You may recall that for several years, WACEP has attempted to work cooperatively with the WI Department of Health Services (DHS) to educate staff about Wisconsin’s worst-in-the-nation rates for reimbursement of Emergency Physician Services in Wisconsin’s Medicaid programs, and seek "fair" reimbursement at least on par with surrounding states. Having once again experienced empathy without action from DHS, WACEP undertook a more aggressive legislative solution this year.
As a part of the State Legislature's Joint Finance Committee’s (JFC) review of the 2017-19 State Budget, Representative John Nygren led an effort to require DHS to create a study group made up of Medicaid program staff and outside Emergency Physicians to examine care provided to Medicaid patients, search for ways to save money, and make recommendations back to JFC. The goal was to find savings in the system that could then turned back into increasing reimbursements for Emergency Physician Services – ultimately costing the Medicaid program nothing more.
This study group, if successful, would have served as a model for other private-public efforts. The JFC ultimately incorporated a requirement for an Emergency Physician Study Group, and it was approved by the full Legislature in September.
Unfortunately, Governor Walker vetoed the provision (along with 99 other items, many of them similar studies or reports from agencies) this week, stating in his veto message that the study duplicated existing “managed care and care coordination efforts in the DHS.”
With healthcare reform, the ACA, discussions about future Medicaid program funding and block grants all still in flux in Washington, these discussions are far from completed, and we will plan to regroup and continue these efforts in the coming months.
Many thanks to Lisa Maurer, MD, WACEP Board member who spearheaded the effort, as well as to all of you who responded to WACEP’s recent Legislative Alerts asking you to contact the Governor’s office.