On October 29, the Senate Committee on Insurance, Housing, Rural Issues and Forestry held a hearing on two bills limiting prior insurance authorization. WiAHC submitted written testimony on both bills.

Senate Bill 434 – Transparency and Regulation of Prior Authorization Requirements

This legislation makes the following changes to existing prior insurance authorization requirements:

• Limits prior authorization decision timelines to 72 hours for standard requests and 24 hours for urgent care requests.
• Requires a patient’s new insurer to honor a prior authorization decision made by a utilization review entity associated with the patient’s prior insurer for at least 90 days. 

WiAHC submitted written testimony in support of this legislation, bearing in mind that commercial insurers in Wisconsin often take as long as 10-15 days to respond to prior authorization requests from home health care agencies.

Senate Bill 373 – Addresses Prior Authorization for Coverage of Physical Therapy, Occupational Therapy, Speech Therapy, and Chiropractic Services

This legislation does the following:

• Allows 12 patient visits for physical therapy, occupational therapy, speech therapy, and chiropractic services – without requiring prior authorization.
• Limits the timeframe for subsequent insurance reauthorization to three business days.

WiAHC submitted written testimony noting that our organization appreciates this legislation, as home health agencies employ physical therapists, occupational therapists, and speech therapists. However, our organization’s testimony also requests the addition of home-based skilled nursing care to this legislation.

On November 6, the state Department of Health Services (DHS) announced that it recently submitted its application to the federal Centers for Medicare and Medicaid Services for $1 billion in Rural Health Transformation Program funding. This program was created by the Budget Reconciliation Act that was signed into law by the President earlier this year and allows each state to apply for rural health funding.

According to its press release, DHS divided its funding application into the following three areas:

“Strengthen the rural health care workforce - $337 million. Recruiting and retaining an adequate health care workforce is a challenge in rural areas, making access to quality, timely care for rural residents difficult. This funding will provide grants for innovative workforce projects in rural communities, support career pathways for rural health care providers, and fund services provided by community health workers.

Drive rural technology and innovation - $329 million. Rural Wisconsin needs the technology to support and reach residents, such as closed-loop referral systems and telehealth capabilities. This funding will invest in upgrades to rural provider systems, digital infrastructure, and develop a digital rural health care collaborative.

Transform rural care through partnerships - $279 million. Rural Wisconsinites experience fragmented coordination across primary care, specialty care, behavioral health, chronic disease prevention, and community social supports. This funding will stand up a competitive grant program for rural regions to create coordinated systems of care where multi-sector partnerships show a clear path to sustainability.”

Further details are included in the DHS press release.

On October 29, 2025, Marquette University Law School Poll released its most recent poll, which surveyed 846 registered Wisconsin voters between October 15-22, 2025. This poll is the first Wisconsin state-specific Marquette poll since June 2025. This new poll covers political approval ratings, candidates for certain 2026 elections, as well as various policy areas.

The following October 2025 poll findings may be of interest:

Elected Officials

President Trump Job Approval

• 46% approve of the job President Trump (R) is doing.
• 53% disapprove.

Governor Tony Evers Job Approval

• 50% approve of the job Governor Tony Evers (D) is doing.
• 45% disapprove.
• 5% don’t know.

Wisconsin Legislature Job Approval

• 39% approve of the state legislature’s job performance.
• 50% disapprove.
• 11% don’t know.

Wisconsin Gubernatorial Candidates – 2026 August Primary Election

The following are the results for polling of Wisconsin Republican primary voters:

• Congressman Tom Tiffany: 23%      
• Washington County Executive Josh Schoemann: 6%
• Medical Service Technician Andy Manske: Less than 0.5%

NOTE: 70 percent of Republican primary voters indicated that they have not made up their minds on a preferred candidate for governor.

The following are the results for polling of Wisconsin Democratic primary voters:

• State Rep. Francesca Hong (Madison): 6%
• Lieutenant Governor Sara Rodriguez:  4%
• Milwaukee County Executive David Crowley: 3%
• State Sen. Kelda Roys (Madison): 3%
• Former Wisconsin Economic Development Corp. CEO Missy Hughes: 2%
• American Family Field Beer Vendor Ryan Strnad: Less than 0.5%
• Former State Rep. Brett Hulsey (Madison Suburbs): 0.0%

NOTE: 81 percent of Democratic primary voters indicated that they have not made up their minds on a preferred candidate for governor.

General Issues

The most important issue among registered voters:

• Inflation and the cost of living: 27%
• Illegal immigration and border security: 16%
• Health insurance: 14%
• Jobs and the economy: 9%
• Gun violence: 9%
• Affordability of housing: 9%
• Taxes: 6%
• Abortion policy: 4%
• Public schools: 4%
• Crime in your community: 2%

State and Local Policy

Data Centers

• Costs of large data centers are greater than the benefits they provide:  55%
• Benefits of large data centers outweigh the costs: 44%

Paid Family Leave

• Support requiring businesses to provide paid family leave for parents of newborns:  77%
• Opposed to requiring businesses to provide paid family leave for parents of newborns: 22%

Handgun Concealed Carry

• Support state law allowing residents to obtain a license to carry concealed handguns: 77%
• Oppose this state law: 22%

• Support state legislative proposals to allow concealed carry without a license: 20%
•  Oppose such proposals: 78%

The House of Representatives passed the Senate Amendment to H.R. 5371, the Continuing Appropriations and Extensions Act, 2026, sending the measure to the President. President Trump subsequently signed this bill into law, formally ending the 43-day government shutdown. The bill provides a CR through January 30, 2026 at FY 2025 funding levels and provides full-year FY 2026 funding for the Agriculture Department, the Food and Drug Administration, the Legislative Branch, military construction projects, and the Veterans Affairs Department.  

Here are some highlights:

• The legislation retroactively restores the COVID-19 era Medicare telehealth flexibilities through January 30, 2026, as if they had never lapsed. For home health agencies, this reinstates the waiver of originating site and geographic requirements under section 1834(m), allowing face-to-face encounters to occur broadly via telehealth. For hospice providers, the required encounter prior to a third or subsequent benefit period may again be completed via telehealth by a hospice physician or nurse practitioner. These flexibilities previously expired on September 30, 2025.  
• The legislation renews $2 million in funding for Medicare hospice surveys, originally included in the IMPACT Act of 2014, to ensure hospices are surveyed at least every 36 months.
•  The legislation waives the Statutory PAYGO requirement through 2026, zeroing out PAYGO scorecard, which included $3.4 trillion in deficit spending resulting from the One Big Beautiful Bill (OBBA). Without this waiver, providers would have been subject to an additional sequestration cut of roughly 4% to Medicare payments. 
• The full-year appropriations for the Veterans Administration will provide more certainty regarding the ongoing stability of VA health services. Included in the CR through January 30, 2026, is the Department of Defense, which funds TriCare. During the shutdown, TriCare was unable to process and pay medical claims for services and this will allow reimbursement for services provided from October 1, 2025 through the end of the CR.

Additional details are published in the National Alliance for Care at Home Alliance Daily article.

For the last several years, WiAHC has been advocating to eliminate an outdated state regulation relating to professional advisory bodies for home health care agencies. WiAHC has been advocating for this change since professional advisory committees were removed from federal regulations in 2017, as home health agencies are already overseen by a governing body pursuant to federal regulations.  In addition, home health agencies are also overseen by governing bodies in Wisconsin regulations.  In 2017, the federal Centers for Medicare & Medicaid Services (CMS) also put in place federal regulations requiring home health agencies to implement ongoing quality assessment and performance improvement (QAPI) programs.  Essentially, CMS replaced professional advisory committees in federal regulations with the creation of the QAPI program.

In January 2023, WiAHC formally requested that the state Department of Health Services (DHS) eliminate professional advisory bodies for home health care agencies in the agency’s biennial rules review – a process by which DHS makes technical changes and updates to existing state regulations. As DHS included this change in their biennial rules review, WiAHC submitted formal testimony to DHS on September 26 in support of this change. In addition, one of WiAHC’s Madison lobbyists testified at the DHS September 26 virtual hearing in support of this change.

Further updates will be included in future editions of this newsletter.

On October 14, the state Senate approved Senate Bill 214, a bill that allows health care providers credentialed in other states to provide telehealth services in Wisconsin within their scope of practice by registering with the applicable occupational credentialing board or with the state Department of Safety and Professional Services (DSPS). This legislation has been referred to the state Assembly for further consideration. WiAHC supports this legislation.

Further updates will be included in future editions of this newsletter.

There have been a number of updates related to the 2026 Wisconsin gubernatorial race since the prior edition of this newsletter.

With respect to Democratic candidates, Lieutenant Governor Sara Rodriguez, Milwaukee County Executive David Crowley, and former labor union official and American Family Field beer vendor Ryan Strnad were the first to announce their respective candidacies. Over the last month, state Senator Kelda Roys (Madison), state Representative Francesca Hong (Madison), former Wisconsin Economic Development Corporation CEO Missy Hughes, and former state Representative Brett Hulsey (Middleton) have all joined the 2026 gubernatorial race. On October 7, Wisconsin Attorney General Josh Kaul announced that he will not run for governor but will run for re-election in his current role. For several months, media reports had considered him as a potential gubernatorial candidate. As this is written, former Lieutenant Governor and 2022 Democratic U.S. Senate candidate Mandela Barnes has indicated that he is seriously considering running for governor.

On the Republican side, Washington County Executive Josh Schoemann and U.S. Representative Tom Tiffany (Minocqua) have announced their candidacies. Over the last few weeks, former four-term Governor Tommy Thompson publicly stated his interest in running for governor in 2026. He also considered running for governor in 2022 but ultimately decided not to run that year. Also, Milwaukee-area businessman Bill Berrien announced his candidacy for governor in early July but ended his campaign on September 26.

The state Department of Health Services (DHS) is seeking providers and professionals with experience with Wisconsin’s Medicaid program to apply to join the state’s Medicaid Advisory Committee. Joining this committee will give individuals an opportunity to give advice and guidance on Medicaid policies and services. In particular, DHS is seeking the following individuals to join this committee:

• Primary care providers
• Federally qualified health center staff
• Hospital administrative staff
• Professionals who help Medicaid members navigate enrollment, care, benefits, and payments (e.g., income maintenance workers, community health workers, benefits specialists, or navigators).

For more information or to apply, please click here. Applications are due by Monday, October 27, 2025.

On October 15, Governor Tony Evers (D) announced that the State of Wisconsin ended state fiscal year 2025 – which ended on June 30 – with a balance of $4.6 billion in the state’s general fund. This amount is $265 million higher than prior estimates. Also, it is notable that the state’s budget stabilization fund – also known as the “rainy day fund” – increased to approximately $2 billion at the end of FY2025. This is the rainy day fund’s largest balance in state history.

Last night, the Senate concluded votes on both a House republican CR and a Democratic CR, with both votes failing. With no path forward, the federal government shut down at midnight last night. This means that, among other things, telehealth flexibilities that were set to expire on September 30 are no longer in effect. The US Department of Health and Human Services (HHS) has also released a contingency plan outlining its operations during the government shutdown.  More updates will be shared as available.  Alliance members are able to view the Alliance Daily Article for more information about the impacts of a government shutdown.