Archive for the ‘Health Care Contracting’ Category

Wisconsin Emergency Order #35 –

Thursday, May 21st, 2020

Tony Evers, Governor of Wisconsin, and Wisconsin Department of Health Services Secretary-designee Andrea Palm have issued another emergency order, Emergency Order #35 (Order #35), directed at suspending certain administrative rules in an attempt to remove unnecessary impediments to the fight against the virus.

A major focus of Order #35 is assuring that Medicaid members retain their coverage eligibility during the COVID-19 pandemic. This provision was required under the Families First Coronavirus Response Act as a condition of eligibility to receive federal funding. Order #35 contains provisions expanding the availability of telehealth in the mental health and substance abuse areas. The order also suspends the requirement that certain mental health and substance abuse services be provided only in a face-to-face setting. This is just one of the many ways in which telehealth received a “shot in the arm” from the pandemic.

A few additional areas touched in Order #35 include:

Temporarily permitting nurses to bill Medicaid for overtime.
Suspension of certain prior authorization requirements, number of refill limitations, and prescription duration limitations.

Waiver of the requirement for parents to make certain payments for the “Birth to 3” program which provides early intervention services for children with developmental delays and disabilities.

Permits supervision of occupational therapists by electronic means in situations where close supervision is required.

Removes the requirement for health departments to conduct a community health assessment resulting in a community health improvement plan at least every five years. The “five-year” requirement is removed but the general obligation remains.

Revises DHS 34.02 (8) relating to emergency mental health services. Reference is directed toward prioritization of services in cases where the need for services outweighs resources.

Extends the time from three months to six months for newly hired mental health training staff who have less than six months experience to complete their 40 hours of documented orientation training.

Makes it easier for volunteers to meet their 40 hour training requirement. Instead of requiring all 40 hours of training be completed before commencing direct client work, trainees must now complete eight hours before starting. Ten additional hours must be completed by the end of the first and second months of volunteer work. The 40 hours of training must be completed within three months of starting volunteer work.

Deleted the minimum staffing requirements for outpatient mental health clinics under Wis. Admin. Code DHS 35. The general requirement the clinic have “a sufficient number of qualified staff members available to provide outpatient mental health services to consumers admitted to care” remains. The two specific options for meeting the minimum staffing responsibility have been removed. Previously, clinics could meet their staffing requirement by meeting any of the three specific staffing scenarios included in the regulation.

This is unlikely to be the last set of waivers issued. Providers who feel they might be restricted by state or federal regulatory requirements during the pandemic should communicate with the regulatory bodies. Federal and state regulators have been sensitive to the needs of providers that are necessary to enable them to address the unprecedented needs created by the COVID-19 virus.

I’ve recapped the highlights, the full Order #35 can be found here.

Health Care Lawyers In Wisconsin

Tuesday, April 8th, 2014

By John Fisher, JD, CHC, CCEP



Read more here: Health Law Blog


Wisconsin Healthcare Attorneys Employment Contracting Issues

Tuesday, December 18th, 2012

Wisconsin Health Care Employment Contract Attorneys

Physicians who are contemplating joining a medical practice or health system need to carefully consider the terms of their employment agreement. Likewise, physician groups need to carefully plan the structure of the relationship between the various members of the group.  In each case, a carefully considered employment agreement is one of the primary components.  The physician employment contract will normally outline the general terms of the physician’s duties, payment of base and bonus compensation, scheduling issues, call coverage requirements, restrictive covenants, and a variety of other issues.  An appropriately crafted employment contract will help define the relationship and set the expectations going forward.  This will help reduce the chance that disputes will arise between the parties due to differing expectations.

We are Wisconsin attorneys who have significant background in health care and other legal issues involved in negotiating, drafting and assisting providers in a variety of healthcare contracting issues.  Health care contracts raise a variety of Federal and state regulatory issues and it is crucial that the attorney assisting in these matters understands the impact of these laws. Failure to comply with Federal laws, such as the Stark Law, can lead to regulatory violations and related penalties.  Wisconsin has unique laws that are applicable to a number of issues such as the enforceability of restrictive covenants.  Wisconsin law issues can create a minefield of potential errors that can be created by providers who attempts to create their own agreement or attorneys who are not up to speed on the application of these laws to physician contracts in Wisconsin.

We have prepared and advised both employees and employers with respect to health care employment and related agreements covering a wide range of provider types and employment scenarios.  Just some of these areas include:

Group Contracts with new hire physicians
Partnership and shareholder agreements and compensation structures
Health care system employment agreements
Hospital-based physician agreements
Medical director and administrative agreements
Production-based compensation agreements
Hospital service line management agreements
Integrated physician group agreements
Practice mergers
Executive employment agreements
Group practice structure
Part-time employment agreements

We also assist physicians and groups in connection with practice separations.  We can analyze employment and other relevant agreements to determine whether a physician who wishes to leave a group or a health care system can do so without restriction.  We can also negotiate the terms of departure.  We also routinuely assist provider groups in issues involving the departure of employed physicians and other providers including enforcement of restrictive covenants and other issues that arise upon termination.

If you require assistance from a Wisconsin attorney in connection with any health care related matter, feel free to contact a member of our health care industry focus group.