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Medigram - February 14, 2008


CONTENTS


TOP STORY

DHFS amends immunization regulations for students

The Wisconsin Department of Health and Family Services (DHFS) filed a final rulemaking order on January 17, 2008 that amends the immunization of students regulations found in Wisconsin Administrative Code Chapter HFS 144.

According to DHFS, the goals of the changes were threefold: (1) to prevent pneumococcal infections, pertussis infections and breakthrough varicella infections among students; (2) to update the rules by deleting obsolete sections and adding clarifying language; (3) and to create a clear requirement for disclosure of immunization information.

DHFS made the following amendments to HFS 144:
  • Pneumococcal infection was added to the list of diseases that students in day care centers are to be immunized against because pneumococcal conjugate vaccine (PCV) has been shown to be highly effective in reducing diseases caused by pnumoccoccus among children less than 5 years old.
  • Tdap was added to HFS 144 Table 144.03-A (Required Immunizations for the 2008-09 School Year and the Following School Years) because the vaccine can be given to adolescents, which DHFS says will prevent pertussis outbreaks in schools and will indirectly protect those too young to be immunized.
  • A second dose of varicella was added to HFS 144 Table 144.03-A because two doses have been shown to be more effective than one in preventing breakthrough cases.
  • Hepatitis B and varicella vaccine coverage phase-in language was removed because the phase-in time periods have passed.
DHFS also made additional changes to HFS 144. One change stated that DHFS may temporarily suspend a vaccine requirement during a vaccine shortage. Another change altered the language regarding the release of immunization information between vaccine providers and schools or day care centers, and among providers, from discretionary to mandatory. This change creates a clear requirement for disclosure. DHFS also revised the definition of “written evidence of immunization” to include electronic records. For a chart of the minimum basic and booster immunizations required under Wisconsin Statute § 252.04, the Wisconsin immunization statute that allows HFS to make the regulations found in Wisconsin Administrative Code Chapter HFS 144, click here. Additional information about the new immunization requirements can be found on the Wisconsin Immunization Program's Web site.

NEWS BRIEFS

Nominees for Society offices

The Wisconsin Medical Society’s House of Delegates Nominating Committee met on October 13, 2007 and selected nominees for the following positions. The Board of Directors, as directed by the Society’s Constitution, selected the candidate for Treasurer at its meeting on February 2, 2008. The slate of candidates will be presented April 11, 2008, at the Annual Meeting in Madison. Click each candidate's name to read his biography.

Candidate for President-Elect 2008-2009
Robert J. Jaeger, MD

Candidate for Treasurer 2008-2009
John Hartman, MD

Candidate for Vice Speaker of the House of Delegates 2009 and 2010
Charles J. Rainey, MD, JD

Candidates for AMA Delegates 2009 and 2010
Clarence P. Chou, MD
Kevin T. Flaherty, MD

Candidate for AMA Alternate Delegate 2009 and 2010
Mahendr S. Kochar, MD


Proposed regulation to enforce Patient Safety Act now available for comment

The proposed regulation to implement and enforce the Patient Safety and Quality Improvement Act of 2005 (Patient Safety Act) was published in the Federal Register Feb. 12 and will be available for comment for 60 days.

The Patient Safety Act establishes a voluntary reporting system designed to enhance the data available to assess and resolve patient safety and health care quality issues. To encourage reporting and analysis of medical errors within health care systems, the Act provides Federal privilege and confidentiality protections for patient safety work product, which includes patient, provider and reporter identifying information that is collected, created or used for patient safety activities. Civil money penalties of up to $10,000 per violation may be imposed for knowing or reckless impermissible disclosures of patient safety work product.

The Department of Health and Human Services Office for Civil Rights (OCR) is responsible for implementing and enforcing the confidentiality protections of the Patient Safety Act. The proposed regulation addresses the listing and operation of patient safety organizations, the privilege and confidentiality protection for patient safety work product, the disclosure permissions for patient safety work product, and the enforcement of the confidentiality protection.

To review the proposed regulation in the Federal Register, click here. You can submit comments through the Regulations.gov web portal or by mail or hand delivery. For more information, visit OCR’s Web site.


Society joins national campaign to discourage teen alcohol abuse

Public service announcements educating the public about teen alcohol abuse are now available, and the Wisconsin Medical Society has joined in the national effort to get the word out.

One ad headline reads: Some Kids are Grounded when Caught with a Drink. Others are Offered Another. The ad goes on to explain that more often than not, adults, sometimes parents, provide the alcohol. The campaign notes that alcohol use may lead to fatal injuries, accidents, sexual assaults and sexual-transmitted diseases.

The answer, according to the campaign which was created by the AMA, lies in taking action. The suggested actions communities can take include reducing alcohol advertising and access, increasing alcohol taxes that haven’t been increased in decades and holding adults accountable for providing teens with alcohol.

The ads are available on the Society’s Web site and can be placed in physician offices. They will also be printed in the Wisconsin Medical Journal. To view or download them, please click here and here.

CAPITOL INSIDER

Reminder: Mental Health Parity Action Day is Feb. 20

Lt. Governor Barbara Lawton is leading efforts to make Mental Health Parity Action Day Wednesday, Feb. 20 a day for employers and workers, health care professionals and advocates, and all citizens to make the case for mental health parity legislation in Wisconsin. Wisconsin is one of only eight states in the nation without mental health parity.

Click here for the full story.


Society testifies on two ‘cost transparency’ bills

The Society led the physician-oriented discussion earlier this week on two bills that would increase physicians’ responsibility to disclose information related to the costs of medical procedures, tests, and the like. Representative Steve Wieckert’s (R-Appleton) Assembly Bill 729 and a Rep.

Click here for the full story.


Congressman Kagen introduces ‘No Discrimination in Health Insurance Act’

US Congressman Steve Kagen, MD, (D-Appleton) introduced today legislation that will ensure citizens have access to affordable health care and end the insurance industry’s practice of denying health coverage due to a pre-existing medical condition.

Click here for the full story.


Update: Statewide smoking ban

For nearly a year the Society has called for legislation banning smoking in all public places as part of the “It’s Time to Breathe Free Wisconsin” coalition. Senate Bill 150 (the “Breathe Free Wisconsin Act”), which would require every workplace in Wisconsin—including bars and restaurants—to become smoke-free, has been supported by team of health organizations, including the Society, business and hospitality groups.

Currently, the coalition is meeting with Senate leadership, who is seeking a compromise between the coalition and the Wisconsin Tavern League. Discussions are ongoing, with the leaders cognizant of the waning session days left to pass a bill.

For more information, contact Jeremy Levin.

FOUNDATION FOCUS

2008 Landis Lecture for patients and physicians

Mood, Depression and Menopause
Presented by David R. Rubinow, MD
Thursday, September 25, 2008
7 – 8:30 p.m.
Monona Terrace Convention Center, Madison

The Wisconsin Medical Society Foundation is pleased to offer a free presentation for patients and physicians through the Charles W. Landis, MD, Memorial Lecture. David R. Rubinow, MD, is the Assad Meymandi Professor and Chair of Psychiatry and Professor of Medicine at the University of North Carolina at Chapel Hill. Prior to assuming these positions, he was the Clinical Director of the NIMH from 1987-2006 and the Chief of the Behavioral Endocrinology Branch, NIMH from 1996-2006.

“Dr. Rubinow is an incredibly gifted and effective teacher, who is able to explain complex medical findings and issues in a way that is easily accessible for the general public,” said Robert Golden, MD, Dean of the UW School of Medicine and Public Health. “He has done pioneering work in the area of mood and hormones. Anyone who is interested in the psychobiology of menopause will find his presentation to be both remarkably interesting and educational.” Dean Golden served on the selection committee for the 2008 lecture.

Dr. Rubinow graduated from the University of Michigan, received his medical degree from the University of Connecticut, and completed an internship and residency at Yale University. In 1979, he began a clinical research fellowship in the Biological Psychiatry Branch at NIMH, in which he later served as Unit Chief and Section Chief. Additionally, from 1982 to 1989, he served as Director of the NIH Psychiatry Consultation-Liaison Service. He currently serves on the editorial boards of six journals and has authored or co-authored more than 300 scientific publications.

The Wisconsin Medical Society Foundation will be printing “save-the-date” brochures with more detailed information about the presentation and Dr. Rubinow. If you would like copies to give to patients or for your waiting room, please click here to complete an order form. The brochures are expected to be available by April 30, and are provided free of charge by the Foundation.

QUALITY CORNER

‘Eating Soup with a Fork’ available now on-line

Donald M. Berwick's National Forum keynote speech, “Eating Soup with a Fork,” is available now through the Institute for Healthcare Improvement’s Web site. In this December 2007 speech, Dr. Berwick examines the role of evidence and the importance of context in promoting improvement. The way ahead, he says, requires both.The 60-minute presentation, which can be viewed on-line at any time, features streaming video of Dr. Berwick’s presentation synchronized with his presentation slides. For more information, or to enroll for this free On Demand presentation click here.

FAQ

Question:
What does “own occupation” mean in regards to disability insurance coverage and why is it important to physicians?

Answer:
In some disability contracts, “own occupation” states that if you cannot perform the material and substantial duties of your occupation/specialty, you may qualify for benefits. For some specialties, the disability benefits will continue even if you are working in another occupation, which is why it is very important to most physicians.

For answers to other Frequently Asked Questions about insurance matters e-mail insurance@wismed.org.