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WiAHC Legislative/Regulatory News and Notes

January 21, 2022 10:35 AM | WiAHC Office
  • All Health Plans to Cover Cost of At-Home COVID-19 Tests
    On January 13, Governor Evers and Insurance Commissioner Nathan Houdek announced that all health insurance plans will be required to cover the cost of at-home rapid, diagnostic COVID-19 tests, starting on January 15, 2022.  This is required by the federal government.  These tests may be free or reimbursable to patients, depending upon arrangements health plans and insurance companies make with retailers/pharmacies.  Health plans and insurance companies will be required to cover up to eight such diagnostic tests per person, per month. 

  • State Improves Prescription Drug Monitoring Program 
    In December, the state Department of Safety and Professional Services (DSPS) announced that the U.S. Department of Justice awarded $1,648,000 to the Wisconsin Enhanced Prescription Drug Monitoring Program (ePDMP).  These dollars will be used to help connect the ePDMP with existing electronic medical records systems in Wisconsin. DSPS intends to focus these efforts on medical providers in rural and underserved regions in our state. 
  • Medicaid Program Surplus Projected
    On December 30, 2021, the Department of Health Services informed the legislature that it projects that the state will have a $184.9 million surplus in the Medicaid program by the end of the 2021-2023 state budget.  The state budget expires at the end of state fiscal year 2023, which ends on June 30, 2023.  This increase is largely due to the extension of the federal COVID-19 public health emergency and the additional 6.2 percent Medicaid match rate, which is provided by the federal government while the emergency declaration is in place. 
  • Gov. Evers Announces Wisconsin National Guard to Support Hospital and Nursing Home Capacity
    Wisconsin Gov. Tony Evers recently announced new efforts with the Wisconsin National Guard to bring needed staffing support to Wisconsin's hospitals and nursing homes by training Wisconsin National Guard members as certified nursing assistants. In an effort to free up capacity at hospitals, staffing relief will allow skilled nursing facilities to open up 200 or more beds by the end of February to receive post-acute care patients. This week, approximately 50 Wisconsin National Guard members were deployed to six nursing homes across the state. A group of about 80 members who started training this week will deploy at the end of January. Another group of about 80 members will start training in early February to deploy by the end of February.
  • Protecting Medicare and American Farmers from Sequester Cuts Actz
    On December 10, President Biden signed the Protecting Medicare and American Farmers from Sequester Cuts Act (S. 610) into law, addressing multiple policies expected to drastically cut  physician Medicare reimbursement in 2022. More specifically, the act does the following:
    • Provides a 3 percent increase to the Medicare Physician Fee Schedule (MPFS) conversion factor in 2022, which provides relief from the scheduled expiration of a 3.75 percent increase passed as part of the Consolidated Appropriations Act, 2021.
    • Extends the suspension of the automatic 2 percent cut to Medicare reimbursement, known as the sequester, until March 31, 2022.
    • Delays an additional 4 percent cut stemming from the Statutory Pay-As-You-Go Act of 2010 (PAYGO) until at least 2023.
  • Supreme Court Blocks Biden’s COVID Vaccine Mandate Rule for Large Businesses; Upholds Health Worker Requirement
    As has been widely reported, the U.S. Supreme Court recently handed down a split decision on two Biden administration COVID-19 vaccine requirement workplace rules: 1.) An OSHA rule requiring businesses with at least 100 employees to compel their workers to get vaccinated or wear masks and test negative at least once per week; and 2.) The CMS rule mandating most health care workers to be vaccinated against COVID-19. The High Court struck down the OSHA Rule on a 6-3 decision, but it upheld the CMS mandate on a 5-4 decision.
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