In support of an effort to increase the Medicaid reimbursement rate for home health agency-based nurses from $96.96 per visit to $117.86 per visit, WiAHC sent out an action alert to all WiAHC members on May 29 and again on June 16 requesting that they contact their respective state representatives and state senators to ask them to support this budget request. Such a rate increase would bring Wisconsin in line with other Midwest states.

In a positive development, WiAHC’s lobbyists have previously secured the support of both Senator Rachael Cabral-Guevara (R-Appleton), a nurse practitioner, and Representative Clint Moses (R-Menomonie), a chiropractor, to formally submit this request to the Joint Committee on Finance for consideration to be possibly included in the FY2025-2027 Department of Health Services budget. 

The Legislature’s budget-writing Joint Committee on Finance has been holding meetings in May and June to approve state Fiscal Year 2025-2027 budgets for various state government agencies. Once the committee has done its work, their work will be consolidated into FY2025-2027 budget legislation, which the full Assembly and Senate will vote on. As the current fiscal year ends on June 30, the Legislature generally attempts to send a budget bill to the Governor for his consideration by the end of June. However, if there are delays with the legislative process or the Governor vetoes the budget legislation in full, state government will continue to operate on existing funding levels until the Governor signs a FY2025-2027 budget bill into law.

In late April, the Department of Health Services (DHS) issued a press release that analyzed the impact of potential federal Medicaid budget cuts on Wisconsin. This analysis is based on federal budget reconciliation legislation that the U.S. House of Representatives approved on May 22.  The following elements of this legislation, which has not yet been approved by the U.S. Senate (as this is written), will likely be of interest to WiAHC:

·        Per-Person Funding Limit– Currently, the federal government provides funding to states based on a percentage of Medicaid costs. This legislation proposes to instead provide a set amount of funding per Medicaid beneficiary. This could cost the State of Wisconsin up to $16.8 billion in federal funds over a decade.

·        Administrative Costs – This funding pays for information technology and for staff to review Medicaid claims and pay health care providers, among other things. This could cost the State of Wisconsin up to $93 million each year.

·        Work Requirement – Such a requirement would likely require able-bodied adults without children to provide proof that they are working in order to receive Medicaid benefits. DHS estimates that the agency would incur up to $6 million in administrative costs to comply with such a requirement. Any employment and training requirements that DHS may need to provide to help Medicaid beneficiaries meet these requirements could cost $60 million annually. 

On June 4, the Wisconsin Department of Health Services issued a press release noting that the agency maintains their recommendation that pregnant women and everyone 6 months or older should obtain the COVID-19 vaccine in order to prevent serious illness and to stop the spread of COVID-19. The press release also referenced that this vaccine has previously gone through rigorous review processes on the federal level and that the recent change in Centers for Disease Control and Prevention (CDC) guidance on this vaccine was “not made based on new data, evidence, or scientific or medical studies.” 

Further, this release notes that the Medicaid program in Wisconsin will continue to cover the existing COVID-19 vaccine for eligible Medicaid program participants.

The Wisconsin Department of Health Services (DHS) has announced that they will hold the state’s only substance use prevention conference on September 10-11, 2025, at the Chula Vista Resort in Wisconsin Dells. There will also be a virtual option for those who are not able to attend in-person.  According to the DHS website, the objectives of this event are to:

• Enhance knowledge of substance use prevention initiatives and resources across Wisconsin
• Strengthen collaboration and networking among substance use prevention professionals
• Develop practical substance use prevention strategies

For more information and to register, please visit the DHS website. Please note that the registration deadline is August 15.

On May 13, the state Assembly voted overwhelmingly – 96 to 1 – to approve Assembly Bill 23, a bill to create a state palliative care council.  This follows the Assembly Health Committee’s 14-1 vote on March 13 to advance this bill to the full Assembly.  WiHPCA has worked closely with the authors of this legislation – state Representative Patrick Snyder (R-Weston) and state Senator Jesse James (R-Thorp) – to both draft and advance this legislation.

This bill would establish a council of individuals with palliative care and other medical expertise to consult and advise the Wisconsin Department of Health Services (DHS) on this type of specialized medical care with the intent of increasing awareness and utilization of palliative care throughout Wisconsin. Also, this legislation would require DHS to create a statewide palliative care consumer and professional information and education program, as this type of specialized care is often misunderstood. 

Now, Assembly Bill 23 has been referred to the state Senate.  It’s also important to note that the Senate Health Committee voted unanimously – 5 to 0 – on March 14 to recommend approval of the Senate companion bill – Senate Bill 39 – to the full Senate for consideration. 

WiHPCA’s government relations team continues to aggressively lobby the Legislature to continue to move this legislation through the legislative process. 

On May 6, the Wisconsin Legislature’s Joint Committee on Finance sent a memo to their members detailing all of the budget items included in Wisconsin Governor Tony Evers’ Fiscal Year 2025-2027 budget request that they intend to remove from further consideration by the committee.  The committee took this up as one vote at their first executive session addressing the FY2025-2027 budget, which occurred on Thursday, May 8 in Madison. 

As Republicans hold a 12-4 majority on this committee, the committee voted to remove these budget items.  However, it is important to note that even if certain budget items from the Governor’s budget request remained in the budget bill after this vote, a majority of committee members would still need to vote to approve including those budget items in the committee’s version of the budget bill.  Those votes will occur at committee meetings on various dates in the future, as the committee considers different state agency budget items.  In addition, the Joint Committee on Finance can offer their own budget amendments to different state agencies.   

The committee removed over 600 budget items from Governor Evers’ budget request, including the following budget items likely of interest to WiAHC members:

Office of the Commissioner of Insurance

• Exemptions from Prior Authorization Requirements
• Authorize the Insurance Commissioner to provide, by administrative rule, that any health benefit plan or self-insured health plan that uses a prior authorization process shall exempt health care providers from obtaining prior authorizations for a health care item or service for a period of time established by the Commissioner if, in the most recent evaluation period, the health benefit plan or self-insured health plan has approved or would have approved a proportion of prior authorization requests submitted by the health care provider for the health care item or service that is not less than a benchmark threshold specified by the Commissioner.

• Prior Authorization Restrictions and Disclosure Requirements
• Specify that the clinical review criteria used by any health care plan for any prior authorization requirement or restriction must: (a) be based on nationally recognized, generally accepted standards except where provided by law; (b) be developed in accordance with the current standards of a national medical accreditation entity; (c) ensure quality of care and access to needed health care services; (d) be evidence-based; (e) be sufficiently flexible to allow deviations from current standards when justified; and (f) be evaluated and updated when necessary and no less frequently than once every year.

According to a recent statewide survey, the state Department of Health Services (DHS) announced that there has been a drop in the percentage of tobacco and vaping products that were sold by tobacco and vape retailers to underage customers in 2024.  Specifically, the percentage decreased from 13.6% in 2023 to 11.8% in 2024. 

For more information, please visit the state DHS website.

In mid-May, the Governor’s Interagency Council on Mental Health announced that it is seeking public input to help craft a statewide action plan to address mental health challenges in our state.  This plan will ultimately include recommendations regarding improving access to mental health care and expanding work on prevention. This survey may be accessed here and will be available until June 30, 2025. 

The state Department of Health Services (DHS) will hold its 2025 Opioids, Stimulants, and Trauma Summit from May 6-8, 2025, at the Kalahari Resort in Wisconsin Dells.  There will also be a virtual option.  According to the DHS website, this “…is an annual event that highlights prevention, harm reduction, treatment, and recovery strategies related to opioids, stimulants, and trauma. All people with an interest in building healthy communities are invited to attend.” 

Please note that attendees must register by May 6, 2025.  To register, and for more information, please visit the DHS website.