In the weeks following the Nov. 8 general election, which saw Republicans increase their majorities in both the state Senate and Assembly, all four partisan caucuses met to elect their leadership teams for the 2023-24 legislative session. Please find below an overview of the leadership elections:
Senate GOP:
There were not many changes in the Senate GOP Caucus. There entire leadership team stayed intact, except Sen. Joan Ballweg replaced retiring Sen. Kathy Bernier as Majority Caucus Vice-Chair.
Assembly GOP:
There was more of a shakeup in the Assembly Republican Caucus, as the retirement of former Assembly Majority Leader Jim Steinke caused a chain reaction, with Rep. Tyler August moving up from Speaker Pro Tempore to Majority Leader, and Rep. Keven Petersen moving up from Assistant Majority Leader to Speaker Pro Tempore. New leadership members filled the positions of Assistant Majority Leader, Caucus Chair, and Caucus Sergeant at Arms.
Senate DEM:
Assembly DEM:
As an ophthalmologist and member of WAO, your role in advocacy – both in the halls of Congress and at the State Capitol – is essential to our success in shaping public policies that improve the delivery of medical eye care. No one is better positioned than you and your colleagues to educate legislators and regulators on issues important to the WAO and Wisconsin’s physician community.
Thankfully, being an effective advocate can be quick and easy with the support of the WAO and our national partners. When it comes to advocating on federal issues, the American Academy of Ophthalmology’s legislative call to action page enables you to contact your Members of Congress on issues of importance to the practice of ophthalmology. And it only takes a few moments of your time!
Please take advantage of this important AAO advocacy tool to urge Congress to support the following key federal legislative proposals currently being considered in Washington:
· Help Us Fight Medicare Cuts that Threaten Seniors' Access to Surgical and Other Physician Services
It is urgent that Congress stop the nearly 8.5% Medicare payment cuts that physicians are facing for 2023 and work with the physician community to develop long-term solutions to the systemic problems with the Medicare physician payment system.
If you haven’t already, please act on this important issue TODAY! Simply CLICK HERE to contact your Members of Congress and urge them to support this important legislation.
· Reduce Prior Authorization Burdens
Physicians are reporting that Medicaid Advantage plans have imposed increasingly onerous prior authorization requirements for medical services and procedures. These requirements can delay or prevent access to necessary medical care and can be particularly burdensome on physician practices. Congress can help relieve prior authorization burdens on physicians and their patients by passing the Improving Seniors’ Timely Access to Care Act.
Nov. 17, 2022
While Congress focuses on end-of-year priorities during its lame duck final weeks of 2022, we are working to keep legislators’ attention on our top two priorities: 1.) Relief from scheduled 2023 Medicare physician payment cuts; and 2.) Senate passage of the much-needed prior authorization reform bill that cleared the House in September.
Since government funding expires Dec. 16, legislators will need to craft a year-end appropriations package over the next few weeks. The Academy is pushing to get our priorities into that package.
Here is where things stand with each proposal:
The Academy and the Surgical Care Coalition are pressing legislators to address the nearly 8.5% Medicare payment cuts that start Jan. 1. Congress has until the end of the year to act. We are urging Congress to do three things:
The Academy is also pushing for the inclusion of our prior authorization reform bill in the year-end package. The Improving Seniors’ Timely Access to Care Act passed the House in September. It would reform prior authorizations in Medicare Advantage and has strong bipartisan support in the Senate. If Congress enacts it this year, the year-end package is the most likely legislative vehicle to do so.
However, some Senators have balked at the latest Congressional Budget Office estimate of the $16 billion cost. The Academy doesn’t think this estimate accurately captures what the bill’s implementation would cost. We’re working with legislative champions to identify actions that could substantially reduce the bill’s projected cost. Such changes would improve its chances of inclusion in a year-end package.
Consistent and focused advocacy is critical to the long-term viability of ophthalmology and the delivery of quality medical eye care in Wisconsin. And the WAO is an active force in Madison working on issues of importance to WAO members that impact the practice ophthalmology. Our comprehensive advocacy program aims to:
1. Strengthen the image of the practice of ophthalmology and educate policymakers on the importance of medical eye care; and
2. Provide public policy leadership to enhance the practice of ophthalmology and ensure high standards for medical eye care are maintained in Wisconsin.
Of course, our most effective advocacy efforts actively engage WAO members in their strategy and execution – aiming to capitalize on the expertise of our physician members.
Member participation in WAO’s advocacy programs is increasingly important, as we are likely to face two highly concerning legislative battles in the 2023-24 legislative session. Nursing special interests will almost certainly reintroduce their “APRN bill” – a proposal to create a new advanced practice nurse practitioner (APRN) license and authorize APRNs to prescribe medication and generally practice an expanded scope of care without direct physician supervision. A similar proposal introduced last session ignored the need for critical title protection for physicians.
In addition, we anticipate Wisconsin optometrists will pursue legislation to expand their permissible scope of services, as they have in several other states. In fact, there are now ten states – with Virginia and Colorado being the latest—that have expanded their optometric scope of practice laws to specifically include certain office-based laser procedures for glaucoma and post-cataract care. Again, it would not be surprising if an optometrist scope of practice battle hits the Badger State as early as the 2023-24 legislative session.
Thankfully, WAO is well-positioned act on these issues. In addition to our direct lobbying efforts thorough our professional lobbying form (HZW), we have several advocacy programs in place – that draw on the collective grassroots voice of WAO members – to influence public policy at every level of government. If are not already involved, WAO encourages you to participate in the following three programs to strengthen our influence in the Wisconsin Legislature and ultimately help us meet our legislative/regulatory goals:
Sign-up for WAO’s Legislative Key Contact Program
WAO’s Legislative Key Contact Program can be a highly effective grassroots advocacy tool to help build and nurture strong on-going relationships between WAO members and lawmakers in Wisconsin. Ultimately, the program can help us help shape new policies important to our members.
The program is live on the WAO website and members can easily and quickly sign-up as a Key Contact. With the campaign season winding down, and the 2023-24 legislative session right around the corner, it’s more important than ever for WAO to have a robust Key Contact Program. It is essential to raising our profile in the State Capitol and beyond.
As a Key Contact, you can help influence the legislative process by cultivating relationships with elected officials. By taking advantage of existing relationships and making new contact with members of the Wisconsin Legislature (as well as the Wisconsin Congressional Delegation), you can help us educate lawmakers on the practice of ophthalmology and ultimately influence legislation.
But the program will not succeed without strong member participation, so please take a few moments to read more about it – and learn how simple it is to “enlist” and participate as a Key Contact. The time commitment is minimal and your responsibility as a key contact depends on your level of comfort and willingness to engage.
Remember, lawmakers are often eager to hear input from their constituents, and as an expert in the home health care field, you can make a real difference in the policy process as a Key Contact. CLICK HERE to sign-up by filling out and submitting a brief online survey.
Participate in the WAO Capitol Connection Program
In WAO’s ongoing effort to raise the profile of ophthalmology and our organization in the State Capitol, we have established our Capitol Connection program to encourage WAO members to invite their local legislators to visit their clinics and facilities.
The program is designed to help WAO members build and strengthen working relationships with legislators and offers a unique face-to-face opportunity to educate them about the importance of ophthalmology and medical eye care. Through the Capitol Connection program, lawmakers can learn firsthand what is important to the ophthalmology community. In many cases, just a single meeting or contact can have a significant impact on a legislator's view or position on a legislative issue.
With potential scope of practice legislative battles on the horizon, it’s more important than ever for WAO members to connect with their state lawmakers to discuss the critical role of ophthalmology, as well as the level of education, training, and knowledge required of ophthalmologists.
To date, we have held multiple successful legislative tours and have several more being planned for the near future. Hosting a legislator at your site is easy, enjoyable, and can make a significant advocacy impact, so we would encourage all WAO members to participate in this highly effective advocacy program.
If you would like to host a legislative tour at your site, please contact the WAO office at wao@badgerbay.co. We will work with you and your legislators to coordinate the meetings and will provide participating members with full support, including legislator bios, advocacy tips, issue briefings, and supporting documents.
Contribute to the WAO Political Action Committee
The Wisconsin Academy of Ophthalmology is committed to offering a wide collection of member services and programing. That includes a comprehensive government affairs program that provides direct lobbying services and grassroots advocacy strategies to increase WAO’s presence in the State Capitol and help shape policy decisions that preserve and enhance the practice of ophthalmology in Wisconsin.
One of the most effective advocacy tools the WAO has as its disposal is the Ophthalmologists for Better Government Political Action Committee (PAC). The PAC allows WAO to collect contributions from members into a single account to support candidates for state legislative office who understand and support issues important to ophthalmologists, the practice of ophthalmology, and Wisconsin’s House of Medicine.
Contributing to our PAC is more important than ever, as optometrists have been successful in expanding their permissible scope of services in several other states – and the debate is heating up in other parts of the country. Wisconsin could very likely be next… and an optometrist scope of practice battle may hit the Badger State as early as the 2023-24 legislative session.
The best way we can win these legislative battles is to significantly enhance our legislative advocacy outreach, and having a robust, well-funded PAC is critical to our efforts. With strong member participation in the Ophthalmologists for Better Government PAC, we will be well positioned to preserve the Ophthalmology scope of practice in Wisconsin.
As mentioned above, the WAO PAC is funded through contributions from ophthalmologists across the state and is only effective as a political tool if members participate in the program. With that in mind, please take a few moments and contribute online TODAY to the Ophthalmologists for Better Government PAC. Every dollar helps, as the risk of non-involvement in the political process is getting too high to ignore.
Voting is a cornerstone of American democracy and gives citizens a voice in choosing the elected officials whose decisions impact us, not only personally, but often professionally for those who work in highly regulated industries. With that in mind, take a few minutes to educate yourself on what you need to know to cast your vote on Election Day – Tuesday, November 8th.
The latest Marquette University Law School Poll, which was conducted October 3-9 and released on October 12 shows incumbent Tony Evers (D) and Tim Michels (R) in an extremely close race for governor. It also shows incumbent Sen. Ron Johnson (R) leading Democratic challenger and current Wisconsin Lt. Governor Mandela Barnes in the contest for U.S. Senate. Please find below highlights of the poll:
Wisconsin Governor’s Race:
· Wisconsin Voters’ Preference for Governor (among likely voters):
Governor Tony Evers (Democrat) – 47% Tim Michels (Republicans) – 46% Joan Beglinger (Independent) – 4% (Beglinger has dropped out of the race but will remain on the ballot) Other – 3%
In the September poll, Evers received 47%, Michels 44%, and Beglinger 5%.
· Evers Favorability:
· Michels Favorability:
Wisconsin U.S. Senate Race:
· Wisconsin Voters’ Preference for U.S. Senate (among likely voters):
In the September poll, Johnson received 49% and Barnes 48%
· Barnes Favorability:
· Johnson Favorability:
CLICK HERE to read the complete results from the latest Marquette University Poll.
Last week, US Department of Health & Human Services (HHS) Secretary Xavier Becerra announced the renewal of the public health emergency (PHE) due to the ongoing COVID-19 pandemic. The PHE was originally declared on January 31, 2020 and has been renewed continuously since then. Renewal of the PHE keeps a number of important waivers and flexibilities active. The current PHE declaration will last 90 days from its effective date of October 13, 2022.
Concerned that a recent change to the Veteran’ Health Administration’s Community Care Program guidelines lowers the standard of eye care for the nation’s veterans, a group of U.S. House of Representatives members and a senator has sent a letter to the agency demanding answers.
The letter was led by Rep. Mariannette Miller-Meeks, MD, R-Iowa, an ophthalmologist and a veteran, and signed by four other physician members of Congress. It was delivered to the VA Under Secretary for Health Shereef Elnahal, MD, MBA, on Oct. 18, 2022.
Their action comes after the VA’s action to remove language from the Community Care “Standardized Episode of Care: Eye Care Comprehensive” guideline that has historically provided that “only ophthalmologists can perform invasive procedures, including injections, lasers and eye surgery.”
The Academy shares lawmakers’ concern that “by removing this standard, even if the VA intends to defer to state licensure and scope of practice law, the VA is creating confusion by implying that someone other than an ophthalmologist — e.g., an optometrist — can perform invasive eye surgery.”
In their letter, the members of Congress are asking the VA for answers to specific questions so the lawmakers can “better understand the steps the VA is taking to prevent poor outcomes for veterans.”
Dr. Miller-Meeks was joined on the letter by Sen. Roger Marshall, MD, R-Kan., and Reps. Larry Bucshon, MD, R-Ind., Andy Harris, MD, R-Md., and Greg Murphy, MD, R-N.C.
The legislation would have dangerously reduced requirements to perform eye surgery
After a handful of states passed legislation into law this year to expand the optometry scope of practice and authorize optometrists to perform certain surgical procedures, there is good news coming out of California. Governor Gavin Newsome recently vetoed legislation that would have allowed optometrists in the Golden State to perform laser and scalpel eye surgeries. Newsome vetoed the bill on Sept. 29, 2022
The legislation would have reduced the medical education, clinical, and surgical training requirements to become licensed in California to perform eye surgery. More specifically, the bill would have authorized optometrists who treat glaucoma to perform advanced procedures, including excision and drainage of small lesions, administering injections in the eyelid, and using therapeutic lasers.
Thankfully, Newsome recognized the bill threatened patient safety and quality medical eye care. In his veto message, he said, “I am not convinced that the education and training required is sufficient to prepare optometrists to perform the surgical procedures identified. This bill would allow optometrists to perform advanced surgical procedures with less than one year of training. In comparison, physicians who perform these procedures must complete at least a three-year residency program. For this reason, I cannot sign this bill.”
While the ophthalmologist/optometrist scope battle in California ultimately ended on a positive note, it won’t be the last scope battle fought across the country in the coming month and years – and even quite possibly in Wisconsin.
· Sign-up for WAO’s Legislative Key Contact Program
· Participate in the WAO Capitol Connection Program
· Contribute to the WAO Political Action Committee
Wisconsin Academy of Ophthalmology
563 Carter Court, Suite BKimberly, WI 54136Ph: 920-560-5645 • WAO@badgerbay.co
