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News & Press: Legislative Updates

WPA Legislative Update, Fall 2017

Thursday, October 26, 2017  
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By Eric Jensen, WPA Lobbyist

Doctor Day 2018

Doctor Day 2018 will be on January 30, 2018 – mark your calendars now!  We are hearing from legislative leaders that they plan to adjourn the session in February, so our earlier-than-usual date looks like it will have been worth it.  We have grown every year, and hope to reach 500 for 2018 to show lawmakers that the physician community is paying attention to and interested in engaging with the State Legislature. Register today at www.WIDoctorDay.org

Advanced Nurse Legislation

Senator Devin LeMahieu (R-Oostburg) and Representative Mike Rohrkaste (R-Neenah) are introducing legislation to create a consistent title for all advanced practice nurses in Wisconsin.  The legislation (as yet not formally introduced) would create the title Advanced Practice Registered Nurse (APRN); under that designation would fall the current categories of advanced nurses:  Nurse Practitioners (NP), Certified Registered Nurse Anesthetists (CRNA) and Certified Nurse Midwives (CNM).  This would make Wisconsin’s advanced nurse nomenclature consistent with numerous other states.

Two years ago, the Wisconsin Nurses Association was pursuing a joint legislative and administrative rule effort that did include these retitling concepts.  That effort, however, also included proposals to add all advanced nurses to the Injured Patients & Families Compensation Fund, eliminate all collaborate relationships and requirements between advanced nurses and physicians, as well as other scope-expansion proposals.  These efforts were rejected by both the Legislature and the Board of Nursing as too expansive.

This proposal is limited to the titling provisions, save for one item.  Currently, CNMs are required by statute to have a collaborative relationship with an obstetrician.  All other advanced practice nurses are required by the nursing Administrative Code (regulations) to have a collaborative relationship with a physician.  The proposal as drafted would eliminate the statutory collaborative requirement for CNMs, and it is unknown whether the existing Administrative Code collaborative requirements would then accrue to CNMs under the new titling scheme. 

WMS and WI-ACOG, as well as the Wisconsin Hospital Association (WHA) have taken positions opposing elimination of this statutory collaboration requirement for CNMs, with the support of many other specialty organizations.  The bill’s authors have pledged to get all the interested parties to the table to look for common ground.

Emergency Detention Liability

Representative John Jagler (R-Watertown) and Senator Rob Cowles (R-Green Bay) have introduced AB 538 and SB 445 relating to emergency detention liability.  The bill is designed to provide liability protection for physicians and others involved in an emergency detention case should the patient involved cause harm to another.  The legislation has the support of the Wisconsin Hospital Association, WMS, WPA and WACEP (Emergency Physicians).  To read more detail, you can find AB 538 at the following link:

https://docs.legis.wisconsin.gov/2017/related/proposals/ab538.pdf

Worker’s Compensation – the Fee Schedule Proposal Returns

The Worker’s Compensation Advisory Council (WCAC) is made up of equal numbers of representatives from “management” and “labor.”  Various health care interests have non-voting “liaison” members who advise the WCAC on health related matters.  Each legislative session, the WCAC meets to discuss issues relating to workplace safety, injuries, health care and other benefits and then recommend consensus legislation.  Normally, the WCAC’s “agreed upon bill” is adopted by the Legislature with little fanfare or opposition.

Four years ago, the WCAC proposed the creation of a “provider fee schedule” for all Worker’s Compensation related healthcare.  The health provider community (hospitals, physicians, nurses, chiropractors, physical therapists and others) rallied together in strong opposition, and for the first time a WCAC proposal failed to pass.

This year, following an aggressive push by Wisconsin Manufacturers & Commerce the WCAC has again approved legislation that could create a “provider fee schedule,” as well as authorize “employer directed care” for injured employees.  WMC argues that Wisconsin’s healthcare costs related to work injuries are among the highest in the nation, necessitating a fee schedule. 

In reality, Wisconsin’s worker’s compensation insurance premiums are the lowest in the Midwest, and this year the Wisconsin Office of the Commissioner of Insurance announced that overall Wisconsin employers will experience an 8.5% decline in worker’s compensation insurance rates (9.3% decline in manufacturing sectors).  Despite experiencing higher than average rates of on-the-job injuries, Wisconsin is also among national leaders in terms of “return-to-work” (the time it takes injured workers to get back on the job) and other categories that depend on quality health care, resulting in the overall rate reductions.

WMS, WHA and specialty organizations will once again be working in concert with nurses, chiropractors, physical therapists and others to defeat these unnecessary proposals that threaten to disrupt our highly successful Worker’s Compensation system and market.