Latest News

  • March 30, 2020 11:59 AM | Deleted user

    CMS has released a regulation that added the emergency department (ED) evaluation and management (E/M) codes (CPT codes 99281 to 99285) to the list of approved Medicare telehealth services for the duration of the COVID-19 national emergency.

    CMS had previously expanded the ability  to perform telehealth services, but had not allowed emergency physicians to use the ED E/M codes—which most accurately reflect the intensity and value of emergency services .

    CMS has now recognized that ED E/M codes are indeed the most appropriate codes to use when delivering emergency telehealth services.

  • March 28, 2020 8:24 PM | Deleted user

    Governor Evers and Wisconsin Department of Health Services (DHS) Secretary-designee Andrea Palm today exercised their authority under Article V, Section 4 of the Wisconsin Constitution and Sections 323.12(4) and 252.02(6) of the Wisconsin Statutes to simplify healthcare license renewals during the COVID-19 public health emergency and to encourage recently retired professionals with expired licenses to re-enter practice. This full order is available online (link).

    The order includes the following policy changes:

    • Interstate Reciprocity: allows any out-of-state health can provider licensed and in good standing to practice in Wisconsin without a Wisconsin credential. The order requires the out-of-state physician to apply for a temporary or permanent Wisconsin license within 10 days of first working at a Wisconsin health care facility; and the health care facility must notify DSPS within 5 days. The order temporarily suspends the visiting physician practice limitations in Med 3.04. 
    • Temporary License: Any temporary licensed to an out-of-state provider during the emergency will be valid until 30 days after the conclusion of the emergency. 
    • Telemedicine: Allows physicians licensed and in good standing in Wisconsin, another U.S. state or Canada to provide telemedicine services to Wisconsin residents. 
    • Physician Assistants: Suspends several current rules regulating the practice of PAs in Wisconsin. This includes: the requirement of PAs to notify the MEB of changes to their supervising physician within 20 days (order changes it to 40 days); the requirement that PAs limit their scope of practice to that of their supervising physician (the order allows them to practice to the extent of their experience, education, training and abilities. It also allows them to delegate tasks to another health provider); the physician to PA ratio of 4:1 (the order allows a physician to oversee up to 8 on-duty PAs at a time, but there is no limit on how many PAs a physician may provide supervision to over time. It also allows a PA to be supervised by multiple physicians while on duty). 
    • Nurse Training and Practice: The order suspends many rules related to nursing. This includes suspending a rule that prohibits simulations from being utilized for more than 50% of the time designated for meeting clinical learning requirements. It also suspends the requirement for nurses to submit an official transcript in order to get a temporary license and allows a temporary license to remain valid for up to 6 months. In addition, it suspends the rule requiring license renewal within 5 years. 
    • Advanced Practice Nurse Prescribers: Temporarily suspends the requirement that Nurse Prescribers must facilitate collaboration with other health care professionals, at least 1 of whom shall be a physician or dentist. 
    • Recently Expired Credentials: Requires the state to reach out to individuals with recently lapsed credentials about renewal options. The order also suspends many of the late renewal fees and continuing education requirements for most health professions. The order temporarily suspends MED 14.06(2)(a) to allow a physician whose license lapsed less than 5 years ago to renew without fulfilling the continuing education requirements. It also suspends RAD 5.01 (1) and (2) to allow radiographers or LXMO permit holders who have let their license lapse renew without completing continuing education. 
    • Fees: The order also gives DHS the ability to suspend fees or assessments related to health care provider credentialing. 

    The order is effective immediately and will remain in effect through the duration of the public health emergency.

    The full version of the Governor’s press release is available online (link).

  • March 28, 2020 11:29 AM | Deleted user

    Governor Evers released a 65-page draft piece of legislation and a draft joint resolution on Saturday night aimed at addressing COVID-19. The Governor also released a chart outlining the proposal.  The Legislative Fiscal Bureau also provided a Summary of provisions Governor Evers’ proposed legislation and Joint Resolution indefinitely extending public health emergency to state legislators.

    The bill includes several healthcare provisions, including language related to out-of-network bills that occur during the public health emergency. The language caps physician payment rates at 250% of the Medicare rate.

    Insurance 

    • Prohibits health plans from charging patients more for out-of-network services related to the diagnosis and treatment of the condition for which a public health emergency has been declared than they do for in-network services (if an in-network physician is not available).
    • The bill requires the plan to reimburse the out-of-network provider at 250% of the Medicare rate. Providers and facilities are prohibited from charging patients more than what they are reimburse by the plan. 
    • Creates a process for out-of-state physicians to have liability coverage in Wisconsin during a public health emergency. They would need to provide OCI with a certificate of insurance for a policy of health care liability insurance issued by an insurer that is authorized in a jurisdiction accredited by the National Association of Insurance Commissioners. 
    • Requires health plans to cover without cost-sharing any testing, treatment or vaccines related to COVID-19.
    • Requires health plans to cover any services provided via telehealth if they cover that service when it is provided in-person. 
    • Prohibits health plans from canceling policies due to non-payment during the COVID-19 emergency 
    • Prohibits health plans and pharmacy benefit managers from requiring prior authorization for any early refills of prescriptions or restricting the period of time in which a drug may be refilled. 
    • Creates a process for pharmacists to extend prescription orders by up to 30 days during public health emergencies. 

    Emergency Preparedness 

    • Provides $300 million to the Department of Military Affairs to respond to the public health emergency. 
    • Provides $200 million to the Department of Administration to respond to the public health emergency. 

    Health 

    • Creates a public health emergency fund for the Department of Health Services.
    • Provides $100 million for a new health care provider grant program specific to planning, preparing for and responding to COVID-19. 
    • Provides $17.4 million to local health departments. 
    • Creates 64 positions within the Department of Health Services’ Division of Public Health.
    • Allows DHS to suspend any premium or cost-sharing requirements for childless adults on BadgerCare in order to qualify for enhanced federal Medicaid matching funds related to COVID-19.  
    • Exempts the Department of Health Services, during a public health emergency, from the current law legislative review requirements for submitting waiver requests to the federal government, amending the state Medicaid plan or raising Medicaid reimbursement rates.  
    • Expands the definition of public health emergency to include toxins or other threats to health. 

    Health Care Workforce 

    • Allows former health care providers to receive a temporary license to provide services during a public health emergency. This would apply to physicians, nurses, PAs, dentists, pharmacists, phycologists, social workers and other health providers who have practiced within the last 5 years but do not currently have a license. The temporary license would be valid until 90 days following the conclusion of the health emergency. 
    • Allows out-of-state health care providers to receive a temporary license to practice in Wisconsin. The temporary license would be valid until 90 days following the conclusion of the health emergency.
    • Allows the state to waive licensure fees for physicians, physician assistants, nurses, dentists, pharmacists, psychologists, and certain behavioral health providers. 
    • Exempts certain health care provider credentials issued by credentialing boards in DSPS from having to be renewed during the public health emergency. 

    Unemployment Insurance

    • Eliminates the one-week waiting period for Unemployment Insurance

    Voting

    The bill contains several provisions related to voting during public health emergencies. Specifically, for elections held during a declared public health emergency, it would: 

    • Require elections held during public health emergencies to be held by mail. 
    • Waive the state’s Photo ID requirement.
    • Waive the requirement that mail-in absentee ballots need a witness signature.
    • Allow mail-in ballots to be counted as long as they are postmarked by Election Day.
    • Allow voters to register electronically until 5 days before the election.
  • March 27, 2020 11:16 AM | Deleted user

    March 26, ACEP COVID-19 Communications Hub

    After hearing a growing number of reports over the past week of emergency physicians being restricted by their hospital from wearing PPE or even being punished for doing so (whether the PPE was supplied by the hospital or personally obtained), ACEP has been in discussions with the Joint Commissions and OSHA advocating for official guidance or clarification from them to hospitals so that your rights to wear PPE are protected. We've been asked to provide them with specific examples of such occurrences, and are therefore reaching out to you here for your help. 

    If you've experienced such PPE restrictions or been sanctioned or punished in any way by your hospital for wearing it, please email me with a short description of what happened at lwooster@acep.org.

    Please rest assured that no identifying information will be passed along to the Joint Commission or OSHA; all individual physician names and hospitals will be redacted before I send any collected anecdotes on to them. Please note that while first-hand accounts are greatly preferred, if you do know of such actions against a colleague at your own hospital only, these could be helpful to us as well, as long as they contain sufficient detail that you are confident is accurate.

    Thank you, and please stay safe.

    Laura Wooster, MPH
    Associate Executive Director, Public Affairs
    American College of Emergency Physicians
    O: (202) 370-9298

  • March 27, 2020 11:06 AM | Deleted user

    Dear Fellow Emergency Clinicians,

    During this unprecedented time, the Well-Being Committee and Wellness Section, both want to express our appreciation to all who accepted the call to serve in the field of Emergency Medicine. You are not alone in this. Your passion and dedication to provide care for those in need is noticed and recognized, even more today during this critical time.

    We are proud to be your colleagues and stand firm in knowing that you are doing the very best to provide care during these difficult times. Though we are overworked, tired, and stretched thin, we continually answer the call to care for our individual communities during the time they need us most. Selflessly, we put ourselves on the front lines; running towards the problems and work tirelessly to find the solutions that allow us to provide the needed care.

    As we work through this pandemic, we want to echo that we hope everyone is able to be safe. In trying times such as these, we as Emergency Clinicians, tend to take care of ourselves last. However, the leadership teams are standing with you to ensure that your wellness is not sacrificed.

    In this setting, we recognize the need to provide you with resources to assist you during this time of need. In response, work behind the scenes continues to support the provision of care to patients and their communities, while protecting your work environment, health, and well-being.

    ACEP is working closely with Federal Government regulators as an advocate for our profession. In doing so, interstate licensing barriers have been changed, protection of liability measures are being developed, and Dr. Bill Jaquis, ACEP President, has met with the White House Administration advocating for PPE and more testing. A new website has been developed to host all clinical resources for our colleagues. In addition, ACEP has many resources to assist you through difficulties.

    ACEP Wellness & Assistance Program

    The ACEP Wellness & Assistance Program offers ACEP members exclusive access to THREE (3) FREE CONFIDENTIAL COUNSELING OR WELLNESS SESSIONS in partnership with Mines & Associates. The one-on-one sessions are available 24/7 by phone, text or online messaging. 

    Counseling sessions can cover everyday issues including stress, anxiety, depression, family issues, drug and alcohol abuse, relationships, death and grief, and more. Wellness coaching sessions are 30-minute phone calls to help you reach your personal wellness goals. NBME board-certified wellness coaches can help you set specific wellness goals and plan for progress checks along the way to help you reach your objectives. This new program is strictly confidential and is free with your ACEP membership.  

    ACEP ‘Let’s Talk’ Community on EngagED

    This online community was specifically designed to create a safe space where peers can discuss ongoing challenges within their roles, ED’s, and life in general. Here, everyone has a voice and a platform where they can reach out to fellow colleagues for advice and encouragement pertaining to the internal and external factors that affect the balance of our wellness.

    If you are interested in having a conversation, all you need to do is click here to sign up

    Our parting thought to you is simple: Even though we are in a crisis, we can still provide compassion and respect for every person who crosses our path.

    ACEP Well-Being Committee

    • Arlene Chung, MD, FACEP, Chair
    • Rita A. Manfredi MD, FACEP
    • Alison Haddock, MD, FACEP

    ACEP Wellness Section

    • Randall Levin, MD, FACEP, Chair
    • Randy Sorge, MD, FACEP
    • Pamela Ross, MD, FACEP
    • Susan Haney, MD, FACEP
    • Angelica McPartlin, MD, FACEP
    • Kristen Nordenholz, MD
    • Matthew Wong, MD, FACEP
    • Michelle Caskey, MD
  • March 25, 2020 5:24 PM | Deleted user

    In response to the COVID-19 outbreak, ForwardHealth is temporarily changing certain policy requirements for services delivered through telehealth.

    Beginning March 12, 2020, these altered policy requirements will be in effect during, and only during, the public health emergency declared by the State of Wisconsin in Executive Order 72.

    Download the ForwardHealth UPDATE for full details.

  • March 25, 2020 11:34 AM | Deleted user

    March 25, Wisconsin Health News

    More health systems and other labs in Wisconsin are coming on line with in-house COVID-19 testing.

    Advocate Aurora Health said that as of Monday, ACL Laboratories, part of the health system, will be able to process COVID-19 tests for emergency department patients authorized for inpatient admission, those being treated in hospitals and team members.

    They expect to be able to process at least 400 tests a day and provide results back in fewer than 24 hours for the affected populations.

    Gundersen Health System said it’s developed a test to detect COVID-19, allowing the health system to process the results in house. That will reduce the amount of wait time for results, according to a statement from the health system. 

    The University of Wisconsin-La Crosse provided the health system with enough supplies for thousands of tests. 

    The Wisconsin State Lab of Hygiene, Milwaukee Health Department and national labs - including LabCorp and Quest - are also running tests in the state. 

    In addition, Children’s Wisconsin and Froedtert Health have confirmed in-house testing for their patients. Mayo Clinic Health System has been sending its specimens to Mayo Clinic in Rochester, Minn.

    “We are seeing more of our healthcare partners and critical labs like UW, Froedtert, Children’s Hospital in Milwaukee, others coming on line with testing capacity,” Department of Health Services Secretary-designee Andrea Palm said Monday. 

    A UW Health spokesperson did not confirm by the newsletter's deadline when or if it would start processing tests. Dr. Nasia Safdar, medical director of infection control and prevention at UW Health, said last week that setting up in-house processing was a "high priority" but couldn't say when when it would happen.

    Dr. Patricia Golden, primary care medical director of Ascension Medical Group Wisconsin, said that they're sending specimens from their mobile testing sites to Quest and LabCorp.

    "We hope to have in-house labs able to process our own tests soon," she said in a statement. "This additional testing capacity will allow COVID-19 testing for a wider group of patients." 

    Dr. Susan Turney, Marshfield Clinic Health System CEO, said last week that they hope to have the ability to process COVID-19 tests soon.

    Gov. Tony Evers told reporters on Monday that Exact Sciences is looking to help boost testing capacity.

    Scott Larrivee, Exact Sciences spokesman, said the cancer diagnostics company is collaborating with Evers, DHS and the Wisconsin National Guard to determine how their Madison-based labs could help process COVID-19 tests and support the state’s response. 

    “We look forward to being a part of shared solutions," Larrivee said in a statement.

  • March 25, 2020 11:25 AM | Deleted user

    Having trouble obtaining CME credits for licensure due to the COVID-19 pandemic?

    The Wisconsin Department of Safety and Professional Services has confirmed that persuant to Wis. Stat. § 440.08 (2), the required renewal date for the Physician credential is October 31 in the odd numbered years. 

    Therefore, no extension or suspension of licensing and registration renewal requirements, including CME requirements, is necessary at this time.  

  • March 25, 2020 8:16 AM | Deleted user

    Governor Evers has issued Emergency Order #12 to institute a Safer At Home policy. The order is effective at 8:00 am on Wednesday, March 25, 2020 and remain in effect until 8:00 am Friday, April 24, 2020, or until a superseding order is issued.

    Wisconsin residents must comply with this order. As outlined in the order, individuals can leave their home to perform tasks essential to maintain health and safety, get services and supplies necessary for staying home, and care for others.

    After reviewing the order, if a business believes their business is doing essential work and they are not exempted in this order please go to this link https://wedc.org/essentialbusiness/.

    These are important steps to ensure we working to slow the spread of COVID-19. 

    Essential services, such as healthcare and public health operations, will continue to be provided to the communities across Wisconsin.

  • March 23, 2020 3:05 PM | Deleted user

    March 23, 2020

    Governor Evers announced today that he be issuing a “Safer at Home” order effective Tuesday, March 24.  Organizations and individuals providing essential care and services will be allowed to continue travelling to and from work.  This includes healthcare professionals, grocers and family caregivers.  The full details of the order to be announced by the Governor’s office.  Everyone else is asked to not take any unnecessary trips, and to limit travel to essential needs such as getting medications and groceries.

    This order is based on the advice and counsel of public health experts, healthcare providers and first responders on the front line of our state’s response to the pandemic.  These unprecedented measures are necessary to reduce rate of spread in COVID-19 cases.  We must do everything we can to keep our healthcare systems from becoming overwhelmed and protect both the public and essential healthcare workers who are taking care of the critically ill.