Doctor Day 2018 is fast approaching and it’s important that physicians like YOU participate in our annual advocacy event in Madison on Tuesday, Jan. 30. 

It’s a full day of speakers, issue briefings and a visit to the Capitol to advocate on behalf of your profession. The day will conclude with a reception at DLUX.  The tentative schedule and online registration can be found at widoctorday.org. The event is free to all physicians and medical students thanks to very generous support from sponsorship organizations. 

Each year, Doctor Day attendees hear from some of the leading voices in Wisconsin politics and health care policy. We’re awaiting final confirmation from speakers, but physicians attending Doctor Day 2018 will enjoy the same high-level experience. Also, our speakers will update physicians on health care issues still under debate in the State Capitol. The January 30 meeting date coincides nicely with the final days of the state legislature’s activity, and therefore puts physicians in policymakers’ offices at the best time to maximize impact on the issues physicians care about. 

Physicians also will hear the latest regarding Wisconsin's cap on noneconomic damages in medical liability cases—currently being heard by the Wisconsin Supreme Court. One of the state’s top medical liability attorneys, Guy J. DuBeau, will explain how a lone case—tried in Milwaukee County—left Wisconsin with no limit on noneconomic damages and what physician organizations are doing to fix that problem. 

Staff and committee members will take care of every detail—from breakfast, briefings, speakers, lunch and scheduling your visits with legislators to the reception at the end of the day! 

Please consider joining us for a great day of advocacy on behalf of your profession and your patients!  Register now on the Doctor Day website.

December 6, Wisconsin Health News

The Department of Health Services has accepted the resignation of Medicaid Director Michael Heifetz, who is leaving for the private sector, according to a statement.

Heifetz, who also serves as administrator of the Division of Medicaid Services, will leave the department Dec. 13. Deputy Administrator Casey Himebauch will serve as the division's interim leader.

“Michael has been invaluable in his role as Medicaid director, representing Wisconsin’s vision for the future in the national spotlight,” DHS Secretary Linda Seemeyer said in a statement. “We will greatly miss his leadership and insight, as well as his candor and energy.”

A DHS spokeswoman said that Heifetz is "pursuing career opportunities" in the private sector. She did not respond to a question asking for more specifics.

Heifetz joined the department as Medicaid director in September of last year. He previously served as state budget director. Before that, he was vice president of governmental affairs at Dean Clinic and SSM Health of Wisconsin.

Heifetz has also left his position on the Group Insurance Board and was replaced by State Budget Director Waylon Hurlburt in October.

The legislature is considering legislation based on proposals from the Workers Compensation Advisory Council.  The proposals were developed Labor and Management representatives on the Council.  But not all of the proposals share the support of the Council’s health care representatives, including a recommended fee schedule.  Health care organizations will need to be even more active this session than last to again defeat the fee schedule proposal.

It is important to note that works compensation premiums have dropped – without a government mandated fee schedule.  This year alone, employers received an 8.46 percent reduction in their worker’s compensation insurance premiums, saving employers an estimated $170 million.  At the same time, Wisconsin’s health care system continues to lead the nation in outcomes with injured employees returning to work a full three weeks earlier than the national average.  And health care costs per worker’s comp claim lower than the national average.

Your calls are needed to both the State Assembly and State Senate to explain why the proposed health care fee schedule could harm Wisconsin’s model worker’s compensation system. Entering your address under "Who Are My Legislators" on the State Legislature’s website to locate their contact information.

Let your State Representative and State Senator know you are a physician in their district, serving patients who are also constituents and that you are opposed to an artificial fee schedule for a worker’s compensation system that provides the nation’s best care at a below-average worker’s compensation cost.  Thank you for your time and action on this important issue.

November 3, WMS Medigram

The Wisconsin Medical Society Board of Directors has named Clyde “Bud” Chumbley, MD, MBA, chief executive officer of the Wisconsin Medical Society.

“I’m excited to have the opportunity to serve as the next CEO of the Wisconsin Medical Society; I consider it a tremendous honor,” said Dr. Chumbley, who will begin on November 27. “Having been a Society member for 37 years, I’m a firm believer in its mission to advance the health of the people of Wisconsin by ensuring access to high-quality, cost-efficient care. And I look forward to drawing on my experience to further strengthen the Society so we can continue to make a difference for our patients and our profession.”

In addition to caring for patients as a board-certified obstetrician/ gynecologist throughout his 36-year medical career, Dr. Chumbley has held numerous leadership and management positions, including serving nearly 20 years as president and CEO of a large, independent multi-specialty medical group practice. He currently serves as chief medical adviser for Wisconsin Medical Society Holdings and as chief medical officer for the Wisconsin Medical Society Holdings Association Health Plan.

Past leadership roles in Wisconsin include serving as chief medical officer/chief clinical integration officer for Aspirus Health and president of Aspirus Clinics, and as president and CEO of ProHealth Care Medical Associates. He also has served on the board of directors and as past chair and treasurer for the Wisconsin Collaborative for Healthcare Quality. In Texas, he served as chief medical officer for Scott & White Healthcare in the Austin region.  

Doctor Chumbley is a graduate of the University of Missouri School of Medicine and the Kellogg School of Management at Northwestern University and holds medical licenses in Wisconsin and Texas.

“We were fortunate to have a number of highly qualified candidates interested in this position,” said Jerry Halverson, MD, chair of the Society’s Board of Directors and co-chair of the search committee. “Doctor Chumbley is an excellent advocate for physicians and the patients we serve, and with his extensive administrative experience and medical expertise, we believe he is an outstanding choice to lead the Society. We look forward to all we can accomplish under his leadership.”

Doctor Chumbley is the eighth Society CEO in its 176-year history. Susan L. Turney, MD, MS, FACMPE, FACP, was the first physician to hold the position from 2004 to 2011.

Deputy Insurance Commissioner J.P. Wieske will outline what a Wisconsin version of the Affordable Care Act could look like at the Dec. 13 Wisconsin Health News Newsmaker Event.

Wieske announced this fall the state is considering applying for a 1332 waiver from the law, which allows states to develop unique solutions for providing affordable healthcare coverage. Wieske will discuss the state’s next steps, as well as provide an update on open enrollment and the current insurance market.

Wieske has served as the state's deputy insurance commissioner since 2016. Before that he was the department's legislative liaison and public information officer for five years. He previously served as the executive director of the Council of Affordable Health Insurance.

 Register here.

November 8, Wisconsin Health News 

Healthcare providers and the state’s business lobby sparred over a proposal that would establish a fee schedule for the workers’ compensation program at a Wisconsin Health News event Tuesday. 

Under the proposal, the Department of Workforce Development would build a fee schedule to approximate the average negotiated price of group health in the state. It would also provide an additional 2.5 percent to 10 percent increase to cover administrative costs. 

“Wisconsin’s costs have gone up pretty dramatically in the last 20 years,” said Chris Reader, director of health and human resources at Wisconsin Manufacturers and Commerce. “We’re now, if not the most expensive, we’re close to it in most areas.” 

Reader said that employers are seeing that they’re paying more for the same procedure compared to group health plans and other states. More than 40 other states have developed their own medical fee schedules. 

The Legislature didn’t enact a fee schedule four years ago. But this time is different because costs have gone up, according to Reader. 

Mark Grapentine, senior vice president of government relations for the Wisconsin Medical Society, called the proposal a “solution in search of a problem.” He said that Wisconsin provides wide access to high quality care, which helps workers get better quicker. 

Grapentine said there’s a lot of attention paid to individual codes for procedures as opposed to the cost per claim. Wisconsin’s cost for all workers’ compensation claims on the healthcare side is around the national average, he said. 

“When you look at the whole picture overall, the story is pretty good,” he said. “The rest of the country looks at Wisconsin workers’ comp. program as a national model.” 

But Charles Burhan, assistant vice president and senior public affairs officer for Liberty Mutual, said most employers cannot negotiate on workers’ compensation. 

“It’s a national model for high prices,” he said of Wisconsin’s current system. “Is there a need for a fee schedule? Yes." 

Joanne Alig, senior vice president of policy and research at the Wisconsin Hospital Association, said that group health has lower prices because of negotiations, such as prompt payment. 

She said that workers' compensation premiums in Wisconsin have declined the last two years too. “To say that costs are not coming down, we just disagree with that,” she said. 

Oct. 12, 2017 WMS Medigram

In partnership with the Wisconsin Department of Justice (DOJ) and the Drug Enforcement Administration (DEA), local law enforcement agencies will be holding Prescription Drug Take Back Day on Saturday, Oct. 28. Police and sheriffs’ departments will host events throughout Wisconsin as part of the Take Back Day.

In partnership with the Wisconsin Department of Justice (DOJ) and the Drug Enforcement Administration (DEA), local law enforcement agencies will be holding Prescription Drug Take Back Day on Saturday, Oct. 28. Police and sheriffs’ departments will host events throughout Wisconsin as part of the Take Back Day.

The goal of Prescription Drug Take Back Day is to provide a safe, convenient and responsible means of disposal of unused or expired prescription drugs, while also educating the community about the potential abuse and consequences of improper storage and disposal of these medications.

Drug take back days are held each spring and fall across the country, and according to Attorney General Brad Schimel, the April 2017 Drug Take Back events in Wisconsin reached a record-breaking collection of 66,830 pounds of unused medications. Wisconsin had more law enforcement agencies participate in the biannual event than any other state in the country with 267 police and sheriffs’ departments from 69 counties hosting 150 events.

In addition to the semiannual Take Back Day event, there are 328 permanent drug disposal drop boxes throughout Wisconsin, providing citizens a convenient, environmentally friendly and anonymous way to dispose of unused medications all year. Wisconsin has more drug disposal boxes than 46 other states, behind only California, Texas and Pennsylvania.

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 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.

Access a list of Board-approved courses here.

Dear WSPS Member,

Since the last update over the summer we have had no healthcare legislation passed.  It appears that Congress is having a difficult time defining priorities in a new healthcare bill.  From all perspectives, a consensus is not on the horizon either especially after the underwhelming response to the Graham-Cassidy bill.  ASPS’s stance includes a number of challenges to the current healthcare law as well as those proposed during recent months. Despite this uncertainty, insurance products in Wisconsin appear to be consistent as fears of widespread market withdrawal has subsided at least for the time being.

On that note, a recent threat to our state’s tort climate has presented yet another example that any future federal healthcare legislation needs to address tort reform on a national level. A Wisconsin appellate court’s ruling that the current cap on noneconomic damages ($750,000) is unconstitutional (Mayo vs Wisconsin Injured Patients and Families Compensation Fund) now presents a challenge to what is considered a stable medicolegal environment.   This ruling puts the WIPFCF in peril and opens a door for frivolous litigation with unchecked settlements that at the end of the day make the practice of medicine more expensive for everyone in the state.  There is no evidence that removing caps on such settlements improves delivery or quality of health care.

Currently, the Wisconsin Supreme Court has not indicated whether they will hear the case but most feel that this will be announced imminently.  WSPS, along with other subspecialty societies in the state, has committed to participating in the creation of an amicus brief outlining the concerns of these societies with the appellate court’s actions.  The American Medical Society and Wisconsin Medical Society have jointly filed an amicus brief to the Court of Appeals. 

The impact of the appellate court’s actions certainly presents an obstacle in how medicine is practiced in this state.  Just talk to one of our colleagues in the state just south of us.  Make your voice known!  Regardless of your practice model or political preferences these legislative issues affect all our professional lives in a profound way!

On a lighter note, October is Breast Cancer Awareness month.  Although we impact so many spheres of healthcare as plastic surgeons, our role in the treatment of breast cancer is front and center.  It’s important that we support the local, regional and national organizations that educate and support our patients facing this diagnosis.

Just a reminder that the WSPS Annual Meeting is Friday, April 20^th at the Milwaukee Marriott West.  We are excited to have Dr. Dan Del Vecchio visit us from Boston, MA.  We encourage everyone to attend as it will be a fruitful, intimate meeting.  More details will be revealed in the next couple of months but please mark your calendars!

Best Wishes,

John LoGiudice

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.