Doctors and acupuncturists oppose a bill that would allow chiropractors to perform physical examinations for student athletes and practice "chiropractic acupuncture" and "chiropractic dry needling" if they receive additional training.
The bill received a public hearing Wednesday before the Assembly Committee on Health.
Under the proposal, schools that require a pupil to have a physical examination to participate in sports and other activities will have to accept a physical examination completed by a chiropractor the same way it accepts those completed by doctors. The chiropractor would have to hold a certificate in health or physical examinations.
The same requirement would apply to the state's technical colleges or a two-year campus within the University of Wisconsin System that require physical examinations for students to participate in sports.
"With some additional training, doctors of chiropractic could provide a high quality exam," Mark Cassellius, a chiropractor practicing in Onalaska, told lawmakers.
Dr. Tosha Wetterneck, past president of the Wisconsin Medical Society, opposes the bill.
The physical examination isn't just focused on the athletics, but on at-risk behaviors, immunizations and other factors that might impact sports participation, she said. That requires extensive training.
"This is rocket science," she said. "This is difficult."
The bill would also allow chiropractors to practice "chiropractic acupuncture" if they complete at least 200 hours of instruction and the acupuncture examination administered by the National Board of Chiropractic Examiners.
The bill would also allow chiropractors to practice "chiropractic dry needling," which involves puncturing the skin with needles to treat "neuromusculoskeletal pain and performance," if they complete 50 hours of postgraduate study.
Shawano-based chiropractor Brian Grieves said the bill could help address the opioid epidemic by increasing access to alternatives pain treatments.
"We have very limited, proven, effective non-drug options to offer people for pain," he said. "Being able to augment that by offering chiropractic acupuncture would greatly expand that access."
Elissa Gonda, chair of the legislative committee for The Wisconsin Society of Certified Acupuncturists, opposes the bill.
"Acupuncture is a serious and rigorous profession," she said. "It's not a method or technique that can be employed on an occasional basis by another healthcare practitioner."
Steve Conway, executive director of the Chiropractic Society of Wisconsin, said they're generally supportive of the bill but they're still vetting it.
The Medical Examining Board approved permanent rules last week that govern the practice of telemedicine and mandate continuing medical education requirements for doctors on opioid prescribing.
The rules are expected to go into effect June 1, Department of Safety and Professional Services staff told board members.
The final telemedicine rule clarifies that a physician-patient relationship can be established through telemedicine and provides guidelines on the use of telemedicine.
The other rule requires doctors renewing their licenses to complete two hours of training on guidelines written by the board that relate to opioid prescribing. Doctors have to complete 30 hours of continuing medical education every two years.
The Wisconsin Medical Society continues to voice concerns regarding HR 1628, the American Health Care Act (AHCA), which may receive a vote in the U.S. House of Representatives as soon as tomorrow.
The Society sent this letter to members of the Wisconsin Congressional delegation earlier today, cautioning that the MacArthur Amendment, which was introduced earlier this week, does not solve the problems inherent in the AHCA.
“Instead, it pushes those decisions to the states while leaving unanswered important questions such as whether Wisconsin’s Medicaid program will be adequately funded under the AHCA. We believe the legislation as currently drafted could have dramatic negative effects on our state’s sickest and poorest citizens,” stated Society Board Chair Jerry Halverson, MD, and President Noel Deep, MD, in the letter.
The Society’s Board of Directors suggested a set of Health System Reform Principles earlier this year that calls for any health reform plan to ensure that Medicaid is properly funded, that those who currently have health insurance maintain coverage, and that some of the key patient protections encompassed in the Affordable Care Act (ACA) such as guaranteed coverage for preexisting conditions and no lifetime caps for coverage be maintained.
The MacArthur Amendment—named for its principal proponent Rep. Tom MacArthur—would allow states to apply for waivers from some of the consumer protections provided in the ACA, including the age rating ratio of 3 to 1, the requirements that health insurers must cover certain essential health benefits, and the ban on health status underwriting.
The American Medical Association (AMA) also expressed concern this afternoon in a letter to Speaker Paul Ryan and Minority Leader Nancy Pelosi.
“The current ban on health status underwriting protects individuals from being discriminated against by their medical conditions. Prior to the passage of the ACA, such individuals were routinely denied coverage and/or priced out of affordable coverage,” wrote AMA President James L. Madera, MD. “We are particularly concerned about allowing states to waive this requirement because it will likely lead to patients losing their coverage. Although the MacArthur Amendment states that the ban on preexisting conditions remains intact, this assurance may be illusory as health status underwriting could effectively make coverage completely unaffordable to people with preexisting conditions.”
The AMA is encouraging physicians to contact their U.S. Representative. Click here for more information.
In partnership with the Wisconsin Department of Justice (DOJ) and the Drug Enforcement Administration (DEA), local law enforcement agencies will be holding Drug Take Back events throughout Wisconsin on Saturday, April 29.
Drug Take Back Day provides a safe, convenient and responsible means of disposal of unused or expired drugs, while also educating the community about the potential abuse and consequences of improper storage and disposal of these medications.
“More than two thirds of people who have abused prescription painkillers got them illegally from a friend or family member,” said Wisconsin Attorney General Brad Schimel. “Wisconsinites can help cut down on prescription drug abuse by storing prescription drugs securely and disposing of unused medication through proper methods, like DOJ’s biannual Drug Take Back Day.”
Drug take back days are held each spring and fall across the country, and according to Schimel, in Wisconsin they’ve resulted in the collection and safe destruction of over 207,000 pounds of unused medications. Last October, Wisconsin ranked second behind only Texas in the volume of medication turned in.
For more information, including a list of accepted medications, visit the DOJ’s website. Additional information also is available on the “Dose of Reality” website, which features an interactive map people can use to find a drug take-back location near them
The Senate Committee on Education approved two bills Monday that are part of a special session ordered by Gov. Scott Walker to tackle the opioid epidemic.
A bill that would provide $50,000 to help establish a recovery charter school, which would serve 15 high school students in recovery from substance use disorder, passed out of committee 6-1. Sen. Steve Nass, R-Whitewater, voted against it.
An additional proposal providing $200,000 a year to expand the use of a substance abuse screening by the Department of Public Instruction passed 7-0. The Assembly has already approved both measures.
Wisconsin will receive $7.6 million from the federal government to combat opioid addiction, the Department of Health and Human Services announced Thursday night.
HHS is providing $485 million to all 50 states, the District of Columbia and six U.S. territories. The funding, made available under the 21st Century Cures Act, will go toward prevention, treatment and recovery services.
States were awarded funding based on rates of overdose deaths and unmet need for treatment. Florida received the most money at $27.2 million, while five territories received $250,000 each.
Gov. Scott Walker directed the Department of Health Services to seek the funding in an early January executive order. DHS can re-apply for additional funding next year.
Gov. Scott Walker has signed into law a bill ending state penalties for those who possess cannabidiol without psychoactive effect if they have written certification from a doctor.
The bill also directs the state's Controlled Substances Board to reschedule CBD oil, which is derived from marijuana and sometimes used to treat seizures in children, within 30 days following a change at the federal level. The bill passed the Senate 31-1, and the Assembly 98-0.
The bill builds on a 2014 law that aimed to make the drug available with a prescription in the state. But supporters said that providers weren't able to prescribe the drug, which is still illegal to obtain under federal regulations.
While Republicans may have walked away from the American Health Care Act, the healthcare debate is certain to continue. Will the Trump Administration fight to keep the Affordable Care Act afloat? Or will it use its power to hasten the law’s demise? Will lawmakers move left or right to forge a new deal?
In the meantime, Gov. Scott Walker is pushing ahead with Medicaid reforms that likely would not have been approved a year ago. What does it mean for the program?
National and regional healthcare experts will tackle these questions and more at the 2017 Wisconsin Health News Conference, July 19 at the Monona Terrace in Madison. Registration now open (link).
April 14, WHA Valued Voice
With the Interstate Medical Licensure Compact’s voluntary expedited licensure process becoming operational this month, WHA will be offering a 45-minute webinar on how the new Compact process can help physicians more quickly receive a Wisconsin medical license or a license in another state if the physician already holds a medical license in a Compact state. WHA General Counsel Matthew Stanford will present information on eligibility, which states are participating in the Compact, completing the application process, fees, how to maintain a Compact expedited license and considerations for utilizing the Compact expedited process versus the traditional licensure process.
The webinar, scheduled Tuesday, May 23 from 12:00-12:45 pm, is being offered through a partnership between WHA and the Wisconsin Medical Group Management Association (WMGMA). There is no fee to participate in this webinar, but pre-registration is required. Registration is now open at: www.cvent.com/d/z5qq0r.
Wisconsin joined the Interstate Medical Licensure Compact through the enactment of legislation in December 2015, which was a key legislative priority for WHA. To apply for a medical license through the Interstate Medical Licensure Compact expedited process, individuals should visit https://imlcc.org.
A compact that aims to expedite the process for doctors obtaining medical licenses in multiple states launched in Wisconsin last week.
So far 18 states have passed legislation to join the Interstate Medical Licensure Compact, which aims to make it easier and faster for doctors to get a license in other participating states.
Illinois, Iowa and Minnesota have entered the agreement. Other states, including Michigan have bills pending in their legislatures that would allow them to join.
The compact began accepting and processing applications from qualified physicians on April 6, according to a statement from the commission overseeing it.
Mark Grapentine, senior vice president of government relations at the Wisconsin Medical Society, said there are still details to work out before the compact process is functional among all participating states. But Iowa and Wisconsin are ready to go, he said.
"It will greatly help physicians and patients who may cross the Mississippi River to either give or receive care," he wrote in an email.
Dr. Donn Dexter, vice chief medical officer at Mayo Clinic Health System northwest Wisconsin, said the compact will help attract doctors to the state, particularly in underserved areas.
It will also support educational efforts by making it easier to get a license in Wisconsin, allowing doctors in neighboring states to "come over and work and train in our community and hopefully stay," he said.
Brian Vamstad, government relations manager for Gundersen Health System, called the launch a "great step." The compact will help with telemedicine efforts, he said.
"It really will help us and others to meet the needs of communities," he said.
So far, doctors with licenses who are either living, employed or have 25 percent of their business in Wisconsin can apply through the compact to practice in any of the other participating states, according to the Interstate Medical Licensure Compact Commission.
Eleven states, including Minnesota, aren't comfortable serving as states of principal licensure, meaning doctors solely licensed by those states and either residing or practicing there can't use the compact until policymakers approve technical fixes.
Diane Shepard, secretary for the commission, said Minnesota is close to approving its technical fix.
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