Medigram, the Society’s electronic newsletter for physicians, features timely news, upcoming events, answers to frequently asked questions and all the information you need to know to make your practice run more efficiently. Topics include legislative updates, legal information, practice management information, government regulations, and much more. Published weekly, Medigram is delivered via email on Thursdays.

If you have a Medigram story idea or would like to offer feedback, please email us or call 866.442.3800.

Wisconsin Supreme Court strikes down “Perfection Rule” for Medicaid recoupment
In a decision released earlier today, the Wisconsin Supreme Court set explicit limits on the Wisconsin Department of Health Services’ (DHS) authority to recoup payments made by Wisconsin Medicaid based solely on technical documentation errors.

Society Reference Committees, HOD scheduled to meet virtually
Reference Committee hearings will be held Saturday, August 8 via GoToWebinar. Hearings will discuss resolutions* and other items of business that will be considered by the Wisconsin Medical Society’s House of Delegates (HOD).

Foundation online auction closes July 10
The Wisconsin Medical Society Foundation’s silent auction is online this year and closes Friday, July 10!

Virtual Pitch Night – preview OnRamp Healthcare
Get a taste of what the OnRamp Healthcare Conference has to offer via Virtual Pitch Night, on July 14, from 5:30 to 6:30 p.m.

Healthy voting during a pandemic
Wisconsin Medical Society member Joel Charles, MD, MPH, shared resources for healthy voting during a pandemic via WisMed Community,* the Society’s online tool for members to connect with physicians around the state.

Primary care takes hit due to COVID-19
Earlier this week an article published in Health Affairs estimated that primary care practices across the nation will lose $15.1 billion in revenue in 2020 due to COVID-19.

Temte to present at next Town Hall
Join Jonathan Temte, MD, PhD, Associate Dean for Public Health and Community Engagement at the University of Wisconsin School of Medicine and Public Health on July 15 at 12:15 p.m.

New WisMed OnCall: Public service loan forgiveness
For those who qualify, Public Service Loan Forgiveness (PSLF) may be a way to help repay student loans. However, there are many factors to consider when determining whether this is a viable option.

Wisconsin Supreme Court strikes down “Perfection Rule” for Medicaid recoupment

In a decision released earlier today, the Wisconsin Supreme Court set explicit limits on the Wisconsin Department of Health Services’ (DHS) authority to recoup payments made by Wisconsin Medicaid based solely on technical documentation errors.   

The case, Papa vs. Wisconsin Department of Health Services, involved the extent of DHS’ authority to require repayment from providers for previously paid claims based on failure to follow all documentation and other technical requirements contained in a confusing series of administrative rules in the Forward Wisconsin Provider Handbook, technical bulletins and other sources. In 2016, a Waukesha County Court found that DHS’ position that compliance with all technical and documentation requirements by providers as a prerequisite for payment amounted to a “Perfection Rule” that exceeded its authority to recoup payments otherwise properly made. However, the Wisconsin Court of Appeals overturned that decision in July 2019.

In today’s 6-0 decision, the Supreme Court reversed the Court of Appeals and restored the county court’s 2016 order limiting DHS’ authority to recoup payments, concluding that “so long as DHS can verify that a covered service was actually provided, the claim was appropriate, and the claim was accurate, DHS cannot recoup payments based on a record imperfection. A record imperfection alone is not an independent basis for recouping payments.” The decision provides clarity and greater certainty for physicians, who could otherwise face demands for repayment of thousands of dollars months or years after the fact based entirely on unintentional documentation errors.

“This is an important case for physicians, but more importantly for patient access to our Medicaid system,” said Wisconsin Medical Society (Society) CEO Bud Chumbley, MD, MBA.

The Society was part of a collation of state health care associations that filed amicus briefs in both the Court of Appeals and the Wisconsin Supreme Court advocating for elimination of the Perfection Rule. According to the briefs, health professionals already face additional administrative burdens and lower reimbursement in treating Medicaid patients. The possibility of having payments revoked after the fact where there is no question whether services were provided, covered or necessary threatens clinicians’ ability to participate and ultimately adequate access to care for Medicaid participants.

“We look forward to our continued work with DHS and other stakeholders to ensure adequate access to care for some of our state’s most vulnerable citizens while also protecting the integrity of our Medicaid system,” added Dr. Chumbley.

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Society Reference Committees, HOD scheduled to meet virtually

Reference Committee hearings will be held Saturday, August 8 via GoToWebinar. Hearings will discuss resolutions* and other items of business that will be considered by the Wisconsin Medical Society’s House of Delegates (HOD).

Preregistration is required to join the hearing, click here to register.

A confirmation email with information about joining the Reference Committee hearings webinar will be sent to registrants.

The Reference Committees will convene at 9 a.m. and will run consecutively as follows:

  • Reference Committee A: Health Insurance Coverage and Access
  • Reference Committee C: Organization and Finances
  • Reference Committee B: Quality and Clinical Outcomes

Following the hearings, each Reference Committee will convene in closed session via Zoom to provide recommendations to the HOD on the items of business before that committee. Reference Committee reports will be emailed to Delegates, Alternate Delegates and Society Officers, and made available to all members on the Society’s website, no later than August 11.

The 2020 HOD will be held August 22 via Zoom. Please watch for emails regarding registration. Voting Delegates or Alternates must preregister to receive the participation link. Please contact Noreen Krueger with any questions.

*Member login is required for WisMed Community. Contact membership@wismed.org for help logging in or for information about membership.

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Foundation online auction closes July 10

The Wisconsin Medical Society Foundation’s silent auction is online this year and closes Friday, July 10! Don’t miss out on a two-week stay in an ocean-side condo in Florida, event tickets, a shawl hand-knitted by Foundation Director Marje Murray, wine tastings and much more. As additional incentive, the minimum bid has been reduced on more than 20 items.

Check out the great selection at foundation.wismed.org/auction, bid high and check back often to help support the mission of the Foundation, which is to advance the health of Wisconsin! Auction proceeds will go towards the Foundation’s COVID-19 Response Fund, which was created to support medical students facing financial uncertainty and provide PPE to clinics caring for underserved populations.

The Foundation has been able to assist 19 students who are struggling and there are at least 30 more students in the queue awaiting your help. As fundraising continues to help provide financial resources for students the Foundation also has been able to deliver PPE to areas that have been hit the hardest by the virus.

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Virtual Pitch Night – preview OnRamp Healthcare

Get a taste of what the OnRamp Healthcare Conference has to offer via Virtual Pitch Night, on July 14, from 5:30 to 6:30 p.m.

Virtual Pitch Night provides many unique opportunities for physicians and health professionals, such as:

  • The ability to inform innovators of the physician perspective in developing technologies for health care
  • Learn revenue opportunities – beyond RVUs
  • Identify how to engage with healthtech

For more information or to register for Virtual Pitch Night, click here.

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Healthy voting during a pandemic

Wisconsin Medical Society member Joel Charles, MD, MPH, shared resources for healthy voting during a pandemic via WisMed Community,* the Society’s online tool for members to connect with physicians around the state:

"As physicians, we all want to make sure both the August 11 primary and November 3 general election are safe for voters and poll workers. The American Public Health Association (APHA) recently released the Healthy Voting Guide, which covers best practices for mail voting and in-person voting, giving voters the opportunity to learn their state's voting options and rules before they cast a ballot. The nonpartisan guidelines were drafted by experts from the APHA, the National Association of County and City Health Officials, the Center for Tech and Civic Life and the Center for Civic Design

Safe voting should be a non-partisan issue. My understanding is that right now the power on this issue mostly resides with the Wisconsin Elections Commission and county/municipal clerks. Municipal clerk information can be found here, or via PDF on this page

For those looking to ensure a safe election, please reach out to your county and municipal clerks and the Wisconsin state elections commission to advocate for the measures found in the APHA guide, including an adequate number of polling stations in order to avoid increased voting density. Also, please encourage the young, healthy people  in your lives to sign up to be poll-workers as this seems to be a key limiting factor in maintaining adequate distribution of low-density polling sites."

*Member login is required for WisMed Community. Contact membership@wismed.org for help logging in or for information about membership.

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Primary care takes hit due to COVID-19

Earlier this week an article published in Health Affairs estimated that primary care practices across the nation will lose $15.1 billion in revenue in 2020 due to COVID-19. This translates to a loss of over $67,000 per physician and is due to the downturn in outpatient visits as a result of the pandemic. These losses could double if telehealth coverage and reimbursement revert to pre-COVID policies.

The Wisconsin Medical Society (Society) is working hard to offset the potential impacts of the pandemic by advocating at both the state and federal levels for financial assistance for physicians so they can keep their practices operational and care for patients. Additionally, the Society is pursuing opportunities with private groups to make it easier for physicians to apply for and receive funding and loans for their practices. The Society is also working with state leaders and supporting the AMA’s efforts to continue the telemedicine coverage and payment policies that were enacted in response to the COVID-19 pandemic. The Society will continue to update physicians on the progress of these efforts.

Please contact HJ Waukau with any questions.

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Temte to present at next Town Hall


Jonathan Temte, MD, PhD, Associate Dean for Public Health and Community Engagement at UW SMPH

Join Jonathan Temte, MD, PhD, Associate Dean for Public Health and Community Engagement at the University of Wisconsin School of Medicine and Public Health on July 15 at 12:15 p.m. Dr. Temte will present on the vaccine development of COVID-19.

The next three weeks of the Virtual Town Hall will feature experts from the University of Wisconsin covering different topics related to COVID-19. Presentation topics include vaccine development, therapeutics and virus biology.

The Society’s Virtual Town Hall sessions are not recorded, and preregistration is required. Click here to register today.

Please email Anne Hauer with any questions.

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New WisMed OnCall: Public service loan forgiveness

WisMed OnCall podcast logo

For those who qualify, Public Service Loan Forgiveness (PSLF) may be a way to help repay student loans. However, there are many factors to consider when determining whether this is a viable option.

In this seventh podcast in the series presented by WisMed Assure and the Wisconsin Medical Society Foundation, medical student Rufus Sweeney and former Wisconsin Medical Society COO Peter Welch, discuss the ins and outs of PSLF. Specifically, they explore reasons whether or not to pursue PSLF and how to qualify.

For details about Public Service Loan Forgiveness, click here.

You can subscribe to Wisconsin Medical Society's podcast in iTunes or wherever you get your podcasts.

Related blogs by Rufus Sweeney:
To Buy or Not to Buy: a personal challenge
Financial Wellness Matters
Is Your Money Unemployed? Replace budgeting with goal setting and give your money a job
Different Kinds of Debt: the good, the bad, and the just-don’t-do-it!

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