State Legislative Update
If you have any questions or would like to discuss how to improve your advocacy efforts, contact Grant Niver.
Federal Legislative Update
Stay up-to-date on #AANAdvocacy by reading the Capitol Hill Report and following the AAN’s Senior Legislative Counsel Mike Amery on Twitter at @MikeAmeryDC.
Medical Economics Update
For more information on AAN practice resources, visit our webpage
AAN Membership Update
September 14-16, 2017 (Thursday-Saturday), Pyle Center, Madison, WI
This Wisconsin Society of Addiction Medicine (WISAM) conference is open to individuals working in addiction prevention and treatment across disciplines, including clinicians, social workers, recovery coaches, individuals in recovery, law enforcement and public health officials. This year's conference will feature a number of workshops, lectures, and a special presentation by Joseph LMS Green (poet. performer. educator.).
Our post-conference workshops on Saturday, September 16th, 2017 will provide training for clinicians in the use of buprenorphine and naltrexone for the office-based management of substance use disorders, and in the Wisconsin Medical Examining Board Opioid Prescribing Guidelines.
Click here to download an agenda for the two day conference and the post-conference day.
Click here to register for the conference.
An appeals court struck down a state law Wednesday capping the amount of money that injured patients can receive for some malpractice claims.
The 1st District Court of Appeals ruled that a state law capping awards for noneconomic damages at $750,000 was unconstitutional. Noneconomic damages are intended to compensate for pain and suffering.
Judge Joan Kessler, who penned the majority opinion, wrote that the law imposes "an unfair and illogical burden only on catastrophically injured patients, thus denying them the equal protection of the laws."
The case involves Ascaris Mayo, who lost her limbs after she wasn't notified she had an infection after visiting a Milwaukee-area emergency room in May 2011. Mayo and her husband sued, and a jury awarded them $16.5 million for noneconomic damages.
The state's Injured Patients and Families Compensation Fund, which is funded by hospitals and doctors and covers large medical malpractice claims, moved to reduce that amount to the $750,000 limit. The Mayos challenged that.
Hospitals and doctors in the state were concerned about the Wednesday's ruling. Wisconsin Hospital Association CEO Eric Borgerding expects the state's Supreme Court to review the decision.
"We believe the court will uphold the well-supported and bipartisan public policy balance set by the Legislature to help ensure accessible healthcare in Wisconsin," he said in a statement.
A spokeswoman for the Office of Commissioner of Insurance, which provides administrative staff to the 13-member board, didn't respond to a request for comment on whether the state would appeal the decision.
Dr. Noel Deep, Wisconsin Medical Society president, said the decision"endangers the long-term solvency of the Injured Patients and Families Compensation Fund and its ability to adequately compensate patients." He warned that it could incentivize "attorneys to file questionable cases in hopes of astronomical jury awards seen in other states without caps."
Dan Rottier, an attorney for the Mayos, called the society's claim regarding fund's solvency "ridiculous." The fund reported a net position of $879 million as of June 2016, according to an annual report.
Rottier said that pursuing such cases are difficult because "they're extremely expensive...these cases are not taken lightly.
Rottier said the court's decision has "implications for a few cases every year where there's horrendous injuries...it's those cases where the inequity is the most severe." He noted that applying a cap in this case would have reduced the jury award by more than 95 percent.
"I would call it 5 percent justice instead of 100 percent justice," he said.
The 4th International Conference on Neurology and Neuroimmunology operating committee formally invite Neurology Research Team to attend as honorable speakers and Delegates at “4th International Conference on Neurology and Neuroimmunology” during Sep 18-19, 2017 in Dallas, USA.
This conference is containing sum of 15 sessions and the following sessions are: Neurology, Neurosurgery, Neurodegenerative Diseases, Neuroimmunology, Auto Immune Disorders, Multiple Sclerosis, Neurotransmitters & Neuroimmune Interactions, Aging & Degeneration, Neuroendocrinology, Pediatric Neurology, Clinical Neuroimmunology, and Neuropharmacology, Stem Cells in Neuroimmunology, Novel Therapeutics, Diagnosis and Therapy.
For more information please follow: http://neuro.alliedacademies.com/
Neuroimmunology 2017 Operating Committee requires the earliest acknowledgement to secure your slot in the agenda.
Doctor Day 2018 has been set for Tuesday, January 30. The event will again be held at the Monona Terrace in Madison and is hosted by over 20 medical societies.
The event provides physicians an opportunity to meet with their legislators, and have input on important health care issues. The day will conclude with a reception in downtown Madison.
Registration is available online (link).
Despite opposition from 22 organizations representing physicians, nurses, physician assistants, hospitals, the WIAA, insurers and others – and support from only one (the Wisconsin Chiropractic Association) – AB 260 passed the full Assembly on Wednesday, June 21 and is now being considered in the Senate for consideration.
It is critically important for physicians to let Senators know their opposition before the Senate makes their decision about how to proceed. To find your State Senator’s office contact information, type in your home address under “Find my Legislators” (link). Please do not delay – sending an email will take you no more than 2 minutes. The coalition memo opposing the bill (link) and related infographic (link) are attached for more information.
The Senate approved the final two proposals that are part of a special legislative session on opioids that Gov. Scott Walker called in January.
All 11 proposals that are part of that session have now passed the Legislature and await Walker's signature to become law.
The bills were based on recommendations from an interim report released in January by the Governor's Task Force on Opioid Abuse, which was chaired by Lt. Gov. Rebecca Kleefisch and Rep. John Nygren, R-Marinette.
"We have a lot of work left to do on a massive epidemic that's sweeping our state," said Ashland Democratic Sen. Janet Bewley, who served on the task force as well. "We are learning that it's even bigger and more profound than we ever thought."
The Senate approved a proposal Tuesday that would provide limited legal immunity to overdose victims. Sen. Steve Nass, R-Whitewater, was the sole no vote.
The chamber also approved a bill allowing for families and others to involuntarily commit a person with drug dependence.
The Senate also voted down along party lines a Democratic amendment to the latter proposal requesting the attorney general to consider filing a lawsuit against opioid manufacturers. A few states, like Ohio, have filed lawsuits against drugmakers.
Senate Majority Leader Scott Fitzgerald, R-Juneau, predicted that a class action lawsuit against drugmakers "is coming. It's just a matter of time...and I'm sure we'll be part of that at some point." He moved to reject the proposal as he didn't want it tied with the bill.
See a list of the special session bills.
CALL OR EMAIL YOUR STATE SENATOR TODAY – ASK THEM TO OPPOSE CHIROPRACTORS’ SCOPE EXPANSION BILLS: ASSEMBLY BILL 260 SENATE BILL 232 Despite opposition from 22 organizations representing physicians, nurses, physician assistants, hospitals, the WIAA, insurers and others – and support from only one (the Wisconsin Chiropractic Association) – AB 260 is expected to pass the full Assembly on Wednesday, June 21. Once passed by the Assembly, AB 260 will move to the State Senate for consideration – and it is critically important for physicians to let Senators know their opposition before the Senate makes their decision about how to proceed. To find your State Senator’s office contact information, type in your home address under “Find my Legislators” (right-hand side of this website: http://legis.wisconsin.gov). Please do not delay – sending an email will take you no more than 2 minutes.
What do AB 260/SB 232 do? Rep. Chuck Wichgers (R-Muskego) and Sen. Frank Lasee (R-DePere) have introduced legislation that would dramatically expand the current scope of practice for chiropractors in Wisconsin. These bills would allow Wisconsin chiropractors to conduct pre-participation physical exams for studentathletes (high school, technical colleges and 2-year UW colleges) and require that the WIAA, Wisconsin technical colleges or 2-year UW campuses to accept pre-participation exams conducted by “certified” chiropractors. The Chiropractic Exam Board is exclusively authorized to set the criteria for a chiropractor to be “certified” – there are no criteria or parameters specified in the bill. In short, comprehensive pre-participation physical exams involve examination and assessment of the musculoskeletal structures as well as an athlete’s heart and lungs, vision, neurological (concussion history), mental health and more – areas in which chiropractors have little or no training. These bills put student-athletes at risk, and represent a significant and unnecessary expansion of chiropractors’ scope. * * * * Also included in these bills, but already largely decided at the Federal level -- the Federal Motor Carrier Safety Administration (FMCSA) sets criteria by which health providers may qualify as a certified medical examiner and conduct FMCSA driver exams. The FMCSA authorizes chiropractors to qualify as medical examiners if they meet FMCSA standards, but leaves to states the final authorization. These bills would allow Wisconsin chiropractors to become FMCSA medical examiners if they meet FMCSA’s standards.
As a consequence of opting out of the federal health reform law's Medicaid expansion, Wisconsin could receive an estimated $37 billion less by 2025 under the Republican healthcare proposal that passed the House earlier this year, according to a new analysis.
The American Health Care Act has "assurances" that aim to "restore equity in Medicaid spending" for the 19 states that chose not to accept federal funds to expand the program, according to a policy brief by the Missouri Hospital Association.
But the association's analysis finds that by 2025, those states would get $683.9 billion less in federal Medicaid funding than they would if they expanded the program under the Affordable Care Act.
That amounts to $36.9 billion less during that period for Wisconsin, according to data used in the report provided by the Wisconsin Hospital Association.
"The report is eye-opening and should be of concern to anyone in a non-expansion state," Eric Borgerding, WHA CEO, said in a statement. "While the AHCA did attempt to provide a measure of relief to non-expansion states like ours, clearly it is insufficient and must be addressed by the U.S. Senate during their deliberations."
Rather than taking federal funding to expand the program, Wisconsin made eligibility changes to Medicaid to cover childless adults up to 100 percent of the federal poverty level and cut eligibility for parents and caretakers.
Arkansas, which previously expanded Medicaid under the ACA, is asking CMS for permission to cap eligibility at 100 percent.
At a Wisconsin Health News event last week, Joint Finance Committee Co-Chair Rep. John Nygren, R-Marinette, said "if a state is going to be rewarded for something that Wisconsin has already done, Wisconsin should be awarded for what Wisconsin has done."
"One of my frustrations with the proposal coming out of Washington was that it basically didn't reward states like Wisconsin that did it the right way and basically continued to reward states that went a different course," he said.
Leading health experts have grave concerns over AB260, mandating Wisconsin’s schools and colleges to accept physical exams completed by chiropractors. Currently primary care providers examine students for clearance to compete in athletic programs.
The coalition opposing the measure includes 19 key physician organizations, other health care providers, health systems, hospitals, academic centers and other parties with a vested interest in the health and well-being of Wisconsin’s student athletes.
“Chiropractors do not have the comprehensive medical training to provide the wrap-around care provided in the primary care office,” said Dr. David Bernhardt, a team physician for the University of Wisconsin-Madison and pediatric and adolescent sports medicine expert. “The safety of youth athletes is at stake.”
During public testimony on the bill in April, some commented that chiropractors “often have more training than physicians in certain areas,” a claim contested by physicians and others.
In contrast, a 2016 American Medical Association issue brief reports that while physicians complete 10,000+ clinical patient care hours (plus additional classroom and laboratory experience), chiropractors are required only to complete 4,200 hours of combined classroom, laboratory and clinical experience.
Dr. Kevin Walter, Program Director for Children’s Hospital of Wisconsin’s Primary Care Sports Medicine program, also cautioned against the proposal. "We want these young athletes to have quality screening by medical experts. When medical professionals are evaluating their health and physical readiness to participate in a sport, the exam includes so much more such as their cardiovascular condition, mental and behavioral health as well as educating them on health issues. The goal should be what is best for Wisconsin's kids and this proposal to allow chiropractors to handle these exams misses that mark."
The Assembly Committee on Health has scheduled a vote on the measure on Tuesday, June 13.
Now is the time for physicians concerned about this bill to contact your State Assembly representatives—please feel free to use the coalition’s April 26, 2017 memo as a source for talking points; you also can share the document with your representative. To verify the contact information for your elected officials, visit the State Legislature’s website and enter your address into the box under the “Find My Legislators” section at the right of the screen.
563 Carter Court, Suite B, Kimberly, WI 54136
Phone: 920-560-5622 |. Fax: 920-882-3655