Want to Be More Involved in WISCA Advocacy? Join the WISCA Legislative Committee
WISCA’s committee structure allows the association to be productive and is essential to meeting our principal goals. Of course, member service is voluntary and can lead to significant committee turnover at times. In fact, the WISCA Legislative Committee already has a handful of vacancies and is facing more member resignations due to retirement. In short, WISCA actively recruiting new members to serve on the Legislative Committee.
The WISCA Legislative committee is responsible for setting and communicating legislative priorities and policy positions that are representative of WISCA’s membership. The committee also works closely with WISCA’s professional lobbying/advocacy team to ensure that state and federal issues important to members are effectively communicated to policymakers.
If you are interested in serving on the WISCA Legislative Committee, please contact he WISCA office at WISCA@badgerbay.co.
Congressman Tom Tiffany, State Lawmakers Tour Northwood Surgery Center as Part of National ASC Month
Wisconsin Congressman Tom Tiffany (WI-07), a Republican from Hazelhurst, recently visited the Northwood Surgery Center in as part of the Association of Wisconsin Surgery Centers (WISCA) Capitol Connection program and to celebrate National Ambulatory Surgery Center (ACS) Month. He was joined by State Sen. Mary Felzkowski (R-Irma) and State Rep. Rob Swearingen (R-Rhinelander). WISCA’s Capitol Connection program aims to connect surgery center members with their local state and federal legislators to show them firsthand the benefits of the ASC model of care.
“We were thrilled to celebrate National Surgery Center Month by hosting Congressman Tiffany, Sen. Felzkowski, and Rep Swearingen for a tour of our surgery center,” said Jackie McLaughlin, RN, Administrator of the Northwoods Surgery Center. “Northwoods Surgery Center provides affordable, quality outpatient surgical care in a collaborative environment, and we were proud to showcase the ASC patient experience to the visiting lawmakers. We greatly appreciated their visit, their support for our center, and their acknowledgment of the hard work of our physicians, nurses, and employees to successfully carry out our vision.”
Northwoods Surgery Center is a partnership between Aspirus Wausau Hospital and local surgeons who created a joint ventured center of surgical excellence. The Center, which opened in 2008 and is certified by Medicare and the Accreditation Association for Ambulatory Health Care, is committed to providing quality service and extraordinary outpatient surgical care to their patients. The Center has two operating rooms where specially trained, highly skilled physicians and their professional health care teams perform ophthalmology, orthopedic, pain management, and podiatry procedures.
The photo includes the following individuals (L to R):State Sen. Mary Felzkowski (R-Irma), Jackie McLaughlin, RN, Dr. Michel Gelinas, Board Certified Ophthalmologist, Congressman Tom Tiffany (R-WI-07), Dr. Mark Balas, Board Certified Orthopaedic Surgeon, State Rep. Rob Swearingen (R-Rhinelander)
Prior Authorization Reform Bill Moving Advancing in Congress
The Improving Seniors’ Timely Access to Care Act recently cleared a key step in the legislative process, as the House Ways and Means Committee voted unanimously to advance the bill, which aims to reform prior authorization in Medicare Advantage plans.
The legislation, which would streamline and standardize prior authorization in the Medicare Advantage program, is now one step closer to consideration by the full U.S. House of Representatives. If passed by the full House, the bill will then move to the U.S. Senate for further consideration.
Providing much-needed oversight and transparency while protecting beneficiaries from unnecessary care delays and denials, the bill would require Medicare Advantage plans to:
Post-Primary Marquette University Law Poll Shows Evers and Michels in Tight Race for Governor; Barnes with Lead in U.S. Senate Contest
The latest Marquette University Law Poll, which was conducted after the Aug. 9 Wisconsin primary election and released on August 17, shows incumbent Tony Evers (D) and Tim Michels (R) locked in a close race for governor, and has current Lt. Governor Mandela Barnes leading incumbent Ron Johnson (R) in the contest for U.S. Senate. Please find below highlights of the poll:
Wisconsin Governor’s Race:
U.S. Senate Race:
CLICK HERE to read the complete results from the latest Marquette University Poll.
Federal Government Affairs News and Notes:
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 government affairs news from ASCA:
ASCA will send the first draft of our ASC/OPPS Proposed Payment Rule comment letter to the Government Affairs Committee and the ASCA Board of Directors this week. They will have one week to provide feedback to Kara Newbury and then a second draft of the letter will be circulated for additional feedback. Comments are due to The Centers for Medicare and Medicaid Services (CMS) by September 13. ASCA will have a state associations sign-on letter ready for circulation by August 29. WISCA will likely sing-on to the letter, pending WISCA Legislative Committee approval.
The first quarterly data submission deadline for ASC-20: COVID-19 Vaccination Coverage Among HCP (Health Care Personnel) was August 15, 2022. While CMS provided no extension for the August 15 deadline, there is an “extraordinary circumstance exception” that can be requested.
When the Biden administration took office, they indicated they would give 60 days’ notice before ending the Public Health Emergency (PHE). Since the current extension of the PHE runs through mid-October and the states have not yet been notified otherwise, the PHE is expected to be extended. CMS did release a document last week to aid healthcare providers in phasing out flexibilities allowed during the Public Health Emergency, entitled “Creating a Roadmap for the End of the COVID-19 Public Health Emergency.”
WISCA Legislative Affairs Report:Update on Proposed Medical Chaperone Rule
By Andrew Engel – WISCA Lobbyist (Hamilton Consulting)
As has been previously reported in the WISCA Advocacy Newsletter, WISCA submitted comments to the Wisconsin Medical Examining Board (MEB) detailing how compliance with the Board’s proposed “medical chaperone rule” could cost Wisconsin ASC’s tens of millions of dollars.
If you recall, the regulatory board was considering a new rule that would have required a medical chaperone be present in an exam room whenever a physician is performing an examination or procedure that involves the breast, genitals, or rectal area of a patient. In addition, the proposed rule would consider these types of exams conducted without a chaperone as unprofessional conduct.
At its meeting last month, the MEB decided to significantly pare back its proposed rule on medical chaperones, abandoning the requirement that ASC’s provide a separate chaperone to patients when requested. At their latest meeting, the MEB reviewed new draft language, which requires physicians and their employers to have a policy on medical chaperones and to make the policy readily available to affected patients. A Department of Safety and Professional Services (DSPS) staff attorney has said during MEB meetings that the policy could theoretically be as simple as “we don’t require the use of medical chaperones here.”
Following some discussion, the board made minor changes to the proposed language so that the rule does not specifically make either physicians or their employers responsible for posting the policy. It simply requires that a policy be made available to patients. MEB members did not want to make physicians responsible for what may be a failure of their employer to create or post a policy, while MEB lacks the authority to directly regulate hospitals and clinics.
A representative from the Wisconsin Medical Society thanked the board for listening to stakeholder input and crafting specific language that considers who bears the burden of the rule.
MEB members approved a motion allowing the board chair and DSPS staff to finalize the rule and submit it once again for public comment on its economic impact. The review is expected to be complete in a month or two, before the board’s October meeting.
DSPS Secretary Dawn Crim Leaving Evers Administration
Earlier in July, Wisconsin Department of Safety and Professional Services (DSPS) Secretary Dawn Crim announced that she will be leaving the Evers Administration on August 1, 2022. The State Medical Examining Board and the State Board of Nursing are housed within DSPS, which also processes nearly all occupational license applications in Wisconsin, including licenses for physicians, nurses, and other health care professionals. Earlier this year, DSPS implemented an online platform for health care occupational license applications. The agency will transition the remaining occupational licenses that they handle to their online platform in the future.
Governor Evers has announced that DSPS Assistant Deputy Secretary Dan Hereth will be the DSPS Secretary-designee upon Secretary Crim’s departure.
DHS Announces Annual Adjustment of Health Care Provider Fees for Patient Health Care Records
Effective on the first day of each July, the Wisconsin Department of Health Services publishes an updated schedule of the maximum fees that health care providers may charge for producing patient medical records. These fees are based on the consumer price indices for the prior two calendar years. The fees vary based on the number of pages and the type of file provided (e.g., paper documents, microfiche, x-rays, etc.). CLICK HERE to view the fee schedule.
State Medicaid Program Projected to End Current Budget Cycle with $414.5 Million Surplus
In their required report to the Legislature on the overall condition of the Medicaid program budget, the Wisconsin Department of Health Services (DHS) said the Wisconsin Medicaid program is expected to end the 2021-23 budget cycle with a surplus of $414.5 million in state finding.
The department cited the COVID-19 public health emergency (PHE) as a contributing factor to the surplus. The federal Families First Coronavirus Response Act passed in 2022 added 6.2 percentage points to the federal Medicaid match as long as the PHE remains in place.
Earlier this month, the Biden Administration and the U.S. Department of Health and Human Services (HHS) announced it has extended the COVID-19 PHE through October 13, 2022. The PHE provides special access to health insurance and offers key flexibilities on telehealth and reporting deadlines. The Biden Administration has long agreed to give 60 days’ notice warning if the PHE will not be extended again.
CLICK HERE to read the entire DHS report.
The Centers for Medicare & Medicaid Services (CMS) released the 2023 proposed payment rule for ASCs and hospital outpatient departments (HOPD) on July 15, 2022.
CMS proposed to continue to align the ASC update factor with the one used to update HOPD payments. Under the proposal, CMS would continue to use the hospital market basket to update ASC payments for calendar year (CY) 2023 as the agency assesses this policy’s impact on volume migration. This will be the last year of the trial period.
If the proposed rule were to be finalized as drafted, ASCs would see, on average over all covered procedures, an effective update of 2.7 percent, which is a combination of a 3.1 percent inflation update based on the hospital market basket and a productivity reduction mandated by the Affordable Care Act of 0.4 percentage points. This is an average and the updates might vary significantly by code and specialty.
In addition, although ASCA provided a list of 47 codes for procedures that are being done safely on non-Medicare populations for consideration to be added to the ASC Covered Procedures List (ASC-CPL), CMS added only one of the requested codes: 38531 (Open bx/exc inguinofem nodes).
“This proposed rule misses an opportunity to lower costs and improve access to care to beneficiaries by not adding many viable procedures that ASCs are safely performing on commercial patients,” says Bill Prentice, chief executive officer of ASCA. “We have provided clinical data to CMS that should be used to add these procedures to our allowable list for 2023.”
The payment rule proposals include:
CLICK HERE to review the full rule and HERE for the rule analysis.
ASCA will provide additional analysis soon, including a rate calculator that allows users to determine what ASCs will be paid locally if the proposal is adopted.
Every year, National ASC Month is celebrated in August to highlight the achievements of ASCs across the country, coinciding with Congress’s long August recess. If your ASC is interested in hosting a facility tour for your member of Congress, please complete ASCA’s Facility Tour Interest Form or visit ASCA’s facility tour webpage for more information. In addition, you can also contact the WISCA office at WISCA@badgerbay.co to set up a legislative tour of your ASC with either your member of Congress or local state legislators. In fact, WISCA recently coordinated a tour of the Northwoods Surgery Center in Woodruff, WI with Congressman Tom Tiffany, State Senator Mary Felzkowski, and State Representative Rob Swearengen.
Association of Wisconsin Surgery Centers 563 Carter Court, Suite B Kimberly WI 54136 920-560-5627 I WISCA@badgerbay.co
