Latest News 


  • April 18, 2017 2:45 PM | Sally Winkelman (Administrator)

    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.

  • April 18, 2017 2:43 PM | Sally Winkelman (Administrator)

    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 17, 2017 2:49 PM | Sally Winkelman (Administrator)

    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 06, 2017 10:55 AM | Sally Winkelman (Administrator)

    April 4, Treatment Advocacy Center, Research Weekly

    Mental health conditions increase the likelihood that adults who visit hospital emergency departments (ED) will become frequent utilizers, according to a new analysis of ED use by high-need, high-cost patients who repeatedly use healthcare services.

    In 2014, ED super utilizers made up no more than 6% of ED patients by age or payer category but generated  up to 26% of all ED visits in 13 states, according to a statistical brief published by the Agency for Healthcare Research and Quality (AHRQ). 

    Mental health symptoms increased the likelihood a patient would be a super utilizer.* 

    The Role of Mental Health in ED Super Utilization

    The authors of "Characteristics of emergency department visits for super-utilizers by payer, 2014" maintain that identifying the characteristics of ED super utilizers is essential to addressing their high use of the ED services. 

    "Over the last several years, health care stakeholders have paid increasing attention to issues specific to high-need, high-cost patients who constitute a very small percentage of the population but account for a disproportionally high amount of health care utilization," H. Joanna Jiang and colleagues say. "These patients, dubbed super-utilizers, represent a broad spectrum of demographic and clinical characteristics and socioeconomic conditions. 

    "Programs designed to improve care for super-utilizers need to be tailored to the specific needs of the different subgroups of these patients. As part of this effort, it is important to examine differences in utilization patterns among different types of super-utilizers, in comparison to national benchmarks." 

    For the statistical brief, AHRQ examined 2014 ED data from 13 geographically dispersed states that are home to about 28% of the US population. They compared ED use patterns by payer: Medicare for recipients 65 years and older, Medicare for recipients 1 to 64 years old, Medicaid, private insurance. 

    Findings 

    Among the findings: 

    • Mental health ED visits were more common for super-utilizers than for other patients regardless of payer. Among super utilizers insured by Medicaid, for example, 7% of ED visits were for mental health complaints, double the rate for individuals who were not making high use of the ED. Super utilizers insured by Medicare, regardless of age, and by private insurers also were more likely than other patients to visit the ED with mental illness symptoms. 
       
    • Super utilizers as defined by AHRQ made an average of four to five more ED visits per year than other patients. The 6.1% of Medicare patients 1-64 years old who were super utilizers, for example, made 26.2% of all ED visits. Similar patterns were seen for older Medicare, privately insured and Medicaid patients. 
        
    • Super utilizers accounted for an outsized proportion of ED costs. For example, while only about 4% of ED users insured by Medicaid were super utilizers, these patients accounted for nearly 20% of total ED charges to Medicaid.  
        
    • Among the payer groups, Medicare and Medicaid patients 1-64 years old were the most likely to be super utilizers. Approximately one in 10 patients in this age group were super utilizers. In contrast, approximately one in 20 patients who were privately insured or 65 years old and insured by Medicare were classified as super utilizers. 

    The most common reasons for super utilizers visiting the ED were medical (e.g., chest pain, superficial injury, abdominal pain and other physical conditions). Patients with three or more chronic conditions were more prevalent among the super-utilizer population than among other ED visitors.

    The role of mental illness on super utilization in America's EDs is one of several issues the Treatment Advocacy Center examines in its upcoming study, A Crisis in Search of Data: The Revolving Door of Serious Mental Illness in Super Utilization, scheduled for release April 18.

    *AHRQ defines ED super utilizers as private patients age 1-64 years who make four or more ED visits in a year or Medicaid/Medicare patients who make six or more visits. 

  • April 06, 2017 10:49 AM | Sally Winkelman (Administrator)

    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:

    • 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 31, 2017 3:03 PM | Sally Winkelman (Administrator)

    March at Wisconsin ACEP: In Like a Lion, Out Like a Tiger
    By Bobby Redwood, MD

    We are over the moon here at Wisconsin ACEP (WACEP). The last month has really showcased the positive impact that Wisconsin emergency physicians can create when we work together and show up in force. To put it succinctly, March was a time of Influence, Education, and Accolades for Wisconsin emergency medicine.

    Influence. Our month started off with an important milestone: the WACEP PAC reached an historic high and 100% of the WACEP board (as well as many general members) donated to the cause. The strength of our PAC gives emergency physicians unprecedented access to representatives in the state and national legislature at a time when the future of our healthcare safety net is more uncertain than ever. With the collapse of the American Health Care Act, our elected officials are scrambling to come up with strategies to provide broad access to care and also maintain a high level of quality care. WACEP will continue to advocate for increased Medicaid reimbursement for emergency physicians (we are 50th in the nation after all, in terms of Medicaid reimbursement for level 3, 4, and 5 emergency visits). Our thriving PAC is how we are able to build relationships, gain access to key meetings, and ensure that emergency medicine always has a seat at the table. Are you feeling me on this? Be a catalyst for change and contribute to the WACEP PAC at http://www.wisconsinacep.org/PAC

    Education. On March 28th, emergency physicians from across the state felt the love of their colleagues and the pride of their specialty at the WACEP 2017 Spring Symposium. We pounded out our 2016 LLSA articles, we learned cutting edge emergency ultrasound techniques, and we celebrated the role of women in emergency medicine while also strategizing against the harmful gender stereotypes that unfortunately continue to plague our physician workforce. Dr. Steve Hargarten gave a provocative and inspiring keynote address on the epidemic of firearm violence in Wisconsin; local EM celebrities Tim Westlake, Brian Sharp, and Julie Doniere educated our membership on the new mandatory opioid prescribing guidelines issued by the state medical examining board; and then educational speed dating ensued with breakout sessions on hot topics in emergency medicine that ranged from contract negotiations to fluid resuscitation in the septic CHF patient. It was a fabulous example of scholarly fellowship in Wisconsin emergency medicine and we cannot wait to reveal what we have planned for the 2018 Spring Symposium.

    Accolades. WACEP was honored to have our signature issue highlighted as a one of three priority issues at the 2017 Doctor Day at the Capitol on March 29th. More than 470 physicians from all specialties flooded the halls of the capitol and, in the spirit of unity and collective impact, advocated face-to-face with our legislators for increased Medicaid reimbursements for EMTALA related care. With passion and conviction, physicians across the board presented legislators with the graphic pasted below, a striking reminder that Wisconsin Medicaid reimbursement rates pale in comparison to our neighbors in the Midwest. 

    But the accolades don't end there. While presenting at the WACEP Spring Symposium, Dr. Rebecca Parker (president of national ACEP) revealed that she has just been named by Modern Healthcare as one of the top 50 Most Influential Physician Executives and Leaders of 2017. We at WACEP are incredibly proud of Dr. Parker (who has visited Wisconsin twice in the past year!) and are asking all WACEP members to vote for Dr. Parker to be THE most influential physician executive and leader by casting your vote at https://www.surveymonkey.com/r/XFVWR78

    I remember learning in grade school that March comes in like a lion and goes out like a lamb. Let's be real, this is Wisconsin; March comes in like a lion and goes out like a tiger. The wind is howling, the rain is nipping fiercely at our noses, and we at Wisconsin ACEP are loving every minute of it!

  • March 31, 2017 2:58 PM | Sally Winkelman (Administrator)

    Doctor Day 2017 Recap
    By Lisa Maurer, MD

    WACEP has been a long-time proud sponsor of Doctor Day, where physicians of all specialties come to Madison to discuss issues important to our practice and our patients.  

    At this week's event, which drew nearly 500 physicians from across the state, Medicaid physician reimbursement--and specifically emergency physician reimbursement--was, without a doubt, the issue that garnered the most energy at the Capitol.

    What I did expect, was that our specialty would be well represented. We had 24 emergency physicians at the event, telling our story of how we are stuck in our practices between a federal mandate and state fee schedule, losing money on each encounter with Medicaid enrollees.  

    What I didn't expect was the overwhelming support from our colleagues in other specialties. We didn't even have to be the ones to speak up! 

    • Primary care physicians were the ones to ask legislators, "If the ED's lose their ability to attract quality EM docs, who will be the front lines for the opioid epidemic?"  
    • Psychiatrists challenged the legislators, "How can we expect EM groups to stay afloat when they lose money every time we have to send them our patients with psychiatric emergencies?"  
    • Our physician partners working as CMOs of Wisconsin insurance companies were there at our sides saying, "Payors in Wisconsin have a responsibility to support the safety net of our health care system."  
    The legislators of Wisconsin heard loud and clear that patients AND physicians of many specialties depend on us! WACEP looks forward to using this momentum to find a solution for our state. Be sure to thank your colleagues around your community this week for the huge impact they had on our behalf.
  • March 31, 2017 2:44 PM | Sally Winkelman (Administrator)

    Wisconsin physicians are now required to follow an additional procedure before prescribing Schedule II, III, IV, and V controlled substances, or any other drug identified by the board by rule as having a substantial potential for abuse.

    Beginning on April 1, 2017, under Wisconsin Statute 961.385, Wisconsin practitioners must review a patient's records in the Wisconsin Prescription Drug Monitoring Program before the practitioner issues a prescription order for the patient.

    This requirement does not apply under the following circumstances:\

    • The patient is receiving hospice care.
    • The prescription is for a dosage that is intended to last 3 days or less and is not refillable.
    • The monitored prescription drug is lawfully administered to the patient.
    • Because of an emergency, it is not possible for the practitioner to review patient records before issuance of the prescription.
    • The practitioner cannot review records because the program is not operational or due to some other technological failure (if the practitioner reports the failure to the board).
    More information regarding Wisconsin's Prescription Drug Monitoring program can be found online at https://pdmp.wi.gov/
  • March 30, 2017 1:19 PM | Sally Winkelman (Administrator)

    ACEP President On the Ballot for Most Influential Physician Executives and Leaders 

    Voting Open Through April 28: Cast Your Ballot

    ACEP President Becky Parker has been nominated to be on the ballot for the 50 Most Influential Physician Executives and Leaders as recognized by Modern Healthcaremagazine.

    Becky has already made the cut for the top 150 people most nominated to be put on this ballot, which in itself is a tremendous accomplishment considering how many influential physician executives and leaders there are and that were no doubt nominated.

    The voting is open now for who will be the Top 50 recognized by this widely read publication. Cast your vote for Becky today! 

    Only one vote per device is allowed, but you may vote from your computer, your phone, your tablet, etc. Your vote will help Becky be recognized for her outstanding leadership, and this honor would be a great credit to Becky, ACEP, and our specialty.

  • March 29, 2017 12:13 PM | Sally Winkelman (Administrator)

    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.