HB 6289

HOUSE BILL NO. 6289
A bill to create the primary care access, improvement, and
transformation commission and prescribe its powers and duties; to provide for
the powers and duties of certain state governmental officers and entities; and
to repeal acts and parts of acts.
the people of the state of michigan enact:
Sec. 1. This act may be cited as the "primary care access,
improvement, and transformation commission act".
Sec.
3. As used in this act:
(a) "Commission" means the primary care access,
improvement, and transformation commission created in section 5.
(b) "Community health
worker" means an individual who serves as a liaison between providers of
health and social services and a community to facilitate access to services,
improve the quality and cultural competence of service delivery, and increase
the health knowledge and self-sufficiency of individuals in the community
through community outreach and education, informal counseling, social support,
and advocacy.
(c) "Department"
means the department of health and human services.
(d) "Federally qualified
health center" means that term as defined in 42 USC 1395x(aa)(4).
(e) "Health professional"
means an individual who is licensed, registered, or otherwise authorized to
engage in a health profession under article 15 of the public health code, 1978
PA 368, MCL 333.16101 to 333.18838.
(f) "Innovation
models" means both of the following as developed
or conducted by the Centers for Medicare and Medicaid Services to support
health care transformation and access to quality care:
(i)
Payment and service delivery models.
(ii)
Demonstration projects.
(g) "Medicaid"
means the medical assistance program established
under title XIX of the social security act, 42 USC 1396 to 1396w-9.
(h) "Practitioner"
means a health professional and any individual who
acts under the direction or supervision of a health professional.
(i) "Primary care"
means the specialty of family practice,
internal medicine, pediatrics, obstetrics, psychiatry, or
emergency medicine.
(j) "Primary care
spending" means spending on a professional service billed by a physician
practicing primary care, including, but not limited to, spending on a
professional claim, an evaluation and management visit, a preventative visit,
care transition or coordination of services, and an in-office preventative
service, screening, or counseling, and is calculated annually in the Medical
Expenditure Panel Survey by the Department of Health and Human Services Agency
for Healthcare Research and Quality.
Sec. 5. (1) The primary care access, improvement, and
transformation commission is created in the department.
(2) The commission must consist of the
director of the department or the director's designee and the following 20 members, appointed by
the governor:
(a) This state's Medicaid director or the director's designee.
(b) A physician practicing primary care who is appointed from a list of 3
nominees submitted by the Michigan State Medical Society, the Michigan Primary
Care Association, the Michigan Academy of Family Physicians, or the Michigan
Chapter American Academy of Pediatrics.
(c) A practitioner practicing primary care who is not a physician and who is appointed from a list of 3 nominees submitted
by the American Nurses Association-Michigan, the Michigan Primary Care
Association, the Michigan Academy of Physician Associates, the Michigan Nurses
Association, or the Michigan Council of Nurse Practitioners.
(d) A representative of a
federally qualified health center who is appointed
from a list of 3 nominees submitted by the Michigan Primary Care Association.
(e) A practitioner or organizational
leader at a federally qualified health center located in this state.
(f) A community health worker appointed from a list of 3 nominees submitted by the
Michigan Community Health Worker Alliance.
(g) A health professional who specializes in rural health care at a
rural health clinic or hospital appointed from a list
of 3 nominees submitted by the Michigan Center for Rural Health.
(h) A representative for
behavioral health who is appointed from a list of 3
nominees submitted by the Community Mental Health Association of Michigan.
(i) A representative for
insurers that deliver, issue for delivery, or renew
in this state health or dental insurance policies, appointed from a list of 3
nominees submitted by Blue Cross Blue Shield of Michigan or Delta Dental of
Michigan.
(j) A representative for
health plans appointed from a list of 3 nominees
submitted by the Michigan Association of Health Plans.
(k) A representative of
hospitals appointed from a list of 3 nominees
submitted by the Michigan Health and Hospital Association.
(l) A
member of a professional medical association located
in this state appointed from a list of 3 nominees submitted by the American
Nurses Association-Michigan, the Michigan Nurses Association, the Michigan
Primary Care Association, or the Michigan Council of Nurse Practitioners.
(m) A representative of
schools of nursing that are located in this state
appointed from a list of 3 nominees submitted by the American Nurses
Association-Michigan, the Michigan Primary Care Association, the Michigan
Nurses Association, or the Michigan Council of Nurse Practitioners.
(n) A representative of
schools of medicine that are located in this state appointed
from a list of 3 nominees submitted by the Michigan State Medical Society, the
Michigan Primary Care Association, the Michigan Academy of Family Physicians, the
Michigan Chapter American Academy of Pediatrics, Michigan State University, the
University of Michigan, Wayne State University, Oakland University, Western
Michigan University, or Central Michigan University.
(o) An individual who is an advocate for patients or
is an employee of an advocacy organization for patients, who is appointed from a list of 3 nominees
submitted by the Michigan Elder Justice Initiative, Disability Rights Michigan,
or the Michigan Primary Care Association.
(p) A member of the health
information technology commission created under section 2503 of the public
health code, 1978 PA 368, MCL 333.2503.
(q) An individual who is an
expert on eliminating health disparities who is
appointed from a list of 3 nominees submitted by the Michigan State Medical
Society, the Michigan Primary Care Association, the Michigan Academy of Family
Physicians, the Michigan Chapter American Academy of Pediatrics, the Michigan
Public Health Institute, Michigan State University, the University of Michigan,
Wayne State University, Oakland University, Western Michigan University, or
Central Michigan University.
(r) Three individuals who
have experience navigating challenges with primary care
who are appointed from a list of 3 nominees submitted by the Michigan State
Medical Society, the Michigan Primary Care Association, the Michigan Academy of
Family Physicians, the Michigan Chapter American Academy of Pediatrics, the
Michigan Elder Justice Initiative, or Disability Rights Michigan. If more than
1 person submits a list of nominees under this subdivision, each individual who
is appointed to the commission must be selected from a different list of
nominees.
(3) The governor shall appoint the first members of the
commission within 90 days after the effective
date of this act.
(4) The governor shall appoint 7 of the first members to
1-year terms, 7 of the first members to 2-year terms, and 7 of the first
members to 3-year terms. After the first appointments, the term of a member of
the commission is 3 years or until a successor is appointed under subsection
(2), whichever is later.
(5) If a vacancy occurs on the commission, the governor shall
appoint an individual to fill the vacancy for the balance of the term in the same manner as the original appointment.
(6) The governor may remove a member of the commission for
incompetence, dereliction of duty, malfeasance, misfeasance, or nonfeasance in
office, or any other good cause.
(7) The director shall call
the first meeting of the commission. At the
first meeting, the commission shall elect a member as a chairperson and may
elect other officers that it considers necessary or appropriate. The commission
shall meet at least every quarter, or more
frequently at the call of the chairperson or at the request of a majority of the members.
(8) A majority of the members
of the commission constitute a quorum for
transacting business. A vote in favor by a majority of
the members of the commission serving is required for any action of the
commission.
(9) The commission shall conduct its business in compliance
with the open meetings act, 1976 PA 267, MCL 15.261 to 15.275.
(10) A writing that is prepared, owned, used, possessed, or
retained by the commission in performing an official function is subject to the
freedom of information act, 1976 PA 442, MCL 15.231 to 15.246.
(11) A member of the commission is not entitled to
compensation for service on the commission, but the commission may reimburse a
member for actual and necessary expenses incurred in serving.
Sec.
7. (1) The commission shall do all of the following:
(a) Make recommendations to the
legislature and the department on ways to increase overall annual health care
spending on primary care spending in this state, with the goal of increasing
primary care spending by not less than 12%.
(b) Examine ways to improve
access to high quality and affordable primary care in this state by analyzing all of the following:
(i)
Other state models of transforming and improving primary care.
(ii)
Efforts by persons that are interested in improving access to primary care in
this state.
(iii)
Innovation models.
(iv)
Data derived from other states that are seeking to improve access to primary
care.
(v)
Any other finding, practice, program, or policy that is intended to improve
access to high quality and affordable primary care.
(c) Guide the direction and
implementation of primary care policies and practices throughout this state.
(d) Align and mobilize
resources on payment and practice transformation and inform multipayer
strategies, quality measures, and policy and program approaches to primary care
improvement.
(e) Advise the governor,
department, and legislature on all aspects of primary care strategy, the
coordination and administration of state programs, changes to federal programs
and programs in this state, budget priorities, and the nature and magnitude of
primary care access, improvement, and transformation priorities.
(f) Inform applicable bureaus or offices
within the department of primary-care-related Medicaid
state plans and state plan amendments.
(g) Hold meetings in each region of
this state to receive feedback from interested persons, including, but not
limited to, individuals who practice in and are seeking to improve primary care
in this state.
(h) Advise the department on grants
that the department has not previously sought.
(i) Create a statewide agenda of
recommendations for evaluating primary care and identify research on primary
care practices that should be prioritized.
(j) Publish an annual report
that complies with section 9. The commission shall post
the report on the department's website in an
area that is accessible to the public and provide the report to the
governor and legislature.
(k) At least annually, review the
commission's bylaws, stated goals, and membership and leadership, and post the information
on the department's website in an area that is
accessible to the public.
(2) The commission may do any
of the following:
(a) Develop and regularly publish public dashboards with
information on primary care spending by payer, primary
care workforce trends, and primary care access
metrics in this state.
(b) Create workgroups focused on specific policy topics,
including, but not limited to, innovation models, access and equity, and
whole-person care.
Sec. 9. The commission shall publish an annual report on
primary care in this state that includes all of the following information:
(a) Primary care spending by payer that tracks progress toward
achieving the commission's goals.
(b) Primary care workforce composition,
growth, and gaps.
(c) Identified opportunities for improving the value and
patient experience of primary care.
(d) Insights and recommendations pertaining to innovation
models.
(e) The risks, benefits, and impacts
of using artificial intelligence in achieving the commission's goals.
(f) The effects of provider
burnout and health system consolidation.
(g) Any other information the commission determines is
relevant.
Sec. 11. (1) Not later than 8 years after the effective
date of this act, the commission shall make a
recommendation to the department on whether there is an existing or ongoing
need for the commission. The department shall evaluate the commission's recommendation and, within 90 days after reviewing the commission's
recommendation, report the commission's
recommendation and the department's evaluation to the governor and
legislature.
(2) The department shall provide the commission with adequate
administrative support.
Sec. 13. This act is repealed effective 10 years after
the effective date of this act.
Enacting section 1.
This act does not take effect unless Senate Bill No. ____ (request no.
S05729'25) or House Bill No. 6288 (request no. H05729'25) of the 103rd
Legislature is enacted into law.