2021-2022 Session Concludes
The Legislature adjourned in March. Barring special sessions, the Legislature will not reconvene until 2023. During this two-year cycle, the Legislature enacted 267 laws (with one being the subject of a partial veto), and Governor Tony Evers vetoed another 126 enrolled bills. Select legislative initiatives enacted, or failing to advance, are highlighted below.
Health Care Laws of Interest Enacted
Licensure
- Interstate Compacts: A couple interstate compacts were ratified or extended to facilitate practice by out-of-state practitioners and strengthen workforce supply within Wisconsin – Occupational Therapy Licensure Compact (SB 412) and Psychology Interjurisdictional Compact (AB 537):
- Genetic Counselors (SB 259): This law provides for regulation and licensing for the practice of genetic counseling under a newly created Genetic Counselors Affiliated Credentialing Board. Licensure provisions take effect on May 1, 2023. In collaboration with advocacy efforts by Gundersen Health System, Marshfield Clinic Health System and UW Health, UnityPoint Health authored a letter to urge Governor Evers to sign SB 259 into law.
- Substance Abuse Counselors (AB 686): This law provides that advanced practice social workers and independent social workers may treat substance use disorder as a specialty without additional certification or education/supervision requirements.
Medical Assistance (MA) Reimbursement
Several bills provide and/or clarify MA program coverage for select services.
- Emergency Medical Transportation Services (AB 874): This law facilitates supplemental reimbursements under the MA program for both privately owned and public ambulance services. For privately owned services, an assessment process including federal approval is established, and for public services, a state plan amendment process is required.
- Medical Assistance Program Coverage (AB 1030): This law aligns state law with federal law, including clarification of coverage for home health services and durable medical equipment.
- Group Physical Therapy Reimbursement (AB 765): This law requires MA coverage of group physical therapy – meaning a physical therapy session at which there are more than one but not more than 10 recipients receiving services together from one or two providers. Group physical therapy services are not billable for services performed by physical therapy aides.
- Prior Authorization of Nutritional Supplements (SB 453): This law removes a requirement from administrative code promulgated by the Department of Health Services that a health care provider must receive prior authorization under the MA program for any enteral nutrition products administered through a tube.
Criminalizing Threats to Health Care Workers (AB 960)
This law creates two new offenses: (1) battery or threat to a health care facility worker and (2) battery or threat to a health care provider. Specifically, these offenses prohibit intentionally causing or threatening to cause bodily harm and extend protections to family members of covered health care workers/providers. The Wisconsin Hospital Association championed the passage of this legislation.
Controlled Substances
- Epinephrine (AB 337): Effective April 20, 2022, this law authorizes the use of an epinephrine prefilled syringe in the same manner as authorized for an epinephrine auto-injector in schools and other settings. Additionally, the Department of Health Services is authorized to issue a statewide standing order to dispense epinephrine to persons who have completed the required training for administration of epinephrine, and similarly authorizes a health care practitioner to issue a standing order to dispense epinephrine to persons who have completed the required training.
- Opioid and methamphetamine data system (SB 49): The law mandates the creation of an opioid and methamphetamine data system for use by state agencies to collect, format, analyze, and disseminate information on opioid and methamphetamine use. State agencies impacted include the Department of Administration, the Department of Health Services, the Department of Safety and Professional Services, the Department of Corrections, the Department of Justice, the Department of Children and Families, and “any other applicable agencies.”
Hospital at Home Services (AB 679)
This law clarifies that under Wisconsin law the ability for hospitals to deliver hospital services in a patient’s home when the hospital has been approved by the Centers for Medicare & Medicaid Services to provide those services, like under the Acute Hospital Care at Home program. UnityPoint Health also co-signed a letter with other Wisconsin integrated health systems to the Wisconsin Congressional delegation to encourage their support of a two-year extension of the federal Acute Hospital Care at Home waiver program.
Health Care Legislation Failing to Advance
Advanced Practice Registered Nurse Licensure (SB 394): This legislation proposed to create a new license for advanced practice registered nurses (APRNs), administered by the Board of Nursing. While passed by the Legislature, Governor Evers vetoed this legislation based on outstanding scope of practice questions differentiating APRNs from physicians.
Prompt Pay Discount (SB 559 / AB 571): This legislation proposed to clarify that Wisconsin health care providers are allowed (but not required) to offer discounts to consumers who owe health insurance cost-sharing amounts, such as copayments, coinsurance, and deductibles, and who pay those costs timely. This legislation had a public hearing but did not advance for consideration by the full Legislature.
White Bagging (SB 753 / AB 718): Referenced as “Koreen’s Law” in homage to an Eau Claire cancer patient whose health insurer’s specialty drug policy threatened access to life-saving medication, this legislation prohibited insurance companies from mandating the source of specialty medications outside of the normal supply chain for such drugs used by an in-network provider. This legislation had a public hearing but did not advance for consideration by the full Legislature.
Emergency Medical Responders Certification Requirements (SB 89): This legislation proposed to make the National Registry of Emergency Medical Technicians exam optional for emergency medical responders (EMR) . This legislation did not change the requirement that each EMR would need to complete a Department of Health Services approved training course and pass all other applicable tests and hands-on experience to receive licensure. While passed by the Legislature, Governor Evers vetoed this legislation.
Complementary and Alternative Health Care Practitioners (AB 86): This legislation proposed to define the practice of “complementary and alternative health care services” as well as exempt those practices from licensure. Complementary and alternative health care services were defined to include practices such as aromatherapy, Ayurveda, healing touch, meditation, and traditional healing practices, among others. While passed by the Legislature, Governor Evers vetoed this legislation.
Eligibility and Disenrollment of BadgerCare Plus Members (AB 934): BadgerCare Plus is the childless-adults demonstration project under the MA program. This legislation proposed to disenroll ineligible BadgerCare Plus members promptly, prohibit automatic eligibility renewals, require eligibility redeterminations every six months, and prohibit the use of prepopulated forms. While passed by the Legislature, Governor Evers vetoed this legislation on the basis that it was conflicting and more stringent than federal law.
Wisconsin Hospital Association (WHA) Resources
As always, WHA is a valued advocacy partner.
2022 Annual Health Care Workforce Report: WHA released its 18th annual Wisconsin 2022 Health Care Workforce Report. This report shows that vacancy rates have increased in 13 of the 17 professions (comprising 70% of the hospital workforce) included in the survey. Not surprisingly, registered nurses make up 51% of vacancies, followed by nursing assistants comprising 13% of vacancies. Other professions within the top tier were radiology technicians, surgical technicians, physical therapists, respiratory therapists, lab technicians and pharmacy technicians. The report also includes strategy recommendations – building public-private partnerships, promoting rapid innovations, removing top-of-licensure barriers, bolstering integrated health care technology, reducing regulatory red tape, and supporting care in the best setting.
Workforce Webinar: Targeted for chief executive and administrative officers, chief clinical officers, chief nursing officers, chief medical officers, recruiting leaders, and legal counsel, WHA is holding a members-only webinar – Wisconsin Protects Its Health Care Workforce – A Recruiting and Retention Advantage – scheduled for Monday, May 2, from 12:15pm-1:00pm. The webinar will review key Wisconsin laws that uniquely protect Wisconsin’s health care workforce from the criminalization of medical errors, protect Wisconsin’s health care workers from threats and violence, and provide a balanced medical liability environment. To register, WHA members can go to the WHA Education and Events website at https://www.wha.org/EducationandEvents.
For more information on State of Wisconsin advocacy, legislative, policy and regulatory issues of impact to UnityPoint Health, please contact Cathy Simmons, executive director of government and external affairs for UnityPoint Health.