Professional groups oppose a move by Gov. Scott Walker to eliminate state boards that regulate optometrists, radiographers and podiatrists as well as consolidate advisory councils and boards that oversee healthcare professions.
Walker's 2017-19 budget would end the Radiography Examining Board, the Podiatry Affiliated Credentialing Board and the Optometry Examining Board and transfer their functions, rules and pending matters to the Medical Examining Board.
The budget would also create a Medical Assistants Council, consolidating advisory councils on physician assistants and others. And it establishes a Medical Therapy Examining Board, ending boards overseeing physical therapists and others.
"Currently, taxpayer dollars are going to provide administrative services to each of the boards that are proposed to be consolidated," Alicia Bork, Department of Safety and Professional Services spokeswoman, wrote in an email. "Merging these functions...will allow efficiencies that cannot be found when separate silos exist."
The combined actions, along with other changes at DSPS, would cut state spending by $50,800 in program revenue over the next two fiscal years, according to the Legislature Fiscal Bureau. There were 1,172 optometrists, 424 podiatrists and 6,994 radiographers with active licenses in Wisconsin as of July 2016.
Peter Theo, executive vice president of the Wisconsin Optometric Association, said his members have "serious concerns" about the proposal as turning regulatory control over to another profession may hurt their ability to diagnose and treat eye diseases.
"Optometrists are primary eye care providers whose regulatory independence is critical to maintaining the high standard of care needed to ensure the safe and competent practice of optometry," he said.
The Wisconsin Podiatric Medical Association raised concerns about not having representation on the Medical Examining Board.
"The Medical Examining Board cannot be expected to keep up with the advances in all of the professions that they are looking to be charged with," Dr. Bob Sage, the association's president, said in a statement. "It is unrealistic."
Sandy Helinski, legislative committee chairperson for the Wisconsin Society of Radiologic Technologists, said the elimination of the Radiography Examining Board, established in 2010, would be an "indisputable step backward in the health of Wisconsin's patients."
"Anything that could possibly dilute the effectiveness of what we've been able to accomplish in these last seven years is of great concern to us," she said.
Connie Kittleson, president of the Wisconsin Physical Therapy Association, opposes eliminating of the Physical Therapy Examining Board and the creation of a Medical Therapy Examining Board.
She noted other states have tried consolidation in the past and have returned to independent boards.
"The data out there shows it doesn't make things more efficient, it doesn't save money," she said. "But more importantly, it wouldn't be worth the risk to public safety to have people who do not have expertise or training in a particular field regulating professionals of another field."
Reid Bowers, Wisconsin Academy of Physician Assistants' advocacy committee chair, raised concerns about the proposed Medical Assistants Council, saying it "would severely limit the ability of PAs to shape how they are regulated by the Medical Examining Board."
At a Medical Examining Board meeting last week, Chair Dr. Kenneth Simons said the budget would put them "in charge of things we have no expertise" in. Others raised similar concerns.
Tom Ryan, the board's executive director, said that the boards put under the authority of the Medical Examining Board meet three to four times a year. Doctors on the board could do "curbside consults," he said.
"I don't think it's as formidable a challenge as you would think," he said.
Mark Grapentine, senior vice president of government relations for the Wisconsin Medical Society, said the Medical Examining Board has to investigate complaints against physicians and regulate the profession.
"If adding these non-medical professions to their duties takes away from that responsibility or makes fulfilling that duty less efficient, it's difficult to divine the upsides to the proposal," he said in a statement.
Buoyed by the promise of better care and lower costs, health organizations are increasingly flocking to care coordination models. But they are not always easy to organize in today’s disjointed healthcare system and current payment structures often don’t reward the effort. Also, coordination among different programs is lacking.
A panel of experts will share their experiences from the field. Find out what’s working, what’s not and what they see as the future of care coordination. Panelists:
· Joy Tapper, Executive Director, Milwaukee Health Care Partnership
· Tom Lutzow, CEO, Independent Care Health Plan
· Jane Pirsig-Anderson, Director, Aurora Health Care Family Service
The event is Tuesday, April 4 from 11:30am – 1pm at the Wisconsin Club in Milwaukee (900 West Wisconsin Avenue). Register online (link).
A group of Wisconsin State Assembly Republicans are promoting legislation this session under the “Wisconsin Rural Initiative” banner, focusing on technology, workforce, education and health care. Called the “Rural Wisconsin Matters Plan,” the group unveiled three health care-related bills* Wednesday:
· Rural system/hospital grants for allied health training—LRB 2202/1813 provides matching funds for rural health care systems or other appropriate entities that provide training for health care team members.
· Wellness facility grants—LRB 2259/2501 allows the state’s Department of Health Services to provide at least two matching grants to rural health care entities dedicated to helping wellness in the rural community. According to the Legislative Reference Bureau analysis, an entity is eligible for a grant if the application is “targeted to address community health needs identified by the applicant’s community needs assessment, including chronic illness management, occupational health services and rehabilitation services.”
· Advanced Practice Clinicians (APC) Training Grants—Similar to the allied health training grants, LRB 2476/1812 provides matching grants for clinical rotations in training APCs such as physician assistants and advanced practice nurses.
The bills are gathering legislative cosponsors through March 24, after which they will be given bill numbers and sent to legislative committees for further action.
The Wisconsin Medical Society last week submitted comments to the Centers for Medicare and Medicaid Services on its proposed “Market Stabilization Rule.” The rule is intended to stabilize the individual and small group insurance markets and to provide insurers some preliminary policy guidance while the Affordable Care Act (ACA) and American Health Care Act (AHCA) are being debated.
The proposed rule would amend existing regulations regarding guaranteed availability requirements, special enrollment periods, annual enrollment periods, standards related to network adequacy and essential community providers and actuarial value.
The Society commented on each of these provisions and incorporated additional comments from Infinity Health Care, Wisconsin Medical Group Management Association, Association of Wisconsin Surgical Centers, Rural Wisconsin Health Cooperative and Mercy Health System Corporation.
The Society also reiterated its commitment to its health care reform principles, stating that any health care reform measures should not result in individuals losing existing coverage, place undue burdens on patients or physicians, restrict access or adversely affect affordability.
Click here to access the Society’s comments.
The Assembly unanimously approved legislation Tuesday that lifts state penalties for possessing cannabinoid oil, sending the bill to Gov. Scott Walker's desk.
The bill would allow patients with documentation from a doctor to possess the CBD oil, which is derived from marijuana. Under federal rules, however, the substance is still classified as a schedule I drug, making it illegal to possess.
While lawmakers voted to approve the bill, some had concerns. Rep. Jill Billings, D-La Crosse, said the bill is "not the fix that we're looking for" because it doesn't create a way for families and patients to get the drug.
"This legislation gets us to the door, but it doesn't get us in the room," Billings said. "And the problem is how do you get it?"
Bill author Rep. Scott Krug, R-Nekoosa, said of the states that have legalized CBD oil, a few have dispensaries, meaning that families in other states are still gaining access to the substance.
"It is not a problem for families to obtain CBD oil in any of the states," Krug said.
The Senate Committee on Revenue, Financial Institutions and Rural Issues approved a bill Thursday that would increase funding for rural broadband and add healthcare criteria the Public Service Commission should consider when awarding money.
Lawmakers are starting to take up proposals introduced as part of the special session Gov. Scott Walker called in January to fight the opioid epidemic.
The Senate Committee on Judiciary and Public Safety held a public hearing Tuesday on bills that would expand limited legal immunity to overdose victims and increase the number of investigators focused on drug trafficking and addiction at the Department of Justice. The two bills are out of 11 proposed during the session.
"Our goal is to save lives and to fight addiction and illegal drug use," Sen. Sheila Harsdorf, R-River Falls, told committee members.
One proposal would extend limited immunity to overdose victims, building on a 2014 law that provided immunity to those who called for help. It has support from the Wisconsin Medical Society.
Harsdorf said Wisconsin is the only state with a 911 Good Samaritan law that does not extend limited immunity to both the caller and the person experiencing the overdose.
"This is a very important change for us to make to save lives," she said. The committee is set to vote on the proposal Thursday.
The other bill would provide $420,000 annually to hire four investigators in the Department of Justice. Access to illegal drugs such as heroin and meth is "far too easy in many of our communities," Harsdorf said.
"We continue to make great strides in the fight against illegal drug and addiction by increasing access to treatment and encouraging prevention programs," she said. "These additional positions will help in the fight by striking at those who are bringing the illegal drugs into the state."
Jason Smith, acting administrator of the Division of Criminal Investigation at the Wisconsin Department of Justice, said the bill would increase the number of staff in their division by four. They have 103 investigators, with about a fifth dedicated to drug enforcement.
"While heroin use remains a focus for Wisconsin law enforcement and treatment services, meth has quietly surged to a point where the number of cases, arrests and charges are on par with heroin," he told lawmakers.
AAN provides monthly updates to state society leaders. In this month’s issue:
· Oregon lawmakers introduced HB2387, targeting out-of-control prescription prices, read more here.
· The Pharmaceutical Research and Manufacturers of America is set to launch a new campaign in NY to fight Governor Cuomo’s plan to curb drug prices, read more here.
· 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. Wondering how the compact works? Check out this short video!
· If you have any questions or would like to discuss how to improve your advocacy efforts, contact Grant Niver.
Federal Legislative Update
· The AAN responded to the recent executive order temporarily suspending some foreign entry into the United States by joining with medical organizations on positions from the Association of American Medical Colleges and the Council of Medical Specialty Societies and sending a message to members and Annual Meeting attendees. The AAN is also exploring alternative methods for researchers who may be affected by immigration policy to present their scientific research at the AAN Annual Meeting. Learn more.
· On February 17, Rep. Morgan Griffith (R-VA) and Rep. Joyce Beatty (D-OH) reintroduced the FAST Act.
· The AAN joined 260 organizations and institutions to send a letter to President Trump and congressional leadership, urging the completion of a FY2017 budget that includes $34.1 billion for NIH.
· David Shulkin was unanimously confirmed by the Senate to become Secretary of Veterans Affairs. Shulkin served as VA undersecretary of health since 2015, is a physician and former health care executive, and will be the first VA secretary in the department's history never to have served in the military.
· 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
· The AAN Medical Economics & Management Committee (MEM) approved its regulatory priorities for 2017, which include: 1) Continuing MACRA advocacy with the goal to reduce burdens on neurologists while improving the Quality Payment Program; 2) Encouraging increased flexibilities for small and solo neurology practices; 3) Advocating for more accurate and improved cognitive reimbursement; and 4) Monitoring regulatory announcements from the new administration to outline further regulatory priorities as needed and address developments.
· Member awareness of the Axon Registry® has consistently increased. According to marketing survey results, 2015 member awareness was 19 percent; by June 2016 member awareness increased to 38 percent; as of November 2016, member awareness increased to 53 percent.
· The MEM and Government Relations committees met jointly in January to discuss collaborations for legislative and regulatory advocacy efforts on Affordable Care Act (ACA) repeal and replacement, drug pricing and access, and physician burnout and regulatory hassle.
· For more information on AAN practice resources, visit our webpage.
AAN Membership Update
· The 2017 Insights Report is now available. The report summarizes research conducted by the AAN in 2016 and also provides demographic data on members as of year-end 2016.
· A study by the AAN of neurologists in the United States shows that 60 percent of respondents had at least one symptom of burnout, and burnout is common in all neurology practice settings and subspecialties. The study was published in the January 25, 2017, online issue of Neurology®.
· A new practice management education curriculum has been developed for residents and fellows. The first webinars, a Business Basics series, are now available and will be followed by additional topics throughout 2017. Program directors may use these brief recorded webinars to enhance the practice management knowledge of their residents and fellows.
· AAN Annual Meeting registration numbers are trending higher than Vancouver. Look for the Science Program soon for information on innovative new methods of delivering scientific information to clinicians.
Group Insurance Board members sent a letter last week to lawmakers, revealing more information on the process they used when deciding to self-fund and regionalize the health plan for state employees.
Their plan, approved last week, would shift the state away from a fully insured model, which involves 18 companies, to a model with six vendors. They estimate the move could save more than $60 million in the 2017-'19 state budget from reduced administrative and insurer risk fees as well as improved discounts. Department of Employee Trust Funds spokesman Mark Lamkins did not provide a further breakdown of the savings.
Any self-insurance contract is subject to approval by the Legislature's Joint Finance Committee.
The board selected Compcare Health Services Insurance Corp. to offer a statewide option as well as a regional option. The other companies serving regions would be Dean Health Plan, HealthPartners Administrators, Network Health Administrative Services, Security Administrative Services and Quartz, which is affiliated with Unity Health Insurance and Gundersen Health Plan.
In a letter sent Friday to JFC co-chairs, GIB Chair Mike Farrell and board member Stacey Rolston, who is a deputy administrator in the Division of Personnel Management at the Department of Administration, wrote that those participating in the state employee health plan will have greater access to providers than are currently available to most members under a proposed move to self-insurance because CompCare has a broader network.
They also wrote that providers that are part of Group Health Cooperative of South Central Wisconsin, which did not respond to an RFP on administering the program, will be included via other third party administrators. In addition, Physicians Plus, which responded to the RFP but wasn't selected as a vendor, is exploring a partnership with Unity and Gundersen, according to the letter.
According to GIB, nine companies responded to the RFP. That also included Mayo Clinic Health Solutions, the self-insurance business unit of Health Traditions Health Plan, which wasn't chosen. WEA Trust also participated in the process and did not receive an offer.
GIB noted that many of the plans with minimal participant enrollment in the program chose not to respond, including Arise, Group Health Cooperative - Eau Claire, MercyCare Health Plans and Medical Associates.
But Patrick Cranley, MercyCare chief operating officer, said GIB's characterization was "a little bit disingenuous."
"We could not respond to the RFP because the RFP required that respondents be able to serve an entire region defined by the RFP," Cranley said. He called it "a conscious decision to limit the number" of plans participating in the state program.
Cranley called the board's decision an "unfortunate choice" for the wider market as it eliminates a number of high quality community health plans from participation in the health plan.
"I think it does long-term damage to the competitive insurance market in the state of Wisconsin," he said. "You're essentially perhaps even crippling some of the plans that are smaller plans that provide important competition in the markets in which they participate."
Cranley said MercyCare serves 1,400 members in Jefferson, Rock and Walworth Counties through the state plan. That's out of 48,000 total members for his plan.
"I would prefer to continue to serve these folks and let them have access to our health plan," he added.
ETF often pursues an "aggressive education campaign" to ensure participants understand their choices under the program, according to the letter. The communication strategy for 2018 "will be unprecedented," Farrell and Rolston wrote.
The board plans to finish contract negotiations by the end of March.
Read the letter.
Democratic lawmakers are circulating a proposal that would allow non-psychoactive cannabidiol oil to be manufactured in the state of Wisconsin, arguing a bill approved by the Senate last week doesn't go far enough.
The bill, authored by Sen. Chris Larson, D-Milwaukee, and Rep. Jimmy Anderson, D-Fitchburg, would establish a licensure program for individuals to produce and distribute CBD oil.
Assembly lawmakers held a hearing on the Senate-approved version Wednesday. That bill allows patients to possess CBD oil without facing a state penalty if they have certification from their doctor, but doesn't allow for its sale or manufacture in Wisconsin.
Democratic lawmakers on the Assembly Committee on Children and Families questioned how people could acquire CBD oil.
"Without having dispensaries in Wisconsin, I'm worried this is not the complete fix," said Rep. Jill Billings, D-La Crosse.
But the bill's authors said patients could purchase CBD oil online and in some neighboring states. Sen. Van Wanggaard, R-Racine, said they considered including dispensaries. But he wanted to avoid regulation.
"If we took it to the regulators, we would never get this passed, not with the mindset of everybody at this point," he said. "I think the first thing we need to do is take away that fear from parents."
563 Carter Court, Suite B, Kimberly, WI 54136
Phone: 920-560-5622 | Fax: 920-882-3655