One of the greatest advantages of participating in national physician advocacy is the opportunity to learn directly from colleagues experiencing many of the same challenges we face in Michigan. Recently, Kate Dorsey, MSMS Director of Government Relations, attended the American Medical Association (AMA) 2026 State Advocacy Roundtable. The meeting brought together advocacy leaders from specialty and state medical societies across the country to discuss legislative trends, successful strategies and emerging threats to physicians and patients. The value of the meeting to MSMS is not simply hearing what other states are doing, but in identifying ideas and strategies that could be adapted to our work in Michigan.
Payer Reform: Addressing Retroactive Clawbacks
Payer reform was a major focus of the roundtable, including growing efforts to address downcoding and retroactive payment clawbacks. Physicians in states across the country are confronting situations in which insurers seek to recoup payments long after care has been provided, sometimes based on changes in coding, payment policies or interpretations of contractual requirements.
Hearing how other state medical societies are addressing these practices provided valuable insight into potential legislative and regulatory approaches for Michigan. These conversations also reinforced the importance of developing reforms that provide physicians with transparency, due process and meaningful opportunities to challenge retroactive payment decisions.
Michigan’s advocacy environment makes this work particularly demanding. Michigan is one of only a handful of states with a full-time legislature, meaning lawmakers are in session—and issues can move—throughout much of the year. For MSMS, that makes advocacy a relentless, year-round effort. Learning from states that have already tackled emerging payer practices can help us move more quickly and strategically when similar issues arise here.
Medical Liability: Preparing for What Comes Next
Medical liability was another particularly important discussion. States across the country are examining ways to stabilize liability systems, address rising costs and protect access to care. The AMA’s work in states such as New Mexico demonstrates that significant liability reforms remain possible when physician organizations build effective coalitions and develop a strong legislative strategy.
The issue is especially important for Michigan as we look toward the November election. If Democrats regain control of the Michigan House while retaining control of the Senate and Governor’s office, Michigan would once again have unified Democratic control of state government. That would likely create a much more favorable environment for trial attorneys seeking significant changes to Michigan’s medical liability laws—similar to efforts pursued during the 2024 lame-duck session.
The lesson from the AMA roundtable was clear: we cannot wait until legislation is introduced to begin preparing. Understanding what other states have experienced, what strategies have succeeded and where efforts have fallen short gives MSMS a head start in protecting Michigan physicians and their patients.
Ultimately, the roundtable reinforced why state-to-state collaboration matters. The challenges facing medicine may look different in each state, but physicians are often confronting the same underlying pressures. By learning from successful advocacy efforts across the country, MSMS can bring proven ideas back to Michigan and put them to work on behalf of our members.
For further information, please contact MSMS Director of Government Affairs, Kate Dorsey, at kdorsey@msms.org.