Lisa Maurer, MD, FACEP
WACEP Legislative Chair
Wisconsin ACEP continues to advocate for the practicing emergency physician and your patients with the state’s legislators and regulators. In the last year, we supported EM physicians as COVID-19 hit, and we’ve also continued important work in our ongoing priorities of Medicaid reimbursement and psychiatric care.
Even though March seems lightyears away, I’ll never forget that overwhelming feeling of the unknown as we started to see patients with COVID. There was little to no research to support best practices, and even our patients without COVID feared hospitalization for concern of having an exposure. In times of such uncertainty, WACEP fought to bring medical liability protection to the physicians on the front line. Wisconsin now provides civil liability immunity for care provided during the Public Health Emergency pending “actions or omissions do not involve reckless or wanton conduct or intentional misconduct.”
We also heard from our members that independent EM physician practice groups should be eligible for state distributions of CARES Act financial support, just as hospitals were, for lost revenue and increased expenses due to COVID. In September, DHS announced that emergency physician practice groups could apply for those funds, and they will be distributed before the month is over.
WACEP will continue its focus on improving Medicaid reimbursement rates, especially as we expect post-pandemic Medicaid enrollment to rise and our state budget to be squeezed. We absolutely must improve our worst-in-the-nation Medicaid fee schedule for emergency services. Our state values the expertise of emergency physicians standing by to save lives, and this is not accurately reflected currently as Medicaid reimbursement does not even pay for half of the cost of providing emergency care to its enrollees. We are honored to have Wisconsin Medical Society also name this as a priority issue as we craft the next state budget. Of note, our state passed a bill last November that would ensure all services covered under Medicaid would be equally valued if provided via telehealth, including consultations and home monitoring.
WACEP also recognizes that we continue to have room to improve our care for patients with psychiatric emergencies, and oftentimes that necessitates progress in legislation. We continue to actively participate in the Wisconsin Emergency Psychiatric Task Force, partnering with our colleague psychiatrists as well as other stakeholders such as law enforcement, the Attorney General, WI Counties Association, and others. We have agreed and published a SMART protocol for risk-based medical evaluation of patients with emergent psychiatric conditions, and look forward to upcoming projects and bipartisan legislation regarding increased transparency in bed availability, regional approaches to stabilization, and pilot projects for novel admissions procedures. We supported legislation that was already passed in March 2020 whereby law enforcement agencies may contract a DHS-approved third-party vendor to transport an individual for emergency detention.
Thank you to all WACEP members for your support and engagement in grassroots advocacy over the last year. Without you, none of this would happen. Please continue to stand together as we anticipate a busy legislative session in the upcoming year, including bills on physician assistant scope of practice, balanced billing for out-of-network care, and much more.