Evers signs step therapy, dialysis bills
Gov. Tony Evers signed into law two bipartisan healthcare bills Tuesday, including one that allows patients to bypass policies that require them to try cheaper medications before more expensive ones.
Under the proposal, insurers have to allow exceptions to step therapy if patients seeking the more expensive treatment have supporting documentation from providers, have tried the drug before, or if the cheaper treatment is expected to be ineffective or have adverse health effects.
Evers also approved a bill so distributors that provide patients with in-home dialysis supplies don't have to get a pharmacist license. The proposal was backed by Baxter Corporation, which has to register its Minnesota and Illinois distribution centers as fully licensed pharmacies.
Evers described the bills as “important steps” in “doing everything we can to make sure that folks in all 72 counties can access the life-saving care they need and deserve without barrier or burden.”
*From Wisconsin Health News, June 19
The Assembly signed off on a bill Tuesday that would allow patients to bypass health plan policies that require them to try cheaper medications before more expensive ones.
The bipartisan proposal, which passed the Senate earlier month, now heads to Gov. Tony Evers’ desk.
The approval comes after lawmakers consulted with insurers and other healthcare providers and amended the legislation. Under the proposal, insurers, pharmacy benefit managers and utilization review organizations have to allow patients to apply for exceptions to step therapy protocols.
The companies would have to grant their requests if providers submit supporting documentation under certain conditions, like if the cheaper drug could cause serious side effects, is expected to be ineffective or the patient has tried the drug before.
“We arrived at a bill that keeps the spirit, integrity, and patient protections of the original bill, while still ensuring the health plans have the ability to meaningfully utilize step therapy protocols in order to keep costs down,” bill author Rep. John Nygren, R-Marinette, said in a statement.
The chamber also signed off on a bill that would change state law so distributors of products necessary for home dialysis don’t need to be licensed as pharmacies. That bill also heads to Evers.
And it passed legislation allowing properly trained pharmacists to administer vaccines prescribed to children under the age of 6. The Senate has yet to take up the measure.
The Senate Health and Human Services Committee signed off on a bill Tuesday that would allow patients to bypass insurance policies requiring them to try cheaper drugs before moving on to more expensive ones.
The committee unanimously approved the legislation requiring insurers, pharmacy benefit managers and utilization review organizations to have exceptions for step therapy protocols.
Lawmakers also approved bills that would:
· allow properly trained pharmacists to immunize patients younger than six who have a prescription for a vaccine.
· allow Wisconsin to continue to participate in a an interstate licensure compact that lets doctors more easily practice in other states.
· eliminate a law requiring distributors that provide patients with in-home dialysis supplies to obtain pharmacist licenses.
Doctor Day 2019 is fast approaching and it’s important that physicians like YOU participate in our unique-to-Wisconsin, annual multi-specialty advocacy event in Madison on Wednesday, May 1, 2019. As always, Doctor Day is a jointly-sponsored event that includes more than a dozen Wisconsin specialty societies and WMS.
As in past years, we strive to invite leading Wisconsin politicians or health policy experts to speak before Doctor Day to keep our attendees attuned to the latest in Wisconsin politics, and healthcare law and policy.
Attorney Guy DuBeau (Axley, Brynelson, SC), who serves as counsel to several special societies, will provide a legal update including discussion of the 2018 Mayo v. IPFCF decision (medical malpractice damage caps), current Wisconsin marijuana law and proposals, and physician non-compete agreements.
Each participating organization is invited to provide an “issue paper” to be left with lawmakers during the afternoon’s Legislative Visits, describing the particular organization and the organization’s key policy or legislative issues. Due to the unique nature of Doctor Day’s multi-specialty approach, and the limited time for each meeting with lawmakers, as always our attendees will be asked to jointly advocate for some key and politically timely health issues. During the morning General Session, lobbyists representing the participating organizations will lead briefings on these key Advocacy Issues, including:
Doctor Day will again conclude with the ever-popular Doctor Day Reception. This year, the reception will be held at a new and larger venue: Madison’s, a popular restaurant and bar located one block off the Square at 119 King Street, providing our attendees a casual opportunity to mingle and debrief with colleagues from a variety of medical specialties.
The tentative schedule and online registration are available at www.WIDoctorDay.org.
In just six years, Doctor Day has grown from just over 100 to nearly 500 attendees – but we need you to maintain that growth. As a Wisconsin physician, Doctor Day is the best way for you to let Wisconsin lawmakers know their physician-constituents are aware and care about what they are doing in Madison. There is no cost to attend Doctor Day, so please register today.
About 30 percent of graduating medical students will remain in Wisconsin for their residencies, according to the state’s two medical schools.
More than 400 Wisconsin Medical students found out where they’re heading for residencies earlier this month when the National Resident Matching Program released its results.
At the Medical College of Wisconsin, 33 percent of the 224 students who obtained positions are remaining in state. The top picks for specialties were internal medicine, pediatrics and family medicine.
The Wisconsin Medical Society plans to create a center focused on fighting physician burnout this year as well as pursue legislation to create a physician health program, according to a recent report showing more than half of Wisconsin physicians reporting burnout.
The report, based on a survey of 1,165 Wisconsin doctors, showed that nearly 53.5 percent are experiencing one symptom of burnout. And 47.1 percent plan to decrease clinical hours or retire early in the next five years.
“We continue to see higher percentages of physicians identifying one or more of the symptoms of burnout,” said society CEO Dr. Bud Chumbley. “That’s troublesome.”
The survey found that electronic health records were a top stressor for doctors, as well as government and insurance regulations and an unsupportive work environment.
To address burnout, Chumbley said that the society is planning to launch the Center for Physician Empowerment this year, which will seek to convene health systems in the state to share what they’re doing to address burnout efforts.
They’re also working on additional physician leadership and mentorship programs. Chumbley also said he's spoken with Verona-based Epic about the problem as well. He’s hoping to talk with insurers about their policies too.
“Our job is to identify these problems, try to get those individuals who can help solve them,” Chumbley said. “Hopefully, if we get all those people in a room, talking about how to solve it, that’s the best way to reverse this trend.”
The medical society is also working with the Medical Examining Board to develop legislation that would create a physician health program run by the state.
Chumbley said Wisconsin is one of the few states that doesn't have a physician health program. The society previously ran such a program, but it ended in 2007 due to "legal concerns and difficulties coordinating funding for the program," the report noted.
Marijuana was among the big winners at the polls in November, with voters in counties across the state signaling their support for legalization. Backers also have a friend in Gov.-elect Tony Evers, who has said doctors should be able to use cannabis to treat patients.
Meanwhile, CBD, a cannabis compound, has been heralded as a cure-all for everything from seizures to chronic pain to better sleep. Lawmakers have approved its use, but questions over its health benefits - and legality - remain.
A Jan. 8 Wisconsin Health News panel in Madison will take a closer look at the legal and health issues around marijuana and CBD – and their future in the state.
· Dr. Mike Miller, American Board of Addiction Medicine
· Michael Queensland, Senior Staff Attorney, Wisconsin Legislative Council
· Rep. Chris Taylor, D-Madison
· Sen. Pat Testin, R-Stevens Point
The Wisconsin Medical Society has urged the state’s Medical Examining Board (MEB) to be flexible when approving courses related to opioid prescribing so that more physicians can receive useful education befitting their particular specialties. The input was given at a public hearing before the MEB on a new administrative rule related to an extension of the opioid prescribing continuing medical education (CME) course requirement until November 2021.
Current rules require physicians holding a U.S. Drug Enforcement Administration number to complete two of the 30 required hours of CME per biennium in an MEB-approved course related to the state’s opioid prescribing guidelines. The current requirement expires in November 2019. The MEB is extending the requirement for another CME reporting biennium while broadening the subject matter scope to “an educational course or program related to opioid prescribing.”
The Society was the only organization to testify before the MEB on the rule proposal.
Flexibility in the types of courses that can gain MEB approval would make the requirement more relevant to certain physicians who, while not being active opioid prescribers, often take care of patients dealing with the aftermath of opioid addiction or abuse. The Society also suggested that the Board could incentivize physicians taking coursework in Medication Assisted Treatment (MAT) by making those courses eligible to satisfy the requirement should they be submitted for CME approval. The MEB welcomed the comments and indicated that such flexibility would be useful as Wisconsin continues to grapple with this issue.
The MEB unanimously approved the rule proposal, which now moves on to standard Governor’s office and legislative review. Contact Mark Grapentine, JD, for more information.
Each of the webinars available in the Society’s opioid prescribing series has been approved by the MEB for fulfilling the 2018-2019 CME requirement, including two 2-hour webinars presented by Michael McNett, MD. The other programs vary in length and may be combined to satisfy the mandate. Click here to learn more.
MCW-affiliated concussion study gets more backing
*From Wisconsin Health News, 11/9/2018
A consortium studying concussions that includes the Medical College of Wisconsin recently received $22.5 million in new funding, according to a statement.
The money from the Department of Defense and NCAA will expand a concussion study that includes MCW, Indiana University School of Medicine, the University of Michigan and the Uniformed Services University.
The NCAA-DOD Concussion Assessment, Research and Education Consortium has collected data on more than 39,000 student-athletes and cadets at 30 colleges and military service academies.
That includes 3,300-plus who have had concussions, the largest sample of concussions researched in a single study.
A $30 million joint NCAA-Department of Defense grant funded the first part of the study, which focused on the acute effects of concussions.
The new phase, funded by $12.5 million from NCAA and nearly $10 million from a DOD grant, will look at the intermediate and cumulative effects of concussion and repetitive head impacts.
"What we learn from this research will advance the science of traumatic brain injury and improve our understanding of how to best support the health and well-being of student-athletes, not only during their collegiate athletics experience but beyond,” Dr. Brian Hainline, NCAA chief medical officer, said in a statement.
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Phone: 920-560-5622 | Fax: 920-882-3655