Hubbard Wilson & Zelenkova
The State Budget process is moving forward. To date, the Joint Finance Committee (JFC) has taken on mostly low hanging fruit as a local funding (shared revenue) and local taxation stand-alone bill is being negotiated separately. The local funding increase will have impacts on the rest of the state budget, so until that is resolved, bigger ticket items like MA and DHS will likely wait. Either way, we expect MA and DHS to be voted on in the next two weeks or so. Typically, JFC budget deliberation wraps up in early to mid-June and the legislature takes up the budget in the subsequent two weeks. We still expect that to be roughly the case and hopefully the Governor will be signing a new 2023-25 budget into law in early July.
Specific Issues
Emergency Physician Medicaid Reimbursement Increase: As you recall, Gov. Evers proposed an executive budget that included a significant increase MA reimbursement for emergency physician codes. The intent of the Governor’s provision is to increase overall emergency physician services reimbursement rates to 50% of Medicare. This is part of the biennial budget bill and deliberations. We are actively lobbying all members of the Joint Finance Committee and will continue to do so to include the Governor’s proposed increase in the final version of the budget.
APRN /Nurse Independent Practice and Physician Title Protection: The Senate Health Committee had a hearing on both SB 143 and SB 145 last week (APRN license/independent practice and Physician Title Protection). This hearing was arguably premature as negotiations continue between stakeholder, key legislators, and the governor’s office. As a coalition we continue to fight for four years of clinical experience before an APRN can practice independently, physician title protection, guardrails on APRN pain practice, and ED requirements. As you recall, our advocacy resulted in the Governor including the following language in his executive budget proposal which he deems part of an overall deal on APRN: 50.36 (3s) of the statutes is created to read: 50.36 (3s) The department shall require a hospital that provides emergency services to have sufficient qualified personnel at all times to manage the number and severity of emergency department cases anticipated by the location. At all times, a hospital that provides emergency services shall have on-site at least one physician who, through education, training, and experience, specializes in emergency medicine.
We know that the WI Hospital Association is opposed to this language, as is the APRN senate bill author, so it is an uphill battle. But we continue to work to keep this important provision on the table.
Post-partum 12 Month Medicaid Extension: WACEP is part of a coalition working to extend post-partum benefits to twelve months. This provision was contained in the Governor’s budget and is also being circulated as stand-alone legislation by republican legislators as LRB 1377/1 and LRB 0324/1 authored by Senators Joan Ballweg and Mary Felzkowski and Representatives Donna Rozar and Tony Kurtz.
SB 205/AB 173: Suicide Prevention Grants: WACEP also registered its support for this bill, authored by Sen. Jesse James and Rep. Shae Sortwell, that requires the Department of Health Services to award grants to organizations or coalitions of organizations, including cities, villages, towns, counties, and federally recognized American Indian tribes or bands, for 1) training staff at a firearm retailer or firearm range on how to recognize a person that may be considering suicide; 2) providing suicide prevention materials for distribution at a firearm retailer or firearm range; or 3) providing voluntary, temporary firearm storage for the lawful owner of a firearm. A grant recipient must contribute matching funds or in-kind services having a value equal to at least 20 percent of the grant amount.
