Governor vetoes WisMed-opposed independent nursing bill

For the second time in two state legislative biennial sessions, Governor Tony Evers has vetoed legislation that would have allowed certain advanced practice nurses to diagnose and treat patients independently. The Wisconsin Medical Society (WisMed) and multiple physician specialty societies strongly opposed the bill, 2023 Senate Bill 145. The Governor took the action today (April 4), as various bills awaiting final action were delivered to the Capitol’s east wing.

The veto follows months of work from Gov. Evers and physician groups to seek a compromise with nursing groups and legislative authors, focusing on ensuring real-world experience, special protections related to complex pain medicine and preventing misleading advertising. Those efforts were unfortunately rebuffed by the bill’s main author, State Senator Patrick Testin (R-Stevens Point) and the Wisconsin Nurses Association, leading to today’s veto.

“We agree with Governor Tony Evers’ decision to veto this APRN legislation,” WisMed President Don Lee, MD said in this statewide press release praising the veto. “The bill the Legislature passed lacked the minimum levels of patient protections we believe are needed for a state to move toward allowing independent nursing health care practice.”

Gov. Evers’ veto statement reflected how the Governor’s office and physician groups viewed the legislation similarly:

“I am vetoing this bill, which received bipartisan opposition in both chambers of the Wisconsin State Legislature, in its entirety,“ the Governor wrote in his veto message “because I object to new licensure and practice standards for APRNs, especially those APRNs practicing independently, that do not provide adequate experience requirements, titling protections, and safeguards for patients who may be treated for chronic pain management.

“I support creating an APRN license and allowing for independent practice of APRNs, and have previously pursued measures to do so that were rejected by the Legislature’s Joint Committee on Finance,” the message continues. “Nevertheless, several concerns I consistently raised throughout this and previous legislative sessions, which could well have been addressed during the legislative process, remain unresolved in the bill before me today.”  

The 2023-24 state legislative calendar provides for a veto review period, where the state legislature can convene to consider attempts to override gubernatorial vetoes, including SB 145. A successful override requires a two-thirds vote of members present in each house; majority Republicans in the State Senate hold 22 of the chamber’s 33 seats, but the GOP holds 64 of 99 seats in the State Assembly – two seats short of what would be needed if all 99 members are present for a veto override session.

Contact WisMed’s Mark Grapentine, JD with any questions.

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Health & Harmony this Friday and Saturday to support community health grants and physician wellness focused CME

WisMed will be holding the Health & Harmony Education Conference this Saturday, April 6 from 8:15 a.m. to 4:30 p.m. with the Foundation Event beginning at 5:00 p.m. on Friday, April 5. The event will focus on physician wellness, click here to view full conference details.

If you are planning to attend the Foundation event, the CME Education Conference is included for free, if you have not yet registered and would like to do so, please email [email protected] to secure your seat.

Plan your weekend for Health & Harmony, the WisMed Annual Event:

• Foundation Fundraising Event - April 5, 5 p.m.
• Medical Education Conference - April 6, 8 a.m.
• Annual Business Meeting - April 6, 12:15 p.m.

Thank you to our sponsors!

Brown County Medical Society

Dane County Medical Society

Dodge County Medical Society

La Crosse County Medical Society

Marathon County Medical Society

Medical Society of Milwaukee County

Waukesha County Medical Society

Western Wisconsin Medical Society

Caroline Krolicki, RN

Doctors David Falk and JoAnne Robbins

Heather Schmidt, DO

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Political perspective

As we head into a very busy (and loud) campaign season, here are some reminders to help you navigate through the noise.

If you have ever given to a political candidate or plan on making political contributions between now and November, please consider doing it through one of two ways.

At the Wisconsin Medical Society, we have two political giving programs:

• WISMedPAC – this state political action committee (PAC) is the perfect opportunity for physicians to contribute to support political leadership committees (which make the world spin ‘round in Madison) without being named or associated with one particular party. The WISMedPAC board decides where PAC funds are spent, ideally in a bipartisan manner to committees and legislators friendly to our agenda.
• WISMedDIRECT – this is a conduit and it’s like having your own political checking account at the Society. YOU control your contributions out of this account. You can give to local, state and federal campaign committees (including presidential). If you want to send a contribution to a certain candidate, just let me know and when I receive solicitations for fundraising events I think you’d be interested in, I’ll reach out to you.

Upcoming fundraising events, at the federal level and hosted by individual WISMedPAC board members, include Congressman Bryan Steil, Senator Tammy Baldwin and Congressman Mark Pocan. If you’re interested in hosting a fundraising event in your area, let me know and I can help you get started for federal candidates and state candidates.

As we always say, in order to advocate for medicine in a meaningful way, we need to be at the table. To be at this table, we need to support candidates that support what’s important to physicians and their patients. YOU can do this by supporting WISMedPAC or WISMedDIRECT.

Heidi Green will be at Health & Harmony, our annual meeting event this weekend so please feel free to stop by the WISMedPAC/DIRECT table on Saturday to learn more about our advocacy efforts. Email Heidi or reach out at 608.358.6116. 

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Social Security for physicians

Social Security is a vital part of retirement income for most Americans, including physicians. But navigating Social Security retirement can be confusing. To make an informed decision requires an understanding of benefits, claiming strategies, spousal and survivor benefits.

Eligibility:

To qualify for Social Security retirement benefits, you must have worked and paid Social Security taxes for at least ten years (forty credits).

Benefits:

The amount of your monthly benefit depends on your average indexed earnings throughout your working career. The Social Security Administration (SSA) uses a formula to calculate your benefit based on your highest 35 years of earnings. Generally, the longer you wait to claim benefits (up to age 70), the higher your monthly payment will be.

Claiming Strategies:

• Full Retirement Age (FRA): This is the age at which you are eligible to receive your full retirement benefit. The FRA is currently between 66 and 67, depending on your year of birth.
• Early Retirement: You can start receiving benefits as early as age 62, but your monthly benefit will be permanently reduced.
• Delayed Retirement: If you wait past your FRA to claim benefits (up to age 70), your benefit will increase each month.

Spousal Benefits:

• Are you married? If you are married to a retiree receiving Social Security benefits, you may be eligible for spousal benefits. These benefits can be up to 50% of your spouse's full retirement benefit if started at your FRA. Starting spousal benefits earlier than FRA results in a reduced amount. However, starting spousal benefits after FRA does not result in an increase.
• Divorced? Even if you are divorced, you may be eligible for spousal benefits if you were married for at least ten years, are currently unmarried and are at least 62 years old.

Survivor Benefits:

• Loss of a spouse? If your spouse dies, you may be entitled to survivor benefits. The amount you receive depends on your age at the time of your spouse's death and whether you have any dependent children.

Choosing the Right Time to Claim:

The best time to claim your benefits depends on your individual circumstances. Consider your retirement savings, health, desired lifestyle and potential spousal or survivor benefits. The SSA offers a retirement benefits planner tool to help you estimate your benefit amount at different claiming ages.

Curious Facts:

• Earning too much: Starting Social Security prior to FRA while still working can result in reduced or no benefits if your income exceeds the retirement earning limit. After FRA, you can work as much as you like and benefits are not withheld due to income.
• Social Security Numbers Weren’t Random: In the past, numbers were issued geographically. Were you born in WI before 2011? The first 3 digits in your Social Security number are probably between 387-399.

Get the Quick Reference:

• Download our 2024 Social Security Retirement Benefits quick reference from.

By understanding your Social Security retirement options, including spousal and survivor benefits, you can make informed decisions to secure your financial future.

For personalized help with your financial plan, please contact Mark Ziety, CFP®, AIF® 608.442.3750. 

Note: This article is for informational purposes only and should not be considered as financial or tax advice. Please consult with a qualified financial advisor or tax professional before making any financial decisions.

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Change Healthcare attack highlights often overlooked cyber insurance coverage

Many health care practices rely on a third party for access to their EMR and for billing. This creates a “contingent” or “dependent” risk. The February 21 cyberattack on Change Healthcare changed the world for many patients and health care providers. The March 14 issue of Medigram included resource links and information on potential payment programs for Part A and Part B providers impacted. For practices and organizations that contracted with Change Healthcare™ to facilitate the electronic transfer of medical documentation and billing for all their insurance claims, revenue stopped, expenses continued and funding programs from Optum and CMS/Medicare have not been comprehensive solutions.

Cyber Insurance programs can provide additional coverage for a scenario like this, but only if the policy includes Business Income or Business Interruption coverage and includes Contingent Business Interruption or Dependent Business Interruption coverage. Without contingent or dependent coverage, your policy would only respond if the cyberattack were on your organization and would not respond if the attack were against a third party upon whom you are dependent. We discussed the importance of comprehensive cyber insurance in the November 2, 2023 issue of Medigram and the Fall 2023 issue of The Antidote.

Important Considerations for Cyber Insurance Coverage:

• Cyber insurance policies do not always include contingent or dependent coverage.
• Cyber coverage included as an add-on to other policies, like a business owners’ package or medical professional liability, typically do not include this coverage.
• Business Interruption or Business Income options are not automatically covered.
• Paying claims for cyber policies is complicated and typically requires forensic information technology and legal review to confirm the breach or attack. This can take weeks or months before any payment will be made.
• Policyholders must provide proof of loss and that the incident in question directly resulted in the policyholder’s loss of income, without regard to whether an event has been widely reported in the news.
• Deductibles and waiting periods will apply.
• Reach out to the insurance carrier as soon as you become aware of an incident, before you hire your own consultants, and respond promptly and completely to their requests for supporting documentation. Your insurer will have specialized relationships at pre-negotiated rates.

If you are concerned about your Contingent or Dependent Risk and wondering if your current cyber insurance policy has coverage, how that coverage works or if you can obtain coverage, contact your WisMed Assure agent or [email protected].

Originally posted in the Antidote  March 30, 2024

Note: This article is for informational purposes only and should not be considered as insurance advice related to your specific policy or situation. Please consult with a qualified insurance advisor or professional before making any policy decisions. Full disclaimer and contact information.

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