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What are Ambulatory Surgery Centers?
Michigan ambulatory surgery centers, or ASCs, are facilities where surgeries that do not require hospital admission are performed. ASCs are not rural health clinics, urgent care centers, or physicians’ offices. ASCs treat only patients who have already seen a health care provider and selected surgery as the appropriate treatment for their condition.
Small Businesses in Your Community
Michigan ASCs are small entrepreneurial businesses that benefit Michigan communities by providing access to reasonably priced surgical care, but also by contributing to the local property and income tax bases and providing service and contributions to community charities. ASCs are family friendly employers that offer flexible work schedules, and good health and retirement benefits to their trained staffs. Michigan ASCs provide over 2,000 direct jobs in Michigan.
Ambulatory Surgery Centers are a Good Choice for Many Reasons
The high level of professionalism, quality and safety Michigan ASCs offer is an important reason patients and physicians choose ASCs for surgical procedures. Low infection rates, high satisfaction, and lower costs are among the reasons patients choose Michigan ASCs. ASCs typically cost less than hospitals for the same procedures, saving the patients a significant amount of money. Physicians choose Michigan ASCs because of the low infection rate, quick room turnover, high patient satisfaction, and efficient boarding and scheduling.
Ambulatory Surgery Centers are positive for the Michigan Economy
By providing high-quality health care and excellent service, Michigan ASCs save patients and insurers money. Medicare and its beneficiaries pay an average 54% more for a procedure performed in a hospital outpatient department than they would pay for the same procedure if performed in a Michigan ASC. Some procedures need to be done in the hospital, but many don’t. That’s why Michigan ASCs are positive for the Michigan economy – they provide a high quality, lower cost alternative for Michiganders.
On Monday, March 4th, 2019, the Metro Health OAM Surgery Center was toured by Michigan State Representatives Lynn Afendoulis (District 73) and James Lower (District 70). Also joining the tour were Dan Papineau, Director of Tax Policy and Regulatory Affairs with the Michigan Chamber of Commerce, Ryan Burtka, Michigan Ambulatory Surgery Center Association (MASA) Lobbyist, and Adam Urber, Legislative Director for Representative Afendoulis.
Representatives Afendoulis and Lower are the Chair and Co-Chair the Tax Policy Committee for the Michigan House of Representatives. On February 20th, Representative Afendoulis introduced House Bill 4203, with the intent of removing the wording “dispensed pursuant to a prescription” from the State of Michigan tax code when referring to surgically implanted devices. This wording has caused medical implants such as plates, screws, anchors, and grafts subject to the 6% Michigan sales tax since July 2018. It was estimated this additional tax could cost Michigan Ambulatory Surgery Centers (ASCs) several million dollars in 2019.
The purpose of the tour at Metro Health OAM Surgery Center (MHOAMSC) was to showcase to the Representatives and guests the quality of care, and level of patient satisfaction, that ASCs offer. In addition, the negative impact on the cost of healthcare that this sales tax generates was discussed. MHOAMSC is an orthopaedic centered facility, providing care for patients throughout Michigan, and performing approximately 5,500 surgeries per year. These surgeries include minimally invasive spine procedures as well as same-day total joint replacements.
The leadership team at MHOAMSC was also able to share with the Representatives and their Guests information regarding how ASCs are able to save Medicare and Medicaid money, by providing the same outpatient services as a hospital, but in a lower cost environment. MHOAMSC’s Executive Director, Tina Piotrowski, spoke on behalf of Michigan ASCs at the Tax Committee hearing on Wednesday, March 6, 2019. Ms. Piotrowski was able to highlight the value that ASCs bring to healthcare as well as the exceptional quality of care provided to patients.
6-5-18 Meeting with US Senator Debbie Stabenow
This is a general and very brief description of the major steps of the legislative process a bill must go through before it is enacted into law.
Bills may be introduced in either house of the Legislature. Senate bills are filed with the Secretary of the Senate and House bills with the Clerk of the House. Upon introduction, bills are assigned a number. At the beginning of each biennial session, House bills are numbered consecutively starting with House Bill No. 4001 and Senate bills are numbered starting with Senate Bill No. 1. In both houses, joint resolutions are assigned a letter.
Under the State Constitution, every bill must be read three times before it may be passed. The courts have held, however, that this requirement can be satisfied by reading the bill’s title. Upon introduction, the bill’s title is read a first and second time in the Senate and is read once in the House. The bill is then ordered to be printed. A bill cannot be passed or become law until it has been printed or reproduced and in the possession of each house for at least five days.
Referral to Committee
Upon introduction, a bill is also referred to a standing committee in the Senate by the Majority Leader and in the House of Representatives by the Speaker of the House. All bills involving an appropriation must be referred either directly to the appropriations committee or to an appropriate standing committee and then to the appropriations committee.
Committee members consider a bill by discussing and debating the bill. The committee may also hold public hearings on the bill.
In the cases of d and e, the bill, upon being reported from committee, is tabled on the floor (temporarily removed from consideration). A majority vote of the members present and voting in the house where the bill is tabled is required to remove the bill from the table before it may be given further consideration.
In both houses, a majority vote of the members serving on a committee is necessary to report a bill. If a committee fails to report a bill, a motion to discharge the committee from consideration of the bill may be offered in the house having possession of the bill. If this motion is approved by a vote of a majority of the members elected and serving, the bill is then placed in position on the calendar for floor action. In the House, at least a one-day prior notice of the motion to discharge must be given to the Clerk of the House.
If a bill is reported from committee favorably with or without amendment or in the form of a substitute bill, the committee report is printed in the journal under the order of business entitled “Reports of Standing Committees” in the House. On being reported favorably from committee, the bill and recommended committee amendments (if any) are placed on the order of “General Orders” in the Senate. In the House, the bill and amendments are referred to the order of “Second Reading.”
General Orders or Second Reading
For the purpose of considering the standing committee recommendations on a bill, the Senate resolves itself into the Committee of the Whole and the House assumes the order of Second Reading. Amendments to the bill maybe offered by any member when the bill is being considered at this stage of the legislative process. In the Senate, a simple majority of members present and voting may recommend adoption of amendments to the bill and recommend a bill be advanced to Third Reading. In the House, amendments may be adopted by a majority serving, and a majority voting may advance the bill to Third Reading. In the House, a bill may be placed on Third Reading for a specified date.
While there are provisions in the House Rules and the Senate Rules for reading bills unless exception is made, in practice, bills are not read in full in either chamber. In both houses, amendments must be approved by a majority vote of the members serving and the previous question maybe moved and debate cut off by a vote of a majority of the members present and voting. At the conclusion of Third Reading, the bill is either passed or defeated by a roll call vote of the majority of the members elected and serving (pursuant to the State Constitution, approval of certain measures requires a “super majority” of a two-thirds or three-fourths vote) or one of the following four options is exercised to delay final action on the bill: (a) the bill is returned to committee for further consideration; (b) consideration of the bill is postponed indefinitely; (c) consideration is postponed until a certain date; or (d) the bill is tabled.
Following either passage or defeat of a bill, a legislator may move for reconsideration of the vote by which the bill was passed or defeated. (A motion to reconsider can be made for any question.) In the Senate, the motion for reconsideration must be made within the following two session days; in the House, the motion must be made within the next succeeding session day.
No bill can become law at any regular session of the Legislature until it has been printed and reproduced and in the possession of each house for at least five days. (Constitution, Art. IV, Sec. 26.)
No act shall take effect until the expiration of 90 days from the end of the session at which the measure was enacted. The Legislature may give immediate effect to an act by a two-thirds vote of the members elected and serving in each house. (Constitution, Art. IV, Sec. 27.)
Enactment by the Legislature
If a bill passes, it is sent to the other house of the Legislature where the bill follows the procedure outlined above, resulting in defeat or passage.
If a bill is passed by both houses in identical form, the bill is ordered enrolled by the house in which the bill originated. Following enrollment and printing, the bill is sent to the Governor.
MASA, your association, has the opportunity to participate more effectively in the political process in Michigan. MASA has formed a political action committee, MASAPAC. MASAPAC is the latest tool for our efforts to advance the interests of the ASC Industry. MASAPAC will inform its members about important issues and decisions made by government officials that can affect the ASC industry. The committee will also provide an opportunity for members to jointly support public policy positions that are important to our industry in Michigan.
MASAPAC is a bipartisan organization that contributes to the campaigns of state and local candidates. MASAPAC typically supports candidates who share MASA’s views on public policy, serve as legislative leaders, represent districts where MASA has a major business presence, or serve on committees that have jurisdiction over legislation that is important to our industry.
I hope you will support your political action committee by making a donation. Checks of $100, $50 or even $25 should be made payable to MASAPAC. Please download the contribution form below. Thank you.