WiHPCA News

WiHPCA is happy to remind members about and provide links to the latest articles and information from Hospice News and the National Association for Home Care and Hospice:

·       SCAN Health Plan CEO Sachin Jain: Don’t Lose Sight of Patients in the Quest for Value

By Jim Parker | April 25, 2022

For better or worse, value-based care may be the most influential concept in 21st Century health care. And with the advent of new payment models, hospices are no longer on the outside of those programs looking in. Read more…

·       Bipartisan Push in Congress to Make Medicare Enrollment Easier

National Association for Home Care and Hospice | April 25, 2022

Legislation has recently been introduced that would work to improve the Medicare enrollment process for individuals nearing Medicare eligibility, aged 60-64. Longtime home care champions Senators Bob Casey (D-PA) and Todd Young (R-IN) are leading the charge for the Beneficiary Enrollment Notification and Eligibility Simplification 2.0 (BENES 2.0) Act, (S. 2675). BENES 2.0 continues the theme of the original BENES Act, many provisions of which became law in the Consolidated Appropriations Act of 2021, in supporting individuals in their Medicare enrollment process. Read more…

·       Rural Hospices, Patients Encounter Higher Needs, Fewer Options

By Jim Parker | April 11, 2022

Hospices that serve rural communities encounter unique challenges to bring care to a geographically dispersed population while contending with a smaller labor pool and higher costs for clinician travel. Read more…

• Hospices Seek Engagement With Policymakers on Payment, Regulation

By Jim Parker | April 8, 2022

In an evolving payment and regulatory environment, hospices would benefit from stepping up their engagement with federal, state and local agencies and legislators. Read more…

·       CMS Proposes 2.7% Hospice Payment Raise for 2023

By Jim Parker | March 30, 2022

The U.S. Centers for Medicare & Medicaid Services (CMS) on Wednesday released the 2023 proposed payment rule for hospice providers, including a 2.7% per diem rate increase. The rule also contains a model for phasing in changes to the way CMS will use the wage index to inform payment rates in future years. Read more…

Hospice News, which is part of the Aging Media Network, is a leading source for news and information covering the hospice industry. National Association for Home Care and Hospiceis the largest professional association representing the interests of chronically ill, disabled, and dying Americans of all ages and the caregivers who provide them with in-home health and hospice services.

• 2021-22 Legislative Session Recap: During the session that ended last month, 2,305 bills were introduced, 393 were passed by the Legislature, and 267 were signed into law by Gov. Evers. The governor also issued 126 vetoes, which sets the new record for most vetoes by a Wisconsin governor in a single session.

• Wisconsin businessman Tim Michels recently announced his candidacy for Wisconsin governor, joining a crowded Republican primary for the state’s top elected position. Michels, who ran unsuccessfully for U.S. Senate in 2004, will face former Lt. Gov. Rebecca Kleefisch, businessman Kevin Nicholson, and current state Rep. Timothy Ramthun in the Aug. 9 primary.

• Earlier this month, the Wisconsin Supreme Court adopted state legislative maps proposed by Republican legislative leaders, which was a reversal of the court’s earlier decision to accept maps submitted by Gov. Tony Evers. The reversal, which is likely to be the final decision on the state’s legislative maps for the next decade, came after the U.S. Supreme Court ordered Wisconsin’s high court to reconsider their earlier ruling.

• The exodus of current state lawmakers from the WI Legislature continues, as Sen. Dale Kooyenga announced this week he will not seek reelection. Please find below a list of state legislators who won’t be seeking reelection this fall:

The 2021-22 Wisconsin legislative session has officially come to a close  and Congress will soon wind down to focus on the upcoming mid-term elections, but that is no reason for the WiHCPA Advocacy Program to sit back and relax. It’s just the opposite, as there is no time like the present to plan for future advocacy efforts that will advance hospice and palliative care in Wisconsin.

And the WiHPCA Government Affairs Team is doing just that… Working with the association’s legislative committee, we are currently developing WiHPCA’s 2023-24 Policy Agenda, which will identify our legislative and regulatory prioritiest.

Last month, to gain valuable feedback from members, WiHPCA sent out a membership-wide state/federal policy priorities survey, which gave members a tremendous opportunity to provide their input on what issues are most important to them. Please find below the top three policy issues identified by survey respondents:

1. Educate the Wisconsin congressional delegation (and state lawmakers) on the potential negative impact and risk to hospice care associated with CMS’ Medicare Advantage VBID “Hospice Carve-In” demonstration.
2. Eliminate the nursing home room and board Medicaid pass-through billing requirement imposed on hospice care.
3. Promote public awareness and increase policy influence of palliative care, such as the creation of a state palliative care advisory council.

WiHPCA leadership will use the member feedback gathered via the survey to help finalize the association’s top policy priorities and guide our government affairs efforts over the next two years. WiHPCA’s final Policy Agenda will be unveiled and distributed to members soon.

Thank you to all WiHCA members who responded to the survey. Your feedback is invaluable in the advancement of the association’s advocacy program.

By Hoven Consulting  – WiHPCA’s lobbying firm

• Governor Signs Bill Protecting Health Care Workers

In April, Governor Evers signed a number of bills that passed both chambers of the legislature earlier this year, including the following bill supported by WiHPCA:

• Proposed Legislative Study Committees Announced

After the legislative session concludes in even-numbered years, the Legislative Council - the legislature's in-house, non-partisan group of attorney advisors - organizes study committees that perform in-depth reviews of various state policy matters facing Wisconsin.  Committees are comprised of both legislators and citizen members. 

Study committees hold hearings, during which they hear public testimony – including from subject-matter experts – on state policies that may need to be fixed or updated.  Once a committee has completed receiving public testimony, it generally drafts legislation for possible introduction and consideration by the legislature.  In mid-April, the list of study committees was finalized.  The following proposed study committees may be of interest to WiHPCA:

·        Study Committee on Occupational Licenses

o   Sen. Rob Stafsholt (R-New Richmond) will be the Chair and Rep. Shae Sortwell (R-Two Rivers) will be the Vice Chair.

·        Study Committee on Uniform Death Reporting Standards

o   Sen. Joan Ballweg (R-Markesan) will be the Chair and Rep. Jesse James (R-Altoona) will be the Vice Chair.

Once the scope of these committees is established, we will share that with WiHPCA members who may wish to consider serving on one of these committees. 

• Upcoming Blackout Period for Initial Occupational Credential Applications

The state Department of Safety and Professional Services (DSPS) will temporarily stop accepting initial applications for 72 types of occupational credentials starting at 12:00PM on Friday, April 29, and ending at 11:59PM on Sunday, May 15.  The list of such credentials may be viewed on the DSPS website and mostly includes professionals in the health care field, including physicians, physician assistants, licensed practical nurses and registered nurses. 

This temporary blackout period will be put in place to allow DSPS to implement its new online occupational credentialing portal, which will replace its current paper application process. This new portal will be unveiled on Monday, May 16. 

By State Senator Patrick Testin (R-Stevens Point)

As chair of the Senate Committee on Health, I’ve had the opportunity to work with my colleagues and stakeholders to advance several bills that improve access to quality health care in Wisconsin. One way to increase access is to address workforce needs; that’s why Rep. Rachel Cabral-Guevara (Appleton) and I authored legislation that eliminates barriers limiting the practice of Advance Practice Registered Nurses (APRNs). By empowering professionals to utilize the full extent of their skillset and training, we free them to provide additional help to more people. We advanced this bill through the committee, it passed both houses of the legislature, and now needs only the Governor’s signature to become law.

The committee also advanced legislation that I authored with Rep. Todd Novak (Dodgeville) that improves access by investing in community health centers. There are seventeen community health centers with nearly 200 satellite sites operating in every corner of the state and serving over 300,000 Wisconsinites. The legislation we passed through the committee served as a catalyst to help secure increased funding for these centers in the 2021-23 state budget.

The pandemic revealed obstacles standing between patients and care that we needed to remove. Last session, the legislature allowed hospitals to seek Medicare reimbursement for numerous medical services provided in a home setting. This session, the committee moved forward legislation authored by Sen. Dale Kooyenga (Brookfield) and Rep. Amy Loudenbeck (Clinton) to make that change permanent. The bill was enacted this week.

In addition to improving access to quality care, the Senate Committee on Health also continued to combat the state’s opioid crisis. Until now, Wisconsin has had several state agencies collecting data on opioid and methamphetamine use, but no central location where it can be stored and analyzed. I authored a bill with Rep. Jon Plumer (Lodi) that will ensure this data will be gathered in a central location so that the state can get a more comprehensive picture of the problem and new ways to fight it. Rep. Plumer and I also wrote legislation that determines how money from the settlement of the multi-district opioid litigation is distributed throughout the state, ensuring that the majority of the settlement go to local governments to bolster their efforts to battle against these drugs. Both of these bills started the legislative process in the Senate Health Committee and have now become law.

We’ve made progress, but the work is not done yet. I enjoy working with health care leaders across the state to enhance health outcomes in Wisconsin. 

Senator Patrick Testin (R-Stevens Point) serves as Chairman of the Senate Health Committee. He represents the 24^th Senate District, which includes Portage County and portions of Wood, Monroe, and Jackson counties. The district also includes the cites of Stevens Point, Wisconsin Rapids, Tomah, and Sparta. He is currently running for Wisconsin Lt. Governor.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of this organization.

Grassroots advocacy is the most powerful tool WiHPCA has at its disposal to shape public policy and building relationships with lawmakers is the most important aspect of advocacy. In effort to capitalize on our greatest advocacy resource – our membership – WiHPCA has unveiled our Coffee Conversations with Legislators advocacy program.

The initiative is designed  to help connect members with their local legislators. Under the program, the WiHPCA Government Affairs Team will set-up in-district meetings between WiHPCA members and state lawmakers who represent them in the Legislature. These meetings, which can be located at your facility, or a local coffee shop provides a tremendous opportunity for WiHPCA 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.

Obviously, the ongoing COVID-19 pandemic can make it difficult for some in-person meetings, but as cases continue to decline and depending on your comfort level with meeting face-to-face, WiHPCA would encourage you to participate in this critical grassroots advocacy program.

Please click here for more information on the program.

We are pleased to report WiHPCA continues to maintain and strengthen our relationship with the Division of Quality Assurance (DQA) at the Wisconsin Department of Health Services. On March 10, we held our latest quarterly meeting with the regulatory agency.  As has been the case at past meetings, DQA provided participants with a review and discussion of numerous key issues, including survey deficiencies, complaint topics, and the number of new hospice applications.

DQA staff also provided an comprehensive briefing on the COVID-19 vaccine survey requirements, as surveyors will be reviewing COVID vaccination policies and employee tracking on every survey to ensure that all health care facility staff are at 100% vaccination rate or have approved exemptions or delays. Survey protocols were discussed, as were the following documents related to the health care staff COVID-19 vaccination requirements:

• QSO Memo 22-07-ALL

https://www.cms.gov/files/document/qso-22-07-all.pdf

• Attachment C - Hospice

https://www.cms.gov/files/document/qso-22-07-all-attachment-c-hospice.pdf

• CDC - Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic

https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html

Please see below a brief overview of what DQA reported on as it concerns surveys performed and complaint survey topics:

• Number of surveys performed in the last quarter:
• • Number of complaint surveys – 4
  • Number of recertification surveys – 2
  • Number of follow-up surveys – 1

• Complaint surveys topics – Top concern areas:
• • Patient Rights
  • Quality of Care and Treatment
  • Admission/Transfer/Discharge Rights
  • DNR Status Failure

The next quarterly meeting is scheduled for June. Stay tuned for more details and the opportunity to register. We certainly encourage participation from all WiHPCA members, as the meeting provides invaluable information and regulatory guidance from DQA.

Hospice News, which is part of the Aging Media Network, is a leading source for news and information covering the hospice industry. WiHPCA is happy to remind members about and provide links to the latest articles and information from Hospice News:

·         Competitive Labor Market Lights a Fire Under Hospice Employers

By Jim Parker | March 18, 2022

Hospice providers now compete for new hires as fiercely as they do for market share. 

And with that competition heating up this year, the largest home health and hospice companies are streamlining their recruitment and onboarding processes to enable more clinicians to hit the ground running. Read more…

·         MedPAC: Cut Hospice Payment Cap by 20%, Report Telehealth on Claims

By Jim Parker | March 15, 2022

Repeating similar calls in prior years, the Medicare Payment Advisory Commission (MedPAC) has recommended to Congress that Medicare hospice payment rates remain at current levels next year. The commission also called on the U.S. Centers for Medicare & Medicaid Services (CMS) to apply the wage index to the hospice aggregate cap, followed by a 20% cut. Read more…

·         Providers Seek Palliative Care Quality Measures to Demonstrate Value

By Holly Vossel| March 18, 2022

The lack of standardized quality measures for palliative care complicates efforts to expand access to those services. This means community-based palliative care providers have limited ways to benchmark their performance and further demonstrate their value. Read more…

·         The Devil in Details of Hospice Strategic Collaboratives

By Holly Vossel| March 21, 2022

Nonprofit hospices are increasingly banding together in varying types of collaboratives to create workforce, operational and cost-effective synergies. As this trend picks up steam, hospices will need to fine-tune the details of these affiliations and choose partners carefully. Read more…

President Joe Biden recently signed into law a $1.5 trillion omnibus spending bill that funds the federal government through the end of September 2022. Among the bill’s numerous provisions is an extension of the use of telehealth services to recertify patient eligibility for hospice. Please find below an overview of the bill’s telehealth provision provided by the National Partnership for Healthcare and Hospice Innovation (NPHI):

• An extension of the CARES Act provision allowing the use of telehealth services in place of the face-to-face encounter required to recertify patient eligibility for hospice.
• The telehealth extension is to last for 151 days following the end of the current COVID-19 Public Health Emergency (PHE). The extension is expected to last through the end of the year.
• The full text of the omnibus package can be found here, and the specific provision referenced above can be found on page 1908.

The federal omnibus spending bill referenced above did not include a provision to extend the moratorium on Medicare sequestration that is set to expire on March 31, 2022. As a result, a 1% reimbursement cut will phase back in on April 1, 2022, and a second 1% cut totaling 2% will phase back in on July 1, 2022.

Earlier this month, the Medicare Payment Advisory Commission (MedPAC) released their March 2022 Report to Congress. Please find below an overview of the report provided by NPHI:

• Chapter 11 of the report focuses exclusively on hospice services and offers two unanimous recommendations from the Commission to Congress and HHS.
• First, the Commission recommends that for fiscal year 2023, the Congress should eliminate the update to the 2022 Medicare base payment rates for hospice and wage adjust and reduce the hospice aggregate cap by 20 percent.
• Second, the Commission recommends that the Secretary should require that hospices report telehealth services on Medicare claims.

By Hoven Consulting  – WiHPCA’s lobbying firm

WiHPCA Legislative and Regulatory Priorities Survey

Earlier in March, the WiHPCA Government Affairs Team sent out a legislative and regulatory priorities survey to all WiHPCA members via email.  The intent of this survey is to find out what hospice and palliative care government policy topics are a priority to you and your organization.  WiHPCA leadership will use this data to craft our legislative and regulatory agenda for 2023-2024.  Once this agenda is prepared, WiHPCA will provide it to all members and will be used as our framework as the association advocates on hospice and palliative care policy before the legislature and state government agencies.  If you have completed this survey, thank you for doing so.

Bill Protecting Health Care Providers and Staff Advances

On February 23, the full Assembly unanimously passed Assembly Bill 960, which makes it a felony to threaten or physically attack a health care provider, a staff member of a health care facility or a family member of either, if the threat or attack is related to an official act of the provider or is related to an occurrence at the health care facility.  Both the Assembly and Senate have passed this bill.  It will now go to the Governor for his consideration. 

WiHPCA supports this bill.  As such, it joined various health care organizations and sent a joint memo to the State Assembly requesting that they support this bill. 

Recent Marquette University Poll

On March 2, Marquette Law School released a new poll that surveyed Wisconsin voters on their opinions of various national and statewide elected officials, as well as candidates for statewide office. 

U.S. Senate Election 

With respect to those voters who intend to vote in the Democratic primary for U.S. Senator Ron Johnson’s seat, Lieutenant Governor Mandela Barnes was the leading candidate with 23 percent, and Alex Lasry followed with 13 percent.  The other candidates only received support in the single digits, while 48 percent of Democratic primary voters have not decided whom they will support. 

Gubernatorial Election

In this poll, Republican gubernatorial candidate Rebecca Kleefisch led her primary rivals with 30 percent of Republicans and Republican-leaning voters selecting her, eight percent selecting former U.S. Senate candidate Kevin Nicholson and five percent selecting State Representative Tim Ramthun.  However, 54 percent of these voters responded that they did not know whom they will support in the Republican primary. 

At this time, Governor Tony Evers leads in popularity among elected statewide officials with 50 percent approving and 41 disapproving.  President Biden has a 43 percent approval rating and a 52 percent disapproval rating.  With respect to Wisconsin’s two U.S. Senators, Senator Tammy Baldwin has a 42 percent approval rating and a 36 percent disapproval rating, while Senator Ron Johnson has a 33 percent approval rating and a 45 percent disapproval rating. 

State Supreme Court Ruling on Redistricting

At the beginning of each decade, each state redraws state legislative and congressional district lines based on data from the most recent federal census.  After the Governor vetoed the legislature’s proposed legislative and congressional district maps last year, this dispute ended up in the courts.  On March 3, 2022, the Wisconsin Supreme Court decided that Governor Evers’ updated state legislative and congressional maps will be used as they make fewer changes to district boundaries than the Legislature’s proposed maps. 

On Monday, March 7, the Legislature appealed this ruling directly to the U.S. Supreme Court.  And just this week, the nation’s highest court threw out the state legislative maps drawn Governor Evers and adopted by the Wisconsin Supreme Court. The U.S. Supreme Court said the state court’s approval of Evers’ maps was flawed, as it did not adequately consider whether certain newly crafted Assembly Districts in Milwaukee complied with the federal Voting Rights Act. The maps were sent back to the Wisconsin Supreme Court for further consideration.

Politicians on the Move - Update

• On February 24, State Rep. Mike Kuglitsch (R-New Berlin) announced that he will not run for re-election in 2022.  He was first elected to the Assembly in 2010.  He serves as the Chair of the Assembly Energy and Utilities Committee and also serves on the following Assembly committees:  Environment; Government Accountability and Oversight; and State Affairs. 

• On March 3, State Rep. Gordon Hintz announced that he will not run for re-election this year.  He used to serve as Assembly Minority Leader and was first elected to the Assembly in 2006. 

• State Sen. Roger Roth (R-Appleton) has announced that he is running for lieutenant governor.  He has served in the Senate since 2015 and also served in the Assembly in 2007-2008.  He chairs the Senate Committee on Universities and Technical Colleges and is vice chair of the Committee on Utilities, Technology and Telecommunications. 

• State Rep. Rachael Cabral-Guevara (R-Appleton) announced on March 17 that she is running for Senator Roth’s seat.  She is a nurse and was elected to the Assembly in 2020.  She is the vice chair of the Assembly Mental Health Committee and is a member of the following Assembly committees:  Health, Colleges and Universities, Public Benefit Reform, and Regulatory Licensing Reform. 

• State Sen. Dale Kooyenga (R-Brookfield) announced on March 8 that he will not run for State Senate this year since this year’s redistricting process relocated his home from his current district to a different Senate district that is not up for election until 2024.  [Note:  The redistricting is based on a March Wisconsin Supreme Court ruling.  However, it is worth noting that this ruling is being appealed to the U.S. Supreme Court, which has not yet decided whether to take this case.]  He was first elected to the Senate in 2018 and served in the Assembly from 2011 through 2018.  He is currently the chair of the Senate Committee on Financial Institutions and Revenue. 

• State Sen. Janis Ringhand (D-Evansville) announced on March 9 that she will not run for re-election this year.  She was first elected to the Senate in 2014 and served in the Assembly in 2011 through 2012.  She serves as the Assistant Minority Leader and serves on the following Senate committees:  Economic and Workforce Development; Financial Institutions and Revenue; and Insurance, Licensing and Forestry.

• State Rep. Mark Spreitzer (D-Beloit) subsequently announced that he will run for Sen. Ringhand’s seat.  He has served in the Assembly since 2015.  He currently serves as the Assembly Minority Caucus Chair and is a member of the following Assembly committees:  Agriculture, Campaigns and Elections, Local Government, and Sporting Heritage. 

• State Rep. Timothy Ramthun (R-Campbellsport) has announced that he will run for Governor this year.  He has served in the Assembly since 2019.  He is the Vice Chair of the Children and Families Committee and is a member of the following Assembly committees:  Constitution and Ethics, Education, Judiciary, Transportation, and Ways and Means. 

• State Sen. Jerry Petrowski (R-Marathon) has announced that he will not run for re-election in 2022.  He was first elected to the Senate in 2012 and served in the Assembly from 1999 to 2012.  He serves as the chair of the Senate Committee on Transportation and Local Government, is vice chair of the Committee on Sporting Heritage, Small Business and Rural Issues and is a member of the Committee on Agriculture and Tourism. 

• State Sen. Brad Pfaff (D-Onalaska) has announced that he is running for Congressman Ron Kind’s (D) seat in 2022.  He was first elected to the Senate in 2020 and currently serves on the following Senate committees:  Utilities, Technology and Telecommunications; Universities and Technical Colleges; Transportation and Local Government; Economic and Workforce Development; and Agriculture and Tourism.  [Note:  If he does not win his congressional race, he will still remain a member of the State Senate as his current term does not run out until 2024.] 

• State Sen. Patrick Testin (R-Stevens Point) has announced that he is running for Lieutenant Governor.  He currently serves in Senate leadership as the President Pro Tempore.  He was first elected to the Senate in 2016 and was re-elected in 2020.  He currently is chair of the Senate Health Committee, is vice chair of the Economic and Workforce Development Committee and is also a member of the Senate Agriculture and Tourism Committee.  [Note:  If he does not win his race for lieutenant governor, he will still remain a member of the State Senate as his current Senate term does not run out until 2024.]