As was reported in last month’s edition of this publication, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2024 Medicare Physician Fee Schedule Proposed Rule in July. Under the proposed rule, clinicians would see a 3.36% decrease to the physician conversion factor. The proposed conversion factor for 2024 is $32.75, which is a reduction compared to the 2023 conversion factor of $33.89.

Prior to the Sept. 11 public comment period deadline, the WAO submitted comments to CMS on the rule, outlining the Academy’s concerns and other thoughts on the proposal. Please CLICK HERE to read the WAO’s comments to CMS on the 2024 Medicare Physician Fee Schedule Proposed Rule.

CMS has said it will issue the final rule in November.

Legislation (AB 408 / SB 398) was recently introduced in the state Legislature to create a Wisconsin income tax credit to help offset the costs of employment-related transportation services incurred by a person considered blind under federal tax guidelines.

The proposed non-refundable tax credit would be equal to 50 percent of the cost of covered transportation services and would be limited to $1,500 per taxable year. Under the bill, eligible transportation services must be provided by mass transit, paratransit, taxicab, or a transportation network company.

The proposed legislation was introduced earlier this month and is awaiting further consideration by state lawmakers.

On August 8, Governor Tony Evers called a special session of the Legislature, urging lawmakers to consider a $1 billion workforce development package the Governor said was needed to address the state’s workforce shortage crisis.

Republicans, who control both houses of the Legislature, convened the session as required by law, but quickly adjourned without acting. They called the special session a “political stunt” that was fiscally irresponsible and did not provide real solutions to Wisconsin’s workforce challenges.

The Governor’s proposed legislative package included $365 million to support childcare programs; the creation of a paid family and medical leave program that would cost $243 million; $66 million for the UW; $40 million for the state’s technical colleges; and nearly $60 million to help address the shortage of healthcare workers across the state. The funding to address the healthcare worker shortage included:

·   $10 million for the state’s nurse educators program, which incentivizes nursing professors to remain in Wisconsin.

·   $6 million for the WisCaregiver Careers program, which is intended to increase the number of certified nursing assistants employed at nursing homes.

·   $17 million for healthcare opportunity grants, which will go to local workforce development boards to help individuals obtain employment in the healthcare field.

·   $936,600 for the state Department of Workforce Development to work on healthcare apprenticeships.

·   $22.5 million for healthcare innovation grants, which will help the healthcare industry recruit and retain employees.

·   Over $1.2 million for graduate medical training support grants.

On August 31, Governor Tony Evers and the state Department of Safety and Professional Services (DSPS) unveiled a new online dashboard that provides high-level data on occupational license processing.  In addition to showing the average number of days to process all new applications, all health applications, and all business applications, users may also look up application review times by profession. 

The Republican-controlled state Assembly recently passed a redistricting reform plan to completely overhaul how legislative district maps are drawn in Wisconsin. Under the proposal, which is based on the model used in Iowa, a nonpartisan committee would draw the legislative maps. The maps drawn by committee would be subject to approval by the state Legislature. 

Gov. Tony Evers roundly criticized the proposal, saying it was essentially election interference by the GOP and strongly inferred he would veto the measure if it made it to his desk. Assembly Republicans praised the legislation as not only the fairest approach to redistricting for citizens, but also a plan that would avoid costly political and legal battles.

Recent polling has shown that a large majority of Wisconsin residents would prefer legislative district maps be drawn by a nonpartisan commission rather than elected officials.

The proposal, which passed the Assembly on a largely partisan vote with one Democrat voting for the measure, is awaiting further action in the Senate.

Earlier this month, the GOP-controlled state Assembly passed a nearly $3 billion state income tax cut proposal that would drop income tax rates from 5.3% to 4.4% for individual filers with incomes between $27,630 and $304,170 and deliver the same tax relief for married couples with incomes between $18,420 and $405,550. The legislation would also exclude the first $150,000 of a couple’s retirement income from state income taxes. The provision would apply to residents over the age of 67.

Gov. Tony Evers has promised to veto the legislation, saying it would jeopardize priorities such as public schools, child care, and public safety. On the flip side of the debate, Assembly Republicans said the measure, which passed on a partisan vote, will help fight inflation, encourage retires to stay in Wisconsin, and give a large portion of the state’s $4 billion surplus back to taxpayers.

The bill is currently under further consideration in the Senate.

Earlier this month, Assembly Minority Leader Greta Neubauer (D-Racine) appointed Rep. Deb Andraca (D-Whitefish Bay) to serve on the Legislature’s powerful budget-writing committee – the Joint Finance Committee – for the remainder of the 2023-2024 legislative session.  Andraca replaces Rep. Evan Goyke (D-Milwaukee) on the committee. Goyke stepped down from the post to focus on his campaign for the position of Milwaukee City Attorney.  The 16-members Joint Finance Committee is comprised of lawmakers from both the Assembly and Senate, with 12 Republicans and four Democrats.

Earlier this month, Gov. Tony Evers called the legislature into special session for Wednesday, Sept.20, 2023, to consider a number of workforce-related initiatives originally included in his state budget bill but rejected by the legislature. Among the proposals Evers is asking lawmakers to act on include the creation of a paid family and medical leave program, financial support (over $300 million) for the state’s childcare industry, and funding ($60 million) to help address Wisconsin’s shortage of health care workers. The $60 million for health care workforce development would fund the following programs under Evers’ plan:

• $22.5 million for healthcare innovation grants, which will help the healthcare industry recruit and retain employees.
• $17 million for healthcare opportunity grants, which will go to local workforce development boards to assist individuals obtain employment in the healthcare field.
• $10 million to increase the number of nurse educators program in Wisconsin.
• $6 million for the WisCaregiver Careers program, which aims to increase the number of certified nursing assistants employed at nursing homes.
• $1.2 million for graduate medical training support grants.
• $936,600 for the state Department of Workforce Development to advance healthcare apprenticeships opportunities.

Despite the governor’s call for a special session, the Republican-controlled legislature is opposed to the Evers initiatives, and they are expected to quickly adjourn the Sept. 20 special session without acting on any of the proposals.  

Earlier this month, Janet Protasiewicz was sworn in as a new justice of the Wisconsin Supreme Court. Protasiewicz, who has positioned herself as a judicial liberal, defeated former Justice Dan Kelly in the April 4 spring general election, replacing two-term Justice Patience Roggensack, who did not seek reelection.

More notably, Protasiewicz’s addition to the state’s high court shifted it from a majority conservative court to a majority liberal one. With the ideological swing to a 4-3 advantage in favor of liberals for at least the next two years, the court is expected to issue several high-profile judicial decisions that could impact the political landscape in Wisconsin.

Among the hot-button  issues that may be determined by the court include voting and election rules, redrawing legislative district maps, the future of abortion and reproductive rights in Wisconsin, and overturning the law that eliminated bargaining rights for most state and local government employees.

“All Copays Count” applies discounts and other assistance toward patients’ out-of-pocket costs 

Guest Column by WI Senator André Jacque

Patients would receive protections from rising health care costs by ensuring that health plans count copay assistance toward a patient’s maximum out-of-pocket cost or annual deductible, under bipartisan “All Copays Count” legislation (Senate Bill 100) I introduced with several of my colleagues earlier this session.

Amid nationwide inflation, health plans have increasingly shifted costs to patients and created barriers between individuals and the medications on which they rely.  For advocates of Wisconsin patients and the providers who care for them, this bill is a clear solution to help those individuals afford the critical medications their physicians prescribe to them to manage their health.

Copay assistance programs often act as a lifeline to help patients afford specialty medications they need to treat serious health conditions. Sixteen other states have already enacted such protections.

Just when patients think they’ve reached their out-of-pocket limit, insurers and benefit managers keep moving the goalposts, and folks wind up paying more.  For someone suffering from a complex disease, the financial hit is especially hard, leaving them to choose between groceries, utilities and mortgage payments - and the prescription medications that keep their condition under control.

In 2020, the average deductible for single coverage was $1,364, which is a 364% increase from 2006. Over the past five years, the percentage of covered workers with a general annual deductible of $1,000 or more for single coverage has grown from 23% to 57%.  Further, in 2020 more than one in four covered workers was enrolled in a plan with a deductible of $2,000 or more.

Many of these patients rely on copay coupons and vouchers to afford their prescribed treatments at the pharmacy counter.  Insurers should not have the power to prevent that copay assistance from counting toward their out-of-pocket expense or deductible.  If patients can’t afford their medications, they may choose to skip doses or stop treatment altogether, which can lead to increased costs in the overall healthcare system.  And worse.

The All Copays Count legislation would ensure that the copay assistance programs patients use to afford their medications count toward their out-of-pocket costs.  It would also close the loophole that allows insurers to define prescription drugs as non-essential and therefore not eligible to count toward their deductible.  At the same time, under this initiative Wisconsin insurers would retain flexibility with their plans, while making sure patients can continue to afford the medications they need.

If you have cancer, epilepsy or any other serious health condition, the last thing you should have to worry about is whether you’ve met your deductible.  “All Copays Count” is about giving patients peace of mind that they can pay for their prescriptions. 

Senator André Jacque represents Northeast Wisconsin’s First Senate District, consisting of Door and Kewaunee Counties and portions of Brown, Calumet, Manitowoc, and Outagamie counties.