February 9, Wisconsin Health News

The Senate has approved a proposal that would lift state penalties for possession of a drug derived from marijuana used to treat seizures in children. 

The bill passed 31-1, with Sen. Duey Stroebel, R-Saukville, casting the no vote. An Assembly Committee is set to take up the proposal next week. 

The bill, which is similar to a proposal that was blocked from passage in the Senate last year, would allow patients to possess CBD oil without facing a state penalty if they have certification from their doctor. The federal government has designated the drug Schedule I, still making it illegal.

"Parents shouldn't have to risk jail time to treat their children," the bill's author, Sen. Van Wanggaard, R-Racine, said in a statement. "It is a sense of relief that we can ease the suffering and fear that too many parents experience trying to improve the lives of their children."

February 8, Wisconsin Hospital Association

As you know, physicians are often assigned a role with a hospital or health system’s quality department or committee or asked to lead a quality improvement project.

The Wisconsin Hospital Association (WHA) has developed an important resource for physicians and advance practice providers who have an assigned role related to quality measurement and improvement within a WHA member hospital or health system. The WHA Physician Quality Academy will provide physicians the opportunity to increase their knowledge of quality improvement tools and principles; therefore, increasing the likelihood that a physician will be more successful in and comfortable with this leadership role.

The Academy offers two non-consecutive days of in-person training and access to supporting resources both between and after the live sessions.

• May 10 and July 21, 2017 at the Glacier Canyon Lodge at The Wilderness Resort, Wisconsin Dells; or
• September 29 and November 3, 2017 at the Glacier Canyon Lodge at The Wilderness Resort, Wisconsin Dells.

As part of the Academy, participants will learn to:

• design and conduct quality improvement projects utilizing proven improvement models;
• interpret data correctly;
• facilitate physician colleague engagement in quality improvement and measurement ;and,
• discuss quality requirements, medical staff functions and their link to quality improvement.

The Academy is offered twice in 2017 (dates below), allowing physicians associated with a WHA member hospital/health system to choose the cohort that works best for his/her schedule. Attendance will be limited to the first 100 registrants per cohort, so if interested, register today at http://www.cvent.com/d/wvq5nm.

Increasing prescription drug costs have caught the attention of the President and the public. What's behind the rapid rise and how far are lawmakers willing to go?

Would allowing Medicare to negotiate with drugmakers make an impact? What about cutting taxes and regulations? And would lower prices mean less innovation?  Learn more at a Wisconsin Health News Panel Event March 7 at the Madison Club (register now).  Panelists:

• Holly Campbell, Senior Director of Public Affairs, PhRMA
• Dr. Mark Huth, CEO, Group Health Cooperative of South Central Wisconsin
• Andy Pulvermacher, Specialty Services Supervisor, UW Health
• Paul Rosowski, Senior Director, Industry Relations and Contracting, Navitus Health Solutions

January 30, 2017

AAN members can now join the new Neurohealth & Integrative Neurology Section and Synapse online community. The new section will be a forum to connect neurologists and practitioners who recognize the need to investigate therapies which may have potential to preserve neurologic health, promote neurologic recovery, and increase patient wellness, including non‐pharmaceutical and complementary treatments.

Membership renewal rates were strong for 2016. The goals for the number of dues-paying US neurologists and retention rate of dues-paying US neurologists were met, along with goals for retention of Early Career members and the number of medical students.

The goal was also met for the number of members applying for Fellow status with the AAN during 2016, with a total of 217 applications submitted.

January 30, 2017

The 2016 Practice Management Webinar series ended strong with a total of 637 unique registrations, which is 113 higher than 2015. The series concluded with a free webinar on MACRA and the 2017 Medicare physician fee schedule; view a Q&A document on these topics. On January 18, the 2017 series of webinars began, including recurring and new topics such as advance care planning, contracting, and coding for risk. Click here for the full list.  

For more information on AAN practice resources, visit our webpage.

AAN Federal Legislative Report

January 30, 2017

The AAN has met its goals for BrainPAC for 2016, in both the number of unique donors and total contributions. BrainPAC, the only political action committee in Washington dedicated to neurology, contributed to 125 candidates up for election in 2016, and 92 percent of those candidates were successful. Roughly 50 percent of the funds go to each side of the political aisle.

AAN efforts helped to cancel a Medicare Part B drug payment model. CMS announced in December that it will not finalize the drug payment model, a demonstration intended to cut costs by changing how physicians are reimbursed for the use of Medicare Part B drugs. The AAN helped lead the effort to fight this demonstration, which would have had an impact on a number of neurology practice groups.

Rep. Tom Price, nominee for Secretary of Health and Human Services, referred to the benefits of stroke telemedicine provided by a neurologist during his confirmation hearing. When asked about the future of telemedicine he responded:  “Telemedicine is one of those exciting innovations that I believe will allow for individuals to access resources from a clinical standpoint…There is a neurologist that works with telemedicine and has a network of clinics and hospitals around the state. If somebody comes in with symptoms of a stroke that physician is able to see the patient in real-time and determine whether or not they have having a stroke…Telemedicine is absolutely vital.”

AAN President Terrence L. Cascino, MD, FAAN; President Elect Ralph L. Sacco, MD, MS, FAHA, FAAN; and Executive Director and CEO Catherine M. Rydell, CAE, met with several members of Congress on the first day of the 115th Congress to ensure that issues affecting the practice of neurology would remain a top legislative priority. Learn more in Capitol Hill Report and continue to check Capitol Hill Report for updates on the transition in Washington and how it may affect neurology.

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.

AAN State Legislative Report
January 30, 2017

Telemedicine continues to be an important issue on the state level. 29 states currently have a telemedicine parity law and more likely to join during the 2017 legislative session. The AMA recently wrote an interesting article on where telemedicine has been, where its headed. 

For California residents, the new year brings new concussion protocols for children of all ages who participate in sports. Young athletes who sustain concussions now have to go through the same return-to-play protocol as high school and college athletes.The player is not allowed to return until a medical professional clears him or her of being symptom free for a minimum of 24 hours.This expansion of ‘return-to-play’ protocol is expected to be introduced in multiple states in 2017, more to come.

The number of states that have adopted the Interstate Medical Licensure Compact stands at 18. 5 states currently have active legislation, which the AAN is supporting. The compact offers an expedited licensing process for physicians interested in practicing medicine in multiple states.  Wondering how the compact works? Check out this short video!

If you have any questions or would like to discuss how to improve your advocacy efforts, contact Grant Niver.

January 19, WMS Medigram

For the third time in as many state legislative sessions, a bill has been introduced related to cannabidiol (CBD) oil—one of the main active chemical compounds founds in marijuana. The proposal—being circulated for legislative sponsors before it is officially introduced—is designed to prevent state or local prosecution for possession of CBD oil if a physician certifies that a patient has a certain malady. The bill’s main sponsors are State Senators Van Wanggaard (R-Racine), Bob Wirch (D-Kenosha) and State Assembly Representative Scott Krug (R-Nekoosa).

Previous legislation allowed CBD oil to be dispensed by a State of Wisconsin Controlled Substances Board-approved pharmacy or physician if the product was to be used as part of an FDA-approved clinical trial. That requirement has been circumvented for the most part due to the lack of clinical trials on the Schedule I substance. Under the bill, a person will be allowed to possess CBD oil if a physician has certified within the past year that the CBD oil is for treating a seizure disorder.

The law would require that the physician certification—in the form of a letter or other document – include:

·         Name, address and telephone number of the physician.

·         Name and address of the patient who is issued the certification.

·         The date the certification is issued.

Public hearings on the proposals could come as early as this month, with committee votes and possible full State Assembly and State Senate action thereafter.

January 19, WMS Medigram

The Wisconsin Department of Safety and Professional Services (DSPS) launched the new Wisconsin Enhanced Prescription Drug Monitoring Program (ePDMP) on Tuesday, replacing the former program.

2015 Act 266 requires physicians and other prescribers to review patient information from the ePDMP before issuing a prescription for any controlled substance beginning April 1, 2017. (More information, including exceptions to the requirement to consult the PDMP, in this nonpartisan Legislative Council memo.)

The following information is required to register for the ePDMP. (Previous logins will no longer work.)

·         Last name.

·         Last four digits of your social security number.

·         License number.

·         License type (profession).

·         Specialty or primary area of practice.

·         DEA number.

 The ePDMP supports current browsers and two previous versions, except it only supports the current and previous version of Internet Explorer. If you experience issues, DSPS suggests that you update your browser.

Once the registration process is complete, users can begin looking up patients and managing delegates. The multistate search function will be available to both prescribers and their delegates as soon as their accounts are established. Training materials, including brief tutorial videos and information about creating and maintaining delegates are available at pdmp.wi.gov.

If you have questions or experience problems with the registration process, contact pdmp@wisconsin.gov.

January 6, Wisconsin Health News

Gov. Scott Walker called for a special session of the Legislature Thursday to consider 11 bills that aim to combat the heroin and opioid epidemic.

The bills are based on recommendations from a task force that Walker convened last year, chaired by Lt. Gov. Rebecca Kleefisch and Rep. John Nygren, R-Marinette.

The task force released an interim report Thursday. Even though it hasn't finished its work, the opioid and heroin epidemic are "such a crisis to deal with, we need to start acting now," Walker said.

"We need to tackle this issue head on," Walker told attendees of a Wisconsin Bankers Association event in Madison Thursday. "Not because it's a quality of life, not because it's a public health issue, but because it's a key part of our workforce."

Among the proposals the Legislature will consider are bills that would in the 2017-'19 biennium provide $2 million to support new medically assisted treatment centers, $1 million for consultation services helping medical professionals connect with addiction medicine specialists and $126,000 to the rural hospital graduate training program.

Another bill would provide money to the Department of Justice to fund criminal investigation agents focused on drug trafficking. And another would expand the Screening, Brief Intervention and Referral to Treatment training program offered by the Department of Public Instruction.

"All of us know someone personally affected by a heroin overdose or drug death," Kleefisch said in a statement. "Together, we're going to continue this initiative as we look for new ideas and evaluate the impact of the policies we've adopted the past several years."

An additional proposal would allow school personnel that can administer life-saving drugs like EpiPens to use the anti-overdose drug Naloxone. And two more would require schedule V substances that contain codeine like some cough syrups by dispensed with a prescription and extend limited immunity from prosecution to overdose victims.

Other bills include permitting the University of Wisconsin System to open a recovery school for students who need in-patient care and allowing relatives to commit a drug-addicted family member in the same way as is currently allowed for alcoholism.

Walker's order doesn't include all the recommendations made in the report, such as providing $2 million over the next biennium for Wisconsin hospitals to hire in-house recovery coaches. His spokesman said the bills are in the final stages of draft form and will be released when introduced.

Another order signed by Walker Thursday directs state agencies to pursue a number of different initiatives to curb opioid abuse, including having the Office of the Commissioner of Insurance conduct a survey of opioid addiction treatment coverage for major insurers in Wisconsin. 

"The recommendations included in this report are not the silver bullet," said Nygren, who's authored 17 laws fighting drug abuse though his Heroin, Opioid Prevention and Education Agenda. "I look forward to continuing the fight."  

Wisconsin Hospital Association CEO Eric Borgerding noted that the interim report includes recommendations they suggested, like providing investments in fellowship training for addiction medicine and streamlining regulations for healthcare providers that are trying to expand access to substance abuse treatment.

Wisconsin Medical Society Chief Medical Officer Dr. Donn Dexter called the package of bills "ambitious, which is exactly what dealing with this crisis demands." The Pharmacy Society of Wisconsin said the proposals aim to increase access to treatments and prevent new addictions.

"We're especially excited about the investments to increase the number of providers available and in telemedicine," Bernie Sherry, senior vice president and Ministry market executive for Ascension Wisconsin, said in a statement. "This is a good day for Wisconsin." 

Myranda Tanck, a spokeswoman for Senate Majority Leader Scott Fitzgerald, R-Juneau, said they'll likely maintain their current session calendar for when the full body meets. 

Kit Beyer, a spokeswoman for Assembly Speaker Robin Vos, R-Rochester, said they hope to have the bills ready for committee hearings by the end of the month.

Assembly Democratic Leader Peter Barca, D-Kenosha, said the urgency of the special session is warranted.  

"The opioid epidemic in our state is a very serious issue that requires a very aggressive response," Barca said in a statement. "I hope the committees will collect input from those who know this issue firsthand -from law enforcement, to educators, to medical professionals - as this will help us address this crisis in the most comprehensive manner possible."

Walker also signed an order directing the Department of Health Services to apply for funding available through the 21st Century Cures Act, which was approved by the federal government last year. The act makes $7.6 million per year available for two years to Wisconsin. His order directs the department to apply for the grants by Feb. 17.   

Sen. Tammy Baldwin, D-Wis, said she helped lead the effort in Congress to include $1 billion in the act for the opioid epidemic. 

"The opioid epidemic is not a partisan issue, and a strong partnership between the federal government and our state is essential to an effective response," she said in a statement. "This is a significant step forward for communities fighting the opioid epidemic across Wisconsin."