HOUSE BILL No. 4682 April 24, 1997, Introduced by Reps. Crissman, Law, Gire, Hammerstrom, Griffin, Profit, Ciaramitaro, Raczkowski, Olshove, Leland, Green, Cassis, Kukuk and Dalman and referred to the Committee on Health Policy. A bill to amend 1978 PA 368, entitled "Public health code," by amending section 20165 (MCL 333.20165), as amended by 1990 PA 179, and by adding sections 16204b and 20210. THE PEOPLE OF THE STATE OF MICHIGAN ENACT: 1 SEC. 16204B. (1) THE LEGISLATURE RECOGNIZES THAT THE EVALU- 2 ATION AND TREATMENT OF INTRACTABLE PAIN IS A FUNDAMENTAL COMPO- 3 NENT OF HEALTH CARE AND ACKNOWLEDGES THAT, SUBJECT TO SUBSECTION 4 (3), PATIENTS WITH INTRACTABLE PAIN SHOULD HAVE ACCESS TO COVER- 5 AGE FOR THAT INTRACTABLE PAIN UNDER HEALTH CARE CONTRACTS, PLANS, 6 CERTIFICATES, AND POLICIES. 7 (2) THE LEGISLATURE RECOGNIZES THAT A PHYSICIAN RECOMMENDING 8 MEDICAL TREATMENT FOR TERMINAL ILLNESS TO A PATIENT WHO HAS BEEN 9 DIAGNOSED AS HAVING A TERMINAL ILLNESS SHOULD ADVISE THE PATIENT 10 OF HIS OR HER OPTION TO CHOOSE HOSPICE CARE, PURSUANT TO SECTION 02457'97 * CPD 2 1 5655. AS USED IN THIS SUBSECTION, "TERMINAL ILLNESS" MEANS THAT 2 TERM AS DEFINED IN SECTION 5653. 3 (3) THE LEGISLATURE RECOGNIZES THAT CARE FOR INTRACTABLE 4 PAIN IS OR DOES ALL OF THE FOLLOWING: 5 (A) GUIDED BY AND CONSISTENT WITH NATIONAL GUIDELINES AND 6 PRACTICE PARAMETERS FOR THE TREATMENT OF INTRACTABLE PAIN. 7 (B) ENCOMPASSES EVALUATION AND TREATMENT OF ILLNESSES THAT 8 FREQUENTLY ACCOMPANY INTRACTABLE PAIN, INCLUDING, BUT NOT LIMITED 9 TO, DEPRESSION, OTHER MENTAL HEALTH DISORDERS, SLEEP DISTURBANCE, 10 AND SUBSTANCE ABUSE. 11 (C) INCLUDES BOTH INPATIENT AND OUTPATIENT TREATMENT SERV- 12 ICES AS DETERMINED BY TREATING HEALTH PROFESSIONALS AND CASE 13 SEVERITY AND COMPLEXITY. 14 (D) INCLUDES, BUT IS NOT LIMITED TO, THE MAKING AVAILABLE OF 15 NECESSARY MEDICATIONS, PROCEDURES, MENTAL HEALTH CARE, MEDICAL 16 DEVICES, REHABILITATION PROGRAMS, AND HOSPICE CARE. 17 (E) INDIVIDUALIZED TO MEET THE NEEDS OF EACH PATIENT. 18 (F) PROVIDES CARE TO MAXIMIZE THE QUALITY OF LIFE AND FUNC- 19 TIONAL CAPACITY OF PATIENTS WITH INTRACTABLE PAIN. 20 (4) THE LEGISLATURE RECOGNIZES THE IMPORTANCE OF AND ENCOUR- 21 AGES THE AGGRESSIVE AND RESPONSIBLE TREATMENT OF INTRACTABLE PAIN 22 ON ALL LEVELS OF HEALTH CARE AND BY HEALTH CARE PROVIDERS 23 LICENSED BY THE STATE. THE LEGISLATURE ACKNOWLEDGES THAT 24 PATIENTS WITH INTRACTABLE PAIN LASTING AT LEAST 6 MONTHS WHO 25 REMAIN COMPROMISED BY THEIR PAIN REQUIRE AND SHOULD BE AFFORDED 26 THE OPPORTUNITY TO BE TREATED IN A COMPREHENSIVE, 02457'97 * 3 1 MULTIDISCIPLINARY PAIN MANAGEMENT PROGRAM APPROPRIATE FOR THE 2 SPECIFIC PAIN OR ILLNESS. 3 (5) THE LEGISLATURE ENCOURAGES ALL HEALTH INSURERS AND MAN- 4 AGED CARE ORGANIZATIONS TO ESTABLISH APPROPRIATE REFERRAL RELA- 5 TIONSHIPS OR HAVE COMPREHENSIVE, MULTIDISCIPLINARY PAIN MANAGE- 6 MENT PROGRAMS WITHIN THEIR OWN SYSTEMS OF CARE TO ENSURE BOTH OF 7 THE FOLLOWING: 8 (A) NECESSARY AND TIMELY ACCESS AND COVERAGE FOR THE SERV- 9 ICES OF COMPREHENSIVE PAIN FACILITIES FOR PATIENTS WHO HAVE HAD 10 INTRACTABLE PAIN FOR AT LEAST 6 MONTHS. 11 (B) NECESSARY AND TIMELY ACCESS AND COVERAGE FOR HOSPICE 12 PROGRAMS TO MANAGE THE CARE OF TERMINALLY ILL PATIENTS WHO ARE 13 EXPECTED TO LIVE FOR 6 MONTHS OR LESS. 14 (6) THE LEGISLATURE RECOGNIZES THAT THE USE OF CONTROLLED 15 SUBSTANCES IS APPROPRIATE IN THE MEDICAL TREATMENT OF CERTAIN 16 FORMS OF INTRACTABLE PAIN, AND THAT EFFORTS TO CONTROL DIVERSION 17 OR IMPROPER ADMINISTRATION OF CONTROLLED SUBSTANCES SHOULD NOT 18 INTERFERE WITH THE APPROPRIATE USE OF THOSE CONTROLLED SUBSTANCES 19 TO RELIEVE PAIN AND SUFFERING. 20 (7) AS USED IN THIS SECTION, "COMPREHENSIVE, MULTIDISCI- 21 PLINARY PAIN MANAGEMENT PROGRAM" AND "INTRACTABLE PAIN" MEAN 22 THOSE TERMS AS DEFINED IN SECTION 16204A(7). 23 Sec. 20165. (1) Except as otherwise provided in this sec- 24 tion, after notice of intent to an applicant or licensee to deny, 25 limit, suspend, or revoke a license or certification and an 26 opportunity for a hearing, the department may deny, limit, 02457'97 * 4 1 suspend, or revoke the license or certification ifany1 OR 2 MORE of the following exist: 3 (a) Fraud or deceit in obtaining or attempting to obtain a 4 license or certification or in operation of the licensed health 5 facility or agency. 6 (b) A violation of this article or the rules promulgated 7 under this article. 8 (c) False or misleading advertising. 9 (d) Negligence or failure to exercise due care, including 10 negligent supervision of employees and subordinates. 11 (e) Permitting a license or certificate to be used by an 12 unauthorized health facility or agency. 13 (f) Evidence of abuse regarding patient health, welfare, or 14 safety or a denial of rights. 15 (g) Failure to comply with section 10102a(7). 16 (h) Failure to comply with part 222 or a term, condition, or 17 stipulation of a certificate of need issued under part 222, or 18 both. 19 (I) A VIOLATION OF SECTION 20210. 20 (2) An application for a license or certification may be 21 denied on a finding ofanyA condition or practicewhichTHAT 22 would constitute a violation of this article if the applicant 23 were a licensee. 24 (3) Denial, suspension, or revocation of an individual emer- 25 gency medical services personnel license under part 209 is gov- 26 erned by section 20958. 02457'97 * 5 1 SEC. 20210. A HEALTH FACILITY OR AGENCY SHALL NOT REPRESENT 2 THAT IT PROVIDES A COMPREHENSIVE, MULTIDISCIPLINARY PAIN 3 MANAGEMENT PROGRAM UNLESS THE PROGRAM IS OPERATED IN ACCORDANCE 4 WITH THE STANDARDS OF 1 OR MORE OF THE FOLLOWING NATIONAL ACCRED- 5 ITING BOARDS, WHICH STANDARDS ARE INCORPORATED BY REFERENCE: 6 (A) THE STANDARDS FOR COMPREHENSIVE, MULTIDISCIPLINARY PAIN 7 MANAGEMENT PROGRAMS ADOPTED BY THE JOINT COMMISSION ON THE 8 ACCREDITATION OF HEALTH CARE ORGANIZATIONS. 9 (B) THE STANDARDS FOR COMPREHENSIVE, MULTIDISCIPLINARY PAIN 10 MANAGEMENT PROGRAMS ADOPTED BY THE COMMISSION ON ACCREDITATION OF 11 REHABILITATION FACILITIES. 12 (C) THE STANDARDS FOR COMPREHENSIVE, MULTIDISCIPLINARY PAIN 13 MANAGEMENT PROGRAMS ADOPTED BY THE AMERICAN OSTEOPATHIC 14 ASSOCIATION. 15 Enacting section 1. This amendatory act does not take 16 effect unless all of the following bills of the 89th Legislature 17 are enacted into law: 18 (a) Senate Bill No. _____ or House Bill No. _____ (request 19 no. 00141'97 **). 20 (b) Senate Bill No. _____ or House Bill No. _____ (request 21 no. 00151'97 **). 22 (c) Senate Bill No. _____ or House Bill No. _____ (request 23 no. 00152'97 **). 24 (d) Senate Bill No. _____ or House Bill No. _____ (request 25 no. 00250'97 **). 26 (e) Senate Bill No. _____ or House Bill No. _____ (request 27 no. 02458'97 *). 02457'97 *