Health Law Section | State Bar of Wisconsin

The Health Law Section addresses areas of interest to health law practitioners including issues such as regulation and operation of health care organizations, bioethics, managed care, accountable care, privacy, and risk management.

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Health Law Section | State Bar of Wisconsin Blogs

Latest from Health Law Section | State Bar of Wisconsin

For the first time in U.S. history,
overdose deaths have exceeded 100,000 per year and one person dies by
suicide every 11 minutes. The U.S. continues to experience a mental health (MH) and substance use disorder (SUD) (behavioral health) crisis of unprecedented proportions. In a powerful move, government agencies reunited to collectively address the long-standing challenges to balancing patient behavioral health treatment needs with health plan and insurer fiduciary financial responsibilities to its insured population by proposing a
Continue Reading The Mental Health Parity and Addiction Equity Act and the Future of Behavioral Health Care

For fiscal year 2023, the Department of Justice (DOJ)
recouped over $2.68 billion through the enforcement of False Claims Act (FCA) settlements and judgments, a notable increase from
FY 2022’s $2.2 billion recoupment.1 Additionally, over $1.8 billion out of the over $2.68 billion recovered are, according to the report, within the “health care industry, including managed care providers, hospitals, pharmacies, laboratories, long-term acute care facilities, and physicians,” which is an increase from FY 2022. As the last
Continue Reading 2023 Broke Records for False Claims Act Recoveries

It’s spring, and the legislative session is in full swing in Wisconsin – the perfect time to reflect on some atypical aspects of the Wisconsin health law environment. In no particular order, here are our top picks.

There is no automatic surrogate decision maker for a patient who becomes incapacitated.

This is Amy’s top pick because, in her experience, Wisconsin’s lack of a surrogate decision-maker law adds more stress than patient protection to many end-of-life situations.

Much to the
Continue Reading Four Atypical Aspects of Wisconsin’s Health Law Environment

As many labor attorneys predicted, 2023 was a huge year for labor organizations in the U.S. We saw a continued uptick in union organizing campaigns and high profile strikes in the health care, auto, and film industries.

In 2023, we saw several remarkable wins at the bargaining table for unions, and significant legal decisions favoring organized labor from the National Labor Relations Board (NLRB).
Strikes and Organizing Campaigns
Health care organizations have not been immune to the rise of
Continue Reading The Rise of Labor in Health Care: Labor Law Developments in 2023

The Wisconsin Prescription Drug Monitoring Program (WI PDMP) is a program that collects and discloses information relating to the prescribing and dispensing of monitored prescriptions drugs.1
What is a Monitored Prescription Drug?
Under Wis Admin. Code § CBS 4.02(12)(a), a monitored prescription drug means:

  • a controlled substance included in Wis. Stat. section 961/385(1)(ag);
  • a drug identified by the Wisconsin Controlled Substance Board as having a substantial potential for abuse (including scheduled II, III, IV, or V in


Continue Reading Why the Wisconsin ePDMP Is Important

Prior to July 1, 2023, the Wisconsin Medical Examining Board (MEB) required self-employed physicians to have chaperone policies for sensitive exams, and make them available to patients.

Recently enacted changes to the rule mean better clarity for both patients and physicians regarding the physician’s policies for sensitive exams.
A Two-year Process
The original rule mandated that a chaperone be present when doctors performed sensitive exams, except in limited circumstances.

In 2021, the MEB proposed changes to the chaperone rule
Continue Reading Now in Effect: New Rule for Medical Chaperones

The pandemic revealed that pharmacists played a critical role in a patient’s health care. It demonstrated that pharmacists are essential to providing the necessary care for patients during a time when accessibility to health care became limited. In Wisconsin, the 2021 Wisconsin Act 98 allows reimbursement for pharmacy-related services rendered to Medicaid patients. The proposed Equitable Community Access to Pharmacist Services Act (H.R. 7213), introduced in the House on March 24, 2022, outlines the expansion of reimbursable services
Continue Reading How Will Expanded Pharmacist Provider Status Impact Our Communities?

On Feb. 15, 2023, the Center for Medicaid & Medicare Services (CMS) published a proposed rule with the goal of increasing transparency between nursing homes and consumers.1

According to the recent Federal Register publication, the proposed rule would implement portions of the Affordable Care Act “which require the disclosure of certain ownership, managerial, and other information regarding Medicare skilled nursing facilities (SNFs) and Medicaid nursing facilities.”2

This is the second time that CMS proposed requiring additional
Continue Reading CMS Proposes Rule to Increase Nursing Home Ownership Transparency

On April 13, 2023, the White House took the unprecedented step of declaring xylazine-laced fentanyl an official emerging drug threat to the nation. The declaration is to be followed by a focused, 90-day response to this drug combination. While fentanyl is well known and ripe for diversion in health care settings, lesser-known xylazine, also called “tranq,” is a veterinary sedative used illicitly as a low-cost cutting agent to extend a user’s high. New stories accompanying the White House’s announcement
Continue Reading As Deadliest Opioid Gets ‘Even Deadlier,’ Care Opportunities Emerge

The U.S. Department of Justice (DOJ) recently announced that it recouped over $2.2 billion through the enforcement of False Claims Act (FCA) settlements and judgments in fiscal year (FY) 2022.

This is less than half of the prior year’s recoupment of more than $5.6 billion from civil FCA claims.However, the DOJ noted “the government and whistleblowers were party to 351 settlements and judgments,” which made FY 2022 the second highest for the number of settlements and judgments in one
Continue Reading False Claims Act: DOJ Recoups Over $2 billion in 2022

This article was originally published in the Healthcare Law Insights blog on the Husch Blackwell website, and is published here with the author’s permission. Blog has been edited for publication on WisBar, with author approval.​

A medical school applicant recently filed suit, alleging that several Texas medical schools improperly rejected him by basing their admissions decisions on race and gender. The complaint asserts that these schools (along with “nearly every school and university in the United States”) participate
Continue Reading The Future of Affirmative Action in Medical School Admissions

As every licensed attorney in Wisconsin is likely aware, on June 24, 2022, the U.S. Supreme Court ruled on the case Dobbs v. Jackson Women’s Health Organization and overturned the constitutional right to an abortion. As such, a woman’s ability to obtain an abortion now falls in the hands of each individual state. Abortion law currently varies from state to state, as does the enforcement (or lack thereof) of abortion-related statutes. While the scope and sophistication of state abortion
Continue Reading Wisconsin Post-Dobbs: Challenges for Health Care Providers (and their Lawyers)

Have you ever paid the price for a hotel room that is listed on the back of the door? Me neither. It’s common knowledge that the market price of a room is typically less than what is posted.

Similarly, most patients and payers don’t pay the price listed on a hospital’s chargemaster. Accordingly, when hospitals were first required to disclose their chargemasters publicly, the data just didn’t mean much.1

The actual cost of health care services is most
Continue Reading Price Transparency Laws Reveal Negotiated Prices between Providers and Health Plans

In mid-April, juries in Texas and Colorado found health care company executives not guilty of criminal antitrust charges brought by the U.S. Department of Justice Antitrust Division (DOJ).

Despite the two losses, DOJ continues to move forward with similar charges brought against other health care companies. Employers in the health care industry (and beyond) should be aware that human resources (HR) practices that restrain competition in the labor market may be investigated or prosecuted by antitrust enforcers.
DOJ Prosecutes
Continue Reading Two Strikes for DOJ: Health Care Executives Not Guilty of Antitrust Conspiracies


Licensed health care professionals are required to comply with both state and federal rules regulations within their practice. In Wisconsin, health care providers are aware they need to renew their license through the Department of Safety and Professional Services. Many providers realize employment termination or a criminal conviction can impact their professional licenses. What a large majority of these licensed health care professionals don’t know is the consequence an adverse legal action may have on their ability to
Continue Reading Medicare Exclusion: A Guide for Health Care Providers

What a past year for the Department of Justice (DOJ) and its False Claims Act (FCA) settlements and judgments.

In February 2022, the DOJ released a statement detailing the efforts by the agency for fiscal year 2021 (FY 2021), including the recoupment of more than $5.6 billion from civil FCA claims – making this the second largest annual total to date and the largest since fiscal year 2014.

Out of the $5.6 billion, over $5 billion related to
Continue Reading False Claims Act: Department of Justice Recoups Second Highest Total in Claims in 2021