Thank You for Making the 5th Annual HealthWatch Wisconsin Conference a Success!

HealthWatch Wisconsin thanks all of the advocates, legislators, policy makers, and community members who helped make this year's conference a great success! We explored complex health care and coverage issues and made very important policy recommendations for Wisconsin's health care system. Media outlets were abuzz with our birth cost recovery information and our bi-partisan panel on health reform implementation. Here are just a few of the comments from our attendees:

• Another great conference!
• "The [Conference materials] are very impressive."
• "Good to get a federal perspective!"
• "A great place to 'recharge my batteries,' so I can be refreshed and ready to keep helping families."

US Department of Health and Human Services Regional Director Ken Munson (pictured top left) and Wisconsin Department of Health Services Secretary Dennis Smith (bottom left) kicked off this year's conference with comments on health reform implementation in Wisconsin. Director Munson encouraged the state to work closely with the federal government. Secretary Smith argued that states are not being given enough flexibility. They were followed by David Riemer and Jon Peacock (top right and bottom right, respectively) who gave a detailed, historical perspective on BadgerCare's bi-partisan birth. Read more below!

Not able to make it to the conference? Conference CDs are  available for purchase. Email HealthWatch or call to reserve your CD today: (608) 261-6939 ext. 204. Visit our conference web page for more information.

Congratulations to the Winners of the 2011 HealthWatch Wisconsin Awards!

On the second day of the conference, HealthWatch Wisconsin presented the 3rd Annual HealthWatch Wisconsin Awards, recognizing exceptional efforts for Advocate of the Year, Outstanding Outreach Effort, and Outstanding Media Coverage. Congratulations to our winners, who were nominated by HealthWatch members and voted on by the HealthWatch Wisconsin Council!

• Advocate of the Year: Susan Garcia Franz, (pictured) Well Woman Program Coordinator; Tri-County HealthWatch Coalition
• Outstanding Outreach Effort: The Save BadgerCare Coalition, coordinated by Sara Finger
• Outstanding Media Coverage: Shawn Doherty, The Capital Times for "Why such little outcry over bill's impact on Medicaid programs?"

Vol. 8, No. 4
March 1, 2012

In This Issue:

Thank you for making the conference a success!

Congratulations to the HWW Award Recipients

Birth Cost Recovery and Infant Mortality

BadgerCare Protection Act

Smith, Munson on Reform and Medicaid

FREE Consumer's Companion to Health Reform

Legislator's Speak to Health Reform Exchanges

Feds Reject Medical Loss Ratio Waiver

Affordable Care Act Turns 2

Share Your BadgerCare Story!

Updated Core Counter and BC Enrollment

HealthWatch News

Case Tip: Medicaid Secrets - Searching for MAPP Coverage

Et Cetera: Announcements, Handbooks, & Memos

Coalition Roundup

3 C's for CYSHCN!

Headlines

On our Website:
HealthWatch Membership
Upcoming Coalition Meetings

Footage of Public Hearings: The Human Impact of BadgerCare Plus

Follow @HealthWatchWi

Is Birth Cost Recovery the Missing Piece of the Puzzle?

HealthWatch Wisconsin welcomed Mike Rust of ABC for Rural Health, Inc. and Dr. Meghan Pesko to the annual conference to address Wisconsin's aggressive birth cost recovery policies. The plenary session profiled new and startling information on unique and harmful Wisconsin policies related to Medicaid birth cost recovery while examining possible implications for infant mortality rates in our state.They recommended that the state move to stop or modify the policies that are impacting low-income pregnant women and their families. HealthWatch debuted a special edition of its HealthWatch Reporter on the topic, which generated quite a bit of media attention, from the Wisconsin State Journal, Badger Herald, and more.

Legislators Unveil the BadgerCare Protection Act

On Tuesday, February 28, Sen. Jon Erpenbach and Rep. Jon Richards presented the "BadgerCare Protection Act," surrounded by advocates, families and children impacted by BadgerCare and Medicaid programs. The bill looks at the budget priorities in the state, and asks the governor to restore funding to the BadgerCare program by closing a corporate tax loophole. "We fix the funding of the program," state Rep. Jon Richards." He argued that the state budget should not be balanced at the expense of families losing their state-funded health insurance. Rep. Richards addressed the audience at the annual HealthWatch Wisconsin conference with remarks on the importance of moving forward with health reform implementation in Wisconsin. Rep. Richards, once a lead on the Study Committee on Health Reform Implementation, asked the people of Wisconsin to share their stories of how BadgerCare helped them. He said that we all were "David" in the story of David and Goliath, yet the Governor took away our stone in our battle with the insurance companies. Our collective stories are our only hope. Media coverage of the unveiling of the BadgerCare Protection Act:

• Capitol Report: Democratic lawmakers want to close tax loophole to aid BadgerCare
• Wisconsin Council on Children and Families: BadgerCare Protection Act Unveiled
• Wisconsin Radio Network: Speaking Up to protect BadgerCare
• Wisconsin Public Radio: Dem bill to stop proposed cuts to BadgerCare

Dennis Smith, Ken Munson Speak To Health Reform, Medicaid Waiver

Secretary Dennis Smith

In his comments to the audience at the annual HealthWatch Wisconsin Conference, Wisconsin Department of Health Services Secretary Dennis Smith began by acknowledging that Wisconsin is facing real challenges. "The decisions being made at the federal, state and local level are difficult," he said, "and decisions are better when more people are involved." Smith said he believed it was important to get out across Wisconsin to "lay out our ideas," and said a trip focusing on Family Care is coming up in the next few weeks. Smith continued to say that we all could count on one thing, that the "issues we talk about this year, we'll discuss again next year, the next year, and the year after that."

Smith was proud of two successes: the unanimous support of the Joint Finance Committee for medical homes as described in the MOE Waiver document, and the lifting of the Family Care cap. His third point, he called the "most controversial," that is, the proposed cuts to BadgerCare programs. Smith said that the State has been negotiating with the Centers for Medicare and Medicaid Services (CMS) over the last several months on the proposed changes to BadgerCare enrollment, eligibility and coverage. Smith said that his goal is to mirror what will be federal policy in 2014. He encouraged us to be "realistic" when thinking about the future of health care and coverage in Wisconsin. He said that many people can afford to buy private insurance in the private sector, and he thinks the Medicaid premiums are fair and realistic. He said it was important to the public dialog to have that discussion in a respectful way.

Striving to be Realistic and Fair

Bobby Peterson of ABC for Health moderated the panel presentation. He thanked Secretary Smith for joining the conference and for his candid remarks. He said that we do want to maintain a dialog and atmosphere of mutual respect. However, he said there were points of disagreement with Secretary Smith. In some areas, the Administration came onto the scene like a "bull in a china shop," canceling the consumer assistance program, fast tracking the budget repair bill, and failing to support outreach like the Children's Health Insurance Program grants that would have helped families connect to health care coverage. Peterson continued, that if "we talk about being realistic, we have to talk about being fair to the people of Wisconsin and working in ways to meet their needs."

HHS Regional Director Munson

US Department of Health and Human Services Regional Director Kenneth Munson then addressed the conference by first introducing his role in working with Secretary Sebelius and representing the agency as the Affordable Care Act is implemented in Wisconsin and the Midwest region. "We are very well award that a lot of changes are not well understood." But he said that it all starts from the idea that health care expenses are at a breaking point. "In the next 20 years, $1 of every $3 will be spent on health care." But, even more important, there are over 50 million people without health care, and people getting "the wrong care at the wrong time at the wrong cost." He said the Affordable Care Act can help. The law aims to provide consumers protections, expand coverage, increase quality and reduce costs. He spoke of early successes in the expansion of coverage through dependent coverage rules and pre-existing condition plans as well as consumer protection improvements such as the medical loss ratio rule and the rolling back of pre-existing condition exclusions. Mr. Munson then spoke to the Wisconsin waiver. He said that right now, the focus is on the non-disabled, non-pregnant adults over 133% of the Federal Poverty Level.

And what about the 124,000+ adults on the BadgerCare Plus Core Plan waiting list? Secretary Smith said that the previous administration chose to cap enrollment. He said that he was not criticizing that decision, but it was the decision that was made and that the State is not "in a position to reverse [it.]"

ABC for Health Unveils The Consumer's Companion to Health Reform

Thanks to support from the Wisconsin Law Foundation, HealthWatch Wisconsin and ABC for Health developed and published “The Consumer’s Companion: A Legal Guide to Health Care Reform in Wisconsin, 2012.” Editors built from the comprehensive “My Heath Reform Guidebook” educational materials oriented to Wisconsin health care consumers, especially those confused by the political conversations, enrollment changes, and legal rights and responsibilities available through health reform. Elements of “The Consumer’s Companion” will be incorporated into future editions of the new consumer-oriented newsletter, “The BadgerCare+ Bulletin." DOWNLOAD YOUR FREE COPY TODAY!

Legislators Speak on Health Reform Exchanges

Sen. Kathleen Vinehout (D-Alma) spoke at the 5th Annual HealthWatch Wisconsin conference about the future of health insurance exchanges in Wisconsin. Sen. Vinehout co-authored Senate Bill 273: Affordable Insurance Exchanges, which proposes to create the Badger Health Benefit Authority to administer a state-wide health insurance exchange, as required by the Affordable Care Act. Sen. Vinehout argued that exchanges can fall short if there is too small a risk pool, if comparisons are uneven, and if good governance standards are lacking. She stressed strong conflict of interest policies for those on an exchange board and transparency of process. In contrast, Secretary Dennis Smith in his comments to the HealthWatch audience stressed that one of the reasons Wisconsin’s Administration returned the Early Innovator grant for exchanges was because the feds were “micro-managing” implementation. His example was that the feds “asked for resumes of board members.” Resumes, argued Vinehout, are just part of good exchange governance standards.

The bill, which was introduced in late 2011, focuses on creating a competitive marketplace by bringing together small businesses and individuals in order to generate big group buying power. In her comments, Sen. Vinehout emphasized the importance of an even and transparent playing field in the exchange, so that consumers can make clear apples-to-apples comparisons of plans. The bill also proposes safeguards to keep the Health Benefit Authority flexible, yet transparent and accountable at the same time. According to Sen. Vinehout, a successful implementation of the proposed exchange will cause the number of uninsured in Wisconsin to drop from 10% of the population to 4%. Wisconsin has until 2013 to create its own health insurance exchange, or else the federal government will set up the exchange for the state.

Feds Reject Medical Loss Ratio Waiver Request, Preserve Consumer Rebates

On February 16, 2012 the US Department of Health and Human Services (HHS) rejected the Walker Administration’s medical loss ratio waiver request. This is a big win for Wisconsin consumers. Federal officials rejected Governor Walker and Insurance Commissioner Nickel’s request for a waiver of requirements for Wisconsin individual insurance carriers to meet minimum medical loss ratio minimum of 80% to control excessive profits at the expense of policyholders. Health insurers that fail to spend at least 80 cents of every dollar collected in customer premiums on medical care are required to provide rebates to their customers. The letter from federal officials referenced Wisconsin’s “highly competitive individual market, characterized by a large number of well-performing HMOs whose experience shows that efficient issuers are able to meet the statutory MLR standard while remaining solvent and profitable.” Federal regulators noted overwhelming public comments that opposed the waiver request. In fact, the letter quoted comments that chastised the Insurance Commissioner for prioritizing insurance industry profits over the people of Wisconsin, saying, “The commenters further express concern with the amount of rebates that consumers would not receive if the OCI’s request is granted, and express disappointment that the OCI’s request prioritizes ‘insurance industry profits over the rights of consumers.’” ABC for Health’s Bobby Peterson called the Fed’s rejection of the waiver request a “win for consumers,” and expected, based on the poorly conceived request by OCI. The Letter to Commissioner Nickel denying his waiver of the federal health reform law as it relates to medical loss ratio standards is available online.

The Affordable Care Act Turns 2 in March!

The Second Anniversary of the Affordable Care Act is right around the corner. On March 23, 2010, President Obama signed ground-breaking legislation to expand coverage for individuals and dramatically alter the delivery of health care services. While some states build insurance exchanges and hold insurance companies to new rate review and medical loss ratio standards, other states have joined a lawsuit to find the Affordable Care Act unconstitutional. In fact, the Supreme Court case against the ACA begins just three days after the second anniversary, on March 26, 2012. Citizen Action is working with Wisconsin Members of Congress as well as the Regional Director of Health & Human Services Ken Munson to hold conference call-in parties around the state between March 19-22, 2012 to discuss the process of passing this law, elements that must be protected, and other health care topics that YOU decide! The sessions are nonpartisan and strictly on the law itself. If you would like to host a house party/office party anywhere in the state or would like assistance in planning an event, follow this survey. 

Tell Your BadgerCare or Medicaid Story

Conference attendees heard Rep. Roys, Rep. Mason, Rep. Hulsey, and Rep. Richards encourage the state, legislature, and governor to do more listening. They encouraged the people of Wisconsin to share their voices, be involved in the process, and tell lawmakers why BadgerCare and Medicaid are important. Now's your time to RAISE YOUR VOICES!

Are you one of the nearly 125,000 childless adults stuck on the Core Plan Wait List? Are you a mother or father just making ends meet who's concerned about the effects of the proposed Alternative Benchmark Plan on your child's BadgerCare coverage? Do you worry about the possibility of losing access to Family Planning Only Services? Do you have another health care issue that needs to be brought to attention of DHS officials and policymakers?

CLICK HERE to complete a story form and email it to ABC for Health or call and talk to one of our advocates (608) 261-6939 ext. 229 and let them know you are calling to tell your BadgerCare story!

Health Care Segregation in Wisconsin

Core Plan Waiting List Adds Almost 100 People Every Day!

Below is our usual demonstration of the Core Plan Waiting List as a counter. This number represents the latest number we have of childless adults in Wisconsin on the BadgerCare Plus Core Plan Waiting List. HealthWatch maintains that the Department of Health Services/ Enrollment Services Center should screen applicants and help identify coverage options for these people, including, but not limited to, Elderly, Blind and Disabled Medicaid, Medicaid Assistance Purchase Plan, HIRSP, or SSI/SSDI.

One hundred twenty three thousand, seven hundred and ninety seven people, and counting...

Et Cetera: Announcements, Handbooks and Memos

Legislative Audit Bureau

Fraud, Waste and Mismanagement Hotline Summary 2011
February 15, 2012
The Legislative Audit Bureau has operated its Fraud, Waste, and Mismanagement Hotline since April 2008. The hotline was established by 2007 Wisconsin Act 126 so that the public, state employees, and contractors could easily and confidentially report suspected fraud, waste, mismanagement and other improper activities within state government.This summary highlights hotline activities in 2011 and describes outcomes and findings related to selected reports that illustrate the variety of issues addressed through the hotline.

HealthWatch Conference participants met Director of the DHS Office of Inspector General, Alan White. Mr. White gave a detailed outline of the programs under the jurisdiction of his office as well as his relationship with other state agencies. He said that their office is most concerned with provider fraud, and is working to implement two measures handed down from the Obama Administration, through the Affordable Care Act focusing on Medicaid integrity and recovery audits. When asked what his office would do if a family was wrongfully denied Medicaid and they were suffering because of it, Mr. White suggested that the family call the Hotline.

Hotline Number: 1-877-FRAUD-17 (1-877-372-8317)

Mr. White was also asked what his office was doing about third party liability payments that are being incorrectly charged to Medicaid, in the instance where a family has private insurance that denies a bill (maybe wrongly) and Medicaid is the second payor. Mr. White said his office is not looking into that.”

Provider Updates

2012-06: Wisconsin Medicaid Electronic Health Record Incentive Program Standard Deduction Information for Eligible Professional
Posted February 20, 2012
This ForwardHealth Update provides Eligible Professionals with information regarding the 2012 Wisconsin Medicaid Electronic Health Record Incentive Program Year and information related to the 2012 standard deduction for determining eligible patient encounters.

2012-05: Eligible Hospitals Reporting Meaningful Use for the Wisconsin Medicaid Electronic Health Record Incentive Program and Other Program Information
Posted February 20, 2012
Effective for dates of service (DOS) on and after January 1, 2012, ForwardHealth is updating disposable medical supplies coverage, policies, and limitations to reflect 2012 Healthcare Common Procedure Coding System procedure code changes.
In addition, ForwardHealth is updating existing codes and modifiers to reflect a recent product and price review; these changes will be effective for DOS on and after March 1, 2012.

2012-04: 2012 Procedure Code Changes for Durable Medical Equipment
Posted February 17, 2012
Effective for dates of service (DOS) on and after January 1, 2012, ForwardHealth is updating disposable medical supplies coverage, policies, and limitations to reflect 2012 Healthcare Common Procedure Coding System procedure code changes.
In addition, ForwardHealth is updating existing codes and modifiers to reflect a recent product and price review; these changes will be effective for DOS on and after March 1, 2012.

2012-03: Procedure Code Changes for Disposable Medical Supplies
Posted February 17, 2012
Effective for dates of service (DOS) on and after January 1, 2012, ForwardHealth is updating disposable medical supplies coverage, policies, and limitations to reflect 2012 Healthcare Common Procedure Coding System procedure code changes.
In addition, ForwardHealth is updating existing codes and modifiers to reflect a recent product and price review; these changes will be effective for DOS on and after March 1, 2012.

Coalition Roundup

Click here for a list of upcoming coalition meetings. Thanks to all of the coalition chairs who were able to present at the HealthWatch member meeting at the conference!

The Chippewa County HealthWatch Coalition meets next on Tuesday, March 13 at the Chippewa County Courthouse. Keri Milbrandt of the Chippewa County Birth-to-3 Program will be coming to speak to the group about primary coaching. Chippewa County is also helping the neighboring Eau Claire County HealthWatch Coalition with recruitment and outreach as it undergoes transition in 2012. For more information about the Chippewa County HealthWatch Coalition, please contact Rose Marsh.

The Dane County HealthWatch Coalition meets on Monday, March 5 at the Waisman Community Outreach Center in Madison. Ruby Dow of Public Health - Madison and Dane County will be speaking to the group about its program for refugees, and Kevin Kane from Citizen Action Wisconsin will present coalition participants information about the upcoming anniversary of the Affordable Care Act and how people can get involved. Steering committee members ask that coalition members to continue documenting their experiences with LogistiCare, so they may be brought to the attention of State officials. The following Dane County HealthWatch meeting will on April 2 and will include speakers from Journey Mental Health. For more information about Dane County HealthWatch, please contact Adam VanSpankeren.

The Eau Claire County HealthWatch Coalition met today, March 1. Mike Rust of ABC for Rural Health spoke to coalition participants about the recent HealthWatch conference topics, including Wisconsin's controversial Birth Cost Recovery policy and EPSDT (Wisconsin's Health Check Other Services). Coalition chair Lou Kelsey continues to solicit ideas from attendees regarding the direction of Eau Claire County HealthWatch for 2012 and beyond. If you are interested in participating in Eau Claire County HealthWatch in 2012 or want more information, please contact Lou Kelsey.

The Milwaukee HealthWatch Coalition met on Wednesday, February 8 at Aurora Family Services in Milwaukee. Emily Palmer and Jennifer Alfredson from the Outreach Community Health Centers spoke to coalition members about SOAR (SSI/SSDI-Outreach-Access-Recovery), a tool to reduce homelessness by providing access to a financial benefit, with a particular focus on mental health. Representatives from DHS fielded questions from attendees regarding the new county consortia and problems that coalition members have encountered with document processing through the CDPU. Remember: Milwaukee HealthWatch continues with bimonthly meetings for 2012. The next Milwaukee HealthWatch meeting is April 11. If you would like more information on Milwaukee HealthWatch, please contact Julie Dixon-Seidl or (414) 773-4646.

The Pierce County HealthWatch Coalition met on January 19 at the Crossroads Community Church in Ellsworth, when a panel of service providers from the area presented on a number of topics and initiatives. The group also discussed the current state of BadgerCare Plus and Wisconsin's Medicaid programs. The next Pierce County Coalition meeting will be May 17 and has invited representatives from LogistiCare to speak. Mark your calendars now! To RSVP for that meeting or for more information about the Pierce County HealthWatch Coalition, please contact Lisa Raethke.

The Tri-County HealthWatch Coalition met on February 21 at the Fox Cities Community Health Centers Dental Clinic (5337 Grande Market Drive in Appleton). At the meeting, the coalition reviewed its strategic plan for 2012, which coalition chair Connie Raether sent out to coalition participants with the meeting reminder. The Tri-County HealthWatch Coalition will continue to meet at the Fox Cities Community Health Centers Dental Clinic until further notice; stay tuned to the coalition roundup for any changes. For more information about the Tri-County HealthWatch Coalition, contact Susan Garcia Franz or Connie Raether.

3 C's for CYSHCN!

Ask a Good Question...

“My child has BadgerCare Plus coverage with Standard Plan benefits. When we were at the clinic last week, we were informed there was a 'co-pay' for some of her services. Is this something we need to pay?"

...Get a Good Answer!

In some situations, a BadgerCare Plus recipient will be asked to contribute toward the cost of a particular service. This contribution is her “co-pay” or “co-payment.” There are rules under BadgerCare that limit how much an individual must pay toward their care. In general, enrollees covered under the Standard Plan will have co-payments ranging from $0.50 to $3.00. Note, however, that while providers are required to make a reasonable effort to collect the co-payment, they may not refuse services to a member who fails to make that payment.

Depending on age and household income, some BadgerCare Plus recipients are exempt from having to pay. For a list of who is exempt from co-pays, please see the BadgerCare Plus Handbook, Ch. 38.2.1. For a list of what covered services might cost a recipient, please see the BadgerCare Plus and Wisconsin Medicaid Covered Services Comparison Chart, available online.

Exempt from Co-payments

• Children under age 19 with family income up to 100% FPL
• Children under age 6 with family income above 100% up to 150% FPL, except for Continuously Eligible Newborns
• Children ages 1-5 who are Tribal members with family income from 185% to 300% FPL
• Children ages 6-18 who are Tribal members with family income from 150%-300% FPL
• Children under age 19 eligible through Express Enrollment
• Children under age 19 in an institution
• Children under age 19 eligible under a BadgerCare Plus Extension
• Pregnant women, except for pregnant girls under age 19 with family incomes above 300% FPL.
• Pregnant women eligible through Express Enrollment
• Pregnant women eligible for the prenatal benefit

Standard Plan - Nominal Co-payments

• Continuously Eligible Newborns with family incomes above 100% up to 200% FPL
• Children under age 6 with family income above 150% up to 200% FPL
• Children ages 6-18, with family income above 100% up to 200% FPL
• Children under age 19 with family income above 150% FPL who have met a deductible
• Parents and caretakers up to 200%FPL
• Parents and caretakers in BC+ Extensions
• Youths Exiting Out-of-Home Care
• Transitional Grandfathered parents and caretakers

Benchmark Plan - Co-payments

• Continuously Eligible Newborns with family incomes above 200% FPL
• Children under age 19 with family incomes over 200% FPL
• Pregnant women under age 19 with family incomes over 300% FPL
• Self-employed parents and caretakers with family incomes above 200% FPL

Questions on this Answer?

Still not sure? Have another question? Send us an email! We may address emailed questions in the next edition of the Update Newsletter.

Events of Interest:

Finding Your Way: A Navigation Guide for Wisconsin Families Who Have Children and Youth with Special Health Care Needs and Disabilities has been published. Download a pdf version of the booklet here.

The National Youth Leadership Network announces their new curriculum: Reap What You Sow: Harvesting Support Systems Curriculum Training Packages. Reap What You Sow brings youth and adults together to build support systems. For more information, click here.

March 30-31. Parents in Partnership: A Leadership Development Opportunity for Parents of Children with Disabilities. 4:30 to 8:30 p.m. on Friday and 9 a.m. to 3:30 p.m. on Saturday at Paradise Shores Conference Center, 26364 County Hwy. M, Holcombe, WI. Parents and guardians must attend all five sessions. For more information, contact Ruth Adix at 715-864-3014 or raadix2@yahoo.com.

April 20-21. Youth in Partnership with Parents for Empowerment. 5 p.m. Fridays ending by 3 p.m. on Saturdays at the Tundra Lodge Resort & Conference Center, Green Bay, WI. Youth, parents and guardians must attend all five sessions. For more information, contact Martha DeYoung at 800-862-3725.

April 16. Parent to Parent of Wisconsin's Support Parent Trainings are held periodically throughout the State.  Trainings are held in small group settings (8-15 participants).  Registration is required for all trainings. The next training will be held on Saturday, April 16, 2012 from 9:00 am to 3:30 pm at the Children’s Hospital of Wisconsin Corporate Center (999 North 92nd, Milwaukee, WI). Call or email to register: 715-361-2934.

WI Youth Leadership Forum is accepting applications for its 2012 Leadership Forum event. The YLF is a FREE program for high school students with disabilities who would like to take part in a unique and fun week long leadership development program. Participants will sharpen their leadership and self-advocacy skills, develop their career awareness, experience college life, meet successful speakers from across the state with similar disabilities as theirs and develop their own Personal Leadership Plan that they will implement when they return home. The YLF will be held June 17 – 22, 2012 on the Edgewood College campus in Madison, WI. The APPLICATION DEADLINE is April 16, 2012. The YLF is a competitive process.  Applicants must complete the application, submit a brief response to 2 essay questions and obtain 3 letters of recommendation.

April 26-27. Circles of Life Conference 2012: a statewide conference for the families of children and youth with disabilities and the professionals who support them. This year's conference will be at the Madison Marriott Hotel. Fore more information, click here.

Is there an event missing from our list? Let us know! Email us with events, directions and details other collaborators may like to attend.

A Training Announcement for All CYSHCN Collaborators: Thursday, March 15, 10:30-11:30am

Tune in Thursday, March 15 at 10:30am for a LIVE training presented especially for CYSHCN collaborators. We can all think of at least one child we have known or worked with who had to go without necessary health care services. Families face service denials, reduction of care or limits on their coverage even when the services are medically needed. During this scenario-based training, we will define coverage options for children, with a very special focus on coverage for medically necessary services. Coverage mechanisms through Medicaid already exist and are, in fact, are entitlements due children who are enrolled in BadgerCare Plus, Katie Beckett or other Medicaid programs. We will clarify the HealthCheck process for families with an eye toward the role CYSHCN collaborators can play in this process.

Participants will benefit from the following learning objectives: 

• Learn the basics of HealthCheck Other Services (EPSDT)
• Learn how to make a referral for HealthCheck other services
• Learn strategies for good case management
• Using HealthCheck to add sustainability--for your patients and for your organization

Referrals to ABC: CYSHCN Collaborators, click the "Referral Form" image at right to be directed to the printable version of the CYSHCN Client Referral Form! Use this handy tool in directing a family to ABC for Health for services. Not able to join the live web cast? Don't worry, email Adam to get information on how to view the new webcast archive.

Headlines

In birth cost debate, children should be the focus
Wisconsin State Journal, Mar. 1, 2012
Wisconsin is one of just nine states that collect birth costs from fathers, according to the ABC report. To stop, Wisconsin legislators would have to change state law, according to the Department of Children and Families.

Dem bill to stop proposed cuts to BadgerCare
Wisconsin Public Radio, Feb. 29, 2012
There's a plan to undo part of a budget law that, among other things, put Governor Walker in charge of Medicaid. Two Democrats have a bill that would stop proposed cuts to BadgerCare.

HP will lay off 157 in Wisconsin, 134 in Madison
Wisconsin State Journal, Feb. 29, 2012
HP Enterprise Services this week notified the state that it plans cut 157 positions in Wisconsin.

Doctor Accused of Big Medicare Scam
Wall Street Journal, Feb. 29, 2012
Federal agents on Tuesday arrested a Dallas-area doctor accused of bilking Medicare of $350 million over a five-year period, in what the government called the largest Medicare fraud scheme by dollar value linked to a single physician.

Language Will be Barrier to Health Coverage, Study Says
HealthyCal, Feb. 29, 2012
The study concludes that more than 1 million Californians with limited English skills will be newly eligible for tax credits to subsidize their coverage through the California Health Benefit Exchange, but fewer than half of those residents are expected to enroll, for various reason. If language were not a barrier, the study says, 110,000 more people would apply.

Joint Finance Committee Democrats Seek Immediate Hearing on Health Care Cuts
Feb. 28, 2012
In a letter to the Committee’s co-chairs sent today, the Committee’s four Democratic members Rep. Cory Mason (D-Racine), Rep. Jon Richards (D-Milwaukee), Sen. Lena Taylor (D-Milwaukee), and Sen. Bob Jauch (D-Poplar) asked that DHS’ latest changes to the waiver proposal be brought before the Committee for a hearing. The objection letter submitted by the Democratic Committee members also asks that the Committee’s co-chairs ensure that DHS Secretary Smith come before the Committee to answer members’ questions about the proposed changes to affordable health care in Wisconsin. The Joint Committee on Finance acknowledged the objection and will schedule a meeting to examine changes.

Letter to Governor Walker requesting he return campaign funds to controversial donor
State Representatives, Feb. 28, 2012
Twelve state representatives signed a letter to Governor Scott Walker requesting that he return campaign donations to a controversial donor and stand in support of women's health.

Group calls to end of collecting birth costs from fathers
Badger Herald, Feb. 28, 2012
Advocacy and Benefits Counseling for Health, Inc., a Madison non-profit law firm, released a report Monday that suggested Wisconsin should discontinue collecting birth costs from unmarried fathers. The report outlined concerns with the state’s policy of requiring unmarried pregnant women to identify the father on Medicaid or BadgerCare applications. According to the report, the father is then required to pay for medical expenses associated with the birth of the child and can be prosecuted or sued if he fails to comply.

Medical school in Wausau not feasible, health system decides
Journal Sentinel, Feb. 28, 2012
Aspirus, a health system based in north-central Wisconsin, has determined that partnering with other regional health systems to start a medical school in Wausau is not feasible. The health system and the Wisconsin College of Osteopathic Medicine announced in November that they were studying the possibility of starting a medical school that would focus on students interested in primary care. Aspirus had proposed owning the medical school - projected to cost $75 million - with other regional health systems. That model proved unfeasible because of problems that could arise among competing health care systems, said Sid Sczygelski, chief financial officer for Aspirus.

Dental Visits to ERs are on the Rise
NPR, Feb. 28, 2012
According to a new report from the Pew Center on the States, more than 800,000 visits to the ER in 2009 were for toothaches and other avoidable dental ailments. The shift from Medicaid reimbursements to hospitals is still costly to states. Dental groups have long since said that ERs only provide temporary relief for dental emergencies and lead to reoccurring hospital visits, which burden taxpayers.

Women's healthcare at risk [Opinion]
New York Times, Feb. 28, 2012
"A wave of mergers between Roman Catholic and secular hospitals is threatening to deprive women in many areas of the country of ready access to important reproductive services. Catholic hospitals that merge or form partnerships with secular hospitals often try to impose religious restrictions against abortions, contraception and sterilization on the whole system."

Tribal concerns in health exchange spotlight
The Lund Report, Feb. 28, 2012
For a variety of reasons, the nine federally recognized tribes in Oregon generally don’t do a good job providing their own healthcare. Their leaders have a federal mandate to provide health services, but when you get away from the metropolitan areas, the services become more expensive.

Senate Nears Showdown on Contraceptive Policy
New York Times, Feb. 28, 2012
Senate Republican leaders sought an immediate vote on legislation to overturn the president’s policy and allow a broad exemption for certain insurers and employers that have religious or moral objections to such coverage. But other Republicans said that the party had other priorities and that they wanted more information about how the new requirement would work.

Obama Makes a Key Play for Scalia
Politico, Feb. 28, 2012
He might seem like one of the least likely candidates to support the constitutionality of the individual mandate. But the Obama administration is directly courting Scalia’s vote. And because his stamp of approval on the requirement that Americans buy insurance in 2014 would be so surprising, it could also go the furthest in appeasing conservatives who steadfastly oppose the law.

Experts examine future of health care reform in Wis.
Badger Herald, Feb. 27, 2012
As part of the HealthWatch Wisconsin Conference taking place Monday and Tuesday, the first member of the panel, Wisconsin Department of Health Serivces Secretary Dennis Smith, explained the tough but realistic changes made to the program over the last year. The second speaker, Midwest Regional Director for the Centers for Medicare and Medicaid Services (CMS) Kenneth Munson, discussed some of the fundamental new changes that will be implemented throughout the country under the Affordable Care Act passed in 2010.

Report urges end to birth cost collection from some men to aid women on Medicaid
Wisconsin State Journal, Feb. 27, 2012
Pregnant women applying for Medicaid must identify the father or risk losing state health coverage after the baby is born, the report says. The state requires a man who fathers a child with an unmarried woman on Medicaid to pay some of the costs for pregnancy care and birth.

Health Care Myths and Realities: Seeking the Truth About High-Deductible Plans
The Huffington Post, Feb. 27, 2012
Recent news releases from two very different organizations paint entirely separate pictures of what can happen to people once they sign up for a high-deductible health plan.

Wisconsin's request to exempt certain health insurers rejected by the Federal Government
Life Insurer's Group, Feb. 25, 2012
The Wisconsin administration’s request was not accepted by the Obama administration because it could imply that a large number of health insurance players may move out of the Wisconsin market which could leave the customers in a lurch. In addition to this reason, the United States Department of Health and Human Services also found out that there was no data provided to substantiate this request. This department has found out that, of the 15 companies in this state, 12 of them are already spending close to 80 percent of the cost towards processing medical claims and providing improved medical care to their customers. Of the pending three companies, two more of them have the plans for leveraging the same in 2012.

Helping Americans with Pre-Existing Conditions Get Needed Care
HealthCare.gov, Feb. 23, 2012
A new report shows that while many Pre-Existing Condition Insurance Plan enrollees have serious and expensive illnesses, they were likely to delay receiving needed care due to lack of insurance before enrolling in the program.  PCIP has worked quickly to help connect Americans with the health insurance and medical care they need.

Plain Talk: Sad email underscores how GOP divides us
Cap Times, Feb. 22, 2012
Scott Walker’s demonization of public workers won’t result in help for family farmers. Instead, he’s leading the charge to destroy the only health care reform the nation has seen since it adopted Medicare. What Walker derisively calls ObamaCare would offer family farmers affordable insurance without a $10,000 deductible, but the governor and his enablers in the Legislature are making it next to impossible for Wisconsin to participate.

Feds load $638 million for health co-ops in Wisconsin, 7 other states
Wisconsin State Journal, Feb. 21, 2012
The Obama administration is awarding loans totaling more than $638 million to start up new health care cooperatives serving eight states, including Wisconsin. The government says the new nonprofit health insurers will be run by their customers and will be designed to offer coverage to individuals and small businesses.

Supreme Court Health Care Arguments Extended to Six Hours
Huffington Post, Feb. 21, 2012
The Supreme Court has added another 30 minutes to upcoming arguments over President Barack Obama's health care overhaul. The sessions now will span six hours over three days in late March. The justices on Tuesday set aside 30 more minutes, 90 minutes overall, for discussion of the effect on the health care case of a federal law intended to make tax collections run smoothly.

Challengers lose on health arguments
SCOTUSblog, Feb. 21, 2012
The Supreme Court on Tuesday resolved a dispute over the time for arguments in March on the new federal health care law, and sided with the suggestions of the U.S. Solicitor General, not those of the 26 states and others challenging key parts of that law (the Affordable Care Act).  The order puts into effect a schedule that the challengers had argued would unfairly favor the federal government’s legal positions.  Overall, the argument time was expanded from five-and-a-half to six hours.

Universal Health Care: A Moral Obligation?
Health Care and Human Rights, Feb. 15, 2012
Most Christian, Jewish, and Muslim authorities endorse the proposition that basic health care is a fundamental human right — a principle also endorsed in the 1948 Universal Declaration of Human Rights, adopted by the General Assembly of the United Nations, and signed by 48 countries.

Proposed state Medicaid changes gain som support from Feds
Wisconsin State Journal, Feb. 15, 2012
The federal government Wednesday confirmed its support of some proposed changes to Wisconsin's Medicaid program but said more details are needed before it can grant approval.

The Secret of American Health Care
Slate, Jan. 31, 2012
The issue today isn’t whether we should redistribute health care dollars. We do, arguably to the same degree that every other country does. Systems with national health insurance systems explicitly redistribute money before patients get in car accidents, discover cancer, or develop heart disease. Here we do it in secret after illness occurs. We create the illusion of actuarial insurance, when the truth is that all major American health care institutions have been socialized for decades.

Seeking Legal Interns for Summer 2012

ABC for Health is seeking volunteer, work-study eligible, or students on public interest fellowships for this summer! The position requires admission to law school. Students will provide legal research and writing support for firm attorneys that may include client interviewing and follow-up, drafting letters and memos, assisting on court filings and briefs, and facilitating projects with other agencies and legislators. Other duties include interviewing clients at intake, client counseling, and investigation of health benefits denials. Legal research and writing experience are desired, as are proficiency in Microsoft Word for Windows and a background in health care. Ability to speak Spanish and/or Hmong is a plus. To apply, please email a cover letter and resume to Brynne McBride, Assistant Director.

Support Our Efforts!

2011 was a difficult year for many, including ABC for Health. Over $300,000 in funding and funding opportunities were eliminated from our budget. Consequently, our ability to serve Wisconsin families was greatly diminished. Please consider a tax-deductible donation to ABC for Health to keep advocacy, legal services, and projects like HealthWatch Wisconsin sustainable for years to come. Thank you!

Copyright © 2012 ABC for Health, Inc. All rights reserved. No reprint without permission.

HealthWatch Wisconsin is a project of ABC for Health, Inc.
Update Staff:
Bobby Peterson, Executive Director
Brynne McBride, Assistant Director
Adam VanSpankeren, Education and Outreach Coordinator
Evan Benner, Publications Assistant