AJ Wilson and Greg Hubbard
Hubbard Wilson Zelenkova LLC
Election Day has come and gone but likely won’t be one we forget anytime soon. When it was all said and done, now President-elect, Joe Biden defeated Donald Trump in Wisconsin by just over 20,000 votes. The close result was anything but new for the Badger State at the top of the ballot. Two years ago, Tony Evers defeated Scott Walker by 29,000 votes; in 2004, John Kerry defeated George W. Bush by only 11,000 votes; and in 2000, Al Gore defeated George W. Bush by only 5,700 votes. As I type, a potential recount is still pending but unlikely to change results significantly.
Notwithstanding the close presidential contest, legislative races were less competitive in Wisconsin. Despite very favorable pre-election polling, Democrats defeated only two incumbent Republicans in the State Assembly where Deb Andraca (D-MKE) and Sara Rodriguez (D-Brookfield) defeated Republicans Jim Ott and Rob Hutton respectively.
The State Senate went the opposite way altogether as Republicans picked up two seats held by Democrats. In the 12th SD that encompasses much of Northwestern WI, Rob Stafsholt (R) defeated Patty Schachtner (D) handily in the seat that Schachtner won in a special election just under two years ago. In the Green Bay area, Eric Wimberger (R) beat Jonathan Hansen (D) to snatch the open seat from Democrats that had long been held by retiring Dave Hansen.
Therefore, Republicans will continue to hold strong majorities in both houses of the State Legislature. The composition of the assembly will be 61-38 when they return in January. The State Senate will be 20-12 with one seat vacant as Scott Fitzgerald’s seat will be open as he won the WI’s 5th Congressional District. That heavily republican seat will most likely give Republicans a 21-12 majority early in session once the seat is filled.
Governor’s Proposal for additional COVID-19 response Legislation
The Governor proposed legislation in mid-November to address a number of pandemic related issues. The Legislature has not said whether it will come in before the end of the year to consider any of the proposals. The Governor’s draft, among several other provisions, includes the following:
- Require that insurers cover all telehealth services that would be covered were the services provided in- person.
- Prohibit insurers from requiring prior authorization or imposing quantity limitations below a 90 days supply through the end of 2021.
- Allow pharmacists to extend most Rx refills by 30 days through the end of 2021, where it is safe to do so.
- Ensure that health plans provide coverage for testing, diagnosis, treatment, prescriptions, and vaccines related to COVID-19.
- Prohibit cost-sharing and prior authorization for testing, diagnosis, treatment, prescriptions, and vaccines related to COVID-19.
- Establish that insurers will reimburse providers for out-of-network care (including telehealth) resulting from COVID-19 related disruptions at 250% of Medicare rates.
- Allow critical workers, including healthcare workers, to claim worker’s compensation benefits related to COVID-19, presuming that they received the illness from their occupation.
We are engaging with the Legislature to improve the Surprise Billing provision should this or any other bill move forward to include a definition of “usual and customary rate” as well as favorable dispute resolution.
We are also asking the Legislature to include a liability immunity provision for health care providers similar to what we were able to get included in the COVID response bill this Spring.
Board of Nursing Rulemaking Activity
The BON has taken action on three issues related to APNP scope of practice in the last two months. The first is a rule proposal that would allow the BON to waive APNP Collaboration Requirements contained in WI Nursing Code 8.10(2) and (7) during a state declared emergency. This rule change is in progress - Clearinghouse Rule 20-069. The comment period closed on Dec. 10 with a hearing where a joint letter was submitted from WACEP, the WI Society of Anesthesiologists, and WI Psychiatric Association in opposition.
The second is a proposed scope statement that would give the BON the ability to draft a new rule that would permanently amend current law collaboration requirements for APNP contained in WI Nursing Code - N8. The third is a proposed scope statement that would give BON the go ahead to draft permanent rule changes related to APNP prescribing limitations also contained in N8. Undoubtedly, this would be to expand those privileges, but details are not yet available. We have expressed front-end concerns and will continue to monitor and engage if these proposals move forward.
Surprise Billing Work Group
WACEP is working with the Wisconsin Radiological Society, the Wisconsin Society of Anesthesiologists, and the Wisconsin Society of Pathologists on comprehensive surprise billing legislation as well as the aforementioned proposal for pandemic response. At this moment, negotiations are taking place again on a federal bill. The direction Congress goes on this issue will dictate our response or pro-action on the state level.
Emergency Psych Task Force Work with State Sheriffs and Wisconsin Counties Association
HWZ, WCA, and Sheriffs’ lobbyists met recently with the Governor’s policy director to discuss options for including proposals of mutual agreement in the Governor’s executive budget. Among those proposals was a more substantive suggestion for regional crisis stabilization centers as well as proposed codification of the SMART medical clearance form.
Over the month, the legislature will fill out committee assignments and will then come back to start the new session in January. It is unlikely that another pandemic response bill will be taken up before inauguration day, however we continue to do outreach on the aforementioned priorities just in case they do come into session.