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On October 19, 2021, legislation was introduced in the Michigan House that would mandate all licensed medical professionals to take Continuing Medical Education (CME) courses on lead poisoning identification and treatment as a condition of license renewal. Specifically, House Bill 5414 would require CME courses to include content regarding the screening of children who are six years of age or less for lead poisoning, the physiological and behavioral signs of lead poisoning, the treatment needs of children with elevated blood lead levels, and the referral of children with elevated blood lead levels to appropriate state agencies. MSMS policy supports Early and Periodic Screening, Diagnosis and Treatment Programs (EPSDT) to reach as many eligible children as possible, and urges all its members to screen children for their risk on contact with lead hazards and subsequent lead poisoning, and to complete a capillary or venous blood test for any child deemed to be at high risk for this serious health problem. However, MSMS policy opposes any attempt to introduce compulsory content of mandated CME in the state of Michigan and opposes House Bill 5414 for the following reasons:
·House Bill 5414 takes a one-size fits all approach that does not take into account different specialties which may never need to use the knowledge provided.
·Many specialists will never need to perform lead screening; however, this bill would require all physicians to take CME for it. ·There are already sufficient guidelines and quality measures related to lead screening (NCQUA-HEDIS Measure, Bright Futures, and CHIP programs). Clinicians seeing these patients are already performing screenings.
·Michigan already ranks amongst the highest in the nation for mandated CME hours at 150 hours per 3-year cycle, a contributing factor to physician burnout.
House Bill 5414 currently resides in the House Health Policy Committee and a hearing is expected in early December. MSMS will be meeting with members of the committee over the coming weeks to discuss solutions that will better serve Michigan’s children and a Call to Action will also be available on MSMS Engage in the coming days for members interested in contacting their Representatives.
On January 1, 2022, the Centers for Medicare and Medicaid Services (CMS) will drastically reduce payments for certain health care providers. If Congress does not act to stop these cuts, it will further strain practices that are still struggling to keep their doors open during the ongoing pandemic. Specifically, physician practices face the following stack of Medicare financial hits amounting to a 9.75 percent cut:
Expiration of the current reprieve from the repeatedly extended 2 percent sequester stemming from the Budget Control Act of 2011. Congress originally scheduled this policy to sunset in 2021 but it will now continue into 2030.
Imposition of a 4 percent Statutory Pay-As-You-Go Act (PAYGO) sequester resulting from passage of the American Rescue Plan Act. Should lawmakers fail to act, it will mark the first time that Congress has failed to waive Statutory PAYGO.
Expiration of the Congressionally enacted 3.75 percent temporary increase in the Medicare physician fee schedule (PFS) conversion factor to avoid payment cuts associated with budget neutrality adjustments tied to PFS policy changes.
A statutory freeze in annual Medicare PFS updates under the Medicare Access and CHIP Reauthorization Act (MACRA) that is scheduled to last until 2026, when updates resume at a rate of 0.25% a year indefinitely - a figure well below the rate of medical or consumer price index inflation.
If allowed to go into effect, these cuts would lead to fewer primary care providers, limited access to specialists, a disruption in care, and additional barriers to life-saving treatment. Members interested in contacting their U.S. Representatives and Senators should urge them to enact legislation to address these issues.
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