HWW Update
Home About HealthWatch Fall Workshop Training Publications
Vol. 11, No. 15 August 17, 2015

Workshop Registration is Now Open!

In this issue...

Registration is now open for our fall workshop! Join us in Milwaukee for an afternoon of Marketplace and Medicaid troubleshooting. We'll gather just after Open Enrollment 3.0 kicks off! Bring your ACA questions to the workshop! See registration links and details below. Also in this edition, we congratulate our newest Green Bay Packers Ticket Prize Drawing winner! We have another chance to win! See details below! We summarize some interesting proposed bills in this Update, one focusing on Caregivers and another on Coverage for Eating Disorders. We also summarize the newest July BadgerCare Plus enrollment data. Are we turning a corner with our Childless Adult data? Maybe, but there are new concerns! We continue our story on insurance company mergers, including the HUGE price tag some companies are willing to pay to merge, and ask, "just what does $54 billion look like anyway?!" All this and more, including a Q & A on BC+ and back to school, Ops Memos, Provider Updates and HealthWatch Coalition updates! 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!

CONGRATULATIONS, Theresa Duello from Madison!
Past prize winner, Julie of Polk Co. and her daughter at Lambeau Field!

Theresa Duello, you're headed to Lambeau Field! Thank you to all those individuals who joined or renewed their membership in HealthWatch Wisconsin before the end of the day July 31st! They were eligible for the second Packers ticket prize drawing of the HealthWatch Wisconsin membership year! This prize drawing was for two indoor, deluxe club seat tickets to the September 3rd preseason match-up between the GREEN BAY PACKERS and the NEW ORLEANS SAINTS at Lambeau Field! Congrats, Theresa, and GO PACK!

There's still time to have your name added to the next Packers prize drawing!

Join or Renew Today:

  • Register online and pay via PayPal at our registration page;
  • Fill out our PDF registration form and return it via fax or email; or
  • Call us at 608-261-6939 x 218 and register over the phone.
A HealthWatch membership provides valuable benefits such as electronic publications, on-demand training videos, and other resources through the HealthWatch Training Portal. We also offer substantial discounts on registration for trainings, workshops, and conferences on health care hot topics in 2015 and 2016. Whether you are renewing last year's membership, or looking to join HealthWatch Wisconsin for the first time, you will not want to miss out!

Give us a call at any time: 608-261-6939 ext 218.

REGISTRATION NOW OPEN: Building Blocks of Health Coverage

Join us in Milwaukee on Tuesday, November 3 for an afternoon of Medicaid & Marketplace workshops! In this "intermediate-level" training, we'll start the afternoon with a session called "Open Enrollment 3.0."

We'll explore issues like taxes, family size, and ways to direct consumers to the correct coverage program. We'll then focus our attention on "Coverage Transitions" for both children and adults. We'll then turn our attention to "BadgerCare Plus Hot Topics and Troubleshooting," as we look at BadgerCare Plus eligibility tips for parents and children--but also childless adults.

The workshop will examine appeals in both Medicaid and the Marketplace, taking a look at the independent review process. We'll conclude the day with a detailed look at "Immigrant Health Coverage Considerations," answering your top questions in eligibility, verification and enrollment.

This rescheduled workshop will better accommodate busy schedules and provide the latest details for the next Marketplace Open Enrollment Period. There are substantial discounts for HealthWatch members! Workshop attendees who register early earn an additional entry in the next Packers Ticket Prize Drawing!

WHAT: The Building Blocks of Health Coverage Workshop
WHEN: Tuesday, November 3, 2015
TIME: 12:30pm - 4:30pm
WHERE: Medical College of Wisconsin (Milwaukee)
PRICE: $20 for HWW members! Join and Register at the same time!
REGISTER: Click the big red button!
QUESTIONS: Call 608-261-6939 ext. 218

In the Training Portal: Newsletter Table of Contents:

Some of the news and analysis features added to the Training Portal as of August 17 includes:

  • New Prize Winner!
  • Building Blocks Workshop Registration Open!
  • WI Refuses $360 Million
  • As the Insurers Grow...What Does $54 Billion Look Like?
  • Mental Health Coverage Denied
  • Senators Introduce RAISE Act
  • One Mother's Fight for Insurance Coverage
  • Medicaid Expansion: Impacts on Top Performing States
  • Coalition Corner: Information and Resources from Local HW Coalitions
  • Ask a Good Question...BC+ Residency question this week!
  • 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. 218.
In Memoriam

HealthWatch Wisconsin extends condolences to family and friends of Gwen Altheimer, previously the Program Manager for the City of Milwaukee Health Department's Community Healthcare Access Program. Gwen passed away July 31, and funeral services were held Saturday, August 8 at Northwest Funeral Chapel. As many of you recall, Gwen was the HWW Outstanding Outreach Effort award winner back in 2010. Here's a sample of the positive comments the public health workforce shared when Gwen was nominated for the award:

  • "Gwen has been with the program for just shy of a year, yet has accomplished some remarkable things with her newly-expanded team."
  • "Gwen's spirit of collaboration in the community is unwavering."
  • "She is quick to help both consumers and advocates when difficulty arises, and is timely and consistent in her follow-up and follow-through."
  • "Gwen is proactive and takes steps to maximize her staff's impact on the community."
  • "She is committed to the excellence and integrity of the CHAP program, and is willing to jump in and work on the 'front lines' at any time."
  • "Her kindness and affable demeanor is also greatly appreciated by her colleagues."
  • "Gwen's commitment to serving the community is admirable, and she is greatly respected in the Milwaukee community."

Check out this great Fox News 6 Milwaukee video link featuring Gwen answering questions and advocating for Milwaukee health care consumers.

Decline of Childless Adults Reverses

On August 6, 2015, DHS released BadgerCare Plus enrollment data for the month of July. After three months of dismal Childless Adult enrollment, the tide might slowly be turning. In July, just over 1,000 childless adults were added to BadgerCare Plus! While enrollment is still down over 13,500 from where we were in March, (now closer to where we were at the end of 2014) it was the first time we saw an increase in enrollment after the annual renewal period began. Recall, at the close of 2015, 14,613 Childless Adults were dropped from BadgerCare Plus. We speculate that the renewal period was the cause.

While we are cautiously celebrating the uptick, albeit small, other data has us concerned: From June to July 2015, another 1,741 children have dropped off BadgerCare Plus, continuing the decline in enrollment. Over 10,500 children have lost BadgerCare Plus coverage since March 2015. (Login to continue reading)

Senators Introduce RAISE Act to Support Family Caregivers 

Wisconsin Senator, Tammy Baldwin, and Maine Senator, Susan Collins, introduced:
Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act at the first session of the 114th United States Congress on July 8, 2015.  The Act intends to create the establishment and maintenance of a National Family Caregiving Strategy. "If we are serious about ensuring that our older adults and loved ones with disabilities receive the highest quality care in their own homes, we must formally recognize and support family caregivers," advocated Senator Baldwin.

According to the AARP, a caregiver is a relative partner, friend, or neighbor who has a significant relationship with, and who provides a broad range of assistance for, a person with a chronic or other health condition, disability, or functional limitation.

Although this strategy does a lot to protect the wellbeing of caregivers and those they serve, the current draft lacks critical coverage elements.  The strategy does not provide support, training or resources to educate caregivers or professionals on health benefits programs - both public and private, as well as advocacy strategies. Navigating the complex health coverage system usually falls to family members and caregivers - who are not equipped to handle the difficult decisions, hearings or appeals. (Login to keep reading.)

New Video Case Tips Just Added!

HealthWatch members continue to request fresh Video Case Tips with a focus on hot topics - and we listened! Check out these brand new videos recorded recently in ABC for Health's studio: Each informative video in our Video Case Tip Library includes links to resources or more information. You can watch these videos at any time- they're on-demand and available wherever there is an internet connection!

Ask a Good Question...

My daughter is starting college in Minnesota this month. Next month, i'll be leaving my work, which means we will all lose our insurance. Can my daughter apply for BadgerCare Plus, even if she is in Minnesota?

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

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.

Note: Dane County HW Coalition will meet Sept. 14 to accommodate Labor Day.

Coalition Next Meeting Contact
Chippewa County Sept. 8 Rose Marsh
Dane County Sept. 14* Anna Kaminski
Eau Claire Sept. 3 Lou Kelsey
Milwaukee TBD Danielle Coterel
Pierce County TBD Kelsi Winter
Polk County TBD Mike Rust
Tri-County August 25 Connie Raether

Et Cetera: Memos & Updates


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 May 15, 2015 in Release 15-01

NEW: Medicaid Eligibility Handbook (MEH), published July 30, 2015 in Release 15-02

Administrator's Memo 14-04, 2015 IM Consortia Administrative Allocation, has been published to the DHS web

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 15-25 Employment Verification for WI Shares

Ops Memo 15-26 Home and Community-Based Waivers Group C Enhancement and Redesign

Provider Memos

2015-33 International Classification of Diseases, 10th Revision, Testing for HMOs

2015-34 Revised Prior Authorization Drug Attachment for Hepatitis C Agents Effective August 1, 2015

2015-35 ICD-10 Diagnosis Codes for Targeted Case Management Services

2015-36 Change to Prospective Drug Utilization Review Alerts



Advocates Say Mental Health 'Parity' Law Is Not Fulfilling Its Promise, Kaiser Health News 

Obamacare‚Äôs Solid Progression, The Washington Post 

Obamacare Works When States Don't Get In Way, Chicago Sun Times

Tax Filing Problems Could Jeopardize Health Aid for 1.8 Million, The Kansas City Star

The Connection Between Health Coverage And Income Security, The Wall Street Journal

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