Yesterday the Legislature passed and Governor Evers signed a package (Act 185) aimed at dealing with the COVID-19 pandemic. The package contained a myriad of proposals, but focused primarily on health care, unemployment and schools. The Wisconsin Medical Society (Society) advocated for many of the health care proposals contained within this package.
Primary amongst the health care proposals were:
- civil liability safe harbors for health care professionals
- temporary licenses for retired health care workers and those working across state lines
- medical liability insurance for those practicing under a temporary license
- provisions for an 1135 Medicaid waiver
- patient protections for patients with a COVID-19 diagnosis
- temporary suspension of licensure renewal requirements (includes CME requirements)
- temporary prescribing provisions
However, the bill did not contain many new funding appropriations as had been initially proposed in the Governor’s package.
Civil Liability Safe Harbors
The civil liability safe harbor grants physicians and many other health care workers immunity from civil suits in relation to their actions or omissions in delivering care during the pandemic. The duration of the immunity extends 60 days past the end of Governor Evers’s initial Safer at Home order. This provision is critical as physicians are providing care to patients for a diagnosis for which there is currently no approved treatment or vaccine and the standard of care has been dramatically impacted due to recommended changes in practice guidelines. Additionally, the language of the provision is intended to be broadly applicable to the temporary changes in practice and standards of care in response to the COVID-19 pandemic. The Society collaborated with the Wisconsin Hospital Association to include the safe harbor provision in the bill; and thanks the Wisconsin Academy of Family Physicians, Wisconsin Chapter of the American College of Emergency Physicians, Wisconsin Psychiatric Association, Wisconsin Society of Anesthesiologists, Wisconsin Chapter of the American Academy of Pediatrics and the Wisconsin Radiological Society for their help as well.
Temporary Licenses and Medical Liability Insurance
The bill also codifies the Governor’s executive order to create temporary licenses for retired physicians and other health care workers such as nurses, physician assistants, pharmacists, dentists and others. Those wishing to reenter the workforce had to have a license within the last five years and never had their credential revoked, limited, suspended or denied renewal. A similar license was also created for physicians from other states who have a valid license granted by another state or territory and are determined to be fit to practice pending a background investigation. The duration of the temporary licenses extends for 30 days past the end of the Governor’s Safer at Home order. Coupled with this temporary license is a provision that requires and allows providers to obtain medical professional liability insurance during the emergency declaration.
1135 waivers are a way for states to modify certain Medicare, Medicaid or CHIP requirements during a declared national emergency to meet the needs of populations affected by the emergency. Regarding Wisconsin’s 1135 waiver the legislature approved allowing providers to receive Medicaid payments for services rendered in alternative settings, waived various fees and bureaucratic procedures, waived prior authorization for covered Medicaid benefits, increased flexibility for teaching physicians via audio/video access and waived sanctions on limitations for physician referral. Also included in the waiver are policies related to long-term care facilities and the removal of limitations placed on the Family Care, IRIS and Children’s Long-Term Supports programs. In addition, the bill temporarily suspends the work requirements, premiums and health screening requirements for Medicaid’s childless adult population. These provisions were a part of the state’s renewal of its 1115 demonstration waiver last year, and in suspending their implementation, allows the state to receive an additional 6.2 percent in federal match for Medicaid as enacted by the Family First Coronavirus Response Act.
The bill also contains several patient protections related to COVID-19 and temporary prescribing guidelines intended to reduce administrative burdens on physicians. Under the bill insurers can’t discriminate against patients with a COVID-19 diagnosis, nor can they apply any cost-sharing for COVID-19 testing or require prior authorization for prescription refills (with the exception of controlled substances) during the emergency declaration.
Reducing Physicians’ Burdens
Pharmacists will be allowed to extend a patient’s prescription without a physician’s order provided the physician does not explicitly state there can be no renewals and the prescription is not a controlled substance. Pharmacists are limited to extensions for a 30-day supply, may only extend the prescription once during the emergency declaration and must notify the prescriber of the extension in a reasonable timeframe. Additionally, the package allows various departments and boards to suspend licensure renewal requirements during the declared emergency. This includes the payment of any fees or continuing medical education requirements that would have applied during the emergency and ends 60 days after the declaration is no longer effective.
Also contained in this bill is a provision that temporarily suspends surprise billing. However, insurers will have to pay out-of-network providers 225 percent of Medicare and can’t charge a patient for more than they would have paid in network.
The bulk of these proposals (with the exception of the surprise billing provision) are the result of sustained advocacy and activity from the Society and its members during this pandemic. The package is also the result of collaboration and partnership between multiple health care organizations and stakeholders.
Please contact HJ Waukau for additional information.
Back to top