WiHPCA News

In December 2023, the state Department of Health Services (DHS) announced that it would extend its free telehealth service to ensure rapid access to COVID-19 antiviral drugs through April 10, 2024.  With this service in place, any Wisconsinite 18 years of age or older who tests positive for COVID-19 is able to receive a telehealth consultation with a health care professional seven days a week during the hours of 8:00AM – 8:00PM.  If the patient is eligible for treatment, the patient will receive a prescription for a COVID-19 antiviral drug that may be filled at a pharmacy.  If the patient does not have access to a pharmacy, the prescription drug will be shipped overnight to the patient.  For more information, go to the DHS website. 

Hospice PEPPER Distribution to Be Delayed Through Fall 2024

In November, the CBRPEPPER website went down. In response, NHPCO reached out to the Centers for Medicare & Medicaid Services (CMS) requesting an update and a timeframe for an expected fix. The website recently posted update indicating that there will be a temporary pause in distributing comparative billing reports (CBRs) and Program for Evaluating Payment Patterns Electronic Reports (PEPPERs) in effect through the fall of 2024. The website also indicates that CMS is working to improve the quality and accessibility of these reports and will be releasing a Request for Information (RFI) soon. NHPCO is reaching out to CMS for additional details and will share more information as the situation develops.

WiHPCA, working in conjunction with state Representative Patrick Snyder (R-Wausau Area) and state Senator Jesse James (R-Eau Claire Area), introduced legislation in the Assembly (Assembly Bill 736) and Senate (Senate Bill 703), respectively, which would create a state Palliative Care Council to advise the Wisconsin Department of Health Services (DHS) and provide recurring reports to the Legislature.  Assembly Bill 736 has been referred to the Assembly Committee on Health, Aging and Long-Term Care and Senate Bill 703 has been referred to the Senate Committee on Government Operations.

The primary intent of this legislation is to improve awareness of and access to palliative care.  That is because there are not enough health care providers who specialize in palliative care in Wisconsin.  Furthermore, there is a shortage of information on palliative care for practicing health care providers, patients, and their loved ones.   

The proposed palliative care council would work with DHS on analyzing existing palliative care programs, as well as identifying ways in which health care providers could improve the quality of life for patients throughout our state.  The council would be comprised of 22 members representing diverse perspectives, including physicians, nurses, a spiritual care professional, palliative care patients or family members of such patients, a health insurance company representative with expertise in palliative care, and members of the Legislature.  The council would meet at least twice per year in various locations across the state.

Many other states have already taken the step of creating a palliative care advisory council or advisory group to increase awareness of access to this specialized type of care.  In fact, 25 other states from coast to coast have formed such entities. 

WiHPCA’s government affairs team is aggressively lobbying members of the Assembly Committee on Health, Aging and Long-Term Care and the Senate Committee on Government Operations to schedule hearings on this legislation.  In addition, they have lobbied Assembly and Senate leadership offices to move forward on these bills. 

As part of WiHPCA’s ongoing effort to boost our legislative advocacy efforts at both the state and federal levels, a group of WiHPCA members recently met with Wisconsin Congressman Glen Grothman (R – WI-6). The meeting provided a great opportunity to have a deep conversation with a key federal policymaker on the tremendous benefits and value of hospice and palliative care – for patients, families, and Wisconsin taxpayers.

WiHPCA members who attended the meeting included Aime Goldman from Agrace Hospice and Rick Rissler and his team from St. Croix Hospice: Daniel Gonzalez, Jennifer Dillman, and Kathleen Metty-Reinhard. They were wonderful ambassadors for Wisconsin’s hospice community and did an excellent job educating Congressman Grothman on a handful of important federal issues, including the VBID hospice carve-in and its impact on hospice providers and patients, and the hospice nursing home pass through and how it creates a financial and administrative burden for hospice providers. In fact, the Congressman said he would be willing to write a letter urging CMS to consider a waiver for Wisconsin on the pass-through issue.

Glenn Grothman is the Congressman for Wisconsin’s Sixth Congressional District. Grothman is currently serving his fifth term in Congress, having first been elected in 2014. 

On November 30, Senator Melissa Agard (D-Madison) announced her candidacy for the position of Dane County Executive.  As such, she immediately stepped down as Senate Democratic Leader. Very soon thereafter, Senate Democrats elected Senator Dianne Hesselbein – who represents a Senate district in the western Madison suburbs – to be the new Senate Democratic Leader.  Senator Hesselbein assumed that position immediately after being elected.

Once Senator Hesselbein was elected as Senate Democratic Leader, she resigned from most of her committee positions – including her role as the top Democrat on the Senate Health Committee.  Soon thereafter, she announced committee changes for Senate Democrats.  Of interest to WiHPCA, Senator LaTonya Johnson of Milwaukee is the new top Democrat on the Senate Health Committee and Senator Tim Carpenter of Milwaukee is a new member of the Senate Committee on Mental Health, Substance Abuse Prevention, Children and Families.  It’s notable that Senator LaTonya Johnson is also the top Democrat on the Senate Committee on Mental Health, Substance Abuse Prevention, Children and Families. 

In early December, the state Department of Health Services announced that it updated its webpage addressing post-COVID-19 pandemic Medicaid renewal datato include an interactive dashboard.  Specifically, this dashboard includes enrollment data for BadgerCare Plus, Medicaid and other programs that are funded by the state government.  DHS will update this page on the third Thursday of each month – by 2:00pm.

WiHPCA is happy to remind members about and provide links to the latest articles and information on the hospice and palliative care industry from Hospice News and other publications:

·        Program Integrity, Health Equity, Workforce Pressures Top of Mind for Hospice Leaders in 2024

Hospice News – By Holly Vassel | Nov. 17, 2023

This year has brought both tumultuous challenges and evolving opportunities for hospices that will steer hospice leadership during 2024. Hospice News spoke with a group of industry leaders about the most impactful forces that will shape the space in the coming year. Some themes from last year have carried over as far as their biggest concerns, but some have adapted their plans to address them. Read More…

·        Medicare Making Fewer Improper Payments to Hospices

Hospice News – By Jim Parker | Nov. 16, 2023

Medicare fee-for-service programs made $31.23 billion in improper payments during 2023, though a smaller proportion of those dollars went to hospices than in years prior. Hospices received nearly 5.4% of improper payments from Medicare in 2023, down from 12% in 2022, according to a new report from the U.S. Department of Health & Human Services (HHS). The leading cause of these payments were inaccurate or incomplete documentation. Read More…

·        Hospice Industry Groups Lobbying Congress to Change CMS’ Special Focus Program

Hospice News – By Jim Parker | Nov. 10, 2023

The four largest hospice industry organizations are urging congressional lawmakers to mandate changes to the Special Focus Program (SFP) currently set to begin in 2024. The U.S. Centers for Medicare & Medicaid Services (CMS) last week issued its 2024 home health payment rule, which contained several hospice provisions. Among them was the Jan. 1 implementation date for the SFP. Read More…

·        CMS: Concurrent Hospice Care Improves Quality, Reduces Costs

Hospice News – By Jim Parker | Nov. 7, 2023                       

Allowing patients to receive concurrent hospice and curative care reduces health care costs and improves quality. The U.S. Centers for Medicare & Medicaid Services (CMS) has released its fifth and final report on the Medicare Care Choices Model (MCCM), which studied the effects of allowing individuals to receive hospice care without foregoing other treatments. Read More…

·       Transparency Essential to Hospice Compliance in 2024

Hospice News – By Holly Vassel | Nov. 2, 2023

Greater transparency in staff evaluation processes and increased education will be keys to navigating a range of hospice compliance challenges in a post-pandemic landscape. Since the COVID outbreak struck, hospices have contended with changes in regulatory requirements around telehealth utilization, emergency preparedness and infection control and prevention. Ramped up auditing activities and program integrity oversight have also occurred alongside the public health emergency’s end in May. Read More…

Hospice News, which is part of the Aging Media Network, is a leading source for news and information covering the hospice and palliative care industry.  

WiHPCA opposes recently introduced legislation (Assembly 611) that would prohibit a health care entity, including hospices from taking action against individual health care providers that express professional opinions related to health or medical guidance that contradict the policies or orders of the health care entity.

In addition, the bill would prohibit state credentialing boards from acting against or denying or revoking a credential of a health care provider for expressing their medical opinions, regardless of the situation. Lastly, the provisions of the bill would not apply to faith-based health care entities have published religious, moral, or ethical policies or guidelines to the extent that an action taken by a health care provider violates the institution's religious, moral, or ethical policies or guidelines.

The bill has been referred to the Assembly Health, Aging and Long-Term Care Committee, but has yet to be scheduled for a public hearing. The WiHPCA Government Affairs Team will continue to lobby against AB 611 and keep members updated on the status of the proposal.

Earlier this month, Gov. Tony Evers issued a proclamation declaring November 2023 as Hospice and Palliative Care Month in Wisconsin. The proclamation, which was requested by WiHPCA, outlines the value of hospice and palliative care in Wisconsin for patients in need of life-ending and life-limiting care. It also applauds the tremendous contributions of hospice and palliative care professionals across the state and the importance of the quality care and services they provide to patients and their families. CLICK HERE to read the full proclamation.