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Vol. 10, No. 12 July 15, 2014

ObamaCare Gaining Traction?


Nine months after the kick-off of Health Reform’s Insurance Marketplaces, research indicates a direct decline in the number of uninsured Americans. But despite enrollment progress as early as November 2013, after a troubled healthcare.gov website launch, there were doubters and nay-sayers. Recall, the US House of Representatives voted at least 50 times to repeal ObamaCare. Others, as NY Times Opinion writer Paul Krugman reminds us, said “nobody but the sick would sign up…” followed by, “ok, a lot have signed up, but they won’t pay…”

Reports from multiple sources are already showing us the decline in uninsured, from the Urban Institute to Kaiser Family Foundation, and more. So now it’s summer, with the next open enrollment period about four months away, and we’re in a lull that Krugman calls  “the absence of disaster,” where ObamaCare is working, people are gaining insurance, and the news is sadly not making headlines.


HealthWatch Comment Maybe the political reality is that health reform’s impact is being felt by the lower income, vulnerable populations. Perhaps that’s why it seems the media or pundits are slow to report on the success stories—these are traditionally the people with little political voice or representation. In Wisconsin, we have 1.2 million enrolled in a Medicaid or BadgerCare Plus program with an additional 120,000 enrolled in new Marketplace coverage. (Wisconsin’s Department of Health Services is holding on to the numbers of how many of these folks were previously uninsured.) Either way, there are a lot of voters in these numbers that could, if they find their voice, make the difference in an election, but they stay pretty quiet. There is comfort in knowing that while not perfect, ObamaCare is connecting more people to coverage.


For more on this topic, and in case you missed it, here’s our latest HealthWatch WatchDog episode. If you missed any of our previous episodes you can always check them out here.


In this issue we will update you on our September 8th Workshop and continue our discussion on the number of previously uninsured Americans. We also get you caught up on provider memos, Ops Memos, and follow the transition at HHS from Secretary Sebelius to new Secretary Burwell. 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 July 15 includes:

  • ObamaCare Gaining Traction
  • Sept 8th Workshop: Marketplace and Medicaid Appeals
  • Green Bay Packer's Tickets Prize Drawing
  • Easy Marketplace Renewals in 2015?
  • A Note from Cassidy, the HealthWatch Membership Coordinator
  • Update: Previously Uninsured
  • Missed Opportunities
  • Share your MTM Story
  • Video Case Tip: Best Available Information
  • Wisconsin Medical Loss Ratio Compliance Improves
  • Prescription Assistance-Cost Sharing or Cost Shifting?
  • Share Your BadgerCare, Medicaid, or Marketplace Story!
  • Coalition Roundup
  • Ask a Good Question... Wisconsin Funeral and Cemetery Assistance Program
  • 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.

September 8th Workshop: Marketplace and Medicaid Appeals

Registration now open!

When: Monday, September 8th, 2014 from 10am-12pm, following the Dane County HealthWatch Coalition Meeting

Where: Both the meeting and the workshop will take place at Warner Park Community Recreation Center, 1625 Northport Dr. Madison, WI 53704

To Register: Please complete and return the Registration Form or Call (608) 261-6939 ext. 219

Registration Fee:

  • $20 for 2014-2015 HealthWatch Members and Subscribers
  • $75 for workshop registration and a 2014-2015 HealthWatch Membership
  • $95 for workshop without a HealthWatch Membership
  • Call (608) 261-6939 ext. 219 for organizational memberships and group pricing

HealthWatch Wisconsin is hosting a September workshop to demystify and simplify the appeals process within Medicaid and health reform’s Marketplace. Health care consumers need to understand their legal rights, responsibilities, how to assert appeal rights and seek remedies in a changing health coverage landscape. The workshop will review common health coverage denials and provide attendees with specific strategies and referral resources to appeal wrongful decisions for both BadgerCare Plus and coverage in the Marketplace.


Join us for coffee, snacks, and a great presentation on Appeals!


This project is supported in part by a grant from the Dane County Bar Association’s “Grants for Worthy Causes;" the Wisconsin Law Foundation, charitable arm of the State Bar of Wisconsin; and ABC for Health. We are grateful for their support!

GO PACK GO! HealthWatch Wisconsin’s First Prize Drawing Winner!


Congratulations Molly Zuehlke, our First Green Bay Packer Ticket Prize Drawing Winner!


Those who registered for HealthWatch Wisconsin as individual members by the end of the day on June 30th were included in our prize drawing for TWO FREE INDOOR DELUXE CLUB SEATS to see the GREEN BAY PACKERS vs OAKLAND RAIDERS preseason game on Friday, August 22 at historic Lambeau Field. The winner of this prize drawing was HealthWatch Member Molly Zuehlke. Congratulations Molly! Watch our ticket drawing video HERE!


2014 Packer Ticket Prize Drawing Winners:

•    August 22 vs Oakland Raiders – Molly
•    August 28 vs. Kansas City Chiefs – You?


Next Green Bay Packer Ticket Prize Drawing Announced

The next Green Bay Packer ticket prize drawing will be for Thursday, August 28 as the GREEN BAY PACKERS take on the KANSAS CITY CHIEFS in a preseason match-up. Anyone registering as an individual member of HealthWatch by 11:59pm on Monday, August 18 will be eligible for the next Packer ticket prize drawing! Join us today for your shot at the tickets! For rules and responsibilities of the Green Bay Packer ticket prize drawings, please click here.

You may register via PayPal online at our registration page, or you may register via check or invoice by filling out our PDF registration form and returning it via fax or email. For any questions on your HealthWatch membership, please contact Cassidy via email or at 1-608-261-6939 x 219.

A Note from Cassidy, the HealthWatch Membership Coordinator!


HealthWatch Update

Two important and FUN updates! The first is that the Dane County HealthWatch Coalition is hosting its annual Summer Picnic this week! All are invited! The picnic will take place on Thursday, July 17th from 3:30 to 5:30 at Vilas Park in Madison. ABC for Health will supply items for the grill, and attendees are encouraged to bring a dish to pass. This is a great opportunity for our regular Dane County HealthWatch Coalition members to relax and for newcomers to see what HealthWatch is all about!


Next—please remember to check out the new content on the Training Portal! If you are having problems navigating the Training Portal, or if you would like to find out more about the Training Portal, check them out by clicking the links within this section. You must be logged in to view the Training Portal Introduction video. Of course you can always contact me for help as well!


How to reach Cassidy: cdavis@safetyweb.org; 608-261-6939 ext. 219

Video Case Tip: Best Available Information


Sometimes it is difficult to get complete or accurate verification information for BadgerCare Plus applications. Just because an applicant could not get specific verification in on time, does not mean their application should necessarily be denied. In this Video Case Tip we go over when using the best available information is acceptable.


Click Here or on the picture to the right to watch this Video Case Tip!


What problems are you seeing in your area?


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


All our videos are archived in our "Video Case Tip Libraryso 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/

Share Your Story!


Tell us your health care and coverage story! Did you gain Marketplace coverage? Lose BadgerCare Plus? Gain BadgerCare Plus? Lose HIRSP? None of the above? We want to hear your story! There are many ways to contact us:


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 Sept. 9 Rose Marsh
Dane County August 4 Anna Kaminski
Eau Claire Sept. 4 Lou Kelsey
Milwaukee August 13 Danielle Coterel
Pierce County TBD Kelsi Winter
Polk County TBD Mike Rust
Tri-County July 22 Connie Raether

*Dane County HealthWatch: There is no meeting in July--the Picnic, which is replacing the July meeting, will take place on Thursday, July 17th from 3:30-5:30pm at Vilas Park! ABC for Health will supply the grilling food, if everyone else would bring a dish to pass. We hope to see everyone there!

Ask a Good Question...

My loved one passed away and along with everything else I have to worry about, I've found out that burial/funeral costs are so high. Is there a program in Wisconsin that helps with this?


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


We have created a new Video Case Tip Series called Back2Basics!


We received a lot of feedback from you that it would be great to get back to the basics of Health Care Reform. We listened and created refreshers on topics such as:



And many more! Check them all out HERE. If you have any ideas that we have not already covered, let us know!

Handbooks


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.

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.


Ops Memos


Ops Memo 14-25 Time Limited FoodShare Benefits for Able-Bodied Adults without Dependents (ABAWDs), has been amended 

Ops Memo 14-26 Exempting Foster Parents, Court Ordered Kinship Care Cases, and Subsidized Guardians from Self-Employment Authorization Limit

Ops Memo 14-27 FoodShare Employment and Training (FSET) participation for Able-Bodied Adults without Dependents (ABAWDs) subject to time-limited FoodShare, has been amended

Ops Memo 14-28, Updates to the Income Maintenance Quality Assurance Second Party Review Tool, has been published to the DHS web

Ops Memo 14-29, Telephonic and Electronic Signature Enhancements, has been published to the DHS web, has been amended

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.


FEATURED LINKS


New resources improve states’ abilities to advance Medicaid payment and delivery system reform, HHS.gov, July 14

May Medicaid & CHIP Eligibility and Enrollment Report, Medicaid.gov, July 2014 

Medicaid Moving Forward Issue 2: Improving Care & Transforming Delivery Systems, Medicaid.gov, July 14

It’s Not the Economy, Stupid, NYTimes.com, July 13

Obamacare Fails to Fail, NYTimes.com, July 13

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.

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