Following the Centers for Disease Control and Prevention’s (CDC) decision on January 5, 2026, to significantly modify the childhood vaccine schedule – including reducing the number of recommended vaccines for all children from 17 to 11 – the Wisconsin Department of Health Services (DHS) announced that they continue to recommend that Wisconsin clinicians follow the American Academy of Pediatrics’ (AAP) vaccine schedule. For more information, please view the DHS vaccine guidance documenton the DHS website.

As many home health agencies also provide palliative care, the Wisconsin Association for Home Health Care (WiAHC) supports passage of Senate Bill 39/Assembly Bill 23, which would create a state Palliative Care Council to advise the state Department of Health Services (DHS) and the state Legislature on key issues impacting palliative care and the patients and their families that depend on this type of care.

We are very close to passing this bill and need your expertise and passion to get the bill scheduled for a vote in the Wisconsin State Senate.

What You Already Know

• Palliative care is specialized medical care for people living with a serious illness such as cancer, heart failure, kidney failure, and advanced neurologic disorders, among others. This type of care is focused on providing relief from both the symptoms and stress of serious illness with the goal of improving quality of life for both the patient and their family.

• Palliative care is based on the needs of the patient, not on the patient’s prognosis. It is appropriate at any age and at any stage for a serious illness, and it can be provided along with curative treatment.

Why Create a Palliative Care Council?

• This council would analyze existing palliative care programs in our state, as well as identify ways in which health care providers could improve the quality of life for patients throughout Wisconsin. This council will help improve awareness of palliative care – which is often misunderstood, even in the field of health care – address the shortage of palliative care providers and increase access to this valuable type of care.

Additional Benefits of Palliative Care

Palliative Care Saves Costs

• Research has demonstrated that patients in hospital systems with palliative care programs experienced reduced emergency department visits, fewer days in intensive care, and fewer hospital re-admissions after discharge.

• According to a summary of palliative care studies prepared by the American Cancer Society:
• According to a 2020 study, hospital patients who received a quick palliative care referral had median hospital charges that were $56,700 less than other patients.
• A 2022 study found that palliative care provided to adult patients at home decreased their medical costs by 16.7%.
• Hospital patients with cancer who received a palliative care consultation within two days of admission experienced up to 32% lower health care costs, according to a 2016 study.

Status of the bill

• The state Assembly voted overwhelmingly (96-1) in May to pass Assembly Bill 23, which has now been referred to the Senate. On March 14, the Senate Health Committee voted unanimously (5-0) to send this bill to the full Senate.

As you can see, this legislation has overwhelming support in the Legislature. We need your help to get this bill over the finish line! Specifically, we need WiAHC home health agency staff members to contact their respective state senators to ask for their support to bring this legislation to a vote in the full state Senate.

WHAT YOU CAN DO TO HELP:

Please email or call your state senator by Monday, February 2 and urge him or her to ask Senate leadership to schedule a vote on the Palliative Care Council legislation (Assembly Bill 23/Senate Bill 39) in order to improve awareness of this specialized type of care, address the shortage of palliative care providers, and increase access to this type of care. Ultimately, the intent is to better support patients living with life-limiting illnesses.

Don’t know who your state senator is? Just click here and type your home address in the “Enter address” field at the top of the screen to find that out, as well as the appropriate office phone number and email address.

Please use WiAHC’s sample e-mail when contacting your state senator. This will only take you a few minutes. Simply cut-and-paste it into an email and send it off. You are also welcome to customize it based on your experience with palliative care. [If you do so, please be sure that any anecdotes/information you share is HIPAA-compliant.] If you prefer to call your state senator’s office, you could use the sample e-mail as a script.

If you have any questions, please contact the WiAHC Government Affairs Team at tim@hovenconsulting.com or nathan@hovenconsulting.com.

Thank you for your advocacy!

 Note to Badger Bay: Please make this a link to the email template that we will provide to you separately.

As we look back over 2025, Tim and Nathan at Hoven Consulting are grateful to have the opportunity to work in Madison to advocate on behalf of Wisconsin’s home health agencies to improve patient safety and increase patient access to our state’s health care system.

With your help, WiAHC helped accomplish a number of important policy and budgetary priorities that benefit home health agencies and the patients you serve:

• Home Health Skilled Nursing Medicaid Rate Increase: Increase the Medicaid reimbursement rate from $96.96 per home visit to approximately $117.86 per home visit, which is 70 percent of the Medicare home health reimbursement rate. Due to funding levels, it appears that this rate increase will be fully implemented in the second year of the budget – in state Fiscal Year 2026-2027.
• Continued to advocate to eliminate outdated home health agency professional advisory bodies from state regulations, including drafting and submitting written and verbal testimony to the state Department of Health Services (DHS). We anticipate that this state regulatory change will likely be complete by mid-2026.

We look forward to 2026 and our continued efforts to advocate for policies that benefit both home health agencies and the patients you serve.

From all of us at Hoven Consulting, we would like to wish all of you and your families a very happy and healthy holiday season! 

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 noted in a prior Madison update that we 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.

The next step in the state regulatory process is for the various legislative committees to review the broader biennial rules review proposal, which includes the provision removing home health agency professional advisory bodies. As this is written, several of those committees are reviewing this broader proposal. If this process remains on schedule, we anticipate that this state regulatory change will likely be complete by mid-2026.

In recent weeks, the state Department of Health Services’ Division of Quality Assurance (DQA) announced that it is launching a new online portal for health and residential care providers to use for licensure/certification, background checks, plan reviews, among other matters. As of December 15, 2025, various providers, including assisted living facilities, will be required to use this system. In the future, home health agencies, nursing homes, hospitals and other providers will also be required to use this online portal.

For more information, please visit the DHS website.

On December 2, former Democratic Lieutenant Governor Mandela Barnes announced his candidacy for governor. He was also the Democratic nominee for the 2022 U.S. Senate race against U.S. Senator Ron Johnson (R) and previously served as a state representative, representing an Assembly district in the City of Milwaukee. His entry into the governor’s race was widely expected. Based on statewide polling prior to his announcement, he appears to be the leading candidate for the Democratic nomination at this time.

A little over a week later, Greater Milwaukee Committee President Joel Brennan also announced his candidacy for the Democratic nomination for governor. In addition, he served as the secretary of the Wisconsin Department of Administration during Governor Tony Evers’ first term. With Brennan now in the race, there are now 10 candidates running for the Democratic nomination for governor.

CMS released the CY 2026 Home Health Final Rule November 28.  It includes significant modifications from the proposed rule released this summer.  The Alliance has prepared an initial high-level analysis of the Final Rule.  This analysis and press release are attached.  The Alliance will also be holding webinar covering the rule on December 4, from 2-3pm ET.

As you may be aware, the Veterans Affairs administration revisits its rates each year and releases the new fee schedule in November or December.

The 2026 rates have now been released. While in most states the rates are unchanged, substantial cuts were announced in parts of these states:

1.       Texas: 43% reduction in home care rates

2.       New Mexico: 19% reduction in home care rates

We're pleased to share that we've arranged access to a free interactive tool from Paradigm which you can use to check the updated rates in your service areas.

Check Your 2026 VA Rates Here

Important reminders about the new fee schedule:

1.       These rates take effect on January 1st, 2026.

2.       The rates will apply throughout the year, though the VA may adjust them at any time.

3.       Reimbursement rates are based on the care location (where the care is provided), not the referring VA Medical Center.

4.       If your agency serves clients across multiple counties or regions, applicable rates may vary.

We encourage all members to review these changes promptly to understand how they might affect your operations in the coming year.

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.