On Friday, April 18, the Wisconsin Supreme Court in a 4-3 decision upheld Gov. Tony Evers’ 2023 partial veto that extended annual school funding increases until the year 2425 by striking numerals and punctuation in the budget bill. The GOP-controlled legislature had passed a two-year increase in schools aids. Gov. Evers used his partial veto authority to, in addition to issued other partial vetoes, change a sentence in the budget bill from “for the 2023-24 school year and the 2024-25 school year” to read “for 2023-2425.” By doing so, he was able to extend these annual funding increases until the year 2425.
Regarding the ruling Gov. Evers said, “This decision is great news for Wisconsin’s kids and our public schools, who deserve sustainable, dependable, and spendable state support and investment.” Scott Manley, executive vice president of government relations with Wisconsin Manufacturers and Commerce, which had filed the lawsuit, described the veto and the court’s upholding of it as “an embarrassing example of executive overreach, and an equally embarrassing example of a hyper partisan judicial ruling.”
This decision significantly affects what had been the general understanding of gubernatorial veto powers in Wisconsin and will dramatically affect how the Wisconsin Legislature proceeds as it considers the next two-year state spending plan. Lawmakers will proceed with caution as they determine how to now proceed in light of this new understanding of gubernatorial veto powers.
Senator Jesse James and Representative Callahan introduced a bill that would require certification for surgical technologists. The bill would prohibit hospitals and ASCs from employing or otherwise retaining any individual to perform surgical technology services unless the individual is qualified.
In order for a surgical technician to be qualified an individual must satisfy one of the following criteria:
1) Successfully completing a training program for surgical technology in connection with an individual’s military service, or
2) Successfully completing an accredited educational program for surg techs and holding and maintaining a certification as a surg tech from a national and accredited certifying body.
The bill provides that a hospital or ASC may employ or otherwise retain the services on an individual to perform surgical technology services during the 24-month period that immediately follows the individual’s successful completion of an educational program for surg techs.
The bill also provides that these requirements do not apply to a licensed health care provider who may provide surgical technology services within their scope of practice. If you have questions or concerns about the bill please contact Andy at engel@hamilton-consulting.com
ASCA is planning to introduce the Medicare Beneficiary Co-Pay Fairness Act, a new federal legislation aimed at addressing the co-pay penalty faced by Medicare beneficiaries when seeking care at ASC's. This legislative effort follows extensive discussions with congressional supporters in the 118th Congress and is backed by key sponsors, including Representatives Mike Kelly (PA-16) and Robert Menendez, Jr. (PA-18), and Senators Bill Cassidy (R-LA) and Richard Blumenthal (D-CT).
The upcoming bill, which draws from language used in ASCA's previous Outpatient Surgery Quality and Access Act, seeks to alleviate the financial burden of co-pays for Medicare beneficiaries. ASCA is working to build a coalition of supporting organizations to send letters of support to key committees, including the House Energy & Commerce, Ways & Means, Senate Finance, and HELP committees.
WISCA has joined the coalition and will share information with members to help reach out to your legislators to help grow support. More details are available on the documents linked below, including a one-pager outlining the co-pay penalty issue.
Medicare Beneficiary Co-Pay Fairness Act Draft.pdf
Issue Brief Copay Cap 2024-12-11.pdf
The 2025-2026 legislative session is now in full swing commencing in earnest with the Governor’s bi-annual budget address. The Governor has deemed this the “year of the kid” as his address focused on education, clean drinking water and a tax cut plan. Governor Evers also honed in on a message that went after prescription drug costs and health insurers. Republican legislators largely dismissed the Governor’s plans and have stated they will once again craft a budget of their own focused on using the Wisconsin’s $4 billion surplus to provide an extensive tax cut.
Highlights from the Governor’s provisions relating to health insurance:
While most of these provisions will get removed by the legislature from the state budget, some of them, like the prior authorization requirements, will likely be proposed in bill form by a bi-partisan coalition. WISCA will follow those developments closely and will voice support for provisions that improve ASC’s ability to serve their patients.
- Andy Engel, Hamilton Consulting
ASCA Recommends Additions to CMS List of Covered Procedures
On February 28, ASCA submitted codes in response to the Centers for Medicare & Medicaid Services’ ASC Covered Procedures List (ASC-CPL) Pre-Proposed Rule Recommendation Request. Based on feedback from ASCA members, including its cardiovascular working group, ASCA submitted the following:
Cardiovascular Codes
Spine Codes
Vascular Code
You can read more about the ASC-CPL Pre-Proposed Rule Recommendation Request process in this Digital Debut. Contact Kara Newbury at knewbury@ascassociation.org with any questions.
Medicare Physician Payment Cuts
Last week, Rep. Murphy highlighted the impact of ongoing Medicare payment cuts, including a 2.83% January reduction, on physician practices, citing a 33% drop in inflation-adjusted reimbursements since 2001 against a 59% rise in practice costs. His re-introduced Medicare Patient Access and Practice Stabilization Act, aiming to reverse cuts and provide a 2% increase, was excluded from the House Rules Committee's "clean" CR, despite prior optimism for March 14 inclusion.
Co-Pay Cap Legislation
Reps. Rob Menendez and Mike Kelly are expected to co-lead the introduction of the co-pay cap bill, following staff approval. David has engaged extensively with their respective staff. Final confirmation is anticipated this week, with optimism for introduction by March's end, preceding Reconciliation.
WISCA works closely with our national association partner – the Ambulatory Surgery Center Association (ASCA) – on advocacy and other issues important to our members. In fact, the WISCA Government Affairs Team joins a national ASCA state chapter call twice a month for a federal regulatory and legislative briefing and closely follows their published Government Affairs Updates. Here is the latest federal government affairs news from ASCA:
Regarding the ASC Quality Reporting (ASCQR) Program, CMS is finalizing the adoption of the following measures:
ASCA will continue to analyze the 1,734-page final rule in detail and provide more information and resources soon, including its proprietary rate calculator, to help ASC operators understand the impact this rule will have on their centers.
Following election night, state lawmakers traditionally convene in partisan caucus – Assembly GOP Caucus, Assembly DEM Caucus; Senate GOP Caucus; and Senate DEM Caucus – to choose their respective leadership teams for the new legislative session. This election cycle was no exception, as all four partisan caucuses have or will meet to elect their leaders for the 2025-26 session.
There were no huge surprises, as most of the leadership team members from all four caucuses from the 2023-24 session retained their positions. However, there were some developments of note. Most prominently, Sen. Chris Kapenga (R-Pewaukee) decided not seek reelection for Senate President, and Sen. Mary Felzkowski (R-Tomahawk) was elected to the post. In addition, Rep. Scott Krug (R-Nekoosa) was selected as Assembly Assistant Majority Leader to replace a retiring colleague, and Sen. Mark Spreitzer (D-Beloit) was chosen as Senate Minority Caucus Chair, after serving in a lower leadership position last session. Please find the full legislative leadership results below:
Assembly Republicans
Senate Republicans
Senate Democrats
The Assembly Democratic Caucus will meet later this week to choose their leadership roster.
Wisconsin lived up to both its “Purple State” and its ticket-splitting reputation on election night (Nov. 5) as election results were razor thin across the ballot. Former President Trump won the state by 30,000 votes, roughly 0.9% of the vote. This is only the second time in the last 40 years the state has voted Republican for President, the first was also for Trump in 2016. Conversely, Democrat US Senator Tammy Baldwin was re-elected by a very narrow margin, roughly 29,000 votes.
There was also uncertainty with state legislative races heading into election night, mostly due to the election being held under new legislative maps. The State Assembly entered the night with a 64-35 Republican majority. Most pundits expected the GOP to lose numerous seats, with some even predicting Democrats taking the majority. However, once all the votes were counted, Assembly Republicans maintained 54-45 seat majority heading into the 2025-26 legislative session.
In the State Senate, Republicans lost all 4 contested seats and will enter the new session with a reduced 18-15 majority – down from their current 22-11 seat majority. Of note, Republican incumbent Senator Joan Ballweg (R-Markeson) lost her re-election battle after her 60% GOP seat was redistricted into a 45% GOP seat. Similarly, Republican incumbent Senator Duey Stroebel (R-Saukville) lost his re-election race after he was redistricted out of his 70% GOP seat into a 49.5% seat. The main take away from the election is that with their 4-seat pick-up, Democrats have put themselves into position to contest for the majority in 2026 election cycle.
The WISCA Government Affairs Team would like to thank every member who provided input on the development of WISCA’s 2025-26 Legislative Agenda – both at our monthly advocacy calls and through our member survey. With your valuable input, we were able to develop a broad legislative agenda that includes specific legislative goals. Please find below an overview of the 2025-26 WISCA Legislative Agenda:
Legislation to Watch:
· Transparency – Legislation targeting price transparency for hospitals, and potentially ASCs.
It is more important than ever for WISCA members to strengthen their relationships with their state lawmakers to educate them on the ASC model of care, the regulatory challenges we face, and the legislative solutions we need to increase access to affordable, quality care provided in the ASC setting. Remember, decisions state legislators make in the Capitol can have a significant impact on the ASC industry, your organization, and your profession.
One of the best ways you as a WISCA member can engage your local legislators is to invite them to tour your ASCs to illustrate firsthand the many benefits of surgery center care. These visits provide a tremendous advocacy opportunity, which is why WISCA members across the state have already hosted numerous successful legislative tours. But we need to maintain the enthusiasm for this critical grassroots advocacy program, and WISCA is excited and ready to set-up additional tours today.
If you would like to host a legislative tour at your site, please contact the WISCA office at WISCA@badgerbay.co. We will work with you and your legislators to coordinate the meetings and will provide participating members with full support, including legislator bios, advocacy tips, issue briefings, and supporting documents.
Association of Wisconsin Surgery Centers 563 Carter Court, Suite B Kimberly WI 54136 920-560-5627 I WISCA@badgerbay.co