Doctor Day 2018 has been set for Tuesday, January 30. The event will again be held at the Monona Terrace in Madison and is hosted by over 20 medical societies.
The event provides physicians an opportunity to meet with their legislators, and have input on important health care issues. The day will conclude with a reception in downtown Madison.
Registration is available online (link).
Despite opposition from 22 organizations representing physicians, nurses, physician assistants, hospitals, the WIAA, insurers and others – and support from only one (the Wisconsin Chiropractic Association) – AB 260 passed the full Assembly on Wednesday, June 21 and is now being considered in the Senate for consideration.
It is critically important for physicians to let Senators know their opposition before the Senate makes their decision about how to proceed. To find your State Senator’s office contact information, type in your home address under “Find my Legislators” (link). Please do not delay – sending an email will take you no more than 2 minutes. The coalition memo opposing the bill (link) and related infographic (link) are attached for more information.
The Senate approved the final two proposals that are part of a special legislative session on opioids that Gov. Scott Walker called in January.
All 11 proposals that are part of that session have now passed the Legislature and await Walker's signature to become law.
The bills were based on recommendations from an interim report released in January by the Governor's Task Force on Opioid Abuse, which was chaired by Lt. Gov. Rebecca Kleefisch and Rep. John Nygren, R-Marinette.
"We have a lot of work left to do on a massive epidemic that's sweeping our state," said Ashland Democratic Sen. Janet Bewley, who served on the task force as well. "We are learning that it's even bigger and more profound than we ever thought."
The Senate approved a proposal Tuesday that would provide limited legal immunity to overdose victims. Sen. Steve Nass, R-Whitewater, was the sole no vote.
The chamber also approved a bill allowing for families and others to involuntarily commit a person with drug dependence.
The Senate also voted down along party lines a Democratic amendment to the latter proposal requesting the attorney general to consider filing a lawsuit against opioid manufacturers. A few states, like Ohio, have filed lawsuits against drugmakers.
Senate Majority Leader Scott Fitzgerald, R-Juneau, predicted that a class action lawsuit against drugmakers "is coming. It's just a matter of time...and I'm sure we'll be part of that at some point." He moved to reject the proposal as he didn't want it tied with the bill.
See a list of the special session bills.
CALL OR EMAIL YOUR STATE SENATOR TODAY – ASK THEM TO OPPOSE CHIROPRACTORS’ SCOPE EXPANSION BILLS: ASSEMBLY BILL 260 SENATE BILL 232 Despite opposition from 22 organizations representing physicians, nurses, physician assistants, hospitals, the WIAA, insurers and others – and support from only one (the Wisconsin Chiropractic Association) – AB 260 is expected to pass the full Assembly on Wednesday, June 21. Once passed by the Assembly, AB 260 will move to the State Senate for consideration – and it is critically important for physicians to let Senators know their opposition before the Senate makes their decision about how to proceed. To find your State Senator’s office contact information, type in your home address under “Find my Legislators” (right-hand side of this website: http://legis.wisconsin.gov). Please do not delay – sending an email will take you no more than 2 minutes.
What do AB 260/SB 232 do? Rep. Chuck Wichgers (R-Muskego) and Sen. Frank Lasee (R-DePere) have introduced legislation that would dramatically expand the current scope of practice for chiropractors in Wisconsin. These bills would allow Wisconsin chiropractors to conduct pre-participation physical exams for studentathletes (high school, technical colleges and 2-year UW colleges) and require that the WIAA, Wisconsin technical colleges or 2-year UW campuses to accept pre-participation exams conducted by “certified” chiropractors. The Chiropractic Exam Board is exclusively authorized to set the criteria for a chiropractor to be “certified” – there are no criteria or parameters specified in the bill. In short, comprehensive pre-participation physical exams involve examination and assessment of the musculoskeletal structures as well as an athlete’s heart and lungs, vision, neurological (concussion history), mental health and more – areas in which chiropractors have little or no training. These bills put student-athletes at risk, and represent a significant and unnecessary expansion of chiropractors’ scope. * * * * Also included in these bills, but already largely decided at the Federal level -- the Federal Motor Carrier Safety Administration (FMCSA) sets criteria by which health providers may qualify as a certified medical examiner and conduct FMCSA driver exams. The FMCSA authorizes chiropractors to qualify as medical examiners if they meet FMCSA standards, but leaves to states the final authorization. These bills would allow Wisconsin chiropractors to become FMCSA medical examiners if they meet FMCSA’s standards.
As a consequence of opting out of the federal health reform law's Medicaid expansion, Wisconsin could receive an estimated $37 billion less by 2025 under the Republican healthcare proposal that passed the House earlier this year, according to a new analysis.
The American Health Care Act has "assurances" that aim to "restore equity in Medicaid spending" for the 19 states that chose not to accept federal funds to expand the program, according to a policy brief by the Missouri Hospital Association.
But the association's analysis finds that by 2025, those states would get $683.9 billion less in federal Medicaid funding than they would if they expanded the program under the Affordable Care Act.
That amounts to $36.9 billion less during that period for Wisconsin, according to data used in the report provided by the Wisconsin Hospital Association.
"The report is eye-opening and should be of concern to anyone in a non-expansion state," Eric Borgerding, WHA CEO, said in a statement. "While the AHCA did attempt to provide a measure of relief to non-expansion states like ours, clearly it is insufficient and must be addressed by the U.S. Senate during their deliberations."
Rather than taking federal funding to expand the program, Wisconsin made eligibility changes to Medicaid to cover childless adults up to 100 percent of the federal poverty level and cut eligibility for parents and caretakers.
Arkansas, which previously expanded Medicaid under the ACA, is asking CMS for permission to cap eligibility at 100 percent.
At a Wisconsin Health News event last week, Joint Finance Committee Co-Chair Rep. John Nygren, R-Marinette, said "if a state is going to be rewarded for something that Wisconsin has already done, Wisconsin should be awarded for what Wisconsin has done."
"One of my frustrations with the proposal coming out of Washington was that it basically didn't reward states like Wisconsin that did it the right way and basically continued to reward states that went a different course," he said.
Leading health experts have grave concerns over AB260, mandating Wisconsin’s schools and colleges to accept physical exams completed by chiropractors. Currently primary care providers examine students for clearance to compete in athletic programs.
The coalition opposing the measure includes 19 key physician organizations, other health care providers, health systems, hospitals, academic centers and other parties with a vested interest in the health and well-being of Wisconsin’s student athletes.
“Chiropractors do not have the comprehensive medical training to provide the wrap-around care provided in the primary care office,” said Dr. David Bernhardt, a team physician for the University of Wisconsin-Madison and pediatric and adolescent sports medicine expert. “The safety of youth athletes is at stake.”
During public testimony on the bill in April, some commented that chiropractors “often have more training than physicians in certain areas,” a claim contested by physicians and others.
In contrast, a 2016 American Medical Association issue brief reports that while physicians complete 10,000+ clinical patient care hours (plus additional classroom and laboratory experience), chiropractors are required only to complete 4,200 hours of combined classroom, laboratory and clinical experience.
Dr. Kevin Walter, Program Director for Children’s Hospital of Wisconsin’s Primary Care Sports Medicine program, also cautioned against the proposal. "We want these young athletes to have quality screening by medical experts. When medical professionals are evaluating their health and physical readiness to participate in a sport, the exam includes so much more such as their cardiovascular condition, mental and behavioral health as well as educating them on health issues. The goal should be what is best for Wisconsin's kids and this proposal to allow chiropractors to handle these exams misses that mark."
The Assembly Committee on Health has scheduled a vote on the measure on Tuesday, June 13.
Now is the time for physicians concerned about this bill to contact your State Assembly representatives—please feel free to use the coalition’s April 26, 2017 memo as a source for talking points; you also can share the document with your representative. To verify the contact information for your elected officials, visit the State Legislature’s website and enter your address into the box under the “Find My Legislators” section at the right of the screen.
The Legislature's budget-writing committee has amended the state's next budget to expand the number of dementia care specialists in the state, rejecting the state's plans to end the program.
The Dementia Care Specialist Program embeds specialists that support those with dementia and their families as well as help foster dementia friendly communities in Aging and Disability Resource Centers.
The program is set to end this year, and Gov. Scott Walker's 2017-19 state budget didn't include funding to continue it. Department of Health Services Secretary Linda Seemeyer said in March that the department wouldn't oppose continuing the program.
The Joint Finance Committee approved a motion last month that amends the budget to provide $3.1 million over the next biennium to support the current 19 dementia specialist positions. The amendment would add an additional four positions that would start July 1, 2018.
Most of that funding, which is ongoing rather than one-time, comes through general purpose revenue, with some coming from the federal government.
"The number of Wisconsinites living with Alzheimer's and dementia continues to grow and we must ensure that these individuals and their families have adequate support," JFC member Rep. Mike Rohrkaste, R-Neenah, said in a statement. Rohrkaste led the Speaker's Task Force on Alzheimer's and Dementia last legislative session.
The retention of the program was a priority for the Alzheimer's Association, Southeastern Wisconsin Chapter. Tom Hlavacek, executive director, said the specialists are playing a greater role in identifying people with dementia and connecting caregivers with resources. They often work with the association, he added.
While they requested expanding the program statewide, the addition of new staff "is a step in the right direction," he said.
"We felt that the victory was important not just for these positions, not just for expanding the program, but because it acknowledges the fact that we have an epidemic on our hands in the state of Wisconsin and across the country," he said.
Rob Gundermann, public policy director at Alzheimer's & Dementia Alliance of Wisconsin, said they were a "little disappointed" with the committee's decision.
"If they're going to spend that kind of money we would have rather have seen that go into respite," he said. "We administer it for Dane County here and we're already out of money this year. There's just such a need for that and it keeps people in their homes."
Gundermann said it's "ridiculous" that the state will be spending more money on the specialists than on respite care. "We need to incentivize home care over institutionalization," he said. "That's the way you save money with this population and you do that by providing respite."
The committee also approved $100,000 over the next two years to support the Wisconsin Alzheimer's Disease Research Center, which was requested by Gov. Scott Walker. The proposal mirrors a bill that was introduced last year by the Speaker's Task Force but didn't make it into law.
Gov. Scott Walker's Department of Health Services officially asked the federal government Wednesday to allow Wisconsin to become the first state to drug screen adult Medicaid enrollees without children. The waiver amendment also caps eligibility, imposes work requirements and charges premiums to members living below the poverty line.
DHS pared back some of the changes after receiving more than 1,000 pages of comments on the proposal.
That includes shrinking the income tiers for premiums from four tiers to two and not making anyone under 50 percent of the poverty level pay premiums. Childless adults with household incomes between 51 percent and 100 percent of the poverty level would pay $8 a month. Walker originally proposed a range of $1 a month to $10 a month for members making between 21 percent of the poverty level and 100 percent. DHS is also considering a grace period of 12 months for members that miss a payment.
In addition, the application decreases a copay for subsequent visits to the emergency room. And members who skip a drug screening can sign back up for coverage as soon as they consent to treatment, instead of waiting six months.
Walker called the application "a step in the right direction." "We're continuing to build on Wisconsin's legacy as a leader in welfare reform," he said in a statement Wednesday.
Jon Peacock, research director for the Wisconsin Council on Children and Families, said the latest changes to the proposal were "modest improvements." But they don't "change the basic problem that the waiver would add new barriers to BadgerCare participation that increase administrative costs and keep people from getting the care they need."
Last month, the state's budget committee voted to require that the panel approve the waiver amendment before it's implemented. At a Wisconsin Health News event Monday, Joint Finance Co-Chair Rep. John Nygren, R-Marinette, said he overall supported Walker's plan, but "there's still a lot of unanswered questions in the proposal." "For us to feel comfortable that we're moving in the right direction, we believe the proposal should come back to Joint Finance and we have the opportunity to vote it up or down," he said.
We are flying in a full slate of national speakers to provide in-depth perspective on the latest updates and developments. That includes:
They will be joining vice presidents from the American Medical Association and America's Health Insurance Plans, as well as influential experts from Wisconsin, including:
We've also expanded network opportunities throughout the day and expect CEOs, executives and senior leaders from across the state to attend. This will be an event you don't want to miss.
State Legislative Update
If you have any questions or would like to discuss how to improve your advocacy efforts, contact Grant Niver.
Federal Legislative Update
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