Health Care Provider Advisory Committee Meeting Minutes

Aurora Medical Center in Summit

May 2, 2014

Present: Mary Jo Capodice DO,  Theodore Gertel, MD; Amanda Gilliland; Barbara Janusiak, RN; James O'Malley (Acting Chairman); Jennifer Seidl PT; Ron Stark, MD; Sri Vasudevan MD. 

Excused:Maja Jurisic, MD; Stephen Klos, MD; Jeff Lyne, DC; Mike Lischak, MD; Marlin Nelson;  Peter Schubbe , DC

Staff present: Janine Smiley; Joy Schmitt

Observers: Kyle O'Brien, Wisconsin Hospital Association Inc.; Forbes McIntosh, ATI Physical Therapy

  1. Call to Order: Mr. O'Malley convened the Health Care Provider Advisory Council(HCPAC) meeting  at approximately 10:10 AM in accordance with Wisconsin’s open meeting law.  HCPAC members, Worker's Compensation staff and observers present at the meeting introduced themselves.

  2. Acceptance of  October 29,2012; May11, 2012; October 11, 2013 and January 31, 2014 Meeting Minutes:  A quorum of the HCPAC was not present at these earlier meetings and  minutes  were not  approved. Ms. Seidl suggested corrections in the minutes of the meetings held on May 11, 2012 and January 31, 2014. The correction for the minutes of the meeting on May 11, 2012 was that Ms. Seidl's name was misstated. In the minutes for the meeting held on January 31, 2014 her name was misspelled. The minutes for all of these previous meetings, as corrected, were unanimously approved

  3. Summary of Necessity of Treatment Disputes: Mr. O'Malley distributed a handout and discussed the top 10 most disputed CPT codes submitted to the Department for resolution of necessity of treatment disputes.

  4. WCAC "Agreed Upon Bill": Mr. O'Malley discussed the proposed statutory changes to ch. 102, Stats, included in the Worker's Compensation Advisory Council's (WCAC) "Agreed Upon Bill" for 2014 related to health care services provided to injured employees. These proposals included the Department maintaining a medical expert on staff, limiting charges for dispensing repackaged drugs, the establishment of a committee to evaluate treatment outcomes and a medical fee schedule. Mr. O'Malley summarized the legislative course of the bill and the outcome. The bill was not adopted by the legislature. The WCAC may submit another bill to the legislature later in the year

  5. Unfinished Business: Ms. Seidl proposed a change to the functional capacity assessment/evaluation language in s. DWD 81.06(1) (k) 4 of the Wisconsin Administrative Code to reflect the difference between functional capacity assessments and functional capacity evaluations. The proposal will be redrafted and put forward for a motion for the HCPAC to adopt at the next meeting.

    Mr. O'Malley advised there are other provisions in the treatment guidelines that cover functional capacity assessment/evaluation. Section DWD 81.06 (1) (k) of the Wisconsin Administrative Code applies to low back pain. Section DWD 81.07 (1) (k) of the Wisconsin Administrative Code applies to neck pain, s. DWD 81.08 (1) (k) of the Wisconsin Administrative Code applies to thoracic back pain and s. DWD 81.09 (1) (k) of the Wisconsin Administrative Code applies to the upper extremities.

    Dr. Vasudevan discussed the paper "Chronic Opioid Clinical Management Guidelines" by Dr. Scott Hardin from Aurora Health Care. Dr. Vasudevan reviewed his proposed changes to the paper by adding the five (5) "A"s and the four (4) "C"s. These will be incorporated into the paper and after the paper is redrafted put forward for a motion for the HCPAC to adopt at the next meeting. The Department may possibly post information from this paper on the DWD website.

  6. Review of Chapter DWD 81, Wis. Admin. Code: Mr. O'Malley reviewed the purpose of the HCPAC which was formed pursuant to s.102.16 (2m) (g), Stats. The mission of the HCPAC as stated in s. DWD 81.14 (2) of the Wisconsin Administrative Code is to clarify the description of the treatment guidelines; update the guidelines at least every four (4) years to include new modalities of treatment, procedures and treatment options for classes of injuries included in the guidelines; and expanding the guidelines to cover new types and classes of injuries.

    The purpose for the treatment guidelines in Chapter DWD 81 of the Wisconsin Administrative Code is to provide factors for an impartial health services review organization or a member from an independent panel of experts established by the Department to consider in rendering opinions to resolve necessity of treatment disputes arising under s. 102.16 (2m), Stats., and s. DWD 80.73 of the Wisconsin Administrative Code. Mr. O'Malley briefly discussed the content and organization of the treatment guidelines

  7. New Business: There was a suggestion that additional training should be provided to practitioners about how to rate permanent disability and that such training could possibly be offered through the Medical Society of Wisconsin. Likewise, the Medical Society of Wisconsin may be able to offer tools for practitioners to help determine causation issues.

    Another possible topic for future meetings is prescription drug issues including dispensing, compounding, and re-packaging.

    The Department has also started an internal project to review and revise the minimum permanent partial disability (PPD) ratings set forth in s. DWD 80.32 of the Administrative Code. There was a discussion and consensus of the HCPAC that collecting and analyzing PPD data for specific procedures might be helpful.

  8. Adjournment: The meeting was adjourned at  12:55 pm. The next meeting is scheduled to be held on July 23, 2014.

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