Advocacy alert: nurses pursuing path to independent practice

Various state nurses’ organizations are pursuing sweeping legislation in the State Capitol that would provide a path toward independent nursing practice, including the ability to diagnose and treat patients with no physician involvement – and prescribe medications as part of that treatment. While nursing groups are touting the Advanced Practice Registered Nurse (APRN) as a “modernization” effort, the bill would create new law allowing nurses to essentially become primary care providers without physician oversight or input.

The bills have yet to be introduced in the state legislature, but earlier this week the draft version of the 70-page proposal was circulating for legislative cosponsors. Wisconsin Medical Society (Society) members subscribing to alerts on the members-only Advocacy in Action Community received an advocacy alert, asking physicians to contact their state senator and state assembly representative with a request that they NOT cosponsor the bill at this time. Concerning items in the current version of the proposal include:

• eliminating requirements for these APRNs (certified nurse-midwives, certified registered nurse anesthetists, clinical nurse specialists and nurse practitioners) to collaborate with physicians
• writing into the statutes the ability for an APRN to assess, diagnose and treat patients, including prescribing most drugs, independently from a physician
• mandating that the state "opt out" of federal certified registered nurse anesthetist supervision requirements
• eliminating current law requiring certified nurse midwives to have a collaborative arrangement with a physician who has experience with obstetrics

Eventually the proposal will be introduced (most likely as “companion bills,” meaning identical Senate and Assembly versions), sent to committees and then scheduled for public hearings.

What you can do
As a physician constituent, you have health care expertise that elected officials and their staffs find valuable. Feel free to share your thoughts on the proposal with your state elected officials (each of you has a state senator and a representative to the state assembly, which you can find via the “Who Are My Legislators?” link on the state legislature’s website). You can also sign up to receive future alerts via the Society’s Advocacy in Action Community.

This nursing bill is just the first of what we expect will be a busy legislative period with numerous boundary-pushing proposals emerging in the Capitol, including initiatives from chiropractors, naturopaths and other non-physician clinicians.

You can also contact Society Chief Policy and Advocacy Officer Mark Grapentine, JD for more information.

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Medical Mystery Tour webinar series: diagnosis & treatment of rare or unusual diseases

Medical professionals are frequently called upon to diagnose a wide variety of disorders, initiate treatment regimens and recognize when specialist referral or emergency management and hospitalization are necessary – particularly in the diagnosis and treatment of rare or unusual clinical diseases or syndromes. This 4-part webinar series will cover current clinical information on the diagnosis and treatment of rare medical conditions such as Acute Lyme Disease, Spontaneous Bowel Rupture, Rare Fungal Infections and Mast Cell Activation Syndrome.

This series is free for Wisconsin Medical Society members, but registration is required to attend. Non-members are welcome to attend as well. Sessions will be available on demand after each live session occurs.

• Lyme Disease – Background and Acute Management, presented by Samuel Shor, MD, FACP

  June 7, 2021, 12:15-12:45 p.m.
  

• Spontaneous Bowel Rupture: Connective Tissue Considerations, presented by Elizabeth Petty, MD

  June 14, 2021, 12:15-12:45 p.m.
  

• Rare Fungal Infections Including Blastomycosis, presented by Greg Gauthier, MD, MS

  June 21, 2021, 12:15-12:45 p.m.
  

• Anaphylaxis without an allergy: An introduction to mast cell disorders, presented by Joshua Steinberg, MD
  June 28, 2021, 12:15-12:45 p.m.

View all sessions and register here! This activity has been approved for AMA PRA Category 1 Credit™.

Please email education@wismed.org with any questions.

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IPFCF premium holiday extended through June 30, 2022

The Injured Patients and Families Compensation Fund (IPFCF) Board of Governors has approved another premium holiday for IPFCF’s annual assessment fees for Fiscal Year 2022 in response to the COVID-19 pandemic.

The IPFCF will be providing Fund coverage for all Fund participants free of charge from July 1, 2021 to July 1, 2022. All Annual Medical Mediation Panel Fees will be paid by the IPFCF on behalf of Fund participants.

The primary medical malpractice coverage requirements are still in effect as defined within Wis. Stat. § 655.23. The IPFCF will continue to monitor compliance regarding the coverage requirements.

All providers should continue to maintain current contact information with the IPFCF and the Department of Safety and Professional Services (DSPS). Group administrators should continue to add and remove providers from their group whenever employment status changes. 

Please contact Rebecca Kamenick at 608.707.5478 with any questions or concerns pertaining to the premium holiday or other IPFCF requirements. For detailed IPFCF information please visit the IPFCF website.

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Another Worker’s Comp insurance premium drop recommended

Worker’s Compensation insurance premiums for Wisconsin businesses could drop for a sixth straight year if a rate recommendation to the state’s Office of the Commissioner of Insurance (OCI) is accepted later this summer. According to minutes of the latest Wisconsin Rating Committee of the Wisconsin Compensation Rating Bureau meeting, the committee is recommending an overall decrease in the rate level of 5.44% to take effect October 1, 2021. If the OCI approves the recommendation as expected, it will mark the sixth straight year of plummeting worker’s compensation premiums:

2016: -3.19%
2017: -8.46%
2018: -6.03%
2019: -8.84%
2020: -0.89%
2021: -5.44%*
*pending OCI approval

“Wisconsin’s worker’s compensation continues to be a bargain for Wisconsin businesses, and in large part that’s a testament to how physicians prioritize treating injured workers quickly and effectively,” said Wisconsin Medical Society Chief Policy and Advocacy Officer Mark Grapentine, JD, who serves as one of four health care liaisons to the state’s Worker’s Compensation Advisory Council. “Wisconsin’s hard-earned reputation as a model worker’s compensation state is good for the state’s business climate, but more importantly is a tremendous benefit for workers who are injured on the job.

“Yet another recommendation to reduce insurance premiums just adds to the pile of data showing how Wisconsin’s work comp system benefits both businesses and employees across the state,” Grapentine said.

Contact Mark Grapentine, JD for more information.

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State COVID-19 small business relief grants now available

Wisconsin-based small businesses, including medical offices and clinics, can apply to the state for grants to help defray economic losses suffered due to the COVID-19 pandemic. The application process opened on May 24 and runs through Monday, June 7. The Wisconsin Tomorrow Small Business Recovery Grant Program will allocate $420 million in federal funds to Wisconsin through the American Rescue Plan Act (ARPA).

Small businesses doing at least 75% of their business in Wisconsin with up to $7 million in annual revenues are eligible to apply. Learn more about other requirements of this grant opportunity and how to apply at the Wisconsin Department of Revenue website.

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The importance of personal disability insurance for graduating residents

Congratulations to our graduating residents!

As your journey continues onward as an attending physician, there’s lots to do but, despite everything that’s going on, right now is the time to make sure you get personal disability insurance.

It will never be easier or less expensive for you to acquire personal disability insurance. As a medical resident, you are entitled to discounts from the five main personal disability insurance companies. Once you graduate, these discounts will not be available.

Plus, because the cost of personal disability protection is based on age and health, now is the best time to act.

After devoting years of dedication and hard work to becoming a physician, you are about to acquire the biggest asset you’ll ever own – the ability to earn a substantial income. And it’s an asset that needs to be protected.

The good news is that this is the only time you will be able to get a high monthly benefit without the insurer taking into account your Group LTD benefits. Additionally, the application process is streamlined and the WisMed Assure team makes it as quick and easy as possible.

For those working for a health system, chances are group disability will be offered as part of the benefits package. It’s important to know that this coverage is not portable if you leave the system and it likely will have limitations that personal disability insurance coverage does not.

Most importantly, with group disability, the total amount of monthly benefits is limited to a specific amount. Since you have worked so hard to earn your new income, it is wise to protect it to the greatest extent possible.

There are several options to consider when designing your personal disability insurance policy. WisMed Assure will work with you to make sure the policy fits your budget while providing optimum benefits.

WisMed Assure does all the heavy lifting for you so you’re free to concentrate on all your other responsibilities at this monumental time. It’s time to take advantage of your Wisconsin Medical Society membership and our years of expertise to get the peace you deserve.

To obtain quotes, call 608.442.3810, email or click here to fill in a short form.

Congratulations once again – you deserve the best!

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Free buprenorphine X-Waiver trainings for eligible Wisconsin prescribers

The Wisconsin Society of Addiction Medicine (WISAM) Buprenorphine X-Waiver Training Series has only three remaining dates available in 2021. This opportunity is made possible through a partnership grant with the Wisconsin Department of Health Services. This series is designed to increase treatment capacity for opioid use disorders by training more prescribers to be able to treat opioid use disorders with buprenorphine.

This live course has been approved by the Wisconsin Medical Examining Board as meeting the requirements for the two-hour continuing education course on responsible opioid prescribing per Med 13.03(3) of the Wisconsin Administrative Code. The ASAM Treatment of Opioid Use Disorder Course involves 4 hours of online training paired with 4 hours of live virtual training. The self-paced online portion will be available through ASAM’s website upon registration. View the full schedule of trainings and register online.

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Saving for college

Besides personal retirement, for most people, their second largest investing goal is their children’s college education. Let’s uncover the cost, tax breaks and right way to save for this expense.

Current college costs might cause some sticker shock. The national average four-year in-state cost is just under $27,000 per year. University of Wisconsin-Madison is right at the national average while UW-Milwaukee is $24,600 and some of the smaller schools like Whitewater are less than $20,000. Private and out of state schools are roughly double, although there is a wide range of prices. For instance, Northwestern University costs $81,200 annually.

There are some tax breaks to help cover the cost. The most lucrative is the American Opportunity Tax Credit, which is worth $2,500 per student for four years, equaling $10,000. Unfortunately, those with an adjusted gross income that exceeds $90,000 single or $180,000 married are ineligible. The second tax break is found on the Wisconsin tax return for contributions to Edvest, Wisconsin’s 529 college savings plan. In 2021, contributions up to $3,380 per beneficiary (child) are subtracted from Wisconsin taxable income. There are tax breaks after school too, notably the student loan interest deduction.

The right way to save for college is through a 529 plan. While taxpayers can use another state’s plan, Wisconsin’s Edvest 529 is a highly rated plan according to savingforcollege.com. All 529 plans provide tax deferred growth and tax-free withdrawals for qualifying education expenses. Those expenses include tuition, room and board (or equivalent off campus housing) and even items like a computer and internet. For a college-bound child, this is the best place to save.

What if a scholarship or other funding comes along and the money isn’t needed for college expenses? The beneficiary can be changed to another child, grandchild, niece, nephew, yourself, pretty much anyone in the family tree – including in-laws. The money can also be taken out of the plan for noneducation expenses. The portion of the distribution that represents investment growth would incur income taxes and a 10% penalty while the portion that represents the initial contribution is tax free and penalty free.

How much do you need to save? Edvest provides a helpful calculator to crunch the numbers.   

Would you like one-on-one advice about your finances? Please contact Mark Ziety, CFP®, AIF® 608.442.3750 to get started.

Mark Ziety, CFP®, AIF®
WisMed Financial, Inc. part of the Wisconsin Medical Society

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