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Health Care Provider Advisory Committee Meeting Minutes January 23, 2015

Aurora Medical Center in Summit

January 23, 2015

Present: Mary Jo Capodice, DO; Amanda Gilliland; Richard Goldberg, MD; Michael Lischak, MD; Jeff Lyne, DC; John Metcalf (Chair) ; Ron Stark, MD; Sri Vasudevan MD (by teleconference).

Excused: Theodore Gertel, MD; Maja Jurisic, MD; Stephen Klos, MD; Marlin Nelson; Peter Schubbe, DC; Jennifer Seidl

Staff present: Mary Lynn Endter, Ana Lopera; James O'Malley

Observers: Forbes McIntosh, ATI Physical Therapy, and Lynn Steffes, Wisconsin Physical Therapy Association

  1. Call to Order/Introductions: Mr. O'Malley convened the Health Care Provider Advisory Committee(HCPAC) meeting at approximately 10:05 AM in accordance with Wisconsin's open meeting law. Committee members, Worker's Compensation Division Staff and observers introduced themselves.
  2. Acceptance of October 14, 2014 Meeting Minutes: Dr. Lischak moved to approve the minutes of the October 14, 2014 meeting. Dr. Stark seconded the motion. The minutes were unanimously approved without correction.
  3. Future Meeting dates: The members agreed to schedule future meetings on the following dates: May 8, 2015, August 14, 2015, and October 16, 2015.
  4. Unfinished business: Dr. Capodice and Dr. Vasudevan discussed the final draft of the paper Chronic Opioid Clinical Management Guidelines for Wisconsin Worker's Compensation Patient Care. Mr. O'Malley reminded the members they agreed at the last meeting to accept the final draft of the paper with the changes that were approved. The members agreed that all of the approved changes were included in the final draft of the paper.

    Mr. Metcalf advised the next step was to present the paper to the Worker's Compensation Advisory Council (WCAC) at the next meeting on February 10, 2015. Dr. Capodice and Dr. Vasudevan will plan to attend that meeting. Dr. Stark wanted to know how the paper would be disseminated. Mr. Metcalf and Mr. O'Malley said it may be posted on the Worker's Compensation Division (WCD) website, that it could possibly be incorporated into an insurance letter, and that it could be shared by the Wisconsin Medical Society on its website with other interested parties such as the Wisconsin Hospital Association. Dr. Stark suggested the paper be submitted as a medical journal article.

    Dr. Vasudevan gave a brief update on the work being done to reduce prescription drug abuse at the national level with the National Governors Association.

    The members discussed working with the Wisconsin Medical Society to develop a webinar for professional education and development for physicians who treat employees with work-related injuries. After the last HCPAC meeting Dr. Capodice, Mr. Metcalf and Mr. O'Malley participated in a telephone conference call with Nancy Nankivil from the Wisconsin Medical Society where four (4) training modules for physicians were discussed. The modules included training in the worker's compensation law, how to write prescriptions, emphasis on employees returning to work and hurdles associated with this, and permanent partial disability (PPD) assignment and ratings. Dr. Capodice recommended that the training modules could be posted on the Wisconsin Medical Society's website after they are completed for easy access to this information. The Wisconsin Medical Society and the Worker's Compensation Division will continue to work together on developing the training modules and other future education and professional development activities.

    The members of the HCPAC engaged in a discussion on compounding drugs. Dr. Capodice explained the difference between re-packaged and compounding drugs. Compound drugs are frequently mixed into a cream and used for topical applications. Compound drugs are needed for patients who cannot take the drug orally. The cost of compound drugs can be high cost, for example a 30 day supply can cost thousands of dollars per prescription. In Wisconsin the pharmacy fee schedule does not cover compound drugs so the cost of the creams is unregulated. Mr. Metcalf stated that proposed law changes to limit charges for re-packaged drugs were contained in the last Agreed Upon Bill but that it did not pass in the legislature. Dr. Capodice and Dr. Vasudevan will discuss issues associated with re-packaged and compound drugs at the next WCAC meeting.

  5. Proposals for legislative changes to the WCAC from the public: Mr. O'Malley discussed the legislative proposals from the public presented to the WCAC for consideration in the current Agreed Upon Bill. The proposals were listed in a handout that was distributed at the meeting.
  6. Status of updating minimum permanent disability ratings in s. DWD 80.32: Mr. O'Malley discussed the status of the project to update the minimum permanent partial disability (PPD) ratings contained in s. 80.32 of the Wisconsin Administrative Code. The minimum ratings are based on a consensus of responses from physicians who responded to previous questionnaires. The WCAC must approve any changes to the minimum PPD ratings to be included in the Wisconsin Administrative Code. A copy of a previous questionnaire used to survey physicians was distributed. Mr. O'Malley requested assistance from the members in developing and responding to new questionnaires that will be used to update the minimum ratings. There was general agreement that it is more convenient for physicians to respond to questionnaires electronically. Dr. Stark supports this process and pointed out that different doctors are more familiar with different types of disability.
  7. New Business: There was no new business.
  8. Adjournment: The meeting was adjourned at approximately 12:30 p.m.