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  • October 18, 2017 9:37 AM | Deleted user

    The deadline for Wisconsin medical license renewal is approaching—Oct. 31, 2017, for MDs and Feb. 28, 2018, for DOs—and new this cycle is the Medical Examining Board (MEB) requirement for most physicians to complete two CME credits on its Opioid Prescribing Guideline

    Upon renewal, physicians must attest that they have completed the required opioid prescribing CME or will by Dec. 31, 2017. Only MEB-approved courses satisfy the mandate. All physicians should maintain a record of their participation; however, documentation is required only in the event of an audit.

    Register for WACEP's on-demand webinar and obtain your required opioid prescribing education today!

  • October 05, 2017 9:32 AM | Deleted user

    September 19, Wisconsin Health News

    Attorney General Brad Schimel has joined the chief legal officers for 36 other states and territories to ask that insurers revise policies to reduce opioid prescribing. 

    Schimel and the other attorneys general wrote Marilyn Tavenner, the CEO of America's Health Insurance Plans, requesting that her members review payment and coverage policies to prioritize non-opioid pain management. 

    "We have witnessed firsthand the devastation that the opioid epidemic has wrought on our states in terms of lives lost and the costs it has imposed on our healthcare system and the broader economy," Schimel and others wrote. 

    They added that they'll soon be working with state insurance commissioners and others "to initiate a dialogue" with insurers to identify practices that can reduce opioid prescription and those that don't.

    "The status quo, in which there may be financial incentives to prescribe opioids for pain which they are ill-suited to treat, is unacceptable," the attorneys general wrote. "We ask that you quickly initiate additional efforts so that you can play an important role in stopping further deaths."

    Cathryn Donaldson, spokeswoman for America's Health Insurance Plans, said they share the attorneys general's commitment to addressing the opioid epidemic. Health plans cover approaches to pain management that include more cautious opioid prescribing, careful patient monitoring and other treatments, she said.

    Many health plans have already instituted programs that are helping to "dramatically reduce how much - and how often - opioids are prescribed," she said.  

    "By working together, doctors, hospitals, health plans and policy leaders can provide people with better pathways to healing - without putting their lives in danger because of opioids," she said.

  • September 22, 2017 10:47 AM | Deleted user

    In July a State Court of Appeals decision in the Mayo v. WIPFCF case ruled unconstitutional Wisconsin’s $750,000 cap on non-economic damages for medical malpractice cases (passed by the Legislature in the late 1990’s).  The case has been appealed to the Wisconsin Supreme Court and awaits the Court’s decision (which is anticipated to occur in the next couple of weeks) on whether they will take the case; most court watchers believe they will do so. 

    The case has great significance for Wisconsin’s medical liability climate.  Facing many other medico-economic challenges, and building from Doctor Day partnerships, WACEP has taken the lead organizing a coalition of eight specialty medical societies to petition the Court to be named Amici (“friends of the court”) -- non-parties to the original case who may be affected by, or who can offer unique insight into the impact of the Court’s ultimate decision.  

    If granted Amici status, the coalition will work together to submit a brief explaining to the Court the potential impact on specialty physicians and their patients.  No doubt many similar briefs will be offered in a case of this significance, and it is anticipated the Court will set a briefing schedule later this fall.

  • September 22, 2017 10:45 AM | Deleted user

    You may recall that for several years, WACEP has attempted to work cooperatively with the WI Department of Health Services (DHS) to educate staff about Wisconsin’s worst-in-the-nation rates for reimbursement of Emergency Physician Services in Wisconsin’s Medicaid programs, and seek "fair" reimbursement at least on par with surrounding states.  Having once again experienced empathy without action from DHS, WACEP undertook a more aggressive legislative solution this year. 

    As a part of the State Legislature's Joint Finance Committee’s (JFC) review of the 2017-19 State Budget, Representative John Nygren led an effort to require DHS to create a study group made up of Medicaid program staff and outside Emergency Physicians to examine care provided to Medicaid patients, search for ways to save money, and make recommendations back to JFC.  The goal was to find savings in the system that could then turned back into increasing reimbursements for Emergency Physician Services – ultimately costing the Medicaid program nothing more. 

    This study group, if successful, would have served as a model for other private-public efforts.  The JFC ultimately incorporated a requirement for an Emergency Physician Study Group, and it was approved by the full Legislature in September.  

    Unfortunately, Governor Walker vetoed the provision (along with 99 other items, many of them similar studies or reports from agencies) this week, stating in his veto message that the study duplicated existing “managed care and care coordination efforts in the DHS.” 

    With healthcare reform, the ACA, discussions about future Medicaid program funding and block grants all still in flux in Washington, these discussions are far from completed, and we will plan to regroup and continue these efforts in the coming months. 

    Many thanks to Lisa Maurer, MD, WACEP Board member who spearheaded the effort, as well as to all of you who responded to WACEP’s recent Legislative Alerts asking you to contact the Governor’s office.

  • September 08, 2017 12:00 PM | Deleted user

    Enhancing the pediatric readiness of the nation’s emergency departments (EDs) to care for children is of utmost importance to improve the quality of care and outcomes for ill or injured children. Wisconsin Emergency Physicians are encouraged to participate in pediatric ED readiness initiatives.

    The US Department of Health and Human Services Health Resources and Services Administration (HRSA) EMS for Children (EMSC) Program and the EMSC Innovation and Improvement Center (EIIC) have partnered with the American Academy of Pediatrics, the American College of Emergency Physicians, and the Emergency Nurses Association to support a pediatric quality improvement collaborative. The collaborative began in April 2016 and efforts are ongoing with a goal of working with existing emergency care systems to improve and encourage pediatric readiness based on compliance with the 2009 joint policy statement, “Guidelines for Care of Children in the Emergency Department (ED).”

     In 2013 the National Pediatric Readiness Project provided a baseline assessment of the nation’s capacity to care for children in an emergency. This assessment identified that the majority of children are cared for in community and rural emergency departments rather than specialized hospitals such as children’s hospitals. It was also noted that the readiness of these institutions to care for the emergency needs of children varied greatly (

    Pediatric readiness programs assist state and territory-specific teams in working closely with stakeholders to identify criteria and characteristics, and to supply resources such as policies, procedures, and equipment, to best meet the needs of children within their own state or territory.

    Additional Resources:

    • Guidelines for Care of Children in the Emergency Department policy statement (link)
    • EMSC Innovation and Improvement Center (link)


    • Ms. Loren Rives, Senior Manager, Academic Affairs, ACEP
    • Dr. Madeline Joseph or Dr. Kathleen Brown, ACEP Liaisons on the EIIC 
  • August 21, 2017 4:09 PM | Deleted user

    Bobby Redwood, MD, MPH
    President, Wisconsin ACEP

    Out of network billing (OONB) is a concept that is understandably difficult for our patients to grasp. The usual story goes like this: an insured patient presents to an emergency department during a period of vulnerability and need, they receive high quality emergency care, but then receive a bill six weeks later stating that their hospital fees are covered by insurance, but their physician services are not. From a patient perspective, that looks like the hospital is charging a couple hundred dollars, while the emergency physician is charging a couple thousand…what gives?!

    As physicians, the problem seems pretty simple…the insurer is refusing to pay. In other words, the patient’s emergency physician did the work and the insurance company, in an effort to increase revenues for their shareholders, has created an unreasonably narrow network of providers in order to cut costs (and stick the patient with the bill for physician services). The patient has done nothing wrong here. They bought insurance and had an emergency. It is quite reasonable to be angry that the insurance they spent their hard-earned money on is not paying for the services it was supposed to cover.

    Of course, as physicians, we have an intimate knowledge of the health care bureaucracy and the unscrupulous maneuvers that insurers turn to in order to avoid payment are nothing new to us. The problem is that physicians and physician staffing companies have been receiving the lion’s share of the blame for a phenomenon that we have very little (if any) control over. The New York Times has reported extensively on OONB. They routinely call it “surprise billing” and have quoted health policy experts calling the practice everything from, “a bait-and-switch” to “financial roulette” to “the health equivalent of a carjacking.” The Times is one of my most trusted news sources, but on this issue, they really miss the mark.

    In an article titled, Surprise! Insurance Paid the E.R. but Not the Doctor, the Times authors state that; “These doctors negotiate separate deals with insurance companies for payment. If the doctor and the insurance company never strike a deal, the visit is billed at much higher out-of-network rates”. There is a partial truth here, some independently owned physician groups are placed in the difficult position of having to contract with as many insurance companies as possible to mitigate the effect of the insurance companies’ cruel insistence on not covering all aspects of emergency care. Still, it is disingenuous to paint problem in such a way that places physicians as equal partners in this inhumane withholding of emergency care coverage. For those physician groups that do need to negotiate their rates in order to be considered “in-network”, the rates that payers offer are often far below fair market value. Personally, as a contracted employee of an independently owned hospital, I am not out there negotiating which unfairly narrow networks will cover my labor—I clock in, I see patients, I clock out.

    Another Times article titled, The Company Behind Many Surprise Emergency Room Bills tries to pin the blame on the national physician staffing company EmCare. Citing a single study that has been widely criticized for flawed methodology, the authors portray EmCare as an evil corporation that swooped in to a rural emergency department, increasing the cost of an average level 5 visit from $467 to $1,649. This sounds concerning of course, but the readers are not told that patients are now being seen by emergency specialists. Has the quality of care improved? Is the hospital able to handle more complex pathophysiology in-house with specialists in the emergency department? Were they even able to staff the facility appropriately prior to the EmCare contract? We do not know, because the article does not say, but I suspect there is a lot more to the story than EmCare running up the tab.

    There is a practical solution to the OONB problem of course. Four states have adopted the Minimum Benefit Standard, which essentially mandates that insurers cannot pay providers less than 80% of usual professional service charges. These charges are based on a geographically comparable database of usual and customary clinician charges and the database is maintained by an independent non-profit organization. In other words, these states let a third party decide what fair compensation is and then compensate their providers fairly without putting the patient in the crosshairs of our unnecessarily complicated insurance landscape. An in-network discount is reasonable, but patients should not be financially punished for having a medical emergency.

    At present, we at WACEP have thankfully not heard many OONB horror stories in our state, but we are keeping our ears to the ground and have put together a task force to explore the issue. Has your group been a victim of unfair OONB practices? Are your patients complaining about billing practices that are out of your control? We’d like to hear from our membership on this important issue.

    For more information, check out ACEP’s website on fair coverage and the cited NY Times articles below:

  • August 16, 2017 1:45 PM | Deleted user

    Join Wisconsin Health News for a discussion on Innovation... one of the biggest buzzwords in healthcare.

    Tuesday, Sept. 5, 2017; 11:30 am - 1:00 pm
    The Wisconsin Club, 900 West Wisconsin Avenue, Milwaukee, WI 53233 

    • How are providers and insurers embracing, and advancing, new technologies? What hurdles stand in their way?
    • Which advancements will have the most impact on patient health?

    Panelists include:

    • Mike Anderes - chief innovation and digital officer for Froedtert Health and the president of Inception Health, a company formed by Froedtert & the Medical College of Wisconsin to accelerate the adoption of digital health, identify and partner with innovative companies and increase the innovation capacity of the network. 
    • Ilya Avdeev - professor of mechanical engineering at the University of Wisconsin-Milwaukee. He's the principal investigator and co-director of the National Science Foundation I-Corps Site of Southeastern Wisconsin - a partnership of UWM, Marquette, Medical College of Wisconsin, Concordia and Milwaukee School of Engineering.
    • Craig Hankins - vice president of digital products at UnitedHealthcare. He oversees the strategy and delivery of mobile solutions. His responsibilities include developing new and innovative mobile technologies that serve an array of healthcare stakeholders, including consumers, care providers and employers.
    • Mike Lappin - chief administrative officer of Aurora Health Care. He is responsible for overseeing compliance, government relations, human resources, information services, internal audit, legal services, real estate and facilities management, as well as affiliations, acquisitions, joint ventures and other transactions.
  • July 26, 2017 12:22 PM | Deleted user

    On September 20, the Wisconsin Hospital Association is sponsoring the “WHA Emergency Preparedness Conference: Ready to Respond” at the Sheraton Hotel in Madison. Conference details and registration are available online.

    This important, one-day conference will feature national experts who will share communication and preparedness lessons learned from real world events and focus on current threats facing health care organizations, including workplace and community violence and highly infectious diseases. Attendees will have the opportunity to collect strategies to enhance their current emergency management programs, practice them through interactive exercises, and integrate those preparedness and communication strategies into daily operations.

    Vincent Covello, PhD, will keynote the conference and offer a deep-dive session in the afternoon specifically for public information officers and health care public relations professionals.

    Covello is a nationally and internationally recognized trainer, researcher, consultant and expert in crisis, conflict, change and risk communications. Over the past 25 years, he has held numerous positions in academia and government. Covello was a senior scientist at the White House Council on Environmental Quality in Washington, D.C., a study director at the National Research Council/National Academy of Sciences and the director of the risk assessment program at the National Science Foundation. Covello has authored or edited more than 25 books and published over 75 articles on risk assessment, management and communication.

    Covello will share principles, strategies and practical tools for communicating effectively in a high stress situation.

    Chris Sonne and William Castellano, both of HSS EM Solutions, will share best practices and lessons learned from live active shooter scenarios, as well as direct tabletop exercises and a practical, scenario-based training exercise, during a special afternoon session focused on planning and preparing for an active shooter.

    Additional sessions include a look at infectious disease outbreaks and what hospitals can do to better prepare; as well as the role of governmental agencies, including the Department of Health Services and the Department of Public Health during an emergency.

    This conference has been designed for hospital emergency preparedness directors, emergency department directors and physicians, infection prevention staff, department directors, public relations professionals and public information officers. 

  • July 26, 2017 11:55 AM | Deleted user

    September 14-16, 2017: WISAM Conference
    Advancing the Art and Science of Addiction Prevention and Treatment in Wisconsin
    Pyle Center, Madison, WI

    This two day conference on addiction prevention and treatment is open to all providers across disciplines.

    A post-conference workshop on Saturday, September 16 will provide training for clinicians in the use of buprenorphine and naltrexone for the office-based management of substance use disorders. Attendees will also have the opportunity on Saturday to participate in an Opioid Prescribing Guidelines session that meets the Wisconsin Medical Examining Board’s mandatory education requirement.

    View conference agenda . Learn more and register.

  • July 19, 2017 12:12 PM | Deleted user

    Bobby Redwood, MD, MPH

    Wisconsin emergency physicians should be leery of the U.S. Senate’s latest version of The Better Care Reconciliation Act (BCRA). Stripping away the loaded messaging from the special interest groups and the political baggage that haunts the Affordable Care Act (ACA), what the Senate has proposed is a bill that will deliver a triple blow to emergency medicine in Wisconsin. Stated simply, passing the BCRA will have a negative impact on our patients, our profession, and our physician workforce.

    Painful Cuts for Patients: With the BCRA, our patients are definitely being forced to take their medicine (and there is no spoonful of sugar to help it all go down). Tax credits for out-of-pocket expenses will be phased out by 2019, insurers can charge older patients up to five times as much as younger patients, and annual/lifetime limits on individual coverage are coming back. Furthermore, patients will again have the option to buy what Kaiser Health News calls “junk insurance” (low cost, minimal coverage plans that were eliminated under the ACA). Oh, and guess what, the BCRA eliminates the individual mandate, so all those invincible young patients coming in with mental health crises, overdoses, and traumatic injuries will no longer be obligated to have insurance, but EMTALA will still require emergency physicians to provide their uncompensated care. The congressional budget office sums up this can of worms quite nicely, estimating that the BCRA will eliminate insurance coverage for more than 20 million people over the next decade and Wisconsin’s hit would be 394,100 newly uninsured patients.

    Painful Cuts for Emergency Department Revenue: Since Wisconsin has a thriving, diverse payer mix; the best course for our state would be to reform the ACA, rather than repeal it, so that even more Wisconsinites can have access to private insurance plans. Wisconsin is already worst in the nation in terms of Medicaid reimbursement*, compensating emergency physicians just $37.77 for a level 5 visit (compared to Medicare’s $169.14 for a level 5 visit). The changes proposed by the BCRA will distribute federal Medicaid funds to the states based on a capped, per-capita or block grant basis. Our state government has already shown us how much they value our work…what will happen to emergency department and emergency physician compensation under the (presumed) cuts of a block grant system?

    Painful New Realities for Practicing Emergency Physicians: For the 99% of us who are not policy wonks, how will the BCRA affect our daily workflow in the emergency department? For starters, an greater underinsured population will equate to more challenges securing inpatient psychiatric beds, so expect those mental health boarding times to increase. Blocking federal payments to Planned Parenthood will decrease young women’s access to contraception, HPV vaccines, cervical cancer screening, and prenatal care; so expect more pelvic exams, more abnormal findings on pelvic exams, and more pregnancy complications. Some of those patients who were briefly insured under the ACA, but have since lost coverage, will be turning to the ED to manage their recently discovered chronic health conditions and lets not forget the return of lifetime limits on individual coverage. “I’m sorry Mrs. Smith, you reached your coverage limit with your last cardiac stent, how about this DNR paperwork instead?” If the BCRA passes, I sincerely hope you compensation is not tied to patient satisfaction, because we are going to be seeing a lot of unhappy individuals under this substandard attempt at health insurance reform.

    National ACEP has already weighed in, warning that “the BCRA would allow insurance companies to offer skimpy plans that offer no essential benefits coverage to consumers” and that “the consequences for emergency patients could be devastating.” I agree and would add that the consequences for Wisconsin will be particularly jarring for our state’s patients, profession, and physician workforce. Tammy Baldwin is a vocal opponent of the BCRA, but Ron Johnson is still on the fence.

    Tell Ron Johnson to vote "NO" on the BCRA:

    *WACEP is working hard to improve this dismal statistic.