HOUSE BILL NO. 5146

October 17, 2023, Introduced by Reps. Schmaltz, Jaime Greene, Thompson, Smit, Mueller, Roth, Aragona, St. Germaine, Bruck, Beson, Markkanen, Cavitt, Bierlein, Hoadley, Outman, BeGole, Bezotte, Neyer, Zorn and DeBoer and referred to the Committee on Elections.

A bill to create a hyperbaric oxygen therapy treatment grant program and pilot program for providing treatment to veterans with traumatic brain injuries or post-traumatic stress disorder; to provide for the powers and duties of certain state governmental officers and entities; to require the promulgation of rules; and to create certain funds.

the people of the state of michigan enact:

Sec. 1. As used in this act:

(a) "Department" means the department of health and human services.

(b) "Eligible veteran" means an individual who meets both of the following criteria:

(i) Is a veteran as that term is defined in section 1 of 1965 PA 190, MCL 35.61.

(ii) Is diagnosed with a traumatic brain injury or post-traumatic stress disorder.

(c) "Fund" means the hyperbaric oxygen therapy treatment fund created in section 7.

(d) "Grant program" means the hyperbaric oxygen therapy treatment grant program created in section 3.

(e) "Hyperbaric oxygen therapy treatment" means treatment for traumatic brain injury or post-traumatic stress disorder that is prescribed by a physician licensed in this state and delivered in a medical-grade hyperbaric chamber.

(f) "Pilot program" means the hyperbaric oxygen therapy treatment pilot program established under section 5.

(g) "Provider" means a provider of hyperbaric oxygen therapy treatment.

(h) "Treatment plan" means a hyperbaric oxygen therapy treatment plan.

Sec. 3. (1) As part of the pilot program, the department shall create and operate a hyperbaric oxygen therapy treatment grant program. The department may make grants under this section only to a provider chosen by the department under section 5 to assist the provider in providing hyperbaric oxygen therapy treatment and related diagnostic testing to eligible veterans under the pilot program. All providers that receive a grant under this section must offer hyperbaric oxygen therapy treatment at no cost to eligible veterans as provided in section 5.

(2) The department shall not make a grant under this section until after the department has established the pilot program and promulgated the rules required by section 5.

(3) The department shall not make a grant under this section after the pilot program ends.

(4) The department shall promulgate rules to implement this section under the administrative procedures act of 1969, 1969 PA 306, MCL 24.201 to 24.328, that must address all of the following for grants under this section:

(a) Application procedures.

(b) Eligibility criteria subject to section 5.

(c) Selection procedures subject to section 5.

(d) A consideration of the extent to which a provider has used assistance available from other assistance programs before the department makes a grant under this section to the provider. However, a grant must not be denied or delayed solely on the basis that assistance available from other programs has not been used.

(e) Department oversight and verification of the use of grant money.

Sec. 5. (1) The department, in consultation with the department of military and veterans affairs, shall establish a hyperbaric oxygen therapy treatment pilot program to assist each provider that the department approves to provide hyperbaric oxygen therapy treatment and related diagnostic testing to eligible veterans. The pilot program must end on January 1, 2027.

(2) The department shall issue a request for proposals within this state to provide hyperbaric oxygen therapy treatment to eligible veterans. In determining the providers that will participate in the pilot program, the department shall prioritize existing providers in this state that meet 1 or more of the following criteria:

(a) Have a medical director who is a physician licensed in this state.

(b) Are staffed with hyperbaric oxygen therapy chamber technicians that have relevant training and certifications as determined by the department.

(c) Follow treatment protocols for using hyperbaric oxygen therapy treatment to treat traumatic brain injuries and post-traumatic stress disorder as determined by the department.

(3) An eligible veteran is eligible for hyperbaric oxygen therapy treatment under the pilot program if the service-related event that caused the traumatic brain injury or post-traumatic stress disorder is documented by a physician licensed in this state.

(4) The department, after consulting with the department of military and veterans affairs, shall promulgate rules to implement this section under the administrative procedures act of 1969, 1969 PA 306, MCL 24.201 to 24.328, that must include standards for all of the following:

(a) Determination by a provider that an eligible veteran is eligible for participation in the pilot program by showing 1 of the following forms as applicable:

(i) DD214.

(ii) NGB-22.

(iii) DD256.

(b) Determination by the department that a provider is eligible to participate in the pilot program, including a requirement that the provider must maintain compliance with applicable state safety regulations and licensing requirements.

(c) Treatment plan requirements, including all of the following:

(i) That a provider must submit to the department, before providing hyperbaric oxygen therapy treatment to an eligible veteran, a treatment plan that includes all of the following:

(A) A prescription from a physician licensed in this state for hyperbaric oxygen therapy treatment.

(B) Verification by the provider that the eligible veteran is eligible under subdivision (a) for participation in the pilot program and voluntarily accepts treatment through the pilot program.

(C) An estimate of the cost of the eligible veteran's hyperbaric oxygen therapy treatment.

(D) Any other information required by the department.

(ii) A requirement that both of the following must occur after the department receives a proposed treatment plan from a provider:

(A) Approval or disapproval by the department of the treatment plan within 10 business days.

(B) Notice to the provider of approval or disapproval of the treatment plan within 15 business days.

(iii) Contingent on sufficient funding available in the fund, approval of each treatment plan that meets the requirements established by the department under this section.

(iv) The sources of funding for the estimated cost of hyperbaric oxygen therapy treatment for each eligible veteran whose treatment plan is approved under this section.

(d) Criteria for approval of payment for hyperbaric oxygen therapy treatment that has been verified by the department to have been provided under a treatment plan approved under subdivision (c), including both of the following:

(i) Whether a drug or device used in the treatment plan has been approved for any purpose by the United States Food and Drug Administration.

(ii) A verification that an eligible veteran received the treatment, as demonstrated through billing documentation from the provider, or attendance documentation signed by the provider and the eligible veteran attesting to the receipt of the treatments.

(e) Confidentiality of all individually identifiable patient information of an eligible veteran.

(5) A provider shall bill only the pilot program and be paid at cost out of a grant made to the provider under the grant program at a rate agreed to between the provider and the department, which may be the current state or federal Centers for Medicare and Medicaid Services rates. A provider shall not bill an eligible veteran for any service provided under the pilot program.

(6) Each provider shall file a quarterly status report concerning the services performed by the provider under the pilot program with the department and the department of military and veterans affairs.

(7) By not later than 1 year after the pilot program ends, the department, in consultation with the department of military and veterans affairs, shall prepare a report and submit it to the governor and the chairpersons of the senate and the house of representatives standing committees on military and veterans affairs. The report required under this subsection must be made available on the department's website and contain, at a minimum, all of the following for the pilot program:

(a) An evaluation of the effectiveness of the pilot program.

(b) The number of eligible veterans participating.

(c) The number of providers participating.

Sec. 7. (1) The hyperbaric oxygen therapy treatment fund is created in the state treasury.

(2) The state treasurer shall deposit money and other assets received from any source in the fund. The state treasurer shall direct the investment of money in the fund and credit interest and earnings from the investments to the fund.

(3) The department is the administrator of the fund for audits of the fund.

(4) The department shall expend money from the fund on appropriation, only for 1 or more of the following purposes:

(a) Providing grants under the grant program.

(b) Establishing and operating the pilot program.