WISCA Legislative Affairs Report:
WISCA Submits Public Comments on Proposed Medical Chaperone Rule
By Andrew Engel – WISCA Lobbyist (Hamilton Consulting)
Good news from the Medical Examining Board (MEB)! The MEB has recently decided against moving forward with the Medical Chaperone Rule as it was written. If you recall, the regulatory board was considering a new rule that would have required a medical chaperone be present in an exam room whenever a physician is performing an examination or procedure that involves the breast, genitals, or rectal area of a patient. In addition, the proposed rule would consider these types of exams conducted without a chaperone as unprofessional conduct.
I want to take this opportunity to thank all the WISCA members who played a role in shaping our Economic Impact response to the MEB on the proposed rule. It’s clear that the costs of implementing the rule was the key factor in MEB moving away from it.
While the MEB was hoping that previous revisions to their proposal would reduce the estimated costs, their attorney Jameson Whitney said, “they did not.” The total estimated implementation and compliance costs of the rule, based on comments from providers including major systems like Aurora and SSM as well as specialty and independent practices and ASCs, came to about $75 million annually. That far exceeds the state’s rulemaking threshold of $10 million over two years. Any language that would require ASCs to provide chaperones appears to be dead for the foreseeable future.
Whitney laid out an alternative option of draft language that would state: “A physician shall comply with the rules established by their hospital or employer regarding chaperones or other observers in patient examinations.” It would also require self-employed physicians to establish a written policy on chaperones/observers.
Whitney acknowledged that this policy could be as simple as “we don’t use chaperones here.” He noted that some systems already have a detailed chaperone policy in place, so this rule wouldn’t force them to change what is working for them. Also, some comments from specialty practices and clinics suggested that the chaperone requirements just don’t make sense for the types of procedures they do.
MEB members discussed Whitney’s proposal and generally agreed that it was better to do something rather than nothing. Signaling to practitioners and providers that MEB takes the issue seriously and will aggressively pursue misconduct claims in this area. Board members confirmed that they will be able to review an applicable written chaperone policy when a misconduct claim arises.
MEB will wait until its next meeting to vote on moving forward with the new language. Whitney predicted that economic impact comments on this version would estimate little to no compliance cost. MEB Chair Dr. Sheldon Wasserman also asked staff to begin auditing the last 20-25 years of disciplinary cases involving sexual assault and violations of patient boundaries to get an idea of the volume of these claims and how they have been investigated in the past.