The Agency for Healthcare Research and Quality (AHRQ) recently published a survey on Patient Safety Culture in response to interest from ambulatory surgery centers.  The survey is designed specifically for ASCs staff and asks opinions about the culture of patient safety in the ASC.  Survey results will help assess patient safety culture in facilities.  Surveys are due June 20.  Visit the AHRQ website for more information on the survey form, survey items and composite measures.

Patient Safety Culture Survey

A number of statewide organizations are working on legislation to provide prior authorization protections in state law. WISCA is working with these organizations and helping prepare for the introduction of this legislation and eventual hearings. We are asking members to share their experience to advance this important policy change. Please share examples of how current prior authorization practices impact your center.  Most notably, share how prior authorization impacts the quality and cost of care to your center and your patients. Your feedback is very important – please take a few minutes to complete a short online survey.

Complete the Survey

A bill relating to certification of surgical technicians has been introduced (SB 260/AB 261).  Provisions of this bill would require surgical technicians to hold and maintain certification from a national and accredited certifying body that certifies surgical technologists as well as requiring completion of an accredited educational program for surgical technologists.  More detail below from the Legislative Reference Bureau’s analysis.

We have received mixed feedback on the bill.  Some suggest the new statutory change is unnecessary and would make it more expensive/cumbersome to become a surg tech, thus diminishing the pool in an area where it is already difficult to find employees.  While others believe the bill would have little impact as they are already abiding by these protocols.

Prior to officially moving forward in opposition we wanted to gain any final additional feedback from WISCA members.  Thank you for your consideration and please let us know your thoughts.  Please pass along your feedback on the bill online by June 17.

Submit Your Feedback

 Analysis by the Legislative Reference Bureau:

This bill prohibits hospitals and ambulatory surgical centers from employing or otherwise retaining any individual to perform surgical technology services unless the individual is qualified as provided in the bill. “Surgical technology” is defined under the bill to mean surgical patient care and includes: 1) collaboration with a team of health care providers prior to a surgical procedure to carry out the plan of care by performing certain preparatory tasks; 2) intraoperative anticipation and response to the needs of a surgeon and other team members in the operating room by monitoring the sterile field and providing the required instruments or supplies in the sterile field; and 3) performance of tasks in the sterile field as directed in an operating room setting, including passing supplies, equipment, or instruments; sponging or suctioning an operative site; preparing and cutting suture material; handling specimens; and holding retractors.

To qualify to perform surgical technology services under the bill, an individual must satisfy one of several possible criteria, including 1) successfully completing a training program for surgical technology in connection with the individual’s military service, or 2) successfully completing an accredited educational program for surgical technologists and holding and maintaining a certification as a surgical technologist from a national and accredited certifying body. The bill provides that a hospital or ambulatory surgical center may employ or otherwise retain the services of 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 surgical technologists. The bill provides that these requirements do not apply to a licensed health care provider who may provide surgical technology services within their scope of practice. Further, the bill provides that a hospital or ambulatory surgical center may establish additional requirements for any individual who performs surgical technology services as a condition of employment or contract.

Find out how your ASC’s performance compares to similar facilities by subscribing to ASCA's annual Clinical & Operational Benchmarking Survey.

This valuable survey gives you access to a full year of national comparison data you can use to improve clinical outcomes, billing performance, staffing and more at your ASC. The survey’s quarterly reporting schedule provides you with valuable insights throughout the year.

Survey content areas include volume, quality, operational measures, outcomes, complications, staffing and financial. There are also specialty-specific sections for joint, spine and ophthalmology procedures.

Participation is open to the entire ASC community. WISCA members can save $150 on survey subscriptions by using the following promo code:

WIBENCH25

The next data submission period opens July 1, so purchase your subscription today!

Clinical & Operational Benchmarking Survey

Make sure your facility’s compensation packages are competitive so you can attract and retain the best employees.

ASCA’s Salary & Benefits Survey is a vital tool that collects national, regional and state data on 20+ ASC positions, and allows you to benchmark your facility’s compensation packages with those offered at similar ASCs.

The 2025 Salary & Benefits Survey will be open June 1–30, and results will be available in July. This survey will not be conducted again until 2027, so make sure your ASC participates this year!

WISCA members that complete at least 40 percent of the survey will receive personalized results for free.

WISCA members that don’t participate in the survey, or that complete less than 40 percent of the survey, can purchase results at ASCA’s discounted member price of $299 (savings of $100) by using the following promo code:

WIBENCH25

Note: This code will not work until survey results are available in July.

Salary & Benefits Survey   

WISCA members shared an interest in monitoring prior authorization policy changes in the state. The following is a summary of recent developments:

1) The State’s Joint Committee on Finance recently met to review budget items included in Governor Ever’s state budget.  On May 8 they voted on party lines to remove what were considered “policy” items from the budget.  These include 2 proposals from the Office of the Commissioner of Insurance.

2) Assembly Health Committee Chair Clint Moses (R-Menomonie) announced at plans to introduce legislation that would reform prior authorization process in the state.  His goals are to have greater consistency among insurers, speed up the process in order to prevent any care delays and reduce provider burdens.

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:

• Require OCI to establish a framework for auditing high rates of health insurance claims denials.

• OCI audit of insurers with claims denial rates above a certain percentage, determined by OCI, and require corrective action plans based on the audit findings.

• Allow OCI to enforce corrective action plans through fines, forfeiture or other mechanisms.

• Prior Authorization Exemption Requirements (Gold Carding)

• Require OCI to develop parameters for when services are exempt from requiring prior authorization; providers who receive prior authorization approvals above a certain rate would be exempt from requiring prior authorization for services provided or 
  recommended by them.

• Prior Authorization Transparency

• Require insurers to provide consumers with a list of treatments and services covered by health plans offered by the health insurer which require prior authorization.

• Create a Public Intervenor Office within OCI to provide information and assistance to consumers in receiving better claim outcomes. Consumers whose health insurance claims are denied would be assisted with appeals and other legal actions to pursue coverage for health care services.

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