMS Bulletin

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