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  • 06/15/2017 8:11 AM | Jamie Michael (Administrator)
    June 13, Wisconsin Health News

    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.

    Read more.

  • 06/12/2017 9:21 AM | Jamie Michael (Administrator)
    June 12, 2017

    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.

    Take Action
    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.

  • 06/12/2017 9:20 AM | Jamie Michael (Administrator)
    June 5, Wisconsin Health News

    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. 

  • 06/12/2017 9:19 AM | Jamie Michael (Administrator)
    June 8, Wisconsin Health News

    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.

  • 06/12/2017 9:18 AM | Jamie Michael (Administrator)
    Get the full story on the twists and turns of federal health reform and what it means for Wisconsin at this year's Wisconsin Health News conference. 

    We are flying in a full slate of national speakers to provide in-depth perspective on the latest updates and developments.  That includes:

    • ·         Avik Roy, a leading conservative thinker on health reform who served as a policy advisor to three Republican presidential candidates, including Mitt Romney in 2012.
    • ·         Julie Rovner, a Washington D.C.-based senior correspondent for Kaiser Health News and former reporter for NPR. 

    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: 

    • ·         State Medicaid Director Mike Heifetz
    • ·         Deputy Insurance Commissioner J.P. Wieske
    • ·         Wisconsin Hospital Association CEO Eric Borgerding
    • ·         Gundersen Health System CEO Dr. Scott Rathgaber
    • ·         Molina Healthcare of Wisconsin Plan President Scott Johnson
    • ·         UW Population Health Institute Program Manager Donna Friedsam
    • ·         Wisconsin Collaborative for Healthcare Quality CEO Chris Queram
    • ·         Wisconsin Council on Children and Families Research Director Jon Peacock

    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. 


  • 06/01/2017 4:10 PM | Jamie Michael (Administrator)

    State Legislative Update

    • The number of states that have adopted the Interstate Medical Licensure Compact stands at 18. 6 states currently have active legislation, which the AAN is supporting. The compact offers an expedited licensing process for physicians interested in practicing medicine in multiple states.

    If you have any questions or would like to discuss how to improve your advocacy efforts, contact Grant Niver.

    Federal Legislative Update 

    • ·         Congress passed the FY2017 spending bill, which includes $34 billion for the NIH, an increase of 6.2% from FY2016. The BRAIN Initiative received $260 million, which was a request of the AAN’s Neurology on the Hill effort in February. The bill also provided substantial increases in funding for Alzheimer’s disease, telehealth, and opioid abuse.
    • ·         On May 4, 2017, the House of Representatives narrowly passed the American Health Care Act (AHCA), a bill that repeals and replaces several provisions of the Affordable Care Act. Due to concerns about reduced access to health insurance coverage, the AAN and most other medical groups oppose the bill. The legislation will now advance to the Senate.
    • ·         The Furthering Access to Stroke Telemedicine (FAST) Act (HR. 1148/ S. 431), now has 80 bipartisan cosponsors in the House and seven bipartisan cosponsors in the Senate. The bill has also been included in several key legislative packages. On May 15, 2017, AAN member neurologist and American Heart Association advocate Lee H. Schwamm, MD, testified in support of this legislation before the Senate Finance Committee.

    Stay up-to-date on #AANAdvocacy by reading the Capitol Hill Report and following the AAN’s Senior Legislative Counsel Mike Amery on Twitter at @MikeAmeryDC.

    Medical Economics Update

    • New resources are available for small neurology practices to comply with the MACRA Quality Payment Program. CMS has announced new regional organizations to provide hands-on support for practices with 15 or fewer clinicians. Practices should identify the organization in their state and contact them today.
    • Neurologists can use the new MIPS Eligibility Tool to see if they are eligible to participate in the Merit-based Incentive Payment System in 2017.
    • The AAN continues to work to reduce regulatory burdens for neurologists. AAN’s Regulatory Counsel participated in a meeting with HHS Secretary Tom Price in April to request reductions in regulatory burdens.

      For more information on AAN practice resources,
      visit our webpage.

    AAN Membership Update

    Quality Update

    • ·         The AAN and American Psychiatric Association released the dementia management quality measurement set update on May 1. The measures and publication are available online. Select dementia management measures are available in 2017 for use in CMS’ Merit-based Incentive Payment System (MIPS).
    • ·         The Axon Registry® has been designated a Quality Clinical Data Registry (QCDR) for reporting year 2017 by CMS. This means the registry can report neurology specific quality measures under the MIPS program. Visit our website for information on how to join the Axon Registry and what it could do for your practice.
    • ·         “Practice Guideline: Sudden Unexpected Death in Epilepsy Incidence Rates and Risk Factors” was published in Neurology during the Annual Meeting on April 24, 2017. It was codeveloped with the American Epilepsy Society and endorsed by the International Child Neurology Association.
    • ·         “Practice Guideline: Reducing Brain Injury After Cardiopulmonary Resuscitation,” was published online ahead of print in Neurology on May 10, 2017. It was endorsed by the Neurocritical Care Society.

    Meeting Promotion Request Form
    Ready to start promoting your upcoming meeting? Complete the new
    Neurosociety Meeting Promotion Request Form today to promote to all AAN members in your state!

    Speaker Request Form

    As you put together the agenda for your 2016 meetings, consider taking advantage of the AAN’s speaker program! We have expert speakers on topics such as ICD-10, MACRA, practice management, quality measures, telemedicine, and much more. To secure a speaker for your state meeting, please refer to the State Neurosociety Speaker Request Form.

    AAN Sports Concussion 2017


    Hyatt Regency Jacksonville-Riverfront
    Jacksonville, FL
    Register now!

  • 05/26/2017 4:18 PM | Jamie Michael (Administrator)

    The Wisconsin Neurological Society is now accepting applications for the Bennett Hiner Research Award.  The Award is presenting to a medical student enrolled at one of the state’s medical schools in recognition for extra-ordinary service, leadership and research in the neurosciences.

    This award is in memory of Bennett Hiner, son of long time Society member Dr. Bradley Hiner.  Bennett passed away unexpectedly in November 2011. He was an enthusiastic and accomplished young man who was a leader in his medical school class at the University of Southern California and actively involved in neuroscience research.

    Qualified applicants are medical students must be enrolled at either the University of Wisconsin School of Medicine and Public Health, or the Medical College of Wisconsin; have completed neuroscience research within two (2) years of application for this award; have demonstrated leadership experience while enrolled in medical school; and have submitted the application and research abstract.  An application form is available by clicking here.

    Medical students should submit their applications and abstracts to the WNS Office by July 31, 2017. A winner will be selected by August 31, and notified in early September.  The Society will invite the Award winner to the WNS Annual Conference, during lunch on Saturday, October 28 at the Osthoff Resort in Sheboygan.

    Please contact the WNS office at wns@badgerbay.co or 920-560-5622 with any questions.

  • 05/25/2017 2:13 PM | Jamie Michael (Administrator)

    Capitol Hill Report: AAN Advocacy on FAST Act, Drug Pricing Gains Traction

    MAY 22, 2017 -  By  Mike Amery, Esq., Senior Legislative Counsel

    Congress is back in action after a short break and first up last week was a hearing and a vote on a top AAN priority, the Furthering Access to Stroke Telemedicine (FAST) Act. 

    Here is the latest from Washington

    Senate Finance Committee Votes on the CHRONIC Care Act

    • The CHRONIC Care Act, S. 870, contains the FAST Act which would extend Medicare payments for telemedicine consults for stroke in urban and suburban areas as it currently does in rural hospitals.
    • Last Tuesday, AAN member Lee Schwamm, MD, FAHA, testified in support of FAST Act in the Senate Finance Committee, which held a hearing on the CHRONIC Care Act.
    • On Thursday, the Finance Committee passed the CHRONIC Care Act out of committee on a unanimous vote, making S. 870 eligible for consideration on the floor of the Senate.

    Senate version of FAST Act Now Has Seven Cosponsors

    • Authored by Sen. John Thune (R-SD), additional sponsors include Sens. Tammy Baldwin (D-WI) and Ben Cardin (D-MD).

    The House Version of the FAST Act Is up to 85 Cosponsors

    With the addition of:

    • Rep. Brendan Boyle [D-PA-13] 
    • Rep. Larry Bucshon [R-IN-8] 
    • Rep. Nanette Diaz Barragan [D-CA-44] 
    • Rep. Markwayne Mullin [R-OK-2] 
    • Rep. David McKinley [R-WV-1] 
    • Rep. Debbie Wasserman Schultz [D-FL-23]
    • Rep. Erik Paulsen [R-MN-03]
    • Rep. Roger Marshall [R-KS-01]

    VA Developing National Telestroke Center

    • The Veterans Administration is developing a national telestroke center, with the first of the 10 pilot sites to go live later this year. The full center should be up and running nationally within five years.

    Drug Pricing Discussions Heat Up

    • Public opinion is soaring that something needs to be done about drug prices. A Kaiser Family Foundation poll finds:
      • 92% in favor of allowing Medicare to negotiate prices
      • 86% support pricing transparency
      • 72% support for reimportation from Canada
      • 56% support for bans on direct-to-consumer advertising
    • David Jones, MD, chair of AAN MS Section, represented an MS Coalition in a meeting about drug prices with Health and Human Services Sec. Tom Price. 
    • Drug companies are responding to the increased pressure from the public and Congress. Pharmaceutical company Sanofi will limit its annual drug price increases to the rate of medical inflation or provide justification for increases above that rate, according to the company's new pricing policy.

    AAN Agrees to Support S. 771 by Sen. Al Franken (D-MN)

    HELP Committee Announces Plans to Hold Hearing on US Drug Prices

    • Senate Health, Education, Labor, and Pensions (HELP) Committee Chairman Lamar Alexander (R-TN) announced plans to hold a hearing on US prescription drug prices after the bipartisan request of several committee members including Al Franken (D-MN), Bill Cassidy (R-LA), Tammy Baldwin (D-WI), Susan Collins (R-ME), Sheldon Whitehouse (D-RI), Lisa Murkowski (R-AK), Bernie Sanders (I-VT), Shelley Moore Capito (R-WV), Elizabeth Warren (D-MA), and Mike Enzi (R-WY).

    Senate Confirms Commissioner of the FDA

    • The Senate confirmed Scott Gottlieb, MD, as commissioner of the Food and Drug Administration by a vote of 57 to 42. Sens. Michael Bennet (D-CO), Tom Carper (D-DE), Chris Coons (D-DE), Heidi Heitkamp (D-ND), Angus King (I-ME), and Bill Nelson (D-FL) joined all Republicans in voting in favor of the confirmation.

    PALF Grad Highlighted by People Magazine 

    • 2015 PALF graduate Mitzi Payne, MD, of West Virginia, shared her success as a leader of Lily's Place, a center for newborns suffering from Neonatal Abstinence Syndrome. Twice a month, Payne holds a follow-up clinic for babies that have graduated from Lily's Place. Her story is highlighted in a video from People Magazine.
    • Last weekend, 29 new Palatucci Advocacy Leadership Forum (PALF) graduates joined the ranks of PALF alumni. This AAN advocacy leadership program now boasts 443 graduates since the first forum in 2003.
  • 05/22/2017 9:05 AM | Jamie Michael (Administrator)
    Management brings back fee schedule proposal for workers' compensation
    Wisconsin Health News

    The management side of a council charged with developing changes to the state's workers' compensation system has proposed creating a fee schedule for healthcare services.

    The Worker's Compensation Advisory Council, which consists of representatives from management and labor, crafts a bill that updates state law around workers' compensation every two years. Management and labor introduced their proposals at a meeting last week.

    Management is calling for setting initial rates at 150 percent of Medicare rates starting in 2017. The schedule would adjust each year with the medical consumer price index.

    The proposal differs from a measure that was pursued by the council four years ago but failed to make it into law, which was based on rates for surgeries and procedures negotiated by group health plans. 

    "The goal is the same, which is to bring cost containment to the state," said Chris Reader, an advisory council member and director of health and human resources policy at Wisconsin Manufacturers and Commerce.

    He said it's easier to construct the fee schedule using Medicare as it's difficult for the state to obtain average group health plan rates. More than 40 other states have fee schedules, he said.

    Mark Grapentine, Wisconsin Medical Society senior vice president of government relations and liaison to the council, questioned why Wisconsin would want to mimic other states when it already has a successful system.

    "The value of the current workers' comp system as it exists is by just about every measure fantastic," he said. "For whatever reason, the management side tends to have this fascination with sticker prices of individual procedures and not the overall cost of care."

    Reader pointed to other proposals from management they believe could help with costs. That includes allowing employers to direct workers to healthcare providers and requiring providers to follow treatment guidelines.

    If a provider decides to deviate from the guidelines, they would have to get prior approval. That ensures providers get employees back to work as soon as possible, he said.

    "Let me be clear - most do an excellent job of getting workers back to work," he said. "But having strong treatment guidelines will ensure that everybody has to do that unless there's a good reason not to."

    Grapentine said they're concerned about both proposals. Treatment guidelines could make it inefficient and frustrating for physicians to provide care to injured workers, he said.

    The proposal relating to guidelines, he said, is coupled with the fee schedule approach. States with fee schedules aren't as efficient in providing care, and treatment guidelines can cut utilization. He compared it to pushing on both sides of a balloon at the same time.

    "If you push on both sides of the balloon really hard, you know what happens," he said. "Why on earth would you do that to a system that people across the board think is a national model?"

    Management and labor are set to negotiate over the coming months to craft an agreed-upon bill for introduction to the Legislature. 

    Stephanie Bloomingdale, secretary-treasurer of the AFL-CIO and an advisory council member, declined to comment through a spokeswoman.

  • 05/15/2017 11:34 AM | Jamie Michael (Administrator)
    JFC Co-Chair Nygren to headline June 5 Newsmaker Event

    Joint Finance Committee Co-Chair Rep. John Nygren, R-Marinette, will provide an update on the state budget, preview what's next for the HOPE agenda and discuss the outlook for other pressing healthcare legislation at a Wisconsin Health News Newsmaker Event, Monday, June 5 in Madison at the Madison Club.

    The event is Monday, June 5 at the Madison Club (5 E Wilson Street, Madison).  Lunch begins at 11:45; conversation starts at 12:15pm and adjourns by 1pm.

    Register now

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