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From Wisconsin Health News
Insurers and pharmacy benefit managers would have to count copayment assistance from drug companies toward patients’ annual deductibles and maximum out-of-pocket costs under a bill introduced by a bipartisan group of lawmakers Tuesday.
In response, associations representing insurers and pharmacy benefit managers raised concerns about drug coupons, warning they increase overall drug costs.
Sen. Andrè Jacque, R-De Pere, said the “critical legislation” is about medication adherence and better health outcomes. He said that it can be “devastating” for patients to learn that they haven’t met their out-of-pocket commitments.
“This is about making sure people can afford their medications and not have to choose between groceries and gas and being able to progress and deal with a chronic condition,” Jacque said at a press conference.
A memo for the bill circulated to gain support for the plan from lawmakers noted that the legislation applies to prescriptions if there's not a "medically appropriate generic equivalent available," which the bill's sponsors argued removes concerns that the financial assistance would drive patients to higher-cost drugs.
Rob Gundermann, CEO of the Coalition of Wisconsin Aging and Health Groups, which is leading a group of around 40 patient and provider groups in support of the bill, said copay assistance programs were created by manufacturers to respond to efforts by health plans to shift the cost burden of prescriptions onto patients.
“Copay assistance is a critical lifeline for patients across our state,” he said.
Similar legislation introduced last session didn’t make it into law. It faced criticism from insurers and the Pharmaceutical Care Management Association.
“Drug companies offer coupons to insured patients, regardless of their incomes, to induce patients to take a more expensive brand drug instead of an equally effective, less expensive, alternative with lower cost sharing,” Sean Stephenson, director of state affairs for the association, which represents pharmacy benefit managers, said in a Tuesday statement. “Numerous analyses show an increase in the use of copay coupons correlates to a total increase in prescription drug spending.”
Wisconsin Association of Health Plans Executive Director John Nygren said some aspects of the proposal have changed since last session.
"Our fundamental concern remains the same: Copay coupons are marketing tools used by pharmaceutical companies to encourage use of their drug over alternative therapeutic options," Nygren said in a statement.
The Alliance of Health Insurers said in a statement that the legislation “would do nothing to control the soaring prices of prescription drugs.”
“Perversely, this legislation would reward drugmakers for steering patients towards and keeping them on expensive brand-name drugs, costing all of us more money,” they said in a statement. “The federal government considers copay coupons an illegal kickback if used by an enrollee in Medicare or Medicaid because they induce a patient to use a specific drug. Copay coupons should be banned."
The standing order from the Department of Health Services now allows people who are trained to take their certificate directly to the pharmacy to obtain epinephrine devices. This is a huge win for those who are certified as trainers under Dillion's Law - as they won't have to call their provider for refills as long as they use their certificate. Certificates are valid for four years.
Read more here.
From Wisconsin Health News:
Wisconsin students entering seventh grade this fall will have to get the vaccines for meningitis and whooping cough, according to the Department of Health Services.
Students are already required to receive the tetanus, diphtheria and acellular pertussis vaccine at the start of sixth grade. The change better aligns with the shot’s recommended age of 11, the state agency said.
In addition, a booster dose of meningitis vaccine will be required at 12th grade.
Past chickenpox infection will also have to be documented by a qualified medical professional. Child care centers will have to start working with parents now to ensure proper documentation, per DHS.
“Each of these vaccines is already recommended for children, and today’s update improves that protection,” DHS Deputy Secretary Deb Standridge said in a Wednesday statement. “Parents who choose to keep their children up to date on vaccinations are not only protecting their own child’s health but are making a choice that protects the people who live and work in their communities.”
Per DHS, vaccination rates have declined during the pandemic. The most recent data during the 2021-2022 school year show 88.7 of students met minimum immunization requirements, a 3.2 percent decrease from the previous year, and 3.3 percent of students were behind schedule on their vaccinations, a 0.4 percent increase from the previous year.
There is no change to exemption options for medical, religious or philosophical reasons. And DHS is encouraging, but not requiring, flu vaccination and COVID-19 vaccination, per the statement.
Attention all pre-med students who are interested in pursuing a career as a DO, WAOPS is here to help! We know the importance of shadowing a DO and are willing to connect interested college students with osteopathic physicians throughout Wisconsin who are willing to have students shadow with them. This is a fantastic opportunity for students to not only network with physicians, but also allows them to gain exposure to the field of osteopathic medicine in a way that is different and/or broader than experiences available through the medical school curriculum.
Please visit the Students page for more information, or email WAOPS at WAOPS@badgerbay.co
Thirty-four percent of Wisconsin students report feeling sad and hopeless almost every day, a 10 percentage point increase over the past decade, according to an annual report released Friday by the Office of Children’s Mental Health.
Children’s sense of belonging in school is dropping. And kids are reporting “alarming rates of mental and emotional distress,” with female and LGBTQ+ students reporting “especially bleak feelings,” said Amy Marsman, senior research analyst at the Office of Children's Mental Health.
“Wisconsin is going in the wrong direction in these areas,” Marsman said at a briefing.
The office's report presents data on 40 different clinical, social, economic and individual health factors, with most data from 2021 or 2022.
Compared to five years ago, bullying and the teen birth rate have declined. The number of school social workers, school counselors and school psychologists has increased, largely due to investments by the Legislature and Gov. Tony Evers, Marsman said.
“This is a great step forward,” Marsman said.
Office Director Linda Hall said one of their focuses in the coming year will be on "youth voice."
“Because we know that youth have good ideas about how to address this youth mental health crisis, we intend to be listening to them more,” she said.
They’ll also be working to find ways of increasing kids' social connectedness, like supporting efforts that invest in school mental health services, making school climates more welcoming, reducing family stress and boosting the availability of culturally sensitive mental health professionals.
Ava Pellegrino, a student at Mukwonago High School, said anxiety and depression are part of many young people's daily experiences. She called on lawmakers to support mental health programming in schools.
The COVID-19 pandemic pushed many to seek help they need, but the mental healthcare system is now overwhelmed, she said.
The Medical Examining Board on Wednesday signed off on a draft of a rule on use of chaperones and other observers during sensitive patient exams. The proposal will now head to the governor's office and then the Legislature for their consideration.
Jameson Whitney, an attorney for the Department of Safety and Professional Services, said the final version factors in comments from Legislative Council, public feedback and a meeting with the Wisconsin Hospital Association.
Under the plan, the Medical Examining Board, when determining whether alleged misconduct occurred, could take into consideration the failure of a doctor to follow the rules established by their employer regarding chaperones or other observers in patient exams.
Self-employed doctors or those practicing in practice settings that do not involve hospitals or employers will have to establish and comply with their own written procedures. They'd have to make those available and accessible to all patients likely to receive a non-emergency examination of the breasts, genitals or rectal area.
The board couldn't find doctors in violation of the rule because a third-party didn't create a chaperone policy or allow its posting or notification.
Another change to the rule clarifies that it's not intended to impose a requirement on any person or entity the board doesn't oversee. There are also modifications to the definition of chaperone, whom is chosen by the doctor, and observer, whom is chosen by the patient.
Matthew Stanford, WHA general counsel, said those working on the rule reached "a good place ... that both will protect patients and provide a good framework for physicians" to know what's required and what's not.
Previous attempts at drafting the rule ran into hurdles from doctor and hospital groups.
Wisconsin’s Doctor Day will take place on June 15, 2023. WI Doctor Day brings together physicians from every specialty and practice environment to meet with their legislators and advocate on health care issues affecting healthcare. The multi-specialty nature of Doctor Day makes it among the most unique advocacy events for physicians in the country.
Physicians and medical students at all stages of their careers will once again join together in Madison to take part in policy breakout sessions, hear keynote presentations and participate in a briefing on the day's priority issues. Attendees will then participate in group visits with legislators and legislative staff at the Wisconsin State Capitol. The day will conclude with a Doctor Day reception where you’ll have the chance to connect socially with both friends and peers.
Whether you’re a seasoned veteran or brand new to the legislative process, attending Doctor Day will provide you advocacy tools and skills to make your voices heard. Continue to watch your email for updates on registration!
Two doctors’ groups filed a brief with the Wisconsin Supreme Court last week arguing that courts shouldn’t compel physicians to provide the antiparasitic drug ivermectin as a COVID-19 intervention.
The American Medical Association and Wisconsin Medical Society asked that the court uphold an appeals court ruling earlier this year that found no legal authority to compel private healthcare providers to administer treatments that they have determined are below the standard of care.
The ruling came in a case brought by Allen Gahl, whose uncle was placed on a ventilator in October 2021 while hospitalized at Aurora Medical Center-Summit with COVID-19.
Gahl obtained a prescription for ivermectin for his uncle, but the hospital staff declined to provide it after deeming the medication below the standard of care. Gahl sued, which led a Waukesha County Court to initially order that the hospital provide his uncle with the drug.
The hospital appealed, and the Waukesha County judge later revised his order to require that the healthcare facility let Gahl find a doctor outside the hospital to administer ivermectin to his uncle. However, an appeals court put a hold on that order.
In their brief, the American Medical Association and Wisconsin Medical Society wrote that most studies investigating ivermectin haven’t found it to be an effective COVID-19 treatment. The consensus view is, apart from clinical trials, it shouldn’t be used to treat the illness, they noted.
They wrote that the hospital met its legal and ethical duties by treating the patient with an “evidence-based protocol” that did not include the drug and that the Wisconsin Supreme Court should affirm the court of appeals' ruling.
"Holding otherwise would allow courts to compel treatments that the medical consensus finds to be substandard,” they wrote. “That outcome forces Wisconsin's physicians to choose between the law and their ethical duties, potentially exposing patients to harm and physicians to liability.”
Click here to read the article on the Wisconsin Health News website.
WAOPS held their Fall Conference last week, November 4-5, at the Holiday Inn & Suites Madison West in Madison, WI. The CME committee planned an excellent program that kept attendees engaged with a range of topics and interactive talks. WAOPS even had their first virtual speaker, Dr. Melisa Lott streamed in successfully from Chicago, IL who spoke on Hypertension in Pregnancy. A great lineup of speakers filled the rest of the program including Dr. Kevin Klauer, the American Osteopathic Association CEO who flew in to speak. WAOPS was also able to once again offer Opioid credits through Drs. Gibbons and Sullivan's talk Medications for OUD (MOUD) Starter Pack. Thank you to all of our presenters, attendees and exhibitors who were able to join us! Save the Dates: 2023 Spring Conference | May 5-6, 2023 | Tundra Lodge Resort, Green Bay, WI 2023 Fall Conference | November 10-11, 2023 | Kalahari Resort, Wisconsin Dells, WI
With many questions surrounding the status of Wisconsin’s abortion-related law following the U.S. Supreme Court’s Dobbs decision in June 2022, the Wisconsin Medical Society (WisMed) is offering members a special webinar with legal experts to describe the current legal landscape. Attorneys from the Madison law firm Pines Bach will present “Providing Patient Care Post-Dobbs: A Look at Wisconsin Abortion Law” live at noon on Tuesday, September 20, including time for Q&A. The presentation will also be recorded and available on-demand for a limited time.
Register for this members-only event here. There is no cost for this WisMed member benefit. If you have questions about the current status of Wisconsin law you think should be covered in the program, please contact WisMed Chief Policy and Advocacy Officer Mark Grapentine, JD.
About the legal experts, Pines Bach attorneys Diane M. Welsh and Leslie A. Freehill:
Attorneys Diane Welsh and Leslie Freehill of Pines Bach LLP
Attorney Diane Welsh is a partner at Pines Bach LLP, where she advises clients on a variety of matters, including government and health law, and represents clients in all levels of litigation. Prior to joining Pines Bach, Diane served as Chief Legal Counsel for the Wisconsin Department of Health Services and as assistant attorney general at the Wisconsin Department of Justice. Attorney Leslie Freehill is an associate at Pines Bach, where she practices in the areas of civil litigation, administrative law and appeals. Prior to joining Pines Bach, she served as a staff attorney for the Dane County Circuit Court.
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