WISAM On-Demand Recordings
April 6, Wisconsin Health News
The premium holiday for Wisconsin’s medical malpractice fund will continue until mid-2022 to help offset impacts on providers from COVID-19.
Insurance Commissioner Mark Afable notified the Joint Finance Committee last week that he’s requesting that fiscal year 2022 rates for healthcare providers participating in the Injured Patients and Families Compensation Fund remain the same as the current fiscal year, which ends June 30.
The committee has until April 15 to approve the request. Currently, the fund is waiving fees for participating healthcare professionals and providers, per a request from the Wisconsin Medical Society. The premium holiday is set to last until June 30, 2022.
OCI spokeswoman Sarah Smith said that the rates will remain the same because the fund won’t be charging due to the COVID-19 pandemic.
Mark Grapentine, chief policy and advocacy officer at the Wisconsin Medical Society, said independent clinics are still fighting COVID-19 related costs and lost revenue and keeping the status quo for now makes sense.
“We’re doing all we can to advocate for those independent clinics who provide such important care to their communities while being on the front lines of the pandemic,” he said in an email. “We’re very fortunate to have a fund that’s run prudently and is in a stable financial condition so that it can provide a little fiscal relief for physicians.”
The Injured Patients and Families Compensation Fund covers claims beyond state-mandated insurance limits, which are set at $1 million by occurrence and $3 million by aggregate annually.
The State of Wisconsin’s Medical Examining Board (MEB) at its most recent monthly meeting advanced a proposed administrative rule that will extend for another biennium the requirement that most physicians obtain two credits of continuing education related to opioid prescribing. The requirement applies to physicians who hold a Drug Enforcement Administration registration number, with the two credits being part of the 30 credits required each biennium. Courses must be approved by the MEB in order to satisfy the subject matter requirement.
The Wisconsin Medical Society (Society) spoke in favor of the rule at the MEB public hearing March 17, noting how the COVID-19 pandemic has exacerbated opioid abuse across the county. The Society also expressed appreciation that the rule widens the scope of qualifying coursework beyond opioid prescribing to include “other controlled substances.” This will allow physicians who hold a DEA number but may not prescribe opioids to access coursework more relevant to their practice.
The MEB also began to discuss whether to add a provision to the “unprofessional conduct” section of the MEB’s administrative code (MED 10) that could require physicians to offer patients a chaperone for certain sensitive physical exams. The idea comes from a January 2020 ACOG Community Opinion paper recommending that a chaperone be present for all breast, genital and rectal examinations. While the MEB discussed the issue only generally during its meeting March 17, it will review potential language at its April meeting.
Contact Society Chief Policy and Advocacy Officer Mark Grapentine, JD for more information.
Wisconsin Doctor Day - May 5, 2021
Opening Keynote Address Featuring AMA President, Susan R. Bailey MDDr. Susan R. Bailey, a distinguished allergist/immunologist from Fort Worth, Texas, is the 175th president of the American Medical Association. Doctor Bailey's presentation, What Will Healthcare Look Like Post COVID-19?, will touch on delivery of care, rebounding from physician stress, and the impact of the pandemic on the physician workforce.
Click here for more information!
The Wisconsin Society of Addiction Medicine will begin the third year of hosting the X-Waiver Training Series with the first training available on March 5, 2021. WISAM partners with the Wisconsin Department of Health Services in order to offer these trainings for FREE to all Wisconsin providers who are eligible to prescribe buprenorphine. The partnership continues with the American Society of Addiction Medicine in order to provide the ASAM Treatment of Opioid Use Disorder Course (TOUD).
This series is designed to increase treatment capacity for opioid use disorders by training more prescribers to be able to treat opioid use disorders with buprenorphine. This live course has been approved by the Wisconsin Medical Examining Board as meeting the requirements for the two-hour continuing education course on responsible opioid prescribing per Med 13.03(3) of the Wisconsin Administrative Code.
The course involves 4 hours of online training paired with 4 hours of in-person training. The self-paced online course will be available through ASAM’s website upon registration.
This course is open to MDs, DOs, NPs, and PAs. MDs and DOs must complete the full 8-hour course to be eligible for their DATA Waiver. NPs and PAs must complete the full 8 hour course, plus 16 additional hours provided free by ASAM (contact firstname.lastname@example.org about registering for the additional 16 hours.) Medical students and NP and PA students are eligible to take the course, but will not be eligible to apply for their waiver. Eligible providers who do not yet hold DATA Waivers are particularly encouraged to attend, but Waiver-holding providers can also attend for CME credit. You must attend the entire course to qualify for CME credit.
Click here to view the full schedule
Wisconsin Health News
Wisconsin has received a grant to help develop an implementation plan for 988, a new calling code that will launch next year for the National Suicide Prevention Lifeline.
The $171,701 grant from Vibrant Emotional Health, the administrator for the national lifeline, will fund a coalition organized by the Department of Health Services to establish a system to ensure everyone in the state has direct access through the number to trained counselors.
“A three-digit calling code will open the door for more people to seek the help they need, while sending the message that healing, hope and help are happening every day,” said DHS Interim Secretary Karen Timberlake.
The new calling code is expected to launch July 2022. The coalition will start meeting in April, with a goal of having a draft of the plan completed by August and the final plan by the end of the year.
Grants states power to restart Medicaid services for incarcerated individuals 30 days before their release
WASHINGTON, D.C. – U.S. Senators Tammy Baldwin (D-WI), Mike Braun (R-IN), Sheldon Whitehouse (D-RI) and Sherrod Brown (D-OH) are leading the Senate introduction of the bipartisan Medicaid Reentry Act, legislation expanding access to addiction treatment and other health services for Medicaid-eligible individuals 30 days before their release from jail or prison. The bipartisan legislation is also being re-introduced in the House of Representatives by Congressmen Paul Tonko (D-NY-20) and Michael Turner (R-OH-10).
Currently, federal statute prohibits any form of federal health coverage for incarcerated individuals except under very limited circumstances. In most states, Medicaid coverage is immediately terminated when someone is sent to a correctional setting. This creates a serious coverage gap when individuals are released, as they often have no access to health care or addiction treatment during a stressful and dangerous time. This bill is a bipartisan response to this issue, following alarming evidence published in the New England Journal of Medicine that individuals reentering society are 129 times likelier than the general population to die of a drug overdose during the first two weeks after release.
“The opioid and substance use disorder epidemic remains rampant in Wisconsin and across the country, and the ongoing COVID-19 pandemic is dramatically impacting the addiction prevention, treatment, and recovery landscape in this country. This problem is harshly affecting incarcerated individuals who are working to reenter society, but currently lack the health care coverage they need to continue their recovery,” said Senator Baldwin. “We need to make sure these rehabilitated folks have Medicaid or other health care coverage needed to seamlessly transition back to community care, and reduce the risk of overdose deaths post-release. I’m proud to work with my Senate and House colleagues on this bipartisan reform to address our nation’s addiction crisis and support our continued fight against this deadly epidemic.”
Washington Post | By Dan Diamond and Lenny Bernstein
The Biden administration is preparing to halt a last-minute plan by the Trump administration to let more physicians prescribe an opioid-treatment drug, said three officials with knowledge of the pending announcement, who spoke on the condition of anonymity because they were not authorized to discuss the plan.
The Trump plan had been hailed by physicians as loosening requirements they said had slowed their response to the nation’s worsening opioid crisis. Then-presidential candidate Joe Biden also criticized the prescribing rules and vowed to lift them if elected president. But some legal experts warned that the Department of Health and Human Services lacked the authority to issue guidelines that allowed physicians to avoid requirements mandated by Congress.
“Unfortunately, the Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder announced by the Trump administration in its last days had significant legal and clinical concerns,” according to a draft announcement obtained by The Washington Post. “The Biden Administration will not issue the Guidelines previously announced.
The previously announced, Trump Administration, HHS practice guidelines regarding a new exemption from certain X-waiver certification requirements for certain physicians never posted to the Federal Register-- which means the exemption never went into effect. The Biden Administration has put a temporary freeze on matters not yet posted to the Register, pending further review. As soon as ASAM receives further information from federal agencies about all of this, we will inform our members.
In the meantime, on Capitol Hill, ASAM continues to advocate for a complete elimination of the X-waiver while ensuring controlled medication prescribers have baseline education on addiction – that will require a legislative “fix.”
We have some important news to share regarding buprenorphine prescribing from HHS. For physicians, the requirement for a separate X-Waiver to prescribe Buprenorphine/naloxone will no longer be required. The patient limit for physicians without the X-Waiver will be 30 patients but it is unclear at this time what it will mean for X-waived providers. This does not apply to PA's or NP's. ASAM plans to put out a statement in the next few days when more details are available.
David Galbis-Reig, M.D., DFASAM
President, Wisconsin Society of Addiction Medicine
HHS Expands Access to Treatment for Opioid Use Disorder
MADISON — Gov. Tony Evers announced today that the the Wisconsin Department of Health Services (DHS) has awarded nearly $9 million to 23 county agencies and five tribal nations to provide treatment services for the harmful use of opioids—such as prescription pain relievers, heroin, and fentanyl—or stimulants—such as cocaine and methamphetamine.
“Too many Wisconsinites, and their friends, family, and neighbors, have experienced the tragedies of harmful use of stimulants and opioids first hand,” said Gov. Evers. “It tears apart families, impacts our kids, and has affected every Wisconsin community in one way or another. I am glad we are able to get these critical funds out the door to provide treatment and hope for so many.”“The problem use of opioids and stimulants is an epidemic in Wisconsin,” said DHS Secretary-designee Andrea Palm. “These grant awards enable our county and tribal partners to expand access to help those who need it most, giving them hope and healing, as we continue our collective work to build healthy communities.”The grant awards listed below are based on the level of need for treatment services in the county or tribe and the types of treatment services to be provided by each county or tribe.
Wisconsin Medical Society | Medigram
Society weighs in on Assembly GOP COVID Response Bill
Signaling the importance of battling the COVID-19 pandemic, Wisconsin State Assembly Republicans and Democrats each unveiled their own COVID-19 response bills on Inauguration Day, January 4. With Republicans in control of that legislative house, Assembly Speaker Robin Vos (R-Rochester) introduced Assembly Bill 1 Monday afternoon, with a committee hearing and vote taking place the next day.
The 63-page omnibus bill hits a wide variety of areas, from schools to unemployment programs to health care workforce and funding. The Wisconsin Medical Society (Society) highlighted both the positive and concerning portions of the bill in this testimony, which was delivered electronically to the Assembly Committee on Health. Protection from COVID-19 exposure civil litigation, ensuring the state’s SeniorCare program covers COVID-19 vaccinations and preventing patients from facing copays or coinsurance for vaccinations garnered the Society’s support. Provisions limiting local public health and state health department powers during communicable disease outbreaks and interfering with employers’ ability to protect employees and customers from SARS-CoV-2 were not supported.
The Assembly Health Committee approved the bill Tuesday afternoon on an 11-5 party-line vote. The full State Assembly convened this afternoon, amending the bill to place stricter limits on public health and school board powers, then passing the bill on a similarly partisan 56-34 vote. The bill now heads to the State Senate, where the bill’s fate in that house is unclear. Any bill passing both houses must then survive Governor Tony Evers’ veto scrutiny.
Society opposes VA rule allowing care without physician supervision
The Wisconsin Medical Society joined with dozens of other state- and specialty-based health care organizations on a letter opposing a U.S. Department of Veterans Affairs proposed rule that would allow virtually all non-physician providers (NPP) to practice without the clinical supervision of a physician. The proposal would trump state scope of practice laws and regulations.
“NPPs are an integral part of physician-led health care teams,” the letter reads. “However, NPPs cannot substitute for physicians especially when it comes to diagnosing complex medical conditions, developing comprehensive treatment plans, ensuring that procedures are properly performed, and managing highly involved and complicated patient cases. Nowhere is this more important than at the Department of Veterans Affairs (VA), which delivers multifaceted medical care to veterans, including those with traumatic brain injuries and other serious medical and mental health issues. As such, our nation’s veterans deserve high quality health care that is overseen by physicians.”
The letter was signed by more than 100 organizations and delivered to the Secretary of the Department of Veteran Affairs today. Contact Mark Grapentine, JD for more information.
You’re a member! Now what? Exploring WisMed Assure
Explore the benefits of Wisconsin Medical Society membership by joining the WisMed team for an overview of WisMed Assure, the only Wisconsin-based insurance firm exclusively serving the health care community. Tune in on Wednesday, January 13 at 12 p.m. and learn how they can help you! Register today!
Designed for the busy schedules of physicians, these 15-minute webinars will occur on the second Wednesday of the month, 12 - 12:15 p.m. Whether you're a brand-new member or have been involved for years, you can learn more about the latest member benefits designed specifically for you!
You’re a member! Now what? January 13 – Exploring benefits available through WisMed Assure
February 10 – Become an active advocate
March 10 – Take hold of your financial future
April 14 – Member benefits 101
Register once to be signed up for all four sessions. Contact Jess Bourin-Schreiter with any questions.
Help shape Medical Society policies in 2021
With the Wisconsin Medical Society (Society) evolving its policymaking process to a year-round schedule, the Society is seeking a special group of members to help review policy proposals that are submitted for discussion and eventual action by the Board of Directors. This group will include Society members from across the state to ensure widespread representation. The function is similar to the role Reference Committees had in the former House of Delegates structure: listening to testimony on policy proposals and making recommendations for final action to the ultimate deciding body.
The committee will include members from all eight Society districts and the young physician, resident physician and medical student sections. They will meet as needed leading up to each Society Board of Directors meeting. If you are interested in serving on this policy-reviewing committee, please fill out this form.
For more information, contact Society Chief Policy and Advocacy Officer Mark Grapentine, JD.
Physician Wellness Advisory Committee moving forward
The Physician Wellness Advisory Committee held its first meeting in December. The purpose of this committee is to design and establish the framework and operability of a Physician Wellness Program to offer help and respite when needed for the physicians of Wisconsin. The intent is to initiate the program in a short period of time and provide the framework for it to grow and be more robust in the future. Special thanks to Mary Jo Capodice, DO, MPH, Jacqueline Landess, MD, Erica Larson, DO, and Michael Miller, MD, for giving their time and providing recommendations as the Wisconsin Medical Society begins this crucial journey towards providing this valuable service to the physicians of Wisconsin.
The committee is currently reviewing options that can be provided in the immediate future. A model that has been adopted in multiple states is being strongly considered. This proposed model is similar to an Employee Assistance Program, where a limited number of confidential counseling/coaching services are provided without the need to go through one’s employer or health insurance. The option to pilot the program in specific counties is also under consideration.
Updates on the Committee’s progress will continue to be shared. Please reach out to Jim Lorence with any questions or comments.
Minnesota Medical Association physician well-being conference Jan. 28
The Minnesota Medical Association’s (MMA) 5th annual physician well-being conference will be held virtually on January 28, 2021. As a promotional sponsor for this event, Wisconsin Medical Society members can access this conference at the discounted MMA member price of $195 with the code JOYMEDPARTNER.
Bryan Sexton, PhD, an associate professor at Duke University and director of the Duke Center for Healthcare Safety & Quality will kick off the conference with his keynote presentation Bite Size Coping During Times of Uncertainty.
For additional information including a full agenda and registration, click here.
Part 2 of COVID Relief Bill
As expected, the COVID Relief Bill was signed into law just before the end of 2020. The $900 billion bill was embedded in the much larger Consolidated Appropriations Act of 2021.
Click here for some key provisions applicable to Wisconsin families and health care.
Please contact Mark Ziety, CFP®, AIF® at 608.442.3750 with any questions.
Mark Ziety, CFP®, AIF®
WisMed Financial, Inc. part of the Wisconsin Medical Society