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Health Care Provider Advisory Committee
Meeting Minutes for February 19, 2010
Crowne Plaza
Madison WI 

Present:  Gina Buono MD,  Mary Jo Capodice DO,  Frances Huntley-Cooper,  Amanda Gilliland,  Barbara Janusiak,  Maja Jurisic MD,  Mike Lischak MD,  Jeff Lyne DC,  Peter Schubbe DC,  Jennifer Siedl,  Ron Stark MD, and Sri Vasudevan MD

Excused:  Gina Buono MD,  Mary Jo Capodice DO,  Frances Huntley-Cooper,  Amanda Gilliland,  Barbara Janusiak,  Maja Jurisic MD,  Mike Lischak MD,  Jeff Lyne DC,  Peter Schubbe DC,  Jennifer Siedl,  Ron Stark MD, and Sri Vasudevan MD

Staff present:  Joy Schmitt and Jim O'Malley

Observers:  Erin Sexton

1. Call to Order:  The Health Care Provider Advisory Committee (HCPAC) was called to order by Frances Huntley-Cooper at approximately 10:15 AM in accordance with Wisconsin’s open meetings law.   Members of the HCPAC, an observer present at the meeting and Department staff introduced themselves. 
   
   
2. Approval of Minutes:  The minutes of the October 16, 2009 meeting were unanimously approved without correction.
   
   
3. Treatment Guidelines Clarification and Update:  Jim O’Malley gave an update on the purpose of the treatment guidelines to be used as factors for an impartial health care services review organization and members from an independent panel of experts established by the Department to consider in rendering opinions to resolve necessity of treatment disputes.
   
   Ron Stark discussed the treatment guidelines as they relate to upper extremity surgery.  Evidence based guidelines are better than consensus based guidelines.  There was a discussion covering the five (5) levels for evidence based guidelines.  Upper extremity guidelines are in their infancy so it is important to be careful of what is codified.  The current guidelines on upper extremity disorders are not believed to be an impediment on treatment.
   
   Maja Jurisic distributed the paper, Low Back Pain and Best Practice Care.
   
 
4. Unfinished Business:  The two (2) papers Mike Lischak distributed at the last meeting were discussed, Diagnosis and Treatment of Low Back Pain and Imaging Guidelines for Low Back Pain Secondary to Work Injury.  The later paper was endorsed by the State Medical Society. The house of medicine is divided and not all agree on guidelines.  A number of specialties have issues with ACOEM guidelines and there is no evidence that that evidence based guidelines improve the quality of care.
   
   Only one (1) difference was noticed comparing the content of these papers and DWD 81.05 covering guidelines for medical imaging.  The recommendation for MRIs to not be performed for non-specific low back pain without spinal nerve involvement was changed from six (6) weeks to four (4) weeks after an injury in DWD 80.05 (2) (c) and (e).  The policy of the Wisconsin Medical Society is contained in this paper.
   
   After a discussion about adopting  Imaging Guidelines for Low Back Pain Secondary to Work Injury as the treatment guideline to replace DWD 81.05 (2) Jim O’Malley was requested to research whether a paper or article of this nature could be adopted as an administrative rule.
   
   A motion to combine and accept  Imaging Guidelines for Low Back Pain Secondary to Work Injury as a replacement to the current treatment guidelines in DWD 81.05 (2) did not pass.

 
5. Section for Lower Back Pain:   Maja Jurisic sent  A Practical Guide to Workers’ Compensation and Return-to-Work for Clinicians to the HCPAC before the meeting.  This paper was discussed.  This is a proactive guide for clinicians to use who work with injured employees.  Information for the paper was obtained from the State of Washington.  This is on Concentra’s website.
   
   A motion to support A Practical Guide to Workers’ Compensation and Return-to-Work for Clinicians and that this be made available to as many people as possible passed.  This could be made available on the Worker's Compensation Division’s website.
   
   
6. Future Meeting:  The next meeting will be scheduled on August 20, 2010.  The HCPAC will review the Worker’s Compensation Division’s publications and forms related to physicians at the next meeting.  
   
   
7. Adjournment:  The meeting was adjourned approximately at 3:00 PM.