Bobby Redwood, M.D., M.P.H.
President, Wisconsin Chapter, American College of Emergency Physicians

Wisconsin ACEP is in the midst of a productive and exciting year. Here’s a recap of some of what the Chapter has been up to: 

• Vision—a Three-Prong Approach. WACEP will take stock of our resources and establish three concrete goals addressing this question: What can we do for our specialty, for our physicians, and for our patients? Member feedback is important as we craft strategic goals for 2017. Contact us!
• Fair Payment: EM Medicaid reimbursement rates in Wisconsin are worst in the nation. We have developed a task force to explore legislative solutions to achieve fair payment.
• WACEP Website: Keep an eye out for a newly designed Chapter website, which should go live by early fall.
• WMS House of Delegates: WACEP now has three emergency physicians serving in the Wisconsin Medical Society’s House of Delegates. We hope to increase the influence of emergency medicine in the broader house of medicine in Wisconsin.
• Wisconsin EM CME Conference: WACEP is currently exploring the logistics of hosting an annual Wisconsin Emergency Medicine CME conference.

Thank you for your service to emergent patients in Wisconsin and your involvement with Wisconsin ACEP. Remember to check the Wisconsin ACEP website for updates on legislative victories, educational opportunities, resident scholarships, and more! 

July 21, Wisconsin Health News

A subcommittee of the Medical Examining Board tasked with developing rules on telemedicine anticipates sending a final version to the board for approval later this fall.

The board first drafted the proposed rules last year but formed a subcommittee to rewrite them after hospitals and others raised concerns at a January public hearing. The new set of rules, modeled on those approved by the state of Florida, is less prescriptive than the original set.

Members of the subcommittee said Wednesday they plan to revise the proposal to reference physician assistants. The Wisconsin Academy of Physician Assistants called for the change.

According to the academy, physician assistants "are already experiencing difficulty being authorized to provide telemedicine by certain health systems."

Elli Health, a Wisconsin-based telehealth company, wrote that they had some concerns about Florida's rules. But after seeing the Wisconsin proposal, they said their concerns had been addressed.

Mark Grapentine, senior vice president of government relations at the Wisconsin Medical Society, praised the board's process.

"I really appreciate how you guys have done this and how you responded from the initial go-around, which was interesting to say the least," Grapentine told board members. "I think you've pivoted to an area that will be helpful for you and understandable for the folks out in the field."

Dr. Kenneth Simons, the board's chair, said they hope to have an additional public hearing on the rule later this fall before deciding to approve it.

July 6, Wisconsin Health News

Sen. Ron Johnson, R-Wis., lauded a proposal Wednesday from the Department of Health and Human Services to sever the connection between Medicare funding and pain management questions on a survey of consumers. 

HHS plans to remove the link between Medicare funding and pain management questions on the Hospital Consumer Assessment of Healthcare Providers and Systems survey.

Hospitals would continue to use the same questions in the survey, but those questions wouldn't affect the level of payment they received, HHS announced Tuesday.

Johnson introduced legislation earlier this year that would have made the federal government unable to tie reimbursement to pain outcome measures.

"Removing questions from payment calculations that could lead to inappropriate pressure on doctors is a bipartisan, commonsense solution to tackling the enormous challenges we face in the ongoing opioid epidemic," Johnson said in a statement. He called the proposal "the responsible thing to do."

Dr. Timothy Westlake, vice-chair of the state's Medical Examining Board called Johnson's bill "the single most important piece of federal legislative reform" at an April congressional field hearing in Pewaukee. 

U.S. Senate Committee on Health, Education, Labor and Pensions Chair Lamar Alexander, R- Tenn., called the HHS announcement a "big win for Senator Johnson, for the people of Wisconsin and for the country."

"These survey questions had the unintended consequence of actually encouraging the overprescribing of painkilling opioids," Alexander said in a statement. "I'm glad to see the administration correct this mistake by removing them from Medicare payment calculations."

HHS Secretary Sylvia Burwell said that they've heard from physicians that some have felt pressure to overprescribe opioids because of the questions. 

"While we haven't found evidence to support this concern, out of an abundance of caution, we have proposed a rule to change that," Burwell said on a conference call with reporters. 

HHS also released a request for information to seek provider, consumer and other public comments on current prescriber education and training programs on Tuesday.

Other federal agencies announced steps to combat the opioid and heroin epidemic as well. Indian Health Service will require its prescribers and pharmacists to check their state PDMP databases before prescribing any opioid for more than seven days. 

The Department of Veterans Affairs will also require prescribers in most cases to check state PDMPs before prescribing a new controlled substance.

November 19, Wisconsin Medical Society

As part of its extraordinary session day on Monday, the Wisconsin State Assembly approved an amendment made by the State Senate to Assembly Bill 253, legislation allowing Wisconsin to join the Interstate Medical Licensure Compact. By concurring with the Senate’s change, the bill now goes to Gov. Scott Walker for his final action. The Society anticipates the Governor will sign the bill into law in the next few weeks.

The Compact cuts administrative red tape for physicians who wish to apply for a medical license in multiple states by eliminating the need for each state to separately re-verify the same basic information about a physician applicant (education, liability history, etc.). This new option will be voluntary, with physicians maintaining the option to apply state-by-state if desired.

Contact Mark Grapentine, JD, in the Society’s Government and Legal Affairs Department with any questions. Visit the Society’s Lobbying Tracker for information on this and other bills the Society is following.