News & Legislation | Michigan Ambulatory Surgery Association

MASA Bill Tracking+

MASA – Aug 2, 2024
HB 4520 – Rep. Mueller, M. (R – Linden) – This bill modifi es the penalties for certain kinds ofassault against health professionals and medical volunteers. TIE BAR WITH: HB 4521’23
Status: 11/14/2023 – H – Assigned PA 271’23

HB 4521 – Rep. Breen, K. (D – Novi) – This bill modifi es the penalties for certain kinds of assaultagainst a health professional or medical volunteer. TIE BAR WITH: HB 4520’23
Status: 11/14/2023 – H – Assigned PA 272’23

HB 4537 – Rep. Andrews, J. (D – St. Joseph) – This bill prohibits employers from obtainingnoncompete agreements from employees.
Status: 05/10/2023 – H – Bill electronically reproduced 05/10/2023

HB 4574 – Rep. Scott, H. (D – Detroit) – This bill provides for family leave optimal coverage benefi ts.
Status: 05/17/2023 – H – Bill electronically reproduced 05/17/2023

HB 4579 – Rep. Price, N. (D – Berkley) – This bill requires the reimbursement rate for telehealthvisits to be the same as reimbursements for offi ce visits.
Status: 06/06/2024 – H – Assigned PA 51’24 with immediate effect

HB 4580 – Rep. Brabec, F. (D – Ann Arbor) – This bill requires the reimbursement rate for telehealthvisits to be the same as reimbursements for offi ce visits.
Status: 06/06/2024 – H – Assigned PA 53’24
8/2/24, 3:31 PM MIRS – MIRS News – Bills
https://mirs.news/legislation/tracking-reports/track-report/462 1/4

HB 4618 – Rep. Coffi a, B. (D – Traverse City) – This bill includes regional airport authorities in thepublicly funded health insurance contribution act.
Status: 04/24/2024 – S – Referred to Committee On Finance, Insurance, And Consumer Protection

HB 4619 – Rep. Rogers, J. (D – Kalamazoo) – This bill prohibits denying insurance coverage basedon gender, gender identity, or sexual orientation or expression.
Status: 10/19/2023 – H – Assigned PA 156’23

HB 4620 – Rep. Edwards, K. (D – Eastpointe) – This bill prohibits denying coverage for preexistingconditions, and prohibits canceling coverage based on the health of the insured.
Status: 10/19/2023 – H – Assigned PA 157’23

HB 4621 – Rep. Fitzgerald, J. (D – Wyoming) – This bill requires health insurance coverage fordependents under the age of 26.
Status: 10/19/2023 – H – Assigned PA 158’23
HB 4622 – Rep. Miller, R. (D – Belleville) – This bill prohibits insurers from instituting annual andlifetime dollar limits on benefi ts.
Status: 10/19/2023 – H – Assigned PA 159’23

HB 4623 – Rep. Koleszar, M. (D – Plymouth) – This bill provides a list of minimum required healthinsurance coverage.
Status: 10/19/2023 – H – Assigned PA 160’23

HB 4830 – Rep. Johnsen, G. (R – Lake Odessa) – This bill restricts the department’s authority to limitpatient visitation in qualifi ed health care facilities.
Status: 06/21/2023 – H – Bill electronically reproduced 06/21/2023

HB 4935 – Rep. Green, P. (R – Millington) – This bill enacts the nurse licensure compact.
Status: 09/05/2023 – H – Bill electronically reproduced 09/05/2023
HB 5004 – Rep. Morse, C. (D – Kalamazoo) – This bill modifi es certain fees and assessments andmakes general revisions to the public health code.
Status: 09/28/2023 – H – Assigned PA 138’23 with immediate effect
8/2/24, 3:31 PM MIRS – MIRS News – Bills
https://mirs.news/legislation/tracking-reports/track-report/462 2/4

HB 5315 – Rep. Steckloff, S. (D – Farmington Hills) – This bill requires coverage for an annualcolonoscopy.
Status: 11/14/2023 – H – Bill electronically reproduced 11/14/2023

HB 5416 – Rep. Liberati, Jr., T. (D – Allen Park) – This bill establishes licensure for medicalassistants.
Status: 01/31/2024 – H – Bill electronically reproduced 01/31/2024

HB 5417 – Rep. Filler, G. (R – St. Johns) – This bill establishes licensure for medical assistants.
Status: 01/31/2024 – H – Bill electronically reproduced 01/31/2024

HB 5526 – Rep. Weiss, R. (D – Oak Park) – This bill prohibit a healthcare professional from refusingto provide services based on a patient’s refusal to allow a provider to photocopy or scan a driver’slicense.
Status: 02/29/2024 – H – Bill electronically reproduced 02/29/2024

HB 5616 – Rep. Steckloff, S. (D – Farmington Hills) – Health: pharmaceuticals; allow patients to takeunused portion of eye drops or eye ointments after certain procedures for continued patient care;provide for.
Status: 06/13/2024 – H – Testimony only

HB 5655 – Rep. O’Neal, A. (D – Saginaw) – Health facilities: other; licensure of supplemental nursingservices agencies; provide for.
Status: 04/24/2024 – H – Bill electronically reproduced 04/24/2024

HB 5734 – Rep. Paiz, V. (D – Harper Woods) – Labor: benefi ts; certain types of accrued leave; requirean employer to pay to an employee when employment is terminated.
Status: 05/16/2024 – H – Bill electronically reproduced 05/16/2024

SB 287 – Sen. Daley, K. (R – Lum) – This bill allows certain private practice offi ces and urgent careclinics to provide information on the donor registry and donating bone marrow.
Status: 06/28/2023 – H – Referred to Committee on Health Policy

SB 332 – Sen. Geiss, E. (D – Taylor) – NEW: This bill provides for family leave optimal coveragebenefi ts.
Status: 05/11/2023 – S – Referred to Committee On Housing And Human Services
8/2/24, 3:31 PM MIRS – MIRS News – Bills
https://mirs.news/legislation/tracking-reports/track-report/462 3/4

SB 333 – Sen. Geiss, E. (D – Taylor) – This bill provides a deduction for family leave optimalcoverage benefi ts. TIE BAR WITH: SB 0332’23
Status: 05/11/2023 – S – Referred to Committee On Housing And Human Services

SB 400 – Sen. Johnson, R. (R – Holly) – This bill restricts the department’s authority to limit patientvisitation in qualifi ed health care facilities.
Status: 06/22/2023 – S – Referred to Committee On Oversight

SB 482 – Sen. McDonald Rivet, K. (D – Bay City) – This bill modifi es the containment of medicalwaste.
Status: 07/30/2024 – S – Assigned pa 0105’24 with immediate effect

SB 832 – Sen. Johnson, R. (R – Holly) – Health: patient directives; Michigan medical treatmentdecisions act; enact.
Status: 04/17/2024 – S – Referred to Committee On Health Policy

ASC-20 Deadline Two Weeks Away+

CMS Releases 2023 Final Payment Rule (ASCA)+

The results are mixed for surgery centers

The Centers for Medicare & Medicaid Services (CMS) released its 2023 final payment rule for ASCs and hospital outpatient departments (HOPD) today.

CMS finalized an effective update of 3.8 percent—a combination of a 4.1 percent inflation update based on the hospital market basket and a productivity reduction of 0.3 percentage points mandated by the Affordable Care Act. This is an increase of 1.1 percent from the proposed rule. Please note that this is an average and updates might vary significantly by code and specialty.

This update is based on CMS’ 2019 policy to align the ASC update factor with the one used to update HOPD payments, the hospital market basket, for a five-year trial period as the agency assesses this policy’s impact on volume migration. As 2023 is slated to be the last year of the trial, CMS indicates in this final rule that the agency intends to “update the public on our assessment of service migration and other factors in the CY 2024 OPPS/ASC proposed rule.”
“

We are relieved that CMS has increased the inflation update from what was proposed initially, but it still falls far short of addressing the escalating costs that surgery centers are experiencing in staffing, services and supplies,” says ASCA Chief Executive Officer Bill Prentice. “CMS needs to do more to support ASCs in confronting the rising costs of providing care to beneficiaries or risk losing access to the outstanding care and significant cost savings ASCs provide.”

Other initial observations about the 1764-page final rule follow. ASCA will provide additional analysis soon, including a rate calculator that allows users to determine what ASCs will be paid locally under this final rule.

ASC Complexity Adjustments
On a positive note, CMS finalized a policy to provide complexity adjustments for combinations of certain service codes and add-on procedure codes that are eligible for a complexity adjustment under the hospital outpatient prospective payment system (OPPS). While add-on codes (N1) do not receive additional reimbursement when packaged into primary codes, the addition of the add-on codes to a primary procedure code often changes the complexity of the procedure, making it more costly to perform. As finalized in this rule, Medicare will now provide a “complexity adjustment” to adjust the payment rate for certain primary procedures to account for the cost of also performing certain add-on procedures.

“We support CMS in adopting complexity adjustments that will enable surgery centers to provide better access to beneficiaries and protect Medicare’s sustainability for years to come,” Prentice says.

The complexity adjustments adoption is a significant change for ASCs. ASCA will provide more educational materials on its implementation in the near future.
Additions to the ASC Covered Procedures List

Although ASCA provided a list of dozens of procedures that are performed safely on non-Medicare populations in the ASC setting for consideration to be added to the ASC Covered Procedures List (ASC-CPL), CMS added only four of the requested codes:
• 19307 (Mast mod rad)
• 37193 (Rem endovas vena cava filter)
• 38531 (Open bx/exc inguinofem nodes)
• 43774 (Lap rmvl gastr adj all parts).
“CMS’s decision to add only four new procedures to the ASC-CPL for 2023 after ASCA proposed 47 procedures that ASCs are performing safely and successfully for privately insured patients is a serious mistake and denies beneficiary access to high-value care,” Prentice says. “Forcing otherwise healthy Medicare beneficiaries to receive care in higher cost settings for these procedures needlessly increases costs to the Medicare program and undercuts Medicare’s mission of serving as a responsible steward of public funds.”

Positive Change to ASC Quality Reporting Program
CMS finalized its proposal to suspend the mandatory adoption of ASC-11: Cataracts: Improvement in Patient’s Visual Function within 90 Days Following Cataract Surgery in the ASC Quality Reporting Program. ASCA has been strongly advocating for this measure to remain voluntary.

ASCA will continue to analyze the rule in detail and provide more information to help ASC operators understand the impact of the proposal on their centers soon.

ASCA No Surprises Act Webinar+

Media+

Overview+

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.

MASA Member Legislative Visits+

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

Find My Legislator+

Legislative References+

How a bill becomes Law – Michigan Legislature

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.

Introduction
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.

Title Reading
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 Review
Committee members consider a bill by discussing and debating the bill. The committee may also hold public hearings on the bill.

Committee Action
A standing committee may act on a bill in various ways. The committee may:

a. Report the bill with favorable recommendation.
b. Report the bill with amendments with favorable recommendation.
c. Report the bill with the recommendation that a substitute be adopted.
d. Report the bill without recommendation.
e. Report the bill with amendments but without recommendation.
f. Report the bill with the recommendation that the bill be referred to another committee.
g. Take no action on a bill.
h. Vote to not report a bill out of committee.

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.

Committee Reports
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.

Third Reading
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.

Five-Day Rule
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.)

Immediate Effect
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.

If a bill is passed in a different form by the second house, the bill must be returned to the house of origin and one of the following occurs:

a. If the amendment(s) or substitute bill of the second house is accepted in the house of origin, the bill is enrolled, printed, and sent to the Governor. It should also be noted that either house may amend an amendment made by the other to a bill or joint resolution. At any time while in possession of the bill, either house may recede from its position in whole or in part and the bill may be returned to the other house for this purpose. If this further action is agreed to by both houses, the bill is ordered enrolled.
b. If the amendment(s) or substitute proposal of the second house is rejected in the house of origin, the bill is then sent to a conference committee (a special committee composed of three legislators from each house) which attempts to compromise differences between the two versions of the bill. The conference committee can consider only issues in the bill upon which there is disagreement between the two houses. However, when the agreement arrived at by the conferees is such that it affects other parts of the bill, such as in an appropriations measure, the conferees may recommend further amendments to conform with the agreement. The conferees may also recommend corrections to any errors in the bill. The conference committee may reach a compromise approved by at least a majority of the conferees from each house, and submit a report to the house of origin. If adopted, the report and bill are transmitted to the second house. If the conference committee report is approved in the second house, the bill is then enrolled, printed, and sent to the Governor. A conference report may not be amended by either house. If the conference committee is notable to agree, or if the report is rejected by either house, a second conference committee is appointed. When a second conference has met and the two houses are still unable to agree, no further conference is in order.

Approval by Governor
Upon receipt of an enrolled bill, the Governor has fourteen days to consider the bill. The Governor may:

a. Sign the bill, which then either becomes law at the expiration of ninety days after the Legislature adjourns sine die or on a date beyond the ninetieth day specified in the bill. If the bill has been given immediate effect by a two-thirds vote of the members elected to and serving in each house, the bill will become law after the Governor signs the bill and files it with the Secretary of State or on a day specified in the bill.
b. Veto the bill and return it to the house of origin with a message stating the Governor’s objections.
c. Choose not to sign or veto the bill. If the bill is neither signed nor vetoed, the bill becomes law fourteen days after having reached the Governor’s desk if the Legislature is in session or in recess. If the Legislature should adjourn sine die before the end of the fourteen days, the unsigned bill does not become law. If the Legislature has adjourned by the time the bill reaches the Governor, he or she has fourteen days to consider the bill. If the Governor fails to approve the bill, it does not become law.

Legislative Veto Response
If the Governor vetoes a bill while the Legislature is in session or recess, one of the following actions may occur:

a. The Legislature may override the veto by a two-thirds vote of the members elected to and serving in each house. The bill then becomes law.
b. The bill may not receive the necessary two-thirds vote and thus the attempt to override the veto will fail.
c. The bill may be tabled.
d. The bill may be re-referred to a committee.

MASAPAC+

Legislative News

Consider an ASC as a site-of-care option for low-risk patients

How a bill becomes Law – Michigan Legislature

Committee Action
A standing committee may act on a bill in various ways. The committee may:

If a bill is passed in a different form by the second house, the bill must be returned to the house of origin and one of the following occurs:

Approval by Governor
Upon receipt of an enrolled bill, the Governor has fourteen days to consider the bill. The Governor may:

Legislative Veto Response
If the Governor vetoes a bill while the Legislature is in session or recess, one of the following actions may occur:

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Legislative News

Consider an ASC as a site-of-care option for low-risk patients

How a bill becomes Law – Michigan Legislature

Committee Action A standing committee may act on a bill in various ways. The committee may:

If a bill is passed in a different form by the second house, the bill must be returned to the house of origin and one of the following occurs:

Approval by Governor Upon receipt of an enrolled bill, the Governor has fourteen days to consider the bill. The Governor may:

Legislative Veto Response If the Governor vetoes a bill while the Legislature is in session or recess, one of the following actions may occur:

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Committee Action
A standing committee may act on a bill in various ways. The committee may:

Approval by Governor
Upon receipt of an enrolled bill, the Governor has fourteen days to consider the bill. The Governor may:

Legislative Veto Response
If the Governor vetoes a bill while the Legislature is in session or recess, one of the following actions may occur:

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Click here for more info.