April 27, Wisconsin Health News

Wisconsin will receive $7.6 million from the federal government to combat opioid addiction, the Department of Health and Human Services announced Thursday night.

HHS is providing $485 million to all 50 states, the District of Columbia and six U.S. territories. The funding, made available under the 21st Century Cures Act, will go toward prevention, treatment and recovery services.

States were awarded funding based on rates of overdose deaths and unmet need for treatment. Florida received the most money at $27.2 million, while five territories received $250,000 each.

Gov. Scott Walker directed the Department of Health Services to seek the funding in an early January executive order. DHS can re-apply for additional funding next year. 

April 25, Wisconsin Health News

The Senate Committee on Education approved two bills Monday that are part of a special session ordered by Gov. Scott Walker to tackle the opioid epidemic.

A bill that would provide $50,000 to help establish a recovery charter school, which would serve 15 high school students in recovery from substance use disorder, passed out of committee 6-1. Sen. Steve Nass, R-Whitewater, voted against it. 

An additional proposal providing $200,000 a year to expand the use of a substance abuse screening by the Department of Public Instruction passed 7-0. The Assembly has already approved both measures.

April 24, Wisconsin Health News

The Medical Examining Board approved permanent rules last week that govern the practice of telemedicine and mandate continuing medical education requirements for doctors on opioid prescribing.

The rules are expected to go into effect June 1, Department of Safety and Professional Services staff told board members.

The final telemedicine rule clarifies that a physician-patient relationship can be established through telemedicine and provides guidelines on the use of telemedicine.

The other rule requires doctors renewing their licenses to complete two hours of training on guidelines written by the board that relate to opioid prescribing. Doctors have to complete 30 hours of continuing medical education every two years.

April 18, Wisconsin Health News

Gov. Scott Walker has signed into law a bill ending state penalties for those who possess cannabidiol without psychoactive effect if they have written certification from a doctor.

The bill also directs the state's Controlled Substances Board to reschedule CBD oil, which is derived from marijuana and sometimes used to treat seizures in children, within 30 days following a change at the federal level. The bill passed the Senate 31-1, and the Assembly 98-0.

The bill builds on a 2014 law that aimed to make the drug available with a prescription in the state. But supporters said that providers weren't able to prescribe the drug, which is still illegal to obtain under federal regulations. 

While Republicans may have walked away from the American Health Care Act, the healthcare debate is certain to continue. Will the Trump Administration fight to keep the Affordable Care Act afloat? Or will it use its power to hasten the law’s demise? Will lawmakers move left or right to forge a new deal?

In the meantime, Gov. Scott Walker is pushing ahead with Medicaid reforms that likely would not have been approved a year ago.  What does it mean for the program? 

National and regional healthcare experts will tackle these questions and more at the 2017 Wisconsin Health News Conference, July 19 at the Monona Terrace in Madison.  Registration is now open (link).

Effective April 1, 2017, Wisconsin Act 266 requires all Wisconsin-licensed physicians and other prescribers to review a patient’s records from Wisconsin’s Enhanced Prescription Drug Monitoring Program (ePDMP) before issuing a prescription order for a monitored prescription drug.

To help members and their health care teams assess options for compliance with this new requirement, the Wisconsin Medical Society has prepared Wisconsin ePDMP: Frequently Asked Questions. Click here to download the PDF.

Part of the Wisconsin legislature’s Heroin, Opioid Prevention and Education (HOPE) Agenda, the requirement pertains to each prescription order for a controlled substance unless one of the following exceptions applies:

1.       The patient is receiving hospice care.

2.       The prescription is for a three-day or less supply with no refills.

3.       The drug is lawfully administered to the patient.

4.       Due to an emergency, it is not possible to review the ePDMP before issuing the prescription.

5.       The practitioner is unable to review the ePDMP data because either the ePDMP or the means to access it are not operational.

Monitored prescription drugs include most Schedule II, III, IV or V controlled substances (as well as any other substance identified by the Controlled Substances Board as having a substantial potential for abuse).

Prescribers subject to this requirement must register with the ePDMP to access the system. Click here to register if you have not done so already.

April 12, Wisconsin Health News

A compact that aims to expedite the process for doctors obtaining medical licenses in multiple states launched in Wisconsin last week.

So far 18 states have passed legislation to join the Interstate Medical Licensure Compact, which aims to make it easier and faster for doctors to get a license in other participating states.  

Illinois, Iowa and Minnesota have entered the agreement. Other states, including Michigan have bills pending in their legislatures that would allow them to join.

The compact began accepting and processing applications from qualified physicians on April 6, according to a statement from the commission overseeing it. 

Mark Grapentine, senior vice president of government relations at the Wisconsin Medical Society, said there are still details to work out before the compact process is functional among all participating states. But Iowa and Wisconsin are ready to go, he said.

"It will greatly help physicians and patients who may cross the Mississippi River to either give or receive care," he wrote in an email.

Dr. Donn Dexter, vice chief medical officer at Mayo Clinic Health System northwest Wisconsin, said the compact will help attract doctors to the state, particularly in underserved areas. 

It will also support educational efforts by making it easier to get a license in Wisconsin, allowing doctors in neighboring states to "come over and work and train in our community and hopefully stay," he said. 

Brian Vamstad, government relations manager for Gundersen Health System, called the launch a "great step." The compact will help with telemedicine efforts, he said. 

"It really will help us and others to meet the needs of communities," he said. 

So far, doctors with licenses who are either living, employed or have 25 percent of their business in Wisconsin can apply through the compact to practice in any of the other participating states, according to the Interstate Medical Licensure Compact Commission. 

Eleven states, including Minnesota, aren't comfortable serving as states of principal licensure, meaning doctors solely licensed by those states and either residing or practicing there can't use the compact until policymakers approve technical fixes. 

Diane Shepard, secretary for the commission, said Minnesota is close to approving its technical fix.

April 14, WHA Valued Voice

With the Interstate Medical Licensure Compact’s voluntary expedited licensure process becoming operational this month, WHA will be offering a 45-minute webinar on how the new Compact process can help physicians more quickly receive a Wisconsin medical license or a license in another state if the physician already holds a medical license in a Compact state. WHA General Counsel Matthew Stanford will present information on eligibility, which states are participating in the Compact, completing the application process, fees, how to maintain a Compact expedited license and considerations for utilizing the Compact expedited process versus the traditional licensure process.

The webinar, scheduled Tuesday, May 23 from 12:00-12:45 pm, is being offered through a partnership between WHA and the Wisconsin Medical Group Management Association (WMGMA). There is no fee to participate in this webinar, but pre-registration is required. Registration is now open at: www.cvent.com/d/z5qq0r.

Wisconsin joined the Interstate Medical Licensure Compact through the enactment of legislation in December 2015, which was a key legislative priority for WHA. To apply for a medical license through the Interstate Medical Licensure Compact expedited process, individuals should visit https://imlcc.org.

Wisconsin's population is aging and healthcare care costs for the elderly and those needing long-term care are growing along with it. Gov. Walker's budget increases Medicaid reimbursement for nursing homes and provides more money for direct care workers. Is it enough to address workforce shortages? And what's next for Family Care? After puling back its plans to overhaul the program, the administration is pushing forward with a statewide expansion. Will they incorporate other proposed program changes? 

Learn more at a Wisconsin Health News Panel Event May 2 in Madison. Panelists include:

• Lynn Breedlove, Co-Chair, Wisconsin Long Term Care Coalition
• Curtis Cunningham, Assistant Administrator of Long-Term Care Benefits and Programs, Department of Health Services
• Tim Garrity, Chief Innovation Officer, Community Link
• John Vander Meer, Executive Director, Wisconsin Health Care Association

Register Online

March 20, Wisconsin Health  News

Professional groups oppose a move by Gov. Scott Walker to eliminate state boards that regulate optometrists, radiographers and podiatrists as well as consolidate advisory councils and boards that oversee healthcare professions.

Walker's 2017-19 budget would end the Radiography Examining Board, the Podiatry Affiliated Credentialing Board and the Optometry Examining Board and transfer their functions, rules and pending matters to the Medical Examining Board.

The budget would also create a Medical Assistants Council, consolidating advisory councils on physician assistants and others. And it establishes a Medical Therapy Examining Board, ending boards overseeing physical therapists and others.

"Currently, taxpayer dollars are going to provide administrative services to each of the boards that are proposed to be consolidated," Alicia Bork, Department of Safety and Professional Services spokeswoman, wrote in an email. "Merging these functions...will allow efficiencies that cannot be found when separate silos exist."

The combined actions, along with other changes at DSPS, would cut state spending by $50,800 in program revenue over the next two fiscal years, according to the Legislature Fiscal Bureau. There were 1,172 optometrists, 424 podiatrists and 6,994 radiographers with active licenses in Wisconsin as of July 2016. 

Peter Theo, executive vice president of the Wisconsin Optometric Association, said his members have "serious concerns" about the proposal as turning regulatory control over to another profession may hurt their ability to diagnose and treat eye diseases.

"Optometrists are primary eye care providers whose regulatory independence is critical to maintaining the high standard of care needed to ensure the safe and competent practice of optometry," he said. 

The Wisconsin Podiatric Medical Association raised concerns about not having representation on the Medical Examining Board. 

"The Medical Examining Board cannot be expected to keep up with the advances in all of the professions that they are looking to be charged with," Dr. Bob Sage, the association's president, said in a statement. "It is unrealistic."

Sandy Helinski, legislative committee chairperson for the Wisconsin Society of Radiologic Technologists, said the elimination of the Radiography Examining Board, established in 2010, would be an "indisputable step backward in the health of Wisconsin's patients." 

"Anything that could possibly dilute the effectiveness of what we've been able to accomplish in these last seven years is of great concern to us," she said.

Connie Kittleson, president of the Wisconsin Physical Therapy Association, opposes eliminating of the Physical Therapy Examining Board and the creation of a Medical Therapy Examining Board.

She noted other states have tried consolidation in the past and have returned to independent boards.

"The data out there shows it doesn't make things more efficient, it doesn't save money," she said. "But more importantly, it wouldn't be worth the risk to public safety to have people who do not have expertise or training in a particular field regulating professionals of another field."

Reid Bowers, Wisconsin Academy of Physician Assistants' advocacy committee chair, raised concerns about the proposed Medical Assistants Council, saying it "would severely limit the ability of PAs to shape how they are regulated by the Medical Examining Board." 

At a Medical Examining Board meeting last week, Chair Dr. Kenneth Simons said the budget would put them "in charge of things we have no expertise" in. Others raised similar concerns. 

Tom Ryan, the board's executive director, said that the boards put under the authority of the Medical Examining Board meet three to four times a year. Doctors on the board could do "curbside consults," he said.

"I don't think it's as formidable a challenge as you would think," he said.

Mark Grapentine, senior vice president of government relations for the Wisconsin Medical Society, said the Medical Examining Board has to investigate complaints against physicians and regulate the profession.

"If adding these non-medical professions to their duties takes away from that responsibility or makes fulfilling that duty less efficient, it's difficult to divine the upsides to the proposal," he said in a statement.