Health Care Service Health Care Service Provider Advisory Provider Advisory

CommitteeCommittee

Frances Huntley – CooperFrances Huntley – Cooper

Administrator of Worker’s Compensation Administrator of Worker’s Compensation DivisionDivision

June 23, 2006

History of this CommitteeHistory of this Committee

Created under rule: 81.00Created under rule: 81.00 Advises:Advises: Department of Workforce Department of Workforce

Development Development andand Worker’s Compensation Advisory Worker’s Compensation Advisory

CouncilCouncil Supervises any modifications of Supervises any modifications of

Treatment GuidelinesTreatment Guidelines

AppointmentsAppointments

Health Care Service Providers Health Care Service Providers Committee:Committee:• Consensus list of twenty four (24) Consensus list of twenty four (24)

namesnames Wisconsin Medical SocietyWisconsin Medical Society

• (Russ Leonard)(Russ Leonard) Wisconsin Chiropractic AssociationWisconsin Chiropractic Association

• (Laura Leitch)(Laura Leitch) Wisconsin Hospital AssociationWisconsin Hospital Association

• (Mark Grapetine)(Mark Grapetine)

Structure of the CommitteeStructure of the Committee

Chair - Administrator of Worker’s Chair - Administrator of Worker’s Compensation (WC) Compensation (WC)

Total of 14 MembersTotal of 14 Members License and Practice in WisconsinLicense and Practice in Wisconsin Providers of medical treatment to Providers of medical treatment to

Worker’s CompensationWorker’s Compensation

Representation of Committee Representation of Committee MembersMembers

12 Members comprised of:12 Members comprised of:• Six (6) medical doctors of different Six (6) medical doctors of different

specialtiesspecialties• Two (2) chiropractorsTwo (2) chiropractors• Two (2) hospital representativesTwo (2) hospital representatives• One (1) registered nurseOne (1) registered nurse• One (1) physical therapistOne (1) physical therapist

Members At-LargeMembers At-Large

Two individuals selected by:Two individuals selected by:• Department of Workforce Development Department of Workforce Development

(Worker’s Compensation Administrator)(Worker’s Compensation Administrator) License and Practice in WisconsinLicense and Practice in Wisconsin

Committee Primary Duties:Committee Primary Duties:

Review Rule: 81.00 (Handout)Review Rule: 81.00 (Handout) Update guidelines to include:Update guidelines to include:

• ““New Procedures”New Procedures”• ““Treatment Options” for injuries Treatment Options” for injuries

classified within the initial guidelineclassified within the initial guideline ““Expanding” the guidelines to cover Expanding” the guidelines to cover

new classes of injuriesnew classes of injuries ““Clarifying” the intent and Clarifying” the intent and

description of the guidelinesdescription of the guidelines

Worker’s Compensation Worker’s Compensation “Agreed Upon” Bill - (SB 474)“Agreed Upon” Bill - (SB 474)

2005 WIS ACT 1722005 WIS ACT 172

Introduced in Senate 12/13/05Introduced in Senate 12/13/05 Passed in Senate 2/25/06Passed in Senate 2/25/06 Passed in Assembly 3/9/06Passed in Assembly 3/9/06 Governor Doyle signed bill 3/21/06Governor Doyle signed bill 3/21/06 Effective 4/1/06Effective 4/1/06

Rules vs. StatutesRules vs. Statutes

State Constitution grants Legislature State Constitution grants Legislature power to enact lawspower to enact laws

Legislature delegates to state Legislature delegates to state agencies (DWD) authority to agencies (DWD) authority to promulgate administrative rulespromulgate administrative rules

Rule implement or interpret statutory Rule implement or interpret statutory provisionprovision

Rule created HCPA committee and Rule created HCPA committee and GuidelinesGuidelines

Administrative RuleAdministrative Rule

Requires Legislative review prior to Requires Legislative review prior to promulgation (adoption)promulgation (adoption)

Allows for monitoring by elected Allows for monitoring by elected officialsofficials

Allows for legislatures & DWD to Allows for legislatures & DWD to work together and resolve issues work together and resolve issues

DWD holds Public HearingsDWD holds Public Hearings

DWD has authority to enact and DWD has authority to enact and revise rulerevise rule

Some rules maybe too controversial Some rules maybe too controversial to be included in lawto be included in law

Allows agency experts the task of Allows agency experts the task of regulating highly technical fields (i.e. regulating highly technical fields (i.e. Heath Care Provider Advisory Heath Care Provider Advisory committee guidelines)committee guidelines)

Allows for quicker response to Allows for quicker response to problems or emergency situationsproblems or emergency situations

Where Are We Now?Where Are We Now?

Rule will be submittedRule will be submitted Amendments or RevisionsAmendments or Revisions Consensus by HCPA committee for Consensus by HCPA committee for

minor revisionsminor revisions Worker’s Compensation Advisory Worker’s Compensation Advisory

Council approval (August 16)Council approval (August 16)

Amendments or RevisionsAmendments or Revisions

Minor ones with committee Minor ones with committee agreement may be considered agreement may be considered

WCAC reviews changesWCAC reviews changes

Worker’s Compensation Advisory Worker’s Compensation Advisory CommitteeCommittee

Respects the committee’s expertiseRespects the committee’s expertise

Will take action based on committee Will take action based on committee work and recommendationswork and recommendations

Thanks for lending your expertise Thanks for lending your expertise and taking on this important task!and taking on this important task!

Questions?Questions?