Legislative Update, Spring 2018

April 18, 2018 11:11 AM | Sally Winkelman (Administrator)

Eric Jensen, WACEP Lobbyist  

Mayo v. WIPFCF, et al.: The Mayo case will be argued before the Wisconsin Supreme Court on Thursday, April 19th.  Before the Court is an Appeals Court decision rendering Wisconsin’s cap on non-economic damages in medical liability cases unconstitutional.  At present, pending the Court’s decision (not expected until sometime this summer), there is effectively no cap on non-economic damages.  WACEP led a coalition of eight medical specialty organizations in writing and submitting an Amicus (“friend of the court”) brief in defense of the caps.

AB 538 Signed into Law: Governor Walker signed Assembly Bill 538 (now 2017 Act 140) providing emergency physicians additional liability protections in cases involving involuntary commitments.  Quoting from a memo written by WACEP counsel, Guy DuBeau:

"The Act accomplishes three major goals toward this end. Specifically, the Act clarifies that providers acting in good faith can seek, without fear of liability, emergency detention even though the process must be formally initiated by law enforcement or county crisis workers. The Act also provides greater control over transfers in that it requires emergency providers to agree that transfer is medically appropriate before the transfer can be made by law enforcement. Lastly, the Act explicitly aligns Wisconsin law with HIPAA by noting that providers may disclose information to third parties in good faith effort to prevent or lessen as serious and imminent threat to third parties."

Medicaid Reimbursement for Emergency Physician Services: Known all too well to you, Wisconsin lags the nation in terms of Medicaid reimbursement for physician services, ranking a shocking 50th for its rate paid for Level 2, 3 and 4 trauma services; it’s a remarkable situation given Wisconsin’s consistently high overall healthcare rankings.  In early April, WACEP President, Lisa Maurer, MD and WACEP’s government affairs consultant met with new Medicaid Director, Heather Smith, in our continuing effort to educate policy-makers about the situation and its consequences for emergency care in Wisconsin, and ultimately to increase reimbursements to a level that is at least competitive with our border states. 

Earlier this year, WACEP succeeded in convincing the Legislature’s Joint Finance Committee, and ultimately the full Legislature, to insert a provision into the State Budget bill directing the Department of Health Services (DHS) to convene a working group including WACEP members to discuss ideas for saving money in Medicaid emergency room services to be used to increase reimbursements without increasing overall taxpayer dollars committed.  At the request of the prior Medicaid Director, Governor Walker ultimately vetoed the provision citing overlapping existing efforts within DHS; but the issue is now on the radar screens of policy makers in the Legislature and Administration.

Doctor Day 2018 and 2019: As many of you know, on January 30th nearly 500 physicians and medical students came to Madison for the 5th annual Doctor Day advocacy event – our biggest turnout yet!  While in Madison, attendees heard from Governor Walker, received a legal update on the Mayo case in which a state appeals court invalidated Wisconsin’s non-economic damages cap for medical liability cases, appeal of which is now pending before the Wisconsin Supreme Court, listened to a legal discussion relating to network adequacy and surprise billing.  The morning session wrapped with briefings on issues including worker’s compensation, advanced practice nurse collaboration and chiropractors conducting youth sports physicals.   Once again, following an afternoon of legislative visits attendees retired to a nearby restaurant for debriefing and camaraderie. Looking ahead, next year’s event will be scheduled later in the year to better coincide with the Legislature’s primary activity for the year – the State Budget.  Subject to change, Doctor Day 2019 is tentatively scheduled for May 1, 2019 – mark your calendars now!

Chiropractor Sports Physicals: One of the items discussed at Doctor Day, Assembly Bill 260, in its original form would have authorized chiropractors to conduct youth pre-participation athletic physical exams and require the WIAA to accept those exams for athletic participation. WACEP joined a large number of health care organizations opposing AB 260, but last June the bill passed the State Assembly.  In the wake of Doctor Day, however, the Senate Health Committee amended AB 260 to remove the sports physical authority (with the amendment, physician organizations dropped their opposition).  The amended AB 260 then passed the Senate, was concurred in by the Assembly and ultimately signed by Governor Walker.  This is a testament to the impact of physicians can have lobbying their lawmakers at Doctor Day!

Campaign Season is Upon Us: Finally, with an odd-year Spring finally upon us, the Legislature has formally adjourned the 2917-18 Session and heads off to campaign for November.  Republicans presently dominate Wisconsin politics holding the Governor’s office, the Attorney General’s office, a 63-35 majority in the Assembly and a 18-15 majority in the Senate.  November will see races for Governor, Attorney General, all 99 Assembly seats and 17 of the 33 Senate seats.  (As well as all 8 of Wisconsin’s Congressional seats and one U.S. Senate seat.)  Recent special elections and Supreme Court elections in Wisconsin, as well as other states, suggest a typical anti-President’s party mid-term election coming.  Republicans downplay prospects of a “blue wave” election favoring Democrats, touting Wisconsin’s economic status and low unemployment among their achievements.  Democrats, meanwhile, believe the  electorate is ready for change and are working hard to recruit candidates and raise money in as many Wisconsin districts as possible.  There is much time between now and November, and elections tend to tighten up as voting day approaches regardless of who appears to be leading early on, but without a doubt 2018 is shaping up to be another in a series of very interesting recent Election Days.