State Assembly amends, passes nursing independence bill

The Wisconsin State Assembly amended and then approved legislation this afternoon (February 17) allowing certain nurses (APRN) to practice independently. The bill’s passage (by voice vote, meaning there was no roll call) occurred despite strenuous concerns that a broad coalition of physician-oriented groups have raised over the last several months. The most recent example of those efforts came February 14, with this memo highlighting how the proposal could roll back progress the state has seen since the mid-2010s in reducing the quantity of opioid medications dispensed by more than one-third.

That coalition memo requested common sense guardrails to better ensure patient safety as well as clarity over the credentials of who is providing care. While an amendment to the bill accomplished a portion of these asks, it left many concerns unaddressed – including a complete absence of “Truth in Advertising” provisions, which would have ensured nurses could not use a professional title using words reserved for physician-level education and training such as “medical doctor,” “anesthesiologist,” “primary care physician,” etc. The Wisconsin Medical Society issued a member-wide advocacy alert February 16 by both email and the WisMed Mobile App, alerting physicians that it was timely to contact their State Assembly Representatives about the bill.

The bill now returns to the Wisconsin State Senate, which passed a previous version of the bill January 25 without today’s amendment. If the senate concurs with the Assembly’s change, the bill will be presented to Governor Tony Evers for his signature or veto. As of press time it is unknown which action the Governor plans to take; the physician coalition will request a veto.

Contact Society Chief Policy and Advocacy Officer Mark Grapentine, JD for more information.

Back to top

Vote now: Nominees, elections for Society offices

President-elect Nominee - Don Lee, MD

Wisconsin Medical Society (Society) Members can now vote for the Society President-elect and Treasurer via the WisMed Mobile app.* According to the Society’s Constitution, Article V, the President-elect and Treasurer will be elected by the general membership.

The Nominating Committee of the Wisconsin Medical Society prepared a slate of nominees for Society offices during its January 21 meeting. The nominees, including those for American Medical Association (AMA) Delegates are as follows:

• President-elect: Don Lee, MD
• AMA Delegate 2023 and 2024: Barbara Hummel, MD
• AMA Delegate 2023 and 2024: Tosha Wetterneck, MD

Treasurer Nominee - John Cook, CPA

The Wisconsin Medical Society Board of Directors, as directed by the Society’s Bylaws, selected its nominee for Treasurer on January 22, 2022:

• Treasurer: Mr. John Cook, CPA

The ballot for President-elect and Treasurer will be available until the close of business March 10. All Wisconsin Medical Society members are eligible to vote via WisMed Mobile.* The candidate materials are available for review on the ballot as well.

The Board of Directors will consider nominees for the AMA Delegates, Board of Director and Nominating Committee members at its meeting in April.

*If you haven’t downloaded WisMed Mobile app, you can do so here. For assistance, please contact membership@wismed.org or 800.762.8975.

Back to top

MEB pushes reset button on chaperone rule

The state of Wisconsin Medical Examining Board (MEB) will need to craft a new version of its chaperone requirement rule to avoid an onerous rulemaking procedure specific to proposals exceeding a certain level of implementation and compliance costs. State law passed in 2017 requires an agency to halt or alter proceedings if a proposed administrative rule would cost affected entities $10 million or more over a two-year period. After two economic impact assessment periods, the department determined that estimated compliance costs for the proposed rule would exceed $55 million.

At its monthly meeting, held virtually on February 16, the MEB began to debate possible changes to the rule with the goal of reducing compliance costs. Potential changes include expanding who can serve as a chaperone, what kind of training is required and who is presumed to already qualify to serve that role (such as clinical staff). The MEB also discussed adding an additional exception for when offering a chaperone would not be required: in cases where the presence of a chaperone may cause the patient “unnecessary trauma” or is otherwise contraindicated. You can see screen shots of the language as it was discussed during the meeting here.

The MEB will continue deliberations over the potential changes at its March 16, 2022 meeting. If the MEB decides to proceed with the new language, another economic impact assessment period will be scheduled, allowing physician offices and clinics the opportunity to again submit estimated compliance costs.

Contact Society Chief Policy and Advocacy Officer Mark Grapentine, JD for more information.

Back to top

Add your National Healthcare Decisions Day event to the Society’s calendar

National Healthcare Decisions Day (NHDD), April 16, 2022, is a day to inspire, educate and empower the public, physicians and the health care team about the importance of advance care planning (ACP). In order to promote NHDD-related events at various locations around the state, the Wisconsin Medical Society (Society) is asking physicians and health care team members to submit their event here so that it can be added to the Society’s web calendar and upcoming events listing.

Back to top

Social Security projected depletion and physicians

Each year the Social Security Trustees publish a report on the financial health of the fund. The 2021 report indicates the retirement benefit and survivors’ benefit (technically called the Old-Age and Survivors Insurance) can make timely payments for 11 more years to 2033. Previous reports had funds available through 2034. Once the fund is depleted, Social Security will be able to pay 76% of scheduled benefits since it is still collecting Social Security taxes on wages.

In the past, Congress has made changes to the Social Security rules to improve the health of the program. If history repeats itself, here are a few of the many historical changes that may be implemented again.

1977 amendments:

• The tax rate was increased over time along with the amount of wages that were taxable.
• Delayed retirement credits were increased to 3% to encourage taxpayers to work longer and delay starting benefits.
• Reduced spousal and survivor benefits by the amount of government pension.

1983 amendments:

• Increased the full retirement age from 65 to 67 over time.
• Accelerated the scheduled tax increases.
• Higher income recipients paid tax on up to 50% of their Social Security benefits.
• Delayed retirement credits were increased from 3% to 8%.

1993 amendments:

• Increased the amount of Social Security that is taxable from 50% to 85% for higher income beneficiaries.

2000 amendments:

• Removed the incentive to not work by allowing benefits to be paid to workers over full retirement age. Previously, workers would have a portion of their benefit withheld while working.

If history is any indication, physicians and other high earners may see increased taxes and delayed or decreased benefits for Social Security in the future as Congress could amend the program again. However, these changes are usually phased in over time, so younger physicians would be impacted the most.

Want help with your Social Security claiming strategy? Download your free guide on timing Social Security or schedule a meeting.

You can also download the 2022 tax brackets, retirement contribution limits, investment checklist and quick decision flow charts from the new WisMed Mobile app.

For personalized help eliminating debt, investing smart, and securing retirement, please contact Mark Ziety, CFP®, AIF® 608.442.3750.

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

Back to top