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Vol. 10, No. 16 September 15, 2014
Good News for BadgerCare Plus Enrollees Terminated last April 1

The Centers for Medicare and Medicaid Services (CMS) announced that it is offering a Special Enrollment Period (SEP) to those who lost BadgerCare Plus and have not yet made their way into the Health Reform’s Marketplace. Spread the word!

The new SEP runs: September 4 – November 2

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).
  • Magic words when calling: I’m from Wisconsin; I lost BadgerCare Plus; I’d like to enroll in a Special Enrollment Period.

The announcement came less than a week after Senator Tammy Baldwin, D-Wis., wrote a letter to CMS urging them to grant a special enrollment period for the individuals who lost Medicaid coverage. Parents and adults who were effected lost coverage because the State’s decision to change eligibility for the program.

As of April 1, 2014 parents enrolled in BadgerCare Plus and adults enrolled in the Core Plan, who were previously covered up to 200% of the federal poverty level, then had to meet the new standard of 100% FPL. This resulted in nearly 63,000 individuals losing coverage. Of that, 38,000 adults did not make it through the eligibility corn maze and into the Marketplace. The SEP became effective September 4th and runs through November 2nd.

Action Steps to Enroll

To enroll, a consumer must call in the Marketplace Call Center to request the special enrollment period. The consumer will receive coverage a month after submitting their application, and will maintain that coverage through 2014. Consumers may automatically enroll into the same plan for 2015, but consider the opportunity to review emerging new Marketplace plan and price options for the intent of this special enrollment period is to get those who lost BadgerCare Plus covered and minimize the health coverage gap. See more on the new SEP below!

In this issue we update you on ABC for Health's 20th Anniversary, auto enrollment in the Marketplace, the upcoming changes to Express 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 September15 includes:

  • Good News for BadgerCare Plus Enrollees Terminated last April 1
  • Changes Coming to Online Express Enrollment Application Tool
  • 20 Years and Still Going Strong!
  • ABC for Health, Inc. is hiring!
  • A Note from Cassidy, the HealthWatch Membership Coordinator
  • Photo IDs now Required for Voting in Wisconsin
  • VCT: Limited SEP for Loss of BC+
  • OCI Announces Wisconsin Insurers in the Marketplace
  • Update: ACA Subsidy Debate
  • CMS Issues Final Rule on Auto Enrollment in the Marketplace
  • MTM Audit: Share Your Story
  • SHOP Talk: Update on the SHOP Exchange
  • Medicaid Third Party Liability Coordination of Benefits
  • Coalition Roundup
  • September is National Infant Mortality Month
  • Ask a Good Question... Birth Cost Recovery vs. Child Support
  • 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.
20 Years and Still Going Strong!

Please RSVP by TODAY!

Join us for a harvest-festival themed corn roast fundraiser at Sweet Cream City Farm in Jefferson, WI. Located half-way between Madison and Milwaukee, our celebration features delicious dishes, outdoor fun, and friends from all over Wisconsin. We hope to see you on the farm as we celebrate 20 years of advocacy, health benefits counseling, and legal services in Wisconsin!

Event Details:

ABC for Health 20th Anniversary Corn Roast
Thursday, September 25, 2014, 4:00-7:30pm
Sweet Cream City Farm
W3006 Ctr Y Jefferson, WI
Suggested donation amount is $50 per adult event ticket.
Click here to view and print a RSVP to return to us!
Questions? Call: 608-261-6939 ext. 219

Proceeds from the 20th anniversary will help us advance and maintain ABC for Health's impact on the health care community. We are grateful to all our past supporters, partners, and friends of our agency, and hope to see you all in September as we celebrate 20 years of success!

About ABC for Health: Since 1994 ABC for Health has provided health care consumers with information, advocacy tools, legal services, and expert support in order to navigate complex and confusing health coverage systems. We have also grown and created new subsidiary organizations, like ABC for Rural Health, Inc., My Coverage Plan, Inc., and soon our HealthWatch Wisconsin Project. ABC truly provides a cadre of services across a diverse Wisconsin.

See our full list of sponsors!

Please join us as we extend a big THANK YOU to this week's Collaborator Level Sponsors, Applied Tech Solutions, Inc. and Independence First and our Modified Silver Level Sponsor, Group Health Cooperative of South Central Wisconsin!
A Note from Cassidy, the HealthWatch Membership Coordinator

Marketplace and Medicaid Appeals Workshop

HealthWatch Wisconsin hosted its first workshop of the membership year on September 8. ABC for Health's, Rich Lavigne, and Administrative Law Judge, Nancy Gagnon, offered great information on the rules and regulations in both Medicaid and Marketplace appeals. They also shared tips and strategies for consumers, especially those representing themselves in front of a hearing officer in an appeal. Overall we had a good turnout and received some great feedback from attendees! Here’s what people said about this workshop:

  • “Hearing from Nancy Gagnon was extremely helpful!”
  • “I learned something new today about Medicaid!”
  • “I enjoyed hearing the perspective of the hearing officer.”

HealthWatch staff were on hand to video record the workshop. HealthWatch members can purchase access to the full workshop webpage complete with 2 hours of video coverage for just $20, the cost of workshop registration. Want to learn more about watching this workshop? Give Cassidy a call! (608) 261-6939 ext. 219.

Join HealthWatch now as an individual member to get discounts and free registrations to our upcoming events! A membership year runs July 1 through June 30, so now is a great time to join! If you have any questions feel free to contact our Membership Coordinator, Cassidy at (608) 261-6939 ext. 219 or at

Photo IDs now Required for Voting in Wisconsin

On September 12, the Seventh Circuit Court of Appeals in Chicago reinstated a law which requires Wisconsin voters to provide photo identification before voting. The decision from the three-judge panel of Easterbrook, Sykes, and Tinder was issued very quickly, overturning the lower court opinion issued by US District Judge Lynn Adelman. Adelman found the ID requirement unconstitutional saying it unfairly burdened poor and minority voters. The Chicago court said new procedures were in place in Wisconsin that make it easier to obtain a photo IDs while also noting that this law was similar to a statute in Indiana.

While this will continue to be a hotly debated topic, many are most immediately concerned about timing. This opinion comes on the cusp of the November 4 elections. Being so close to elections, some speculate, will cause confusion among voters.  Government Accountability Board Director Kevin Kennedy, as reported by the Associated Press, says, "We are taking every step to fully implement the voter photo ID law for the November general election…We are now focused on communicating with local election officials and voters, and will have more information about the details next week."

Wisconsin’s League of Women Voters has already added resources to its website as voters will have to show an acceptable photo ID to receive a ballot and have it counted.

Video Case Tip: Limited SEP for Loss of BC+

Over 63,000 people lost BadgerCare Plus coverage in April this year when new eligibility rules started The Walker Administration predicted that most of the people terminated from BadgerCare Plus would obtain Marketplace coverage. Unfortunately, for over 38,000 people that did not appear to happen as outlined in recent OCI and DHS reports.  As discussed earlier, CMS granted a new, Special Enrollment Period in the Marketplace for these individuals. The time period started on September 2 and will go through November 4. For more information on this topic, please watch our Video Case Tip!

Click Here or on the image to the right to watch the 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 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:

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 TBD Rose Marsh
Dane County Oct. 6 Anna Kaminski
Eau Claire Oct. 2 Lou Kelsey
Milwaukee Oct. 1 Danielle Coterel
Pierce County TBD Kelsi Winter
Polk County TBD Mike Rust
Tri-County Sept. 23 Connie Raether

**The next Milwaukee County HealthWatch Coalition meeting for will take place Wednesday, October 1, not October 8.


Ask a Good Question...

My child is starting college and I'm worried because I don't know if she will still be able to be covered under our insurance plan or if there are better options in a network closer to her school. What options for coverage do students have?

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


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, 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 14-37, FFY 2015 FoodShare Mass Change, has been amended

Ops Memo 14-39, Attendance Reporting Timelines, has been published to the DHS web

Ops Memo 14-29, Telephonic and Electronic Signature Enhancements, has been amended

Ops Memo 14-30, Cobell Settlement, has been published to the web

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

Ops Memo 14-40, FoodShare Intentional Program Violations (IPV) System Updates

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 update on consumers who have data matching issues, CMS, Sept 15

HHS awards more than $295 million in Affordable Care Act funds to increase access to primary care at health centers,, Sept. 12

ACOs, Bundled Payment Lead Health Affairs Blog August Most Read- List, Health Affairs Blog, Sept. 12

Mortality Rate Increases with Emergency Department Closures, Health Affairs Blog, Sept. 11

Rob Portman: Obamacare repeal still atop Senate Republicans' to-do list, CBS News, Sept. 11

New Report: Wisconsin Small Group Silver Insurance Cost 18% Higher Than Minnesota, Citizen Action of Wisconsin, Sept. 11

UnitedHealthcare enters Wisconsin Obamacare exchange, Milwaukee Business Journal, Sept 11

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.
Update Staff:


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