HWW Update

HWW Update
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Vol. 10, No. 18 October 15, 2014
Our LAST Packers Tickets Prize Drawing is Almost Here

Join HealthWatch Wisconsin as an Individual Member by 5:00pm Friday, October 24 in order to be entered in to our last Packers Tickets Prize Drawing of the membership year. All Individual Members will be entered to win 2 indoor, deluxe club seat tickets to the November 16 game against the Philadelphia Eagles at beautiful Lambeau Field.

Ways to Join:

Remember, Packer Ticket Prize Drawings are just one of the many benefits of being a HealthWatch Wisconsin member! Other member benefits include: access to our comprehensive online Training Portal, access to the full version of our HealthWatch Update newsletter, short Video Case Tips, full-length on-demand trainings, and free and discounted registrations to our workshops, events, and popular annual conference.

Congratulations to our latest HealthWatch Wisconsin Packers Tickets Prize Drawing winner, Carlos Gonzalez of Madison! Carlos won two indoor deluxe club seat tickets to the October 19 game against the Carolina Panthers. Don't forget to join HealthWatch Wisconsin by the end of the day on Friday, October 24, in order to be entered to win in our final Packers Tickets Prize Drawing of this membership year!

In this issue...

We update you on the Voter ID Law, Marketplace issues, last months BC+ Enrollment, and more! We also get you caught up on Provider Memos, Ops Memos and showcase some great articles from the past two weeks. Of course, we bring you case tips and a news round-up, per usual!

Thanks to all of the current members, subscribers, and supporters--you make the HealthWatch Update possible!

HealthWatch members and subscribers, click on the red button below to start reading the full version of this newsletter! Remember to enter your login and password when prompted.

If you are new to the Training Portal, simply click "register" after clicking on the red button above. Answer the questions, create a username and password, and we'll help you take it from there! Not a member? Click here to join HealthWatch Wisconsin!

In the Training Portal: Newsletter Table of Contents:

Some of the news and analysis features added to the Training Portal as of October 15 includes:

  • Our LAST Packers Tickets Prize Drawing is Almost Here
  • Only 19 days left of the BC+ Limited SEP
  • Medicare Open Enrollment Begins Today!
  • HealthWatch Member Profile: Kevin Kane
  • Photo ID NOT Required for November Elections!
  • Video Case Tip: What is Spousal Impoverishment Protection?
  • Looking ahead to Open Enrollment
  • CMS "5 Steps to Staying Covered"
  • September BC+ Enrollment Numbers
  • ForwardHealth Updates
  • MTM Audit: Share Your Story
  • Penalties for the Uninsured
  • Coalition Roundup
  • Excepted Benefits
  • Health Insurance Coverage Options for Children
  • HealthWatch Member Announcements
  • Ask a Good Question... Renewing Coverage for Children
  • Et Cetera: New Handbook links, Ops Memos & Updates
  • Headlines
  • And much more!

Members and paid subscribers, click here to login and view the Update online!

Not a member yet? No problem! Click here to register online and pay for your membership or subscription with a credit card. Or, you can print a registration form to mail or fax back to us (instructions provided on the form). If you would like to register over the phone or have questions about the registration process, please call 1-800-585-4222 ext. 219 and talk to Cassidy.
Only 19 days left of the BC+ Limited SEP

If you lost BadgerCare Plus in April 2014 and did not regain coverage, you are now eligible for a brand new Limited Special Enrollment Period in Health Reform’s Marketplace. The new Special Enrollment Period runs: September 4 - November 2, 2014. What you need to know:

  • Coverage start dates are based on when individuals apply. Apply and enroll between the 1st and the 15th of the month, coverage starts on the 1st of the subsequent month.
  • The SEP is effective through 2014.
  • Those who lost BC+ on or before April 1 are eligible to apply
  • To apply, CALL the Marketplace at 1-800-318-2596 (do not go online). TTY users should call 1-855-889-4325.

Important: If you apply for the Special Enrollment Period, you will still need to purchase insurance during the Open Enrollment Period. The Special Enrollment Period will only cover you through 2014, while the Open Enrollment shopping you do will connect you to a plan for 2015.

Note to Advocates and Assisters: Be patient and persistent on the phone. Ask to speak to a supervisor at the call center if you need to. Call center staff are not all familiar with Wisconsin’s unique SEP. If you feel like you are not able to adequately evaluate if someone is eligible for the “new” SEP, consider seeking the help of HHS Region V Director Kathleen Falk’s office (HHS Region V Director) and having one of their staff people assist:

Regional Director Kathleen Falk
Office of the Regional Director, Region V
US Dept of Health and Human Services
233 N. Michigan Ave., Suite 1300
Chicago, IL 60601
(312) 353-5160

HealthWatch Member Profile
Kevin Kane, Citizen Action of Wisconsin

HealthWatch Wisconsin periodically features a “Member Profile,” in the Update newsletter. This feature spotlights the important work of current HealthWatch members. The profile also provides our membership with a closer look at the dynamic professionals and community members behind HealthWatch Wisconsin. Today, we profile a conversation with Kevin Kane, Lead Organizer at Citizen Action of Wisconsin.

HWW: What is your favorite part about Health Watch Wisconsin?
Kevin: I like how connected we are around the state with professionals from both rural and urban areas. You don’t see that deep level anywhere else.

HWW: Why did you decide to run for the HealthWatch Wisconsin Council? How would you encourage others to join the Council?
Kevin: I was nominated. It’s a great opportunity to stay connected with professionals who are concerned about public health in WI

HWW: You recently received an award in 2013 as The HealthWatch Wisconsin Advocate of the Year. Can you describe what that award meant to you?
Kevin: I was really honored. It was a chance to be recognized for the small contribution I have been able to make to the public health care movement. I was very touched by the award.

HWW: How do you use HealthWatch in your work?
Kevin: I use the Updates for important pieces of policy information. I also use it to work closely with others around the state in both rural and urban areas.

HWW: Can you highlight a current project you are involved in at you work?
Kevin: Right now, I am actively promoting the upcoming advisory referendums on accepting funds for BadgerCare around the state. It will be on the ballots in 20 cities and counties, with almost half of the state's population living in these areas. We have been promoting them, finding nonpartisan allies, asking candidates for their take on them and mobilizing voters in advance of the election and getting it covered in the news over 160 times since last May around the state."

HWW: What is your favorite movie/book/TV show involving health care and why?
Kevin: House md. I like watching them solve the health, and behavioral, puzzle. It takes something complicated and makes it understandable.

HWW: What is a little known fact about yourself?
Kevin: One of my first jobs was teaching chess to grade schoolers across southeastern Wisconsin.

Medicare Open Enrollment begins today (October 15) and runs through December 7!

As reported in the October 1 Update newsletter, Medicare’s open enrollment period will begin on October 15 and run through December 7. During this time, Medicare beneficiaries may make changes to their prescription drug plans or Medicare Advantage coverage. If consumers stick with their same plans as last year, about 70% of them will see some type of premium increase. Beneficiaries should take this in to account when selecting a plan, along with the network the plan covers. In a press release issued today by Wisconsin’s Commissioner of Insurance, seniors are cautioned that not all plans will look exactly the same as last year. Commissioner Nickel says, “Plans may change their premiums, deductibles, and coinsurance. They may also add or drop physicians and hospitals from their plan or change which drugs they cover.” The press release points to Medicare.gov as both a useful informational resource and a “one stop shop” for signing up for a plan.

  • To compare Medicare Advantage plans or to find out what plans are available in your area, you can:
  • Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, or visit Medicare.gov on the Web.
  • Contact the Medigap Helpline at 1-800-242-1060 (Medigap Helpline) or on the Web at longtermcare.state.wi.us/.
Video Case Tip: What is "Spousal Impoverishment" Protection?

ABC for Health's Anna Kaminski defines "spousal impoverishment" and explains when the rules come into play. Click here or on the picture to the right to watch.

What problems are you seeing in your area?

Send your questions or comments in an email, and we'll create a follow-up web cast filled with the answers!

All our videos are archived in our Video Case Tip Library so you can visit them at any time.

State Audit of Medicaid Transportation Issues: Share Your MTM Story

The Wisconsin Medicaid Transportation Program and vendor will face a state audit. Auditors are encouraging members of the public to contact them or the Legislative Audit Bureau directly with complaints and other information that they think should be included within the audit.

The Legislative Audit Bureau wants individuals with complaints or experiences with MTM to contact the LAB hotline (1-877-372-8317) to get an accurate picture of the quality of services MTM is providing. The Audit Bureau is online: http://legis.wisconsin.gov/lab/

Coalition Roundup

Help us complete our new listing of 2014 upcoming HealthWatch local coalition meetings! Email us! As always, contact the coalition directly for more information.

Coalition Next Meeting Contact
Chippewa County Nov. 11 Rose Marsh
Dane County Nov. 3 Anna Kaminski
Eau Claire Nov. 6 Lou Kelsey
Milwaukee Dec. 10 Danielle Coterel
Pierce County TBD Kelsi Winter
Polk County TBD Mike Rust
Tri-County Oct. 28 Connie Raether

*Dane County HealthWatch Coalition: Don't forget to bring your canned and dry goods to our November 3 meeting for our annual food drive!

Ask a Good Question...

“I’ve heard I need to renew my Marketplace coverage for myself. Do I need to renew my daughter’s BadgerCare?”

...Get a Good Answer: Login to the Training Portal to see the answer to this question!

HealthWatch Member Announcements:

Start Thinking About Your Health Care Hero’s!

The 8th Annual HealthWatch Wisconsin Conference is right around the corner! At this event, HealthWatch will again include an awards ceremony to recognize outstanding efforts for 2014. We need your help! Send us a nomination for a deserving person in one of our award categories:

  • Advocate of the Year
  • Elected Official of the Year
  • Outstanding Media Coverage
  • Outstanding Outreach Effort

Make your nomination today! Send an Email or Fax (608-261-6938) to HealthWatch with the following information:

  • Your Name & Contact info
  • The Award Nominee's Name and Contact Info
  • Which Award You are Nominating this person for
  • A few words why this individual/organization is worthy of the honor

Please submit all nominations by Friday, January 16, 2015.

Annual Call for Nominations to the HealthWatch Leadership Council!

Are you interested in being more involved in helping to guide project activities and trainings of HealthWatch Wisconsin? Each year, the membership of HealthWatch Wisconsin elects a new class of public health professionals to serve a three-year term on the HealthWatch Council. These leaders direct and amplify the powerful voice of the membership!

HealthWatch solicits nominations each fall from the membership-looking for people of diverse backgrounds and public-health-oriented professions. The last opportunity to submit nominations is at the Annual Conference in early 2015.

If you know someone you would like to nominate--or if you wish to nominate yourself, send us an email! Include your name, workplace, contact information, and the name of the individual you are nominating. Thank you!


NEW: BadgerCare Plus Handbook, published May 15 in Release 14-02

Section 51.1 has been revised

Release 14-01 of the Medicaid Eligibility Handbook (MEH), May 1, 2014

FoodShare Handbook, published February 27, 2014 in Release 14-01.

FoodShare Handbook, published July 31, 2014 in Release 14-02.

Marketplace Handbook: On October 3, CMS's Center for Consumer Information and Insurance Oversight released the first edition of a "Federally Facilitated Marketplace Enrollment Operational Policy & Guidance" Handbook, effective October 1. All enrollments made on or after October 1, 2013 MUST be processed in accordance with these requirements. This is a "living document!" Advocates, providers, and consumers are encouraged to submit comments or recommended changes. Email EnrollmentGuidance@cms.hhs.gov, and write "Comments on Enrollment Manual" in the subject line of the email.

Wisconsin Medicaid Plus Estate Recovery Program Handbook (P-13032) has been revised effective July 2014. The Handbook will be available to order July 28, 2014, through the normal process. Click here to order.

Release 14-03 of the BadgerCare Plus Handbook, September 5, 2014

ACCESS Handbook has published Chapter 12, ACCESS for Partners and Providers, it includes new information about the Express Enrollment process for making presumptive eligibility determinations in ACCESS.

Ops Memos

Ops Memo 14-38, Error Prone Profile, has been published to the web

Ops Memo 14-41, "Gap Filling" Referrals from the Marketplace, has been published to the DHS web

Ops Memo 14-42, BadgerCare Plus Transistional Benefit for Children, has been published to the web

Public Notices Health Services Annual Adjustment to Fees That May be Charged by a Health Care Provider for Providing Copies of a Patient's Health Care Records. See PDF for Diagram.


CMS kicks off effort to help Marketplace enrollees stay covered, CMS Press Release, Oct. 15

Medicare Advantage Open Enrollment Period Starts Early - Check Your Options Now, OCI Press Release, Oct. 15

A call for more scrutiny of private Medicare Advantage plans, The Center for Public Integrity, Oct. 15

How the new HealthCare.gov stacks up with the old, Washington Post, Oct. 14

FTC cracks down on a health insurance scam, CBS, Oct. 14

Tell Us What You Think!

HealthWatch Wisconsin Update readers, we want to hear from you! What do you think of the format? How do you find the material on the HealthWatch Wisconsin Training Site? Do you have any topics you'd like to see or questions you want answered. Please email HealthWatch and let us know!

Help HealthWatch Wisconsin & ABC for Health with a Tax-Deductible Contribution!

Support ABC for Health as we pursue our mission of helping people in Wisconsin secure access to health care and coverage. Our staff works tirelessly with the thousands of families and individuals who contact our office each year. To continue, we do need your help and support. A tax-deductible financial contribution will support direct legal, advocacy, and education services to families in Wisconsin.

Copyright © 2014 ABC for Health, Inc. All rights reserved. No reprint without permission.

HealthWatch Wisconsin is a project of ABC for Health, Inc.
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