1-Year Prior Authorization Reform Anniversary Highlights Power of Advocacy PDF Print Email
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Friday, April 07, 2023 12:36 PM

Prior Authorization Reform Anniversary Highlights Power of Advocacy

April 7 marks one year since Gov. Gretchen Whitmer signed historic Senate Bill 247 of 2022 into law, codifying prior authorization reform in Michigan by reducing determination response times and standardizing the process and paperwork. This is a day to celebrate!

Weeks before the reform bill was signed into law, many family physicians, family medicine residents, and medical students attending our 2022 Michigan Family Medicine Advocacy Day were in the Michigan House gallery when SB 247 got its final vote. The bill’s passage was the culmination of years of advocacy work on behalf of Michigan Academy of Family Physicians, our members, and partners, and is a testament to the power of a unified family medicine voice.

MAFP Advocacy Wins Continue

Michigan Academy of Family Physicians continued to achieve advocacy success throughout the remainder of 2022, and that momentum is picking up steam in 2023.

An additional $15 million was included in the Fiscal Year 2023 state budget to increase Medicaid payment rates for certain child wellness visit E/M codes, bringing them up to at least 95% of Medicare rates.

MAFP and grassroots advocates stopped the advances of nurse practitioners and other non-physicians on scope expansion, preventing the movement of bills which ultimately expired on Dec. 31, 2022—the end of the previous legislative cycle. Scope expansion efforts never end, however. While new expansion bills have yet to be introduced in the current legislative term, they are undoubtedly coming. Your MAFP advocacy team is already meeting with key legislators to discuss the potential danger to patients that scope expansion presents and educate them on the critical importance of preserving physician-led team-based care.  

Gov. Whitmer’s FY 2024 (Oct. 1, 2023 through Sept. 30, 2024) executive budget recommendation calls for investing in several initiatives that are key to increasing access to primary and preventive care and preserving physician-led team-based care:

  • Maintain $6.4 million for MIDOCs, a state-funded programs that draws Medicaid matching dollars for expanding and supporting graduate medical education positions in family medicine, internal medicine, pediatrics, obstetrics/gynecology, and general surgery—all high-need specialties.
  • Maintain $1.5 million for the Michigan State Loan Repayment Program which, through a federal/state/local funding partnership, provides medical education loan repayment assistance to primary care providers who commit to practicing in medically underserved areas of the state.
  • An additional $129 million for expanding access to equitable primary and preventive care for Michigan’s Medicaid beneficiaries, $73 million of which would fund a Medicaid payment rate increase for certain primary care professional services.

Call to Action: Grassroots Advocacy is Needed

In the midst of FY 2024 state budget negotiations, revised projections now show nearly $600 million needs to be trimmed from the proposed budget. As the Governor and legislators work on cutting funding to reach a balanced budget, MAFP continues to advocate for full funding for MIDOCs, the MSLRP, and the Medicaid payment increase.

As always, ongoing grassroots advocacy is essential for success, especially in light of necessary state budget cuts and the continued efforts of non-physician providers toward gaining scope expansion.

“As a practicing family physician or family physician in training, you are the ideal healthcare resource/expert for your elected officials. Please check out the “How to Advocate” section of MAFP’s new website to get involved and take action to influence the legislative and policy making process on behalf of your patients, practice, and profession,” said MAFP President Glenn Dregansky, DO, FAAFP.