Healthcare (Primary Care)

This bill amends Michigan's social welfare act to establish a new prospective payment system that funds certified community behavioral health clinics based on anticipated costs rather than individual services. It requires the state department to develop payment rates using actuarial methods and mandates that any new clinic sites approved starting in 2028 undergo a review process to prevent service duplication and ensure geographic distribution. The legislation defines eligible clinics as nonprofit or government-run entities and prioritizes approval for sites operated by community mental health services programs. Additionally, the bill outlines specific policies to mitigate conflicts of interest, define retaliatory actions, and create a dispute resolution process, while noting that implementation depends on future legislative funding.

This bill directs Michigan to align its policies with federal requirements for certified community behavioral health clinics, ensuring the state does not create rules that conflict with federal standards. It mandates the development of a process to determine new clinic locations in specific regions to prevent overlapping service areas. Additionally, the bill requires continued cooperation with the federal government on these clinics, allowing the legislature to vote on opting out, which would give state officials 12 months to stop operations if chosen. The legislation will not take effect unless it is tied to the passage of a companion bill, SB 1000.

SB 805 establishes licensing requirements for standalone hyperbaric oxygen therapy clinics in Michigan. It mandates that these facilities obtain state licensure, appoint a qualified medical director and safety coordinator, comply with NFPA 99 safety standards, and meet FDA-approved treatment protocols. Clinics must display their license/permit and accreditation publicly, provide patients with clear information about treatment risks, FDA-approved uses, and insurance coverage limitations, and obtain written consent before treatment. The bill directly affects clinic operators, healthcare providers, and patients receiving hyperbaric oxygen therapy, ensuring standardized safety and transparency.

HB 5200 requires health insurance plans in Michigan that cover gynecological care to include annual pap smear screenings for women aged 21 or older, with coverage mandated every three calendar years. This applies to all health insurance policies delivered, issued, or renewed in Michigan that provide gynecological coverage, directly affecting women 21+ and insurers offering such plans. The bill eliminates cost-sharing requirements (like copays, deductibles, or coinsurance) for these screenings, ensuring full coverage without out-of-pocket costs. It amends Michigan’s Insurance Code (MCL 500.3406nn) to standardize this preventive care requirement. The bill is currently pending in the House Committee on Insurance after introduction on November 4, 2025.