Michigan Academy of Family Physicians (MAFP) is the state’s largest specialty physician association. With more than 4,200 members, MAFP is dedicated to assisting Family Physicians and their practices as they work to ensure high-quality, cost-effective healthcare for patients of all ages.
News & Announcements
Finding solutions to mitigate the surprise medical billing issue is on the radar of legislators at both the state and federal level. This week, the Michigan House Health Policy Committee held a hearing on a package of bills that call for mandating out-of-network providers to notify patients of services at least 14 days prior to a procedure or during surgical consultation. Out-of-network providers would also be required to accept the average negotiated rate between the health plan and the provider, or up to 150% of Medicare rates. The legislation is opposed by most healthcare professional groups, who agree patients must be protected but contend the bills are built on an unsustainable payment model, increase the potential for out-of-network services, and apply to a too-broad scope of specialties.
As the 2019-2020 flu season gets underway, the Centers for Disease Control and Prevention release coverage estimates from last year. Among the highlights: nationally, more adults and children were immunized against the flu in 2018-2019 than in 2017-2018. That was not the case in Michigan, however, where just over half of adults and less than half of children received the influenza vaccine last year.
On October 9, Centers for Medicare & Medicaid Services issued a proposed rule that seeks to add new, permanent exceptions to the Stark Law for physicians participating in value-based care models. Enacted in 1989, the Stark Law prohibits physicians from making referrals for certain services reimbursable by Medicare if he/she or an immediate family member has a financial relationship with the entity performing the referred service.
The Health Can’t Wait coalition, spearheaded by Michigan State Medical Society and of which MAFP is a founding member, has been working hard during 2019 to educate state lawmakers about how the current prior authorization process puts patients’ health at risk. Your voice and the voices of patients are needed to amplify the Health Can't Wait message. The coalition is calling on physicians to take three actions to help change the prior authorization requirements to protect the health and well-being of your patients.
Pharma Risk Management: Not Such a Hard Pill to Swallow
November 15, 2019
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