WiAHC Legislative Key Contact Program

If you were not yet aware, we would like to remined you about WiAHC’s Legislative Key Contact Program, which can be a highly effective grassroots advocacy tool to help build and nurture strong on-going relationships between WiAHC members and lawmakers in Wisconsin. Ultimately, the program can help us help shape new policies important to our members.

The program is now live on the WiAHC website and members can easily and quickly sign-up as a Key Contact. With the campaign season winding down, and the 2023-24 legislative session right around the corner, it’s more important than ever for WiAHC to have a robust Key Contact Program. It is essential to raising our profile in the State Capitol and beyond.

As a Key Contact, you can help influence the legislative process by cultivating relationships with elected officials. By taking advantage of existing relationships and making new contact with members of the Wisconsin Legislature (as well as the Wisconsin Congressional  Delegation), you can help us educate lawmakers on industry issues and influence legislation.

But the program will not succeed without strong member participation, so please take a few moments to read more about it – and learn how simple it is to “enlist” and participate as a Key Contact. The time commitment is minimal and your responsibility as a key contact depends on your level of comfort and willingness to engage.

Remember, lawmakers are often eager to hear input from their constituents, and as an expert in the home health care field, you can make a real difference in the policy process as a Key Contact. CLICK HERE to sign-up by filling out and submitting a brief online survey.

WiAHC Legislative Outreach 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 grassroots advocacy. In effort to capitalize on our greatest advocacy resource – our membership – WiAHC has established 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 provide 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.

WiAHC encourages all members to participate in this critical grassroots advocacy program. Please click here for more information on the program. If you’re interested in participating in the program, contact the WiAHC office at wiahc@badgerbay.co.

WiAHC is happy to remind members about and provide links to the latest articles and information on the home health care industry from Home Health Care News and other publications:

·         ‘Most Intense Advocacy Effort Of My Lifetime’: Home Health Industry Braces For Rate Cuts

Home Health Care News - By Andrew Donlan | October 24, 2022

Any day now, the home health final payment rule will officially be released by the Centers for Medicare & Medicaid Services (CMS). As providers await its arrival, many of them are gathered in St. Louis at the National Association for Home Care and Hospice’s (NAHC) annual conference. If the final rule is as bad – or close to as bad – as the proposed rule, it will be a dark day for the industry. Read more…

·         Is CMS’ Proposed Home Health Rate Cut Legal? Other Court Decisions Suggest No

Home Health Care News - By Andrew Donlan | October 16, 2022

The entire home health industry is anxiously awaiting the release of the final payment rule for 2023, which should be released by the Centers for Medicare & Medicaid Services (CMS) at some point over the next two weeks. The anxiousness is due to the home health proposed payment rule, which included a 4.2% aggregate decrease in payments – or $810 million – and an avenue for future CMS clawbacks of perceived overpayments to providers. Read more…

·         As Labor Competition Heats Up In Health Care, Home Health Sector Left Behind

Home Health Care News - By Joyce Famakinwa | October 21, 2022

Home health providers are dealing with a number of headwinds — inflation-induced financial challenges, labor shortages, pandemic pressures and more — that will only worsen if the proposed payment adjustments for 2023 become finalized. That’s the major takeaway from a recent labor cost study from the Partnership for Quality Home Healthcare (PQHH). The study was conducted by Dobson DaVanzo & Associates and examines the changes in the home health labor costs. The study is based on the survey responses of six PQHH member organizations, and interviews from five industry leaders. Read More…

·         ‘Care Delayed Is Care Denied’: What Prior Authorization Changes Mean For Home Health Providers

Home Health Care News - By Patrick Filbin | October 10, 2022

Home health providers could potentially see a speedier prior authorization process thanks to legislation moving through Washington, D.C. While the changes in the Improving Seniors’ Timely Access to Care Act are welcomed, many experts in the space feel like more work needs to be done in order to have a more efficient care delivery process. 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.

As WiAHC members know well, grassroots advocacy is critical in our efforts to influence lawmakers and policy decisions that impact home health care in Wisconsin and across the country. And there is no issue more important today than the devastating CMS-proposed home health payment cuts that if implemented would significantly reduce access for vulnerable Medicare beneficiaries and their families.

As you certainly know by now, the CMS’s CY2023 proposed payment rule would cut rates for Medicare home health services in 2023 by an unprecedented, permanent -7.69% ($1.33 billion in 2023 alone). The net result of this cut along with inflation updates is -4.2% in 2023, equaling an $810 million cut starting next year.

In addition, CMS seeks to impose an additional $2 billion in cuts as soon as 2024, which is an unjustified clawback of payments for critical healthcare delivered to seniors and people with disabilities during the pandemic in 2020 and 2021. CMS also plans to add an additional $1 billion for alleged “overpayments” for 2022 services.

Fortunately, legislation was recently introduced in Congress – the Preserving Access to Home Health Act of 2022 – that would prevent proposed cuts to home health payment rates from taking effect prior to 2026. With that in mind, WiAHC would urge you to contact your Members of Congress TODAY and ask them to support this critical legislative proposal. 

Of course, when advocating for home health with your Members of Congress, it is important to ensure your message is both compelling and clearly presented. Thankfully, our national partner, the National Association for Home Care and Hospice (NAHC), has made connecting with your elected representatives as easy as a few clicks on your computer or mobile device. Visit NAHC’s Legislative Action Center or simply CLICK HERE to contact your federal lawmakers on the Preserving Access to Home Health Act of 2022. All you need to do is fill in your name and contact information and hit SEND.

Please act today to prevent CMS’s drastic cuts, which would carve billions of dollars out of the Medicare home health program, even as providers are facing numerous other challenges.

Last month, the WiAHC Advocacy Newsletter reported the association’s 2023-24 Policy Agenda was pending final WiAHC Legislative Committee approval before being sent to the full board. This month, we are pleased to announce the Legislative Committee has completed its work.

In addition to using member input to develop the association’s advocacy roadmap, the WiAHC Legislative Committee considered the following criteria when developing the Policy Agenda and individual issue priorities: 1.) The benefit to WiAHC members; 3.) The extent to which it will improve home health care in Wisconsin; and 3.) The likelihood of legislative/regulatory success.

The WiAHC Policy Agenda provides a broad policy vision for advancing home health care in Wisconsin and identifies the following specific legislative and regulatory goals for 2023-24:

• ·         Regulatory reform legislation to modernize DHS 133, including provisions to better align Wisconsin home care regulations with federal home care regulations.

• ·         Promote public awareness and increase policy influence of home health care, such as the creation of a Home Health Care Advisory Council at the Wisconsin Department of Health Services.

• ·         Grow/strengthen Wisconsin’s home health care workforce: Secure additional state funding to support    increasing the supply of nurse educators in Wisconsin.
• ·         Expand home health telehealth flexibility to leverage the effective delivery of virtual care, which ultimately benefits patients and helps to alleviate industry-wide workforce challenges.

CLICK HERE to review the full 2023-24 WiAHC Policy Agenda, which will be used to guide the association’s advocacy efforts over the next two years.

The WiAHC Government Affairs Team recently presented Sen. Mary Felzkowski (R-Irma) and Sen. Joan Ballweg (R-Markesan) with the organization’s 2022 Champion of Home Health Care legislative award for their leadership on policies to advance home health care in Wisconsin and improve the delivery of patient care provided by home health professionals.

“Both Sen. Felzkowski and Sen. Ballweg were fierce advocates for home health care during the 2021-22 legislative session, and their work was critical in efforts to strengthen the home health care workforce and increase patient access to skilled nursing provided in the comfort of their own homes,” said Jayne Thill, Chair of the WiAHC Board of Directors. “They both clearly understand the value of home health care for Wisconsin patients, and we are excited to thank them for their work on behalf of our members and the patients we serve every day.”

The Champion of Home Health Care award is presented at the end of each two-year legislative session to state lawmakers who exemplify WiAHC’s mission of promoting, protecting, and advancing the highest quality health care at home for Wisconsin patients. In 2022, WiAHC is presenting the award to only four legislators, including Felzkowski and Ballweg. These lawmakers exhibited an exceptional commitment to supporting home health care based on several factors, including voting record, sponsorship of legislation and responsiveness to critical home health issues during the 2021-22 session.

Ballweg and Felzkowsi earned the Champion of Home Health Care designation for their leadership on a successful legislative effort to increase the Medicaid reimbursement rate for skilled nursing provided in a home health setting, as well as their work on a bill to improve regulation of the home health care industry.

Ballweg, who was first elected to the Wisconsin Senate in 2020 after serving eight terms in the Assembly, represents the 14th Senate District, which includes numerous counties in central Wisconsin, stretching from Columbia County up to Waupaca County in the northern most part of the district. She is a member of the Legislature’s powerful Joint Finance Committee. 

Felzkowski was first elected to the Wisconsin Senate in 2019, after serving four terms in the Assembly, and represents the 12th Senate District, which covers the northeast portion of the state. She also serves on the Joint Finance Committee.

 

Under WiAHC’s legislative awards program, state and/or federal legislators who demonstrate support for policies that advance home health care in Wisconsin and are aligned with WiAHC’s mission are eligible to receive one of WiAHC’s legislative awards: 1) Champion of Home Health Care or 2)Friend of Home Health Care. These awards are given out every two years, following the end of each legislative session.

Lawmakers who display exceptional support of WiAHC and home health care in Wisconsin are eligible for recognition as a Champion of Home Health Care. Lawmakers who display general support of WiAHC and home health care in Wisconsin are eligible for recognition as a Friend of Home Health Care.

The following state legislators were recognized as Champions of Home Health Care:

• Rep. Amy Loudenbeck (Clinton)
• Rep. Donna Rozar (Marshfield)
• Sen. Mary Felzkowski (Irma)
• Sen. Joan Ballweg (Markesan)

WiAHC has recognized the following state lawmakers as Friends of Home Health Care:

• Rep. Robin Vos (Rochester)
• Rep. Mark Born (Beaver Dam)
• Rep. Rick Gundrum (Slinger)
• Sen. Devin LeMahieu (Oostburg)
• Senator Howard Marklein (Spring Green)

By Hoven Consulting  – WiHPCA’s lobbying firm

• ·         New Marquette Law School Poll Released on October 12

On October 12, Marquette Law School released a new statewide election poll, which was conducted between October 3-9.  The following poll findings may be of interest:

Gubernatorial Race

This poll asked likely Wisconsin voters about their preferred candidate for this year’s governor’s race.  The poll found the following:

·         Governor Tony Evers (Democrat): 47%

·         Tim Michels (Republicans): 46%

·         Joan Beglinger (Independent): 4%

o   NOTE:  Joan Beglinger ended her gubernatorial campaign in early September and endorsed Republican candidate Tim Michels.  However, her name will remain on the November general election ballot.

The October poll also asked respondents if they approved or disapproved of how Governor Evers is handling his job. The poll found the following:

Governor Tony Evers

·         Job Approval:  46%

·         Job Disapproval:  48%

·         No Opinion:  5%

U.S. Senate Race

This poll asked likely Wisconsin voters about their preferred candidate for this year’s U.S. Senate race.  The poll found the following:

·         Lt. Governor Mandela Barnes (Democrat): 46%

·         U.S. Senator Ron Johnson (Republican): 52%

The poll also asked respondents if they have a favorable or unfavorable opinion of Lt. Governor Mandela Barnes and U.S. Senator Ron Johnson.  The poll found the following:

Lt. Governor Mandela Barnes (Democrat)

·         Favorable: 39%

·         Unfavorable: 40%

·         Haven’t heard enough: 15%

·         Don’t know: 6%

U.S. Senator Ron Johnson (Republican)

·         Favorable: 41%

·         Unfavorable: 45%

·         Haven’t heard enough: 9%

·         Don’t know: 4%

• ·         Legislative Council Study Committee on Occupational Licenses - Update

This study committee’s most recent meeting occurred on Wednesday, October 12.  During the meeting, committee members expressed frustration with the state Department of Safety and Professional Services (DSPS) for their ongoing occupational license processing delays, as well as the limited amount of information the agency has provided to the study committee.  As such, there was discussion of potentially moving the responsibility of processing certain licenses to other state agencies (e.g., moving health care-related licenses to the state Department of Health Services). 

Other committee members stated their support to provide authority to DSPS to use more of their fee revenue to hire additional employees to assist with processing delays.  Interestingly, Committee Chair/Senator Rob Stafsholt noted that he does not oppose providing DSPS with the authority to hire more staff.  However, he would like the agency to provide the legislature with data to justify that.  Also, Chair Stafsholt and Vice Chair/Rep. Shae Sortwell noted their support for universal licensure recognition. 

A list of committee members, the full meeting agenda, as well as written presentations may be viewed on the legislature’s website.  This committee’s next public meeting will occur on Tuesday, November 15 in Madison.

WiAHC Legislative Key Contact Program

If you were not yet aware, we would like to remined you about WiAHC’s Legislative Key Contact Program, which can be a highly effective grassroots advocacy tool to help build and nurture strong on-going relationships between WiAHC members and lawmakers in Wisconsin. Ultimately, the program can help us help shape new policies important to our members.

The program is now live on the WiAHC website and members can easily and quickly sign-up as a Key Contact. With the campaign season winding down, and the 2023-24 legislative session right around the corner, it’s more important than ever for WiAHC to have a robust Key Contact Program. It is essential to raising our profile in the State Capitol and beyond.

As a Key Contact, you can help influence the legislative process by cultivating relationships with elected officials. By taking advantage of existing relationships and making new contact with members of the Wisconsin Legislature (as well as the Wisconsin Congressional  Delegation), you can help us educate lawmakers on industry issues and influence legislation.

But the program will not succeed without strong member participation, so please take a few moments to read more about it – and learn how simple it is to “enlist” and participate as a Key Contact. The time commitment is minimal and your responsibility as a key contact depends on your level of comfort and willingness to engage.

Remember, lawmakers are often eager to hear input from their constituents, and as an expert in the home health care field, you can make a real difference in the policy process as a Key Contact. CLICK HERE to sign-up by filling out and submitting a brief online survey.

WiAHC Legislative Outreach 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 grassroots advocacy. In effort to capitalize on our greatest advocacy resource – our membership – WiAHC has established 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 provide 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.

WiAHC encourages all members to participate in this critical grassroots advocacy program. Please click here for more information on the program. If you’re interested in participating in the program, contact the WiAHC office at wiahc@badgerbay.co.

By Joyce Famakinwa | September 2022

Home health stakeholders – and many others – recently had the opportunity to weigh in on the way Medicare Advantage (MA) is currently administered by the U.S. Centers for Medicare & Medicaid Services (CMS).

The National Association for Home Care & Hospice (NAHC) and Moving Health Home are among the two groups that answered CMS’ request for information.

In July, CMS released that request for information seeking public comment on the MA program. Comments were to be submitted by Aug. 31, 2022.

“The significance is that CMS is beginning to evaluate the plans more closely in terms of provider relations and approaches to health care delivery for enrollees and how the plans can improve health care services for these beneficiaries,” Mary Carr, vice president of regulatory affairs at NAHC, told Home Health Care News in an email.

Broadly, the comment period gave home health stakeholders the opportunity to affect potential future rulemaking on various aspects of the MA program. This is notable because Medicare Advantage enrollment continues to grow — having more than doubled over the last decade.

In fact, Medicare Advantage has 28.4 million beneficiaries, or 45% of the Medicare population. By 2030, Medicare Advantage is expected to have over 52% of total Medicare enrollment, according to data from the research and advocacy organization Better Medicare Alliance.

With enrollment on the rise, it’s likely that providers will become even more entangled with health plans offering Medicare Advantage. And as this happens, it’s the responsibility of providers and plans to work together, NAHC President William A. Dombi wrote in the organization’s comments to CMS.

“It is imperative that the [MA] plans and the provider community work together to ensure patient-centered, high quality health care is provided to all beneficiaries,” he said.

This comment period is also significant because it gives home health stakeholders the floor to share their point of view. In the past, providers have been vocal about the challenges surrounding MA.

Specifically, providers have struggled with receiving fair rates for the services they deliver. NAHC took the time to directly address this in their comments.

“[Providers] continue to struggle with the payment structures and payment rates for care

by the MA plan,” NAHC wrote. “MA plan reimbursement for home health services is below the cost of care in many plans. With the growing proportion of home health patients enrolled in MA, that level of reimbursement jeopardizes the ability of the HHA to continue to operate.”

Overall, NAHC addresses the questions that CMS lays out while offering recommendations. In order to make sure that all enrollees receive the care they need, NAHC suggests that CMS focus on language.

“All communications with enrollees, including service/claims determinations, should be in plain language using the medium of language best understood by the specific enrollee,” NAHC wrote.

In its comments, NAHC also criticized the misinformation surrounding MA.

“Much of the information provided to the public regarding MA plans is misleading in terms of the limitations of MA plans and benefits of choosing traditional Medicare,” the organization wrote. “Plans should be required to use uniform content and display format in describing benefits and cost within each plan. For example, CMS should require the plans to use side-by-side comparisons for cost sharing, utilization data and how provider networks differ from traditional Medicare.”

NAHC also noted that there is confusion among beneficiaries when it comes to what the individual MA plans offer.

“Enrollees may believe they are required to choose an MA plan for their Medicare benefits,” NAHC wrote. “All MA plan marketing should be subject to CMS approval for accuracy and comprehensiveness and celebrity endorsement or promotions should be prohibited. All MA plan marketing should include a reference regarding an option to enroll in traditional Medicare and include information as stated in the previous response.”

On its end, the Washington, D.C.-based advocacy coalition Moving Health Home believes that CMS should urge MA plans to provide access to in-home care through the network adequacy standards.

“The scope could focus on certain specialties where in-home care is appropriate or on specific patient populations who may benefit the most from in-home care such as high-cost, high-need patients,” the organization wrote. “The existing process for requesting an exception to network adequacy requirements should remain for those plans who are unable to offer in-home care, or who believe it is inappropriate for their patient populations.”

Moving Health Home also suggests that CMS replicate the MA telehealth bonus.

“CMS now provides a 10-percentage point credit towards meeting time and distance standards for affected providers in states that have certificate of need laws,” Moving Health Home wrote. “The telehealth and the CON credits can be combined together to reduce the percentage of beneficiaries that are within the maximum time and distance requirements. Under this option, CMS could replicate one or a combination of these policies to encourage MA plans to cover in-home services.”

In addition to this, NAHC pointed out the important role telehealth played in home health care during the public health emergency.

“The value of telehealth will continue even after the PHE ends and will likely remain an essential tool for HHAs that provide care in the home to vulnerable populations,” the organization wrote. “Telehealth should be equally available as a benefit under MA Plans and traditional Medicare as it brings value to enrollees and improves access, especially for the homebound.”

Ultimately, NAHC hopes that CMS will ensure there is uniformity of coverage for home health services among Medicare Advantage plans and traditional Medicare.

“We also hope that beneficiaries are fully informed of the differences in the offerings between the plans and traditional Medicare,” Carr said. “Further, we hope that the plans recognize home health care as an important, if not necessary, step along the care continuum in ensuring that beneficiaries obtain their maximum level of health and avoid unnecessary health care costs.”

As WiAHC members know well, grassroots advocacy is critical in our efforts to influence Congress and its actions that impact home health care in Wisconsin and across the country. Being a strong advocate can have far-reaching positive impacts on the home health care profession and the patients you serve. And with Congress currently considering several proposals to strengthen home health care, it is a great time to engage your Members of Congress and urge their support for these important initiatives.

Of course, when advocating for home health with your Members of Congress, it is important to ensure your message is both compelling and clearly presented. Thankfully, our national partner, the National Association for Home Care and Hospice (NAHC), has made connecting with your elected representatives as easy as a few clicks on your computer or mobile device. Simply CLICK HERE to visit NAHC’s Legislative Action Center, choose the issue or issues that matter most to you, fill in your name and contact information, and hit SEND.

Please find below just a few of the legislative proposals you can advocate for through the NAHC Legislative Action Center:

·         The Preserving Access to Home Health Act of 2022 – Tell Congress to pass critical legislation pausing devastating home health payment cuts that will impact access for vulnerable Medicare beneficiaries and their families.

·         The Choose Home Care Act of 2021 – The Choose Home Act would create an enhanced home health benefit providing additional services and supports, including personal care services, non-emergent transportation, meal delivery, and respite care among others that serve to support a patient in their home as they recover post hospital discharge. It is a step towards providing individual choice in where a patient decides to receive care and an important modernization in the Medicare program.

Earlier this year, you had an opportunity to respond to WiAHC’s Legislative and Regulatory Priorities survey, allowing you to provide your input on what policy issues are most important to you, your organization, and the Wisconsin home health care industry. The purpose of surveying the membership was to collect valuable data to help association leadership develop the WiAHC Policy Agenda and determine what legislative and regulatory issues the organization should make a priority in 2023-2024.

As such, the WiAHC Legislative Committee is pleased to present an outline of the association’s 2023-24 Policy Agenda. The Agenda, which will be used to guide the association’s advocacy efforts over the next two years, is pending final WiAHC Legislative Committee approval before it is sent to the full board for review

In addition to using your feedback to develop the association’s advocacy roadmap, the WiAHC Legislative Committee considered the following criteria when developing the Policy Agenda and issue priorities: 1.) The benefit to WiAHC members; 3.) The extent to which it will improve home health care in Wisconsin; and 3.) The likelihood of legislative/regulatory success.

The WiAHC Policy Agenda provides a broad policy vision for advancing home health care in Wisconsin and identifies the following specific legislative and regulatory goals for 2023-24:

• ·         Regulatory reform legislation to modernize DHS 133, including provisions to better align Wisconsin home care regulations with federal home care regulations.

• ·         Promote public awareness and increase policy influence of home health care, such as the creation of a Home Health Care Advisory Council at the Wisconsin Department of Health Services.

• ·         Grow/strengthen Wisconsin’s home health care workforce: Secure additional state funding to support    increasing the supply of nurse educators in Wisconsin.

Thank you to all WiAHC members who responded to the Legislative and Regulatory Priorities survey. Your feedback is invaluable to the policy agenda development process.