Wisconsin Bill to BAN Cash Payment for Treatment at Pain Clinics


An unprecedented provision in Assembly Bill 366, currently under consideration in the Wisconsin legislature, puts at risk the right of patients to self pay for medical care.  The bill contains a prohibition on cash payment for treatment received at pain clinics.

A law outlawing the payment of cash for a legal product would seem unthinkable in the United States, yet the Wisconsin Assembly Committee on Health has already, this past Thursday October 22, unanimously recommended AB 366 for passage.

Please contact your Wisconsin State Representative TODAY and ask him or her to oppose the bill as written.  Tell your representative that the ban on cash transactions in Section 5 of the bill should be removed and the definition of pain clinic should be revised to avoid needlessly and harmfully over-regulating physicians and patients.

While the intent of the bill may be to stop “pill mills” any ban on payment by cash is a dangerous approach. In addition, an overly broad definition of “pain clinic” in the bill will harm patients seeking legitimate treatment for pain, even treatment that does not involve narcotic or opiate prescriptions. Shockingly, spine and sports medicine clinics performing interventional injections for conditions like sciatica would fall under the cash ban! Spine conditions are the fourth leading cause for physician visits.

“It is unethical to deny patients the right to pay for their own health care services when the act is not posing a threat to the public,” explains one concerned Wisconsin physician. Click here to read additional concerns about AB 366.

AAPS Executive Director Jane Orient, MD points out that:

The provision states that uninsured patients, and ONLY uninsured patients may use credit, a credit card, a check, or a draft (but not cash). This implies two things: (1) Insured patients cannot pay for pain treatment that their insurance supposedly covers but denies in their case. (2) Uninsured patients who are hard up and don’t have a checking account or credit cannot buy this type of medical care. Why should they not be allowed to use currency that is legal tender (and does not involve paying fees to a bank)? And what can practitioners do to protect themselves against fraudulent checks–which cost the recipient a substantial fee from the bank?

The original Assembly version of the bill, as well as the Senate version – SB 272, do not contain the draconian prohibition on cash nor the over-reaching definition of “pain clinic.”   An “Assembly Substitute Amendment” introduced and approved by the Assembly Committee on Health brought in these problematic provisions.

If you don’t know who your representative is, you can type your address into the “Find My Legislators” tool herehttp://legis.wisconsin.gov/.  If you already know who represents you, you can find contact info for representatives here.

Here is a sample letter you can personalize and send to your Representative:

Dear Representative [Name],

I am a physician/patient in your district and am concerned about the unintended consequences of provisions in AB 366 as amended.  While curbing the abuse of pain-related prescriptions is a laudable goal, the bill as currently written will harm patients’ access to all pain treatment, including those that do not involve controlled substances.

The ban on cash payments by patients must be removed.  In an age where health insurers are increasingly seeking to cut costs through rationing of care, it is critical for patients to retain the right to self-pay for medical treatments.

In addition I ask that the definition of “pain clinic” be revised to exclude practices that do not prescribe or minimally prescribe controlled substances.

Thank you for looking closely at the above concerns.  I am hopeful you will help stand up for the rights of patients and their physicians in this state.



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