By Hoven Consulting – WiAHC’s lobbying firm

• DHS Now Processing Higher Medicaid Reimbursement Rates

WiAHC members are now reporting that they are finally receiving the following long-awaited payment increases from the state Department of Health Services (DHS): (1) the skilled nursing services payment increase included in the 2021-2023 state budget and (2) the additional five percent Medicaid reimbursement rate for home and community-based services, which was funded by the federal American Rescue Plan Act (ARPA).  In particular, DHS informed WiAHC on May 16 that they implemented these rate increases on April 29, 2022, for claims submitted on or after that date with a date of service of January 1, 2022, or after.  The agency is now processing adjustments for claims they received before April 29, 2022.  The processing of these delayed payments is a result of the WiAHC government affairs team’s advocacy before the state Department of Health Services (DHS). 

If your home health agency has submitted such claims to DHS and has not received payment increases, please contact WiAHC Madison lobbyist Tim Hoven at tim@hovenconsulting.com or (414) 305-2011.

• Real-Time Prior Medicaid Authorization Available for More Services

As of April 5, 2022, the Department of Health Services implemented a real-time prior Medicaid authorization review and approval process for personal care services for Medicaid recipients who are 21 and older, as well as physical therapy, occupational therapy and speech and language pathology for Medicare recipients who are younger than six.  Once such a request is submitted to DHS, one of two things will occur:  (1) it will be approved automatically or (2) it will be reviewed manually.  While such a request could be denied after a manual review, a request will not be denied during the real-time review. 

According to media reports, DHS is considering expanding real-time prior Medicaid authorization to other areas where prior authorization is needed. 

• New Occupational Credentialing Application Website Unveiled

On Monday, May 16, the state Department of Safety and Professional Services (DSPS) unveiled its new online occupational credentialing portal – which is called “LicensE”.  This will replace their paper-based occupational credentialing application process.  At this time, most initial occupational credential applications in the health care field – including physicians, physician assistants, licensed practical nurses and registered nurses – will now need to be submitted via this portal.  The list of initial license applications that transitioned to LicensE on May 16 may be viewed here.  License renewals and other initial credential applications will move to the LicensE portal at a later time.

• New Marquette Law School Poll Released

On April 27, Marquette Law School released a new poll that surveyed Wisconsinites on their opinions of various national and statewide elected officials, as well as candidates for statewide office. 

o   U.S. Senate Election – Democratic Primary 

With respect to those voters who intend to vote in the Democratic primary for U.S. Senator Ron Johnson’s seat, Lieutenant Governor Mandela Barnes was the leading candidate with 19 percent, Alex Lasry followed with 16 percent, State Treasurer Sarah Godlewski polled at seven percent, while Outagamie County Executive Tom Nelson followed with five percent.  The other candidates received one percent or less, while 48 percent of Democratic primary voters have not decided whom they will support. 

o   Gubernatorial Election – Republican Primary

In this poll, former Lieutenant Governor Rebecca Kleefisch led her primary rivals with 32 percent of Republicans selecting her, former U.S. Senate candidate Kevin Nicholson polled at 10 percent and four percent selected State Representative Tim Ramthun.  However, 46 percent of these voters responded that they did not know whom they will support in the Republican primary.  This poll did not ask about recently announced Republican gubernatorial candidate Tim Michels, as this poll was conducted between April 19-24 – before he entered the race.

o   Current Elected Officials – Approval/Favorability Ratings

At this time, Governor Tony Evers leads in popularity among elected statewide officials with 49 percent approving and 43 disapproving.  President Biden has a 43 percent approval rating and a 53 percent disapproval rating.  With respect to Wisconsin’s two U.S. Senators, 43 percent of poll respondents have a favorable view of Senator Tammy Baldwin and 36 percent have an unfavorable view, while 36 percent of poll respondents have a favorable view of Senator Ron Johnson and 46 have an unfavorable view of him.

o   State Legislature Approval Rating

In addition, the poll asked about views of the state legislature.  Poll respondents gave the state legislature a 38 percent approval rating and a 47 percent disapproval rating.

Grassroots advocacy is the most powerful tool WiAHC has at its disposal to shape public policy and building relationships with lawmakers is the most important aspect of advocacy. In effort to capitalize on our greatest advocacy resource – our membership – WiAHC has unveiled our Coffee Conversations with Legislators advocacy program.

The initiative is designed  to help connect members with their local legislators. Under the program, the WiAHC Government Affairs Team will set-up in-district meetings between WiAHC members and state lawmakers who represent them in the Legislature. These meetings, which can be located at your facility, or a local coffee shop provides a tremendous opportunity for WiAHC members to build or strengthen their relationships with local legislators and to educate them on home health care and on policy issues important to home health care professionals and their patients.

Obviously, the ongoing COVID-19 pandemic can make it difficult for some in-person meetings, but as cases decline and depending on your comfort level with meeting face-to-face, WiAHC would encourage you to participate in this critical grassroots advocacy program.

Please click here for more information on the program. Please contact the WiAHC office at wiahc@badgerbay.co if you’re interested in participating.

WiAHC is happy to remind members about and provide links to the latest articles and information from Home Health Care News and the National Association for Home Care and Hospice:

·       Home Care Providers Take Note as Medicare Advantage Grows, Creates Savings for Seniors

Home Health Care News - By Joyce Famakinwa | April 23, 2022

Compared to fee-for-service Medicare, seniors save close to $2,000 on average in total annual health care spending with Medicare Advantage (MA). That’s according to a new study — based on 2019 Medicare Current Beneficiary Survey data — from Better Medicare Alliance. The study features an analysis conducted by the Washington, D.C.-based research and consulting firm ATI Advisory. Read more…

·       Home-Based Care Stakeholders Break Down ‘Uncertain’ Legislative, Regulatory Landscapes

Home Health Care News - By Joyce Famakinwa | April 23, 2022

With more eyes than ever on home-based care, there are a number of legislative and regulatory developments that will be critical for providers to stay on top of. For providers like Help at Home, which is working in the Medicaid space along with private pay, the short-term gains have been apparent. Read more…

·       What Innovative States Are Doing to Recruit, Retain Workers in Home-Based Care

Home Health Care News - By Patrick Filbin | April 12, 2022

Several states around the country are taking unique measures to combat the direct care workforce crisis in home-based care. And it would benefit other states and agencies to follow suit, according to a new report from PHI. Read more…

·       Bipartisan Push in Congress to Make Medicare Enrollment Easier

National Association for Home Care and Hospice | April 25, 2022

Legislation has recently been introduced that would work to improve the Medicare enrollment process for individuals nearing Medicare eligibility, aged 60-64. Longtime home care champions Senators Bob Casey (D-PA) and Todd Young (R-IN) are leading the charge for the Beneficiary Enrollment Notification and Eligibility Simplification 2.0 (BENES 2.0) Act, (S. 2675). BENES 2.0 continues the theme of the original BENES Act, many provisions of which became law in the Consolidated Appropriations Act of 2021, in supporting individuals in their Medicare enrollment process. Read more…

·       HHS to Provide $110 Million in HCBS for Seniors & Disabled

National Association for Home Care and Hospice | April 20, 2022

The Centers for Medicare & Medicaid Services (CMS) announced it will offer more than $110 million to expand access to home and community-based services (HCBS) through Medicaid’s Money Follows the Person (MFP) program. Read more…

 Home Health Care News, which is part of the Aging Media Network, is a leading source for news and information covering the home health industry. National Association for Home Care and Hospice is the largest professional association representing the interests of chronically ill, disabled, and dying Americans of all ages and the caregivers who provide them with in-home health and hospice services.

• 2021-22 Legislative Session Recap: During the session that ended last month, 2,305 bills were introduced, 393 were passed by the Legislature, and 267 were signed into law by Gov. Evers. The governor also issued 126 vetoes, which sets the new record for most vetoes by a Wisconsin governor in a single session.

• Wisconsin businessman Tim Michels recently announced his candidacy for Wisconsin governor, joining a crowded Republican primary for the state’s top elected position. Michels, who ran unsuccessfully for U.S. Senate in 2004, will face former Lt. Gov. Rebecca Kleefisch, businessman Kevin Nicholson, and current state Rep. Timothy Ramthun in the Aug. 9 primary.

• Earlier this month, the Wisconsin Supreme Court adopted state legislative maps proposed by Republican legislative leaders, which was a reversal of the court’s earlier decision to accept maps submitted by Gov. Tony Evers. The reversal, which is likely to be the final decision on the state’s legislative maps for the next decade, came after the U.S. Supreme Court ordered Wisconsin’s high court to reconsider their earlier ruling.

• The exodus of current state lawmakers from the WI Legislature continues, as Sen. Dale Kooyenga announced this week he will not seek reelection. Please find below a list of state legislators who won’t be seeking reelection this fall:

By Hoven Consulting – WiAHC’s lobbying firm

The Wisconsin Legislature has adjourned for the 2021-21 and does not plan to reconvene until next year.  Although the session is over, WiAHC members can review the WiAHC Legislative Bill Tracker to look back at what happened in the halls of the State Capitol. The bill tracker lists and allows members to follow and learn more about the bills WiAHC lobbied on and monitored during the 2021-22 legislative session. The Bill Tracker, which you can find below, includes the bill number, a brief description of the bill, its final status, and WiAHC’s position on the proposal.

·        Bill: Assembly Bill 215 / Senate Bill 230

·        Description: Relating to visitation of a long-term care facility resident or hospital patient by an essential visitor or member of the clergy.

·        Status: Failed to pass this session.

·        WiAHC Position: Support

·        Bill: Assembly Bill 679 / Senate Bill 687

·        Description: Relating to hospital services provided in a home setting.

·        Status: AB 679 was passed by the full Assembly and Senate. The governor has signed the bill into law as 2021 WI Act 208.

·        WiAHC Position: Currently Neutral/Actively Monitoring

·        Bill: Assembly Bill 718 / Senate Bill 753

·        Description: Relating to prohibiting certain practices relating to insurance coverage of clinician-administered drugs (“white bagging” legislation).

·        Status: Failed to pass this session.

·        WiAHC Position: Support

·        Bill: Assembly Bill 729 / Senate Bill 700

·        Description: Relating to modifying administrative rules related to home health agencies.

·        Status: AB 729 was passed by the full Assembly on 02/23/22. It was not considered by the full Senate. Failed to pass this session.

·        WiAHC Position: Support

·        Bill: Assembly Bill 960/ Senate Bill 970

·        Description: Increases criminal penalties for battery or threat to a health care provider or staff member of a health care facility.

·        Status: AB 960 was passed by the full Assembly and Senate. The governor has signed the bill into law as 2021 WI Act 209.

·        WiAHC Position:Support

• Bill: Assembly Bill 1030/ Senate Bill 999
• Description: Medical Assistance program coverage of home health services or products provided outside the home.

·        Status: AB 1030 was passed by the full Assembly and Senate. The governor has signed the bill into law as 2021 WI Act 208.

• WiAHC Position: Support

By Hoven Consulting – WiAHC’s lobbying firm

Governor Signs Several Health Care Bills of Interest to WiAHC

In April, Governor Evers signed a number of bills that passed both chambers of the legislature earlier this year.  The following is a list of these bills of interest to WiAHC:

• SIGNED - Assembly Bill 960 – This bill makes it a felony to threaten or physically attack a health care provider, a staff member of a health care facility or a family member of either, if the threat or attack is related to an official act of the provider or is related to an incident at the health care facility.  WiAHC supports this bill.  As such, it joined various health care organizations and sent a joint memo to the Legislature supporting this bill earlier this year.
• SIGNED - Assembly Bill 1030 – This bill eliminates the requirement that home health services and products be provided in a patient’s home to be reimbursable under the Medical Assistance program.  This legislation was introduced at the request of the Department of Health Services.  WiAHC supports this bill. 

Next Steps on Home Health Rules Legislation

Rep. Donna Rozar (R-Marshfield) introduced Assembly Bill 729 and Sen. Joan Ballweg (R-Markesan) introduced the Senate companion bill (Senate Bill 700) at the request of WiAHC.  This legislation brings Wisconsin’s home health regulations in line with federal regulations by eliminating home health care professional advisory bodies but maintaining governing bodies.  Assembly Bill 729 passed the Assembly in late February.  The Senate Labor and Regulatory Reform Committee held a hearing on Senate Bill 700 in January.  Unfortunately, however, it did not pass the full Senate before the end of the 2021-2022 legislative session.  In the meantime, the WiAHC Legislative Committee is exploring alternative options to make this change through the regulatory process at the state Department of Health Services (DHS) and has requested an initial meeting with the appropriate DHS staff.  We will provide updates regarding these efforts in future WiAHC monthly newsletters. 

DHS Payment Increase Delays – Update

As of mid-April, WiAHC members have reported that they have not received either the skilled nursing services payment increase included in the 2021-2023 state budget or the additional five percent Medicaid reimbursement rate for home and community-based services, which was funded by the federal American Rescue Plan Act (ARPA).  As such, WiAHC followed up with the state Department of Health Services (DHS) to request a specific timeline for the issuance of these increased payments.  DHS informed WiAHC that any claims that home health agencies submit to DHS after April 29, 2022, will be paid out at the higher amounts.  If a home health agency submitted such a claim before the end of April 2022, DHS will make appropriate adjustments internally to increase such payments – DHS anticipates that they will send out such payments during the week of May 9, 2022. 

In addition, please let WiAHC know if there are any specific home health care providers that are at risk of closure due to these delayed payments.  If so, WiAHC will make DHS aware of this and they will attempt to expedite processing. 

Proposed Legislative Council Study Committees

After the legislative session concludes in even-numbered years, the Legislative Council - the legislature's in-house, non-partisan group of attorney advisors - organizes study committees that perform in-depth reviews of various state policy matters facing Wisconsin.  Committees are comprised of both legislators and citizen members. 

Study committees hold hearings, during which they hear public testimony – including from subject-matter experts – on state policies that may need to be fixed or updated.  Once a committee has completed receiving public testimony, it generally drafts legislation for possible introduction and consideration by the legislature.  In mid-April, the list of study committees was finalized.  The following proposed study committees may be of interest to WiAHC:

• Study Committee on Occupational Licenses

o   Sen. Rob Stafsholt (R-New Richmond) will be the Chair and Rep. Shae Sortwell (R-Two Rivers) will be the Vice Chair.

• Study Committee on Uniform Death Reporting Standards

o   Sen. Joan Ballweg (R-Markesan) will be the Chair and Rep. Jesse James (R-Altoona) will be the Vice Chair.

•  Electronic Visit Verification (EVV) Update

The state Department of Health Services (DHS) is thinking ahead to addressing electronic visit verification (EVV) with respect to home health services.  At this time, DHS's goal is to have a "soft launch" of home health EVV in January 2023.  As such, DHS has organized a group of external stakeholders to provide input.  Their intent is that this group of stakeholders would ultimately turn into their EVV Advisory Workgroup for Home Health.  At the request of DHS, several WiAHC representatives have attended a few initial meetings of this group.  We will provide updates about the work of this group in future WiAHC monthly newsletters.

• Upcoming Blackout Period for Initial Occupational Credential Applications

The state Department of Safety and Professional Services (DSPS) will temporarily stop accepting initial applications for 72 types of occupational credentials starting at 12:00PM on Friday, April 29, and ending at 11:59PM on Sunday, May 15.  The list of such credentials may be viewed on the DSPS website and mostly includes professionals in the health care field, including physicians, physician assistants, licensed practical nurses and registered nurses. 

This temporary blackout period will be put in place to allow DSPS to implement its new online occupational credentialing portal, which will replace its current paper application process.  This new portal will be unveiled on Monday, May 16. 

By State Senator Patrick Testin (R-Stevens Point)

As chair of the Senate Committee on Health, I’ve had the opportunity to work with my colleagues and stakeholders to advance several bills that improve access to quality health care in Wisconsin. One way to increase access is to address workforce needs; that’s why Rep. Rachel Cabral-Guevara (Appleton) and I authored legislation that eliminates barriers limiting the practice of Advance Practice Registered Nurses (APRNs). By empowering professionals to utilize the full extent of their skillset and training, we free them to provide additional help to more people. We advanced this bill through the committee, it passed both houses of the legislature, and now needs only the Governor’s signature to become law.

The committee also advanced legislation that I authored with Rep. Todd Novak (Dodgeville) that improves access by investing in community health centers. There are seventeen community health centers with nearly 200 satellite sites operating in every corner of the state and serving over 300,000 Wisconsinites. The legislation we passed through the committee served as a catalyst to help secure increased funding for these centers in the 2021-23 state budget.

The pandemic revealed obstacles standing between patients and care that we needed to remove. Last session, the legislature allowed hospitals to seek Medicare reimbursement for numerous medical services provided in a home setting. This session, the committee moved forward legislation authored by Sen. Dale Kooyenga (Brookfield) and Rep. Amy Loudenbeck (Clinton) to make that change permanent. The bill was enacted this week.

In addition to improving access to quality care, the Senate Committee on Health also continued to combat the state’s opioid crisis. Until now, Wisconsin has had several state agencies collecting data on opioid and methamphetamine use, but no central location where it can be stored and analyzed. I authored a bill with Rep. Jon Plumer (Lodi) that will ensure this data will be gathered in a central location so that the state can get a more comprehensive picture of the problem and new ways to fight it. Rep. Plumer and I also wrote legislation that determines how money from the settlement of the multi-district opioid litigation is distributed throughout the state, ensuring that the majority of the settlement go to local governments to bolster their efforts to battle against these drugs. Both of these bills started the legislative process in the Senate Health Committee and have now become law.

We’ve made progress, but the work is not done yet. I enjoy working with health care leaders across the state to enhance health outcomes in Wisconsin. 

Senator Patrick Testin (R-Stevens Point) serves as Chairman of the Senate Health Committee. He represents the 24^th Senate District, which includes Portage County and portions of Wood, Monroe, and Jackson counties. The district also includes the cites of Stevens Point, Wisconsin Rapids, Tomah, and Sparta. He is currently running for Wisconsin Lt. Governor.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of this organization.

Sign-up for WiAHC’s Coffee Conversations with Legislators Program

Grassroots advocacy is the most powerful tool WiAHC has at its disposal to shape public policy and building relationships with lawmakers is the most important aspect of advocacy. In effort to capitalize on our greatest advocacy resource – our membership – WiAHC has unveiled our Coffee Conversations with Legislators advocacy program.

The initiative is designed  to help connect members with their local legislators. Under the program, the WiAHC Government Affairs Team will set-up in-district meetings between WiAHC members and state lawmakers who represent them in the Legislature. These meetings, which can be located at your facility, or a local coffee shop provides a tremendous opportunity for WiAHC members to build or strengthen their relationships with local legislators and to educate them on home health care and on policy issues important to home health care professionals and their patients.

Obviously, the ongoing COVID-19 pandemic can make it difficult for some in-person meetings, but as cases decline and depending on your comfort level with meeting face-to-face, WiAHC would encourage you to participate in this critical grassroots advocacy program.

Please click here for more information on the program.

WiAHC is happy to remind members about and provide links to the latest articles and information from Home Health Care News and the National Association for Home Care and Hospice:

$1.5 Trillion Omnibus Spending Bill Leaves Out Home Health Telehealth Reimbursement

Home Health Care News - By Joyce Famakinwa | March 10, 2022

The U.S. House of Representatives passed a comprehensive $1.5 trillion omnibus spending package on Wednesday. The legislation, among other things, extends the temporary virtual care flexibilities that were put in place during the public health emergency. Read more…

New Legislation Would Extend the Hospital at Home Program

National Association for Home Care and Hospice | March 22, 2022

The bipartisan Hospital Inpatient Services Modernization Act is new legislation introduced in both the Senate and House of Representatives that would extend the acute care hospital at home waiver program. Initially introduced in November of 2020, during the height of the COVID-19 public health emergency (PHE), the program provides an alternative setting of care for certain conditions, such as asthma, pneumonia, and COPD. Read more…

How the PE Nursing Home Crackdown Could Affect the Home Health Industry

Home Health Care News - By Patrick Filbin | March 13, 2022

Pushed by the White House, federal watchdogs have a new directive – cracking down on private equity in health care. While they’ll largely be targeting nursing homes and PE investment as part of a recently unveiled senior care initiative from the Biden administration, there will likely be ripple effects in the home-based care space. Read more…

NAHC Shares Tech Recommendations with Congress

National Association for Home Care and Hospice | March 21, 2022

The National Association for Home Care & Hospice and a coalition of long-term & post-acute care (LTPAC) and health information technology (HIT) groups have submitted comments to an important congressional task force exploring ways to accelerate innovation in the health care system. Read more…

Home Health Care News, which is part of the Aging Media Network, is a leading source for news and information covering the home health industry. National Association for Home Care and Hospice is the largest professional association representing the interests of chronically ill, disabled, and dying Americans of all ages and the caregivers who provide them with in-home health and hospice services.

Help WiAHC Develop a Legislative & Regulatory Agenda for 2023-24

The 2021-22 legislative session, which came to an end earlier this month, gave WiAHC plenty of opportunities to engage in the legislative process, build relationships with lawmakers, and ultimately pass legislation important to our members.

While the Legislature has adjourned for the year and lawmakers have returned to their districts to run for reelection, there is plenty of advocacy work to do behind the scenes. In fact, it is a perfect time for WiAHC to begin planning for the 2023-24 legislative session, which includes the development of a legislative agenda.

Crafting a legislative agenda serves two specific purposes:

1.)    Inform WiAHC membership on the foremost state legislative and regulatory issues that impact home health care in Wisconsin and provide direction on which issues to actively advocate for before the legislature and executive branch.

2.)    Provide state lawmakers, the governor’s office, and state agency officials with WiAHC’s position on key legislative and regulatory topics that will be relevant during the two-year session.

Identifying and prioritizing issues critical to home health care is the initial – and the most important – step in developing a legislative agenda. By deciding what the most important issues are before the start of 2023-24 legislative session, WiAHC can determine what resources will be necessary to meet the legislative and regulatory goals of our members.

To best determine WiAHC’s legislative and regulatory priorities, the WiAHC Government Affairs Team will be sending out a legislative priorities survey within the next month to give all our members an opportunity to provide their input on what issues are most important to them. The information gathered via the survey will be presented to the WiAHC Legislative Committee and Board and used to identify the association’s top priorities that will make-up association’s 2023-24 legislative agenda.

In addition to the member survey data, WiAHC leadership will consider the following criteria when finalizing legislative and regulatory priorities: 1.) The benefit to WiAHC members; 3.) The extent to which it improves home health care in Wisconsin; and 3.) The likelihood of legislative/regulatory success.

WiAHC values its members’ input and encourages everyone to participate in the legislative priorities survey when they receive it in their email inbox.