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Health Care Provider Advisory Committee
Minutes for August 4, 2006
Crowne Plaza
Madison WI.

Present: David Bryce MD, Mary Jo Capodice DO, Eric Carlsen MD, Amanda Gilliland, Frances Huntley-Cooper, Maja Jurisic MD, Mike Lischak MD, Jeff Lyne DC, Jennifer Pollak, Peter Schubbe DC, Sri Vasudevan MD, Timothy Waldoch

Excused: Gina Buono MD, Barbara Janusiak RN, Steven Kirkhorn MD

Staff present: Jim O'Malley, Mike Topp

Observers: Margie LaBarge, RN-Ministry Health Care; Ron Kuehn-WI Biotech & Medical Device Assoc, Jordan Lamb-WI Biotech & Medical Device Assoc, Laura Leitch-WI Hospital Assoc, and Ed Ballweg-Medtronic

10:17 am meeting called to order by Chair Frances Huntley Cooper

Quorum is met with 12 in attendance.

Members of the committee went around the room and introduced themselves.

Motion to approve the meeting minutes for June 23, 2006 by Jeff Lyne
Seconded by Jennifer Pollak
Motion carried with one correction (Waldoch)

Mike Topp presented an overview of the necessity of treatment dispute resolution request process. (Handout was provided)

Maja Jurisic presented information regarding MetaStar. (Handout was provided)

Jim O'Malley reviewed the drafting conventions used for administrative rules in Wisconsin.

Rule 81.00 discussion

1. Moved by David Bryce for 81.14(2)(b) to read: “Updating the guidelines every 4 years to include new modalities of treatment, procedures and treatment options for classes of injuries included in the initial guidelines.”
   Second by Mike Lischak
   Motion carried.
2. Moved by David Bryce to replace in 81.03(10) “to cure and relieve” with “to cure or significantly relieve”
   Second by Mike Lischak
   4 ayes/ 7 nays/1 abstention (Frances Huntley-Cooper)
   Motion failed
3. Moved by Mike Lischak to replace in 81.03(10) “cure and relieve” with “cure or relieve”
   Second by David Bryce
   11 ayes/1 abstention (Eric Carlsen)
   Motion carried
4. Moved by Mike Lischak that “the guidelines in DWD 81” only cover current version of ICD (International Classification of Disease).
   Second by David Bryce.
   Motion carried
5. Chronic pain syndrome is not an accepted diagnosis. Mary Jo Capodice will scan the rule to assure it is aligned with current International Classification of Diseases (ICD) coding.
   
   Break
    
6. Moved by Eric Carlsen to change areas in 81.05(2)(b) and (d) referring to MRI scanning and CT scanning “not necessary in the first eight weeks after an injury” to “not necessary in the first four weeks after an injury”.
   Second by David Bryce
   Motion carried
7. 81.05(2)(h) Delete “Gadolinium”
   Unanimous consent
8. 81.05(2)(i)(1)(d) Change “Lumbar fusion surgery is being considered as a therapy.” to “Lumbar fusion surgery, or other surgical procedures, are being considered as a therapy.” (David Bryce)
   Unanimous consent
9. 81.05(2)(j) Rewrite as “A health care provider may order a discographic CT when it is necessary to view the morphology of the disc.”(David Bryce)
   Unanimous consent
10. Delete 81.05(2)(j)(1).
    Unanimous consent
11. Delete 81.05(2)(j)(2).
    Unanimous consent
12. 81.09(11)(b)(6) Rewrite as “If surgery is indicated, it may be performed after initial non-surgical management fails.” (Mary Jo Capodice)
    Motion carried with one “No” vote by Eric Carlsen
    Unanimous consent
13. 81.12(3)(b) Delete “or Maquet procedure” and therefore will read “Patella tendon realignment” (Mary Jo Capodice)
    Unanimous consent
14. Moved by Sri Vasudevan to rename 81.10 to “Complex regional pain syndrome”.
    Second by Eric Carlsen
    Motion carried
    
    Use AMA definition or AMA guidelines related to complex regional pain syndrome was tabled until membership can review AMA guideline/definition.
    
    Agenda item #9, Guideline information dissemination deleted per requester Jeff Lyne
15. 81.06(10), 81.07(10), 81.08(10), 81.09(10) to be titled, “Medication Management.”
    Unanimous consent
16. 81.06(10)(a), 81.07(10)(a), 81.08(10)(a), 81.09(10)(a), to read, “Prescription of controlled substance medications under ch. 450, Stats., including without limitation, opiods and narcotics, are indicated primarily for the treatment of severe acute pain. These medications are not recommended in the treatment of patients with persistent regional low back pain. (Applies as referenced throughout the rule.)
    Unanimous consent
17. 81.06(1) Rewrite as “DIAGNOSTIC PROCEDURES FOR THE EVALUATION OF LOW BACK PAIN.” (Mike Lischak)
    Unanimous consent
18. 81.06(1)(f) 3rd sentence to read, “Repeat EMG and nerve conduction studies for radicular pain and cauda equine syndrome are not indicated unless a new neurologic symptom or progression of existing finding has developed….” (Mike Lischak)
    Unanimous consent
19. Discussion
    81.04(5) What is a complication?
    What is “accepted standard of practice”?
    No action taken.
20. Discussion
    81.08
    No action taken.

Motion to adjourn – Jennifer Pollak
Second – Mary Jo Capodice
Motion carried
Meeting adjourned at 3:00 pm

NEXT MEETING
September 8, 2006
10:00 am – 3:00 pm
Crowne Plaza
4402 E. Washington Avenue
Madison, WI
 

Posted on September 15, 2006