20 March 2020

Governer Whitmer Issues Executive Order Postponing Non-Essential Medical and Dental Procedures

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On March 20, 2020, Governor Gretchen Whitmer signed Executive Order 2020-17, which is effective March 21, 2020 at 5:00 pm. The order applies to all “hospitals, freestanding surgical outpatient facilities (ambulatory surgery centers or ASC), and dental facilities and all state-operated outpatient facilities,” which are referred to as “covered facilities.” A “freestanding surgical outpatient facility” is defined as a “facility, other than the office of a physician, dentist, podiatrist, or other private practice office, offering surgical procedure and related care that can be safely performed without requiring overnight inpatient hospital care and is not operated as part of a hospital.” Accordingly, not every physician’s office that provides outpatient surgery appears to be a “covered facility” subject to the Executive Order.

Covered facilities are required to implement a plan to temporarily postpone all “non-essential procedures.” The order defines “non-essential procedures” to mean medical or dental procedures that are not necessary to address a medical emergency or preserve the health and safety of a patient.  Covered facilities must postpone joint replacement, bariatric surgery and cosmetic surgery except for emergency or trauma-related surgery where postponement would impact the health, safety and welfare of the patient. Any covered facility that performs dental procedures must postpone, at a minimum, cosmetic or aesthetic procedures (such as veneers, teeth bleaching, or cosmetic bonding), routine hygiene appointments, any orthodontic procedures that do not relieve pain or infection, do not restore oral function, or are not trauma-related, initiation of any crowns, bridges, or dentures that do not relieve pain or infection, do not restore oral function, or are not trauma-related; any periodontal plastic surgery; any extractions of asymptomatic non-carious teeth; and any recall visits for periodontally healthy patients.

In addition to permitting procedures that significantly impact the health, safety, and welfare of the patient, the order allows facilities to perform: surgeries related to advanced cardiovascular disease (including coronary artery disease, heart failure, and arrhythmias) that would prolong life; oncological testing, treatment, and related procedures; pregnancy-related visits and procedures; labor and delivery; organ transplantation; and procedures related to dialysis. Trauma-related procedures that would significantly impact the health, safety, and welfare of patients are also excluded.

The order is consistent with guidance from the Centers for Medicare & Medicaid Services (“CMS”) which was released on March 18, 2020 and recommended postponing all non-essential medical, surgical and dental procedures.