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Vol. 11, No. 9 May 15, 2015

The Good & Bad News for Childless Adults

In this issue...

A new HealthWatch Wisconsin membership year starts July 1! Start making plans to RENEW membership, REFER a colleague, or JOIN HealthWatch for the first time! We update you on a BIG policy change for Childless Adults enrolled in BadgerCare Plus, but also share April enrollment data that shows a drop in Childless Adults. We summarize the MTM Audit Report and recommendations from the Legislative Audit Bureau and remind folks of the cut-off date for energy assistance! Finally, we share the latest news and Provider Memos, Ops Memos and the top articles from the past two weeks. Happy reading!

Enjoy this "free" version of the newsletter! Are you a member of HealthWatch Wisconsin? 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!

ATTENTION: A New Membership Year Starts July 1!

The start of a new HealthWatch membership year is almost here! The HealthWatch Wisconsin membership years run July 1 - June 30. A HealthWatch membership provides valuable benefits such as in depth information about access to care and coverage programs. HealthWatch Wisconsin also helps amplify the voice of members as we work toward quality and accessible health care for people across Wisconsin. Members gain access to electronic publications, on-demand training videos, and other resources through the HealthWatch Training Portal, and substantial discounts on registration for trainings, workshops, and conferences on health care hot topics in 2015 and 2016!

Current HealthWatch Wisconsin members: Watch your inbox for an opportunity to renew your membership while taking advantage of new membership benefits!

In order to keep enjoying the wonderful benefits provided through HealthWatch, members will need to renew their current memberships for the 2015-2016 HealthWatch year. We also encourage you to refer colleagues who may benefit from joining us in our efforts! And don't forget about chances to win Green Bay Packers tickets in our Prize Drawings!!

Considering joining HealthWatch for the first time? Registration for the new membership will open soon! Watch your inbox, or give us a call at any time: 608-261-6939 ext 210.

In the Training Portal: Newsletter Table of Contents:

Some of the news and analysis features added to the Training Portal as of April 30 includes:

  • Start Planning for a New HWW Membership Year!
  • Long Term Care Coverage for Childless Adults
  • Childless Adults, Parents, & Childre Fall Off BC+ in April
  • MTM Audit Report is Released
  • Energy Assistance: Last Chance
  • JFC Calls for Modest Changes to FamilyCare & IRIS
  • CMS Clarifies Women's Preventive Services
  • Coalition Corner: Information and Resources from Local HW Coalitions
  • Ask a Good Question...Crowd Out Rules
  • 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 608-261-6939 ext. 210.

MTM Audit Report is Released

On Tuesday, May 12, the Legislative Audit Bureau (LAB) released its report on Wisconsin's Non-Emergency Medical Transportation (NEMT) services. Since September 2012, Wisconsin's Department of Health Services (DHS) has administered a contract with vendors to serve as a statewide transportation broker. MTM’s contract extends through July of 2016 with a possible two-year renewal.

Report Findings
The Legislative Audit Bureau analyzed concerns with the transportation provided by MTM, including no-shows and late arrivals, and abandoned calls:

  • From August 2013 through June 2014, MTM provided 2.3 million trips to approximately 69,300 Medicaid recipients.
  • From August 2013 through June 2014, MTM received 12,748 complaints
  • Of 103,431 calls made to MTM's call center in June 2014, 14.3% were abandoned before they were answered.
  • From August 2013 through June 2014, the LAB found 4,154 instances in which transportation providers did not arrive for a scheduled trip.
  • From August 2013 through June 2014, the LAB found 55,320 instances in which transportation providers arrived more than 15 minutes late to take recipients to their appointments.
  • Data on NEMT expenditures are incomplete because of limitations in how they were collected and reported before FY 2011-2012.
  • From July 2010 through January 2015, the Legislative Audit Bureau received a total of 386 complaints regarding NEMT services

The Report made recommendations to improve NEMT services and enhance oversight by DHS. Continue Reading (login required).

May 15: Last Date to Enroll in Energy Assistance

From the Home Energy Plus website: The Wisconsin Home Energy Assistance Program (WHEAP) provides assistance for heating costs, electric costs, and energy crisis situations. Operating with federal and state funding, the program provides assistance to approximately 225,000 Wisconsin households annually. Most types of fuel are eligible to receive assistance. Whether you use wood, propane, natural gas, electricity, or fuel oil to heat your home, energy assistance is available if you qualify. Continue Reading (login required).

For more information on the Wisconsin Home Energy Assistance Program (WHEAP) and how to apply, please call 1-866-HEATWIS (432-8947), or visit the "Where to Apply" tab on www.homeenergyplus.wi.gov to find your local energy assistance agency.

New Conference Video Added to the Training Portal!

Thank you again to everyone who made our 8th Annual HealthWatch Conference a success. If you missed a session or wanted to watch it again, it's now easier than ever. If you were a paid conference attendee, you will have access to the Conference Webpage inside the HealthWatch Wisconsin Training Portal.

Simply "hover" your mouse over the tab titled "HWW Training Content" and click on "2015 HWW Conference." Click on the image of the session you would like to see, sit back, and enjoy! Having trouble with the video? Send us an email!

Ask a Good Question...

I'm not able to pay my full Marketplace premium right now. Will my insurer terminate my coverage?

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

A Closer Look at Our "Elected Official(s) of the Year" Award Winner(s)!

At the annual "HealthWatch Wisconsin Awards," we celebrated outstanding work in advocacy, outreach, media, and as an elected official. In our last Update newsletter, we profiled our  Outstanding Media of the Year award recipient Adam Rodewald! In this edition, we take a look at our "Co-Elected Officials" of the Year--it was a TIE!

In Memorium, Portage County Supervisor Joanne Suomi
HealthWatch Wisconsin recognizes Joanne Suomi, in memorium, from Portage County. Joanne fought two uphill battles in 2014. She led the charge, working for months to get a BadgerCare resolution and referendum in Portage County. That’s how some of our HealthWatch members learned of Joanne’s passion for advocacy and access to health care, and made this nomination.

Even more important to Joanne, however, was the opportunity for people in local communities to have a voice in state level decision-making. Sadly, Joanne passed away from Breast Cancer just before the successful vote on the BadgerCare referendum she worked so hard for. Joanne would have been proud: in Portage County, 72% of voters said “Yes” to strengthening the state’s BadgerCare program.

This past year was the start of Joanne’s second term on the County Board. Folks from central Wisconsin might remember that Joanne was first elected by a coin toss in 2012 after she and her opponent each received the same number of write-in votes for the job. Neither of them actually ran for the county position. This past April, she was re-elected, working until August when she decided to step down from the county board to giver herself a little time to focus on her health. It was in September that she passed after her courageous battle with cancer. We should be calling her Dr. Joanne. She got her bachelor’s degree in Connecticut, her home state, followed by a Masters from Western Illinois. She got her Doctorate in Special Education from UW-Madison.  Her schooling, love of all things athletic, and work experience—at places like the Indiana Institute for Developmental Disabilities at Indiana University, let to Joanne and her husband founding the Special Needs Aquatic Program at UW-Stevens Point. She was considered an expert in aquatic instruction for people with and without disabilities. What you might not know is that Joanne was a nationally-ranked powerlifter and continued to be a competitive runner and avid tennis player in her later years.

Joanne was extremely proud of her service to the City of Stevens Point and Portage County Board. She was respected by her constituents for her ability to advocate for them and the issues-sometimes difficult or controversial-that she brought up to the common council.  On behalf of HealthWatch Wisconsin, congratulations to the family of Joanne Suomi, our co-Elected Official of the Year.

Lincoln County Supervisor Jim Alber
Jim was nominated by a HealthWatch Wisconsin Council member who described him first and foremost as "fiery." A farmer outside of Tomahawk, WI, Jim was not afraid to use some muscle and fight through a strong BadgerCare referendum with a committed minority of his Lincoln County Board of Supervisors. But Jim didn’t stop there. He helped get media attention on the issue of access to BadgerCare in Wisconsin and the fiscal consequences of accepting Medicaid Expansion money, and worked to convince other county boards to take part. On Election Day, 67% of voters in Lincoln County said “Yes” to strengthening the state’s BadgerCare program. 

Jim has been on the Lincoln County Board since 2000. Jim says he understands the struggles of small businesses, needs of the elderly, and has a frugal stance on spending and taxation. Jim also sees potential revenue for his county in the form of green energy. Jim is a graduate of UW-Stevens Point and continues to learn and try new things. In fact, in 2009 he became a licensed cheesemaker after over 30 years in the construction business working as a millwright; construction superintendent; and managing boiler, turbine, and coal processing equipment construction and repair. What’s next for Jim? A continued commitment to the people of Lincoln County, and, he hopes, a future making cheese! On behalf of HealthWatch Wisconsin, congratulations to Jim Alber, our co-Elected Official of the Year.

HealthWatch Wisconsin Welcomes Matt Keller, New Membership Coordinator!

On Monday, June 1, ABC for Health will welcome Matt Keller as our new HealthWatch Wisconsin Membership Coordinator! Matt brings experience from past jobs in environmental outreach and advocacy, campaign field organizing, and independent living advocacy for individuals with disabilities. A graduate of UW – La Crosse, Matt completed AmeriCorps service in post-Hurricane Katrina Louisiana and also served as a Service Manager for Covenant House in New Orleans while in school. He was also active in Model UN conferences and work with Campus Camp Wellstone while working at the Family and Children’s Center as a Program Aid in Leadership and Alternative Education.

Matt says he looks forward to personally introducing himself to our membership, but also introducing more folks to HealthWatch. He envisions local coalitions, providers, and communities working together with a shared passion around access to health care and coverage. Matt will be joining us in time to share more thoughts "in his own words" in the June 1 Update newsletter. Welcome aboard, Matt!

Wisconsin State Budget Proposal: There is Still Time to Share Your Story!

The Wisconsin State Budget proposal is working its way through the Joint Finance Committee. There is still time to share your story, and make your voice heard! Learn more about the state budget proposal and then contact your elected officials. Visit legis.wisconsin.gov and click "Find my Legislator" to get contact information.

Elements of the State Budget: Many of the health care related items are getting widespread attention at a state and national level—calls to drug test public benefits recipients, hoops and hurdles for Childless Adults, and elimination of programs like Family Support programs. Other notable provisions create a Dental Pilot Project, the extension of Disproportionate Share Hospital (DSH) payments, the extension of Adoption Assistance, the extension of Family Care, and much more.

The executive budget introduced new requirements for adults to maintain or gain access to BadgerCare Plus, including paying premiums, undergoing drug screenings, undergoing a health assessment (and paying more in premiums if the assessment shows “risky behaviors,” and being terminated from coverage after 48 months. Some of the changes envisioned are subject to federal approval. To view a summary of the health coverage-related pieces of the proposed budget, click here.

Not sure where to start? The State Legislative Council Staff has prepared a guide to help you share your story. The "Citizen's Guide to Participation in the WI State Legislature" gives an introduction to the legislature, how to find legislative documents and follow the legislative process, how to contact your legislator, how to testify at public hearings and a glossary of terms.

Coalition Roundup

Help us complete our new listing of 2015 upcoming HealthWatch local coalition meetings! Email us! As always, contact the coalition directly for more information.

Coalition Next Meeting Contact
Chippewa County June 9 Rose Marsh
Dane County June 1 Anna Kaminski
Eau Claire Sept. 3 Lou Kelsey
Milwaukee June 10 Danielle Coterel
Pierce County TBD Kelsi Winter
Polk County TBD Mike Rust
Tri-County May 26 Connie Raether


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.

BadgerCare Plus Handbook, published November 20, 2014 in Release 14-04

Medicaid Eligibility Handbook (MEH), published December 18, 2014 in Release 14-02

Release 15-01 of the ACCESS Handbook was published on January 16th

Release 15-01 of the Electronic Case File (ECF) Handbook was published on January 16th

Release 15-01 of the FoodShare Handbook was published

Ops Memos

Ops Memo 15-12, Requirement for Social Security Numbers or SSN Applications for Children receiving Child Care under Wisconsin Shares

Ops Memo 15-13, Child Support Cooperation Requirements for Child Care

Ops Memo 15-14, Unearned Educational Aid Income

Ops Memo 15-16 Using Equifax Data to Verify Earned Income

Ops Memo 15-07 Long Term Care for Childless Adults

Provider Memos

2015-13 Changes to Pharmacy Policies for Hepatitis C Agents Effective April 1, 2015

2015-14 Outpatient and Inpatient Hospital Observation Policy

2015-15 Upcoming Training Sessions Available for Providers Regarding International Classification of Diseases, 10th Revision Readiness

2015-16 Clarification of Copayment Exemptions for BadgerCare Plus and Medicaid Members

2015-17 Important Information and Reminders Related to ForwardHealth's Transition to International Classification of Diseases, 10th revision, Code Sets

2015-18 Institutionalized Childless Adults Eligible for Long Term Nursing Home Care


About 137 million individuals with provate insurance are guaranteed access to free preventive services, Press Release HHS

Here's a radical approach to big hospital bills: Set your own price, NPR

Healthcare.gov contractor optum delcares its job done, Wall Street Journal (login may be required)

Does Obamacare help hospitals? Kaiser Health News Morning Briefing

Millions of Americans Have Gained Coverage, Health Affairs

Putting data to work to improve health, Health Affairs Blog

Counting the Uninsured: Are We Getting it Right?, Health Affairs Blog

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 © 2015 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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