August 12, 2016
Volume 60, Issue 32
Top of page (8/12/16)
Primary Elections Set Stage for State and Federal Races
Marquette Law School Poll: Clinton 46%, Trump 36%; Feingold 49%, Johnson 43%
Candidates in select congressional and state legislative districts across Wisconsin faced off in a primary August 9 to represent their party in the upcoming November general election. Meanwhile, the Marquette University Law School released its latest poll results following the Democratic and Republican national conventions. Details on this latest poll and a recap of the primary results are below.
Congress - Wisconsin
In the state’s most competitive Congressional primary, the 8th Congressional District to replace retiring Rep. Reid Ribble—Mike Gallagher, a former adviser to Gov. Scott Walker, garnered nearly 75 percent of Republican primary voters. Gallagher will now face off in the general election against his Democratic opponent, Outagamie County Executive and former state Assembly Majority Leader Tom Nelson in the November 8 contest.
Wisconsin State Senate
In the state Senate, two Republicans faced off in the 18th Senate District to replace retiring Sen. Rick Gudex (R-Fond du Lac). The primary resulted in Republican Dan Feyen now moving on to face Winnebago County Executive Mark Harris, Democrat, in the general election.
State Sen. Lena Taylor (D-Milwaukee), an incumbent Democrat in Wisconsin’s 4th state Senate district, defended her seat in the Senate and beat back a challenge from sitting state Rep. Mandela Barnes (D-Milwaukee). Taylor will not have a Republican opponent in the general election and is the presumptive winner of this seat come November.
Sitting state Rep. LaTonya Johnson (D-Milwaukee), defeated her primary opponents to become the next Senator from Wisconsin’s sixth Senate district. She will face no Republican opponent in November.
On the Republican side of the aisle, sitting state Rep. Dave Craig (R-Big Bend) faced no primary opponent and will face no general election opponent to replace retiring Sen. Mary Lazich (R-New Berlin).
Republicans currently hold a three-seat majority in the state Senate.
Wisconsin State Assembly
Several new faces to the Wisconsin state Legislature successfully beat out their primary opponents and will become a state representative since they face no general election challengers from the opposing party. Some of these incoming elected officials will include David Crowley (D-17), Jimmy Anderson (D-47) and Chuck Wichgers (R-83). Jason Fields (D-11), who was previously elected to the state Assembly, won his primary and will likely return to the Legislature, as he does not face an opponent in the general election.
In the state Assembly, 46 out of 99 seats are uncontested. In other words, 46 percent of state Assembly races have no challengers from the opposing party.
Republicans currently hold a 13-seat majority in the state Assembly.
Pulse of the Wisconsin Voter – Marquette Law School Poll
The Marquette University Law School poll released August 10 showed Secretary of State Hillary Clinton’s lead growing in Wisconsin over businessman Donald Trump to be the next President of the United States. Among registered voters, 46 percent say they will vote for Clinton and 36 percent say they will vote for Trump.
Marquette Law School Poll (Registered Voters) July August
Clinton 43 46
Trump 37 36
The previous Marquette University Law School poll in July showed Clinton up by a seven-point margin, 43 percent to 37 percent. When adding in third-party candidates to the Presidential election, the margin between Clinton and Trump remains relatively unchanged—with Clinton receiving 42 percent of the vote and Trump receiving 33 percent.
United States Sen. Ron Johnson (R-WI) faces a re-election challenge from former U.S. Sen. Russ Feingold, who Johnson defeated in 2010. The Marquette University Law School poll shows Feingold remains ahead with 49 percent of registered voters supporting him and 43 percent of voters supporting Johnson.
In state government, Gov. Scott Walker’s job approval rating remains unchanged from July at 38 percent. Forty-five percent of Wisconsin voters believe the state is headed in the right direction, while 51 percent say the state is on the wrong track.
Top of page (8/12/16)
WI Hospitals State PAC & Conduit Campaign Tops $200,000
Full contributor list to run in August 19 Valued Voice
With the primaries now behind us, the 2016 Wisconsin Hospitals State PAC & Conduit campaign moves into the general election with over $200,000 of its $300,000 goal. This puts the 2016 campaign at over 67 percent of its aggressive $300,000 goal for this year. A total of 235 individuals have contributed to date, which is up 32 contributors from this same time last year.
“As WHA Advocacy Committee chair, I strongly encourage everyone to consider participating in the 2016 Wisconsin Hospitals State PAC and Conduit campaign,” said Therese Pandl. “This is an extremely important election year, and as individuals we can collectively come together and make a difference in who will be making policy in Madison next year.”
In this pivotal year, remember that elections matter and participation is important.
“As a health care leader, I believe it is my personal obligation to get involved in the advocacy process, and that includes our political process,” said John Russell. “I believe a contribution to the Wisconsin Hospitals State PAC and Conduit is an important way for individuals to support candidates for state office who value the role of hospitals and health systems in Wisconsin.”
The next contributor list for the 2016 campaign will run in the August 19 edition of WHA’s Valued Voice newsletter. Make sure you are on the list by making your contribution today at www.whconduit.com or by contacting Jenny Boese at 608-268-1816 or email@example.com or Nora Statsick at 608-239-4535 or firstname.lastname@example.org.
Top of page (8/12/16)
WHA to Lead September 13 Washington DC Fly-in
Topics: Medicare, HOPD
The Wisconsin Hospital Association will staff and lead a group of Wisconsin hospital representatives to Washington, DC September 13 in conjunction with the American Hospital Association (AHA) Capitol Hill fly-in. Key topics to be discussed include the need to legislatively correct a change to off-campus provider-based hospital outpatient departments (HOPD) and problems for HOPDs with the Centers for Medicare & Medicaid Services proposed Outpatient Prospective Payment System rule.
“The Wisconsin Hospital Association continues to urge Congress to fix issues it created last year under the Bipartisan Budget Act of 2015, which is negatively impacting certain HOPDs,” said WHA President/ CEO Eric Borgerding. “We are traveling to Washington, DC to make sure our Delegation continues to understand the urgency of correcting this issue in the fall.”
WHA will schedule and coordinate all Hill meetings. If you are interested in participating in the September 13 Washington, DC fly-in, contact Jenny Boese, WHA vice president, federal affairs & advocacy, at email@example.com or 608-268-1816. Details on the AHA trip can be found at: https://www.surveymonkey.com/r/GHYDW77.
Top of page (8/12/16)
Register today for WHA Webinar Focused on MACRA
On August 25, WHA is hosting a Member Forum webinar, “MACRA—Implementation of the Merit-based Incentive Payment System (MIPS).” This webinar will provide an overview of MIPS that is proposed in the new Medicare Access and CHIP Reauthorization Act (MACRA), scheduled to affect provider reimbursement beginning in 2019. Hospital quality managers, chief financial officers and chief medical officers are encouraged to participate.
The one-hour complimentary webinar will include overviews of MACRA and MIPS; identify the providers to which MIPS applies; and discuss the MIPS measure categories, including quality, resource use, advancing care information and clinical quality improvement activities.
Register today at: https://events.signup4.net/16MACRA-MIPS0801. This complimentary webinar is open to all WHA hospital and corporate members, but pre-registration is required. An audio recording of the webinar will be available after the event, but you must pre-register to receive the recording. Content questions can be directed to Kelly Court at firstname.lastname@example.org. Registration questions can be directed to Kayla Chatterton at email@example.com.
Top of page (8/12/16)
CMS Final IPPS Rule for 2017 Issued
The Centers for Medicare and Medicaid Services (CMS) has issued its inpatient prospective payment systems (IPPS) final rule for fiscal year 2017. The final rule will be published in the Federal Register August 22 and take effect October 1. WHA will provide a more detailed analysis soon, which can be found on the WHA website at www.wha.org/pps_inpatient.aspx.
Here are some key points from the 2,434-page CMS final IPPS rule for 2017.
Under the final rule, acute care hospitals that report quality data and that are meaningful users of electronic health records (EHRs) will receive a 0.95 percent increase in Medicare operating rates.
Hospitals that do not submit quality data would lose a fourth of the market basket update (2.7 percent), and hospitals that are not meaningful users of EHRs will be subject to a three-fourths reduction of the market basket update in FY 2017.
CMS arrived at its proposed rate of 0.95 percent (again, which only would apply to hospitals that report quality data and attest to meaningful use) through the following updates: a positive 2.7 percent market basket update, a negative 0.3 percentage point update for a productivity adjustment, a negative 0.75 percentage point update for cuts under the Affordable Care Act, a negative 1.5 percentage point documentation and coding adjustment as part of the American Taxpayer Relief Act of 2012 and an increase of approximately 0.8 percentage points to remove the adjustment to offset the estimated costs of the two-midnight rule.
In its FY 2017 rule, CMS removed this adjustment for FY 2017 and also its effects in FYs 2014 through 2016. “CMS believes the assumptions underlying the -0.2 percent adjustment were reasonable at the time they were made,” wrote CMS in the final rule. However, in light of the unique circumstances surrounding this adjustment, the agency decided to remove it.
CMS projects total medical spending on inpatient hospital services will increase by about $746 million in fiscal year 2017.
CMS did not allow Nantucket Cottage Hospital to adjust its wage rates, meaning the wage indices for other areas of the country won’t be negatively affected.
As part of the Affordable Care Act (ACA), Medicare disproportionate share hospital (DSH) payments will be reduced by 75 percent, or $49.9 billion, by 2019. CMS will distribute nearly $6 billion in DSH payments in FY 2017, about $400 million less than in FY 2016.
In the final rule, CMS added four new claims-based measures (three clinical episode-based payment measures and one communication and coordination of care measure) for the FY 2019 Inpatient Quality Reporting Program and subsequent years. CMS also removed 15 measures for the FY 2019 payment determination and subsequent years.
CMS made changes to the Hospital Value-Based Purchasing Program, which was established under the ACA. CMS added two condition-specific payment measures (one for acute myocardial infarction and one for heart failure) beginning with the FY 2021 program year and a 30-day mortality measure following coronary artery bypass graft surgery beginning with the FY 2022 program year. CMS said the condition-specific payment measures capture payments for all care, including readmissions and subsequent cardiac events, across multiple care settings, services and supplies during the 30-day episode of care.
CMS made several changes to existing Hospital-Acquired Conditions Reduction Program policies in the FY 2017 final rule, including changing the program scoring methodology from current decile-based scoring to a continuous scoring methodology.
Top of page (8/12/16)
WHA Legal & Regulatory Webinar Series Highlights Hot Topics for Hospitals
WHA’s Legal & Regulatory webinar series continues to roll, with the next two scheduled webinars focusing on telemedicine and CMS alternative payment programs.
On August 31, the session “Managing Risk in Telemedicine Platforms” will be offered. This webinar will identify the primary risk management issues and provide guidance for establishment of best practice policies for this delivery model. The session will be presented by Guy DuBois of Axley Law Firm, a WHA corporate member.
On September 20, WHA will offer the session “CME Alternative Payment Programs: What Can Hospitals Do to Succeed?” This webinar will examine the various models that have been utilized and identify certain common aspects of them. It also will discuss a variety of potential compliance issues and application of existing laws to these models, as well as discuss results under these programs, suggest what aspects of these models are likely to be repeated in future programs and what steps hospitals can take to be successful with such programs. This session will be presented by Fred Geilfuss of Foley & Lardner LLP, a WHA corporate member.
Online registration for both of these sessions, as well as all other sessions scheduled as part of the Legal & Regulatory webinar series, can be found at https://events.SignUp4.net/16LegalSeries.
There is no fee for webinars in this series, but pre-registration is required. The series is intended for WHA hospital and corporate members as a member benefit, and will include a range of topics, each presented by a representative of a WHA corporate member law firm.
In addition, if you missed any of the previous webinars from this series, the slide decks and audio recordings are available on demand in the WHA member portal at https://members.wha.org in the dropdown menu under the “Legal” tab. Currently, that includes the session “A Practical Approach to Complying with EMTALA,” originally presented July 13, and “Examining the DOL’s Final White Collar Exemption Regulations,” originally presented July 19.
The WHA members-only portal is a secure location on wha.org and requires a first-time user to obtain a username and password. If you do not have a member account, go to members.wha.org and click on “Register” to create an account. If you have questions about how to register, contact Tammy Hribar, firstname.lastname@example.org or 608-274-1820.
Top of page (8/12/16)
No Locally Transmitted Zika Cases in Wisconsin, Response Plan in Place
The Wisconsin Department of Health Services (DHS), along with local health partners, continues to work on prevention and response plans in relation to the Zika virus, however, there is no sign of mosquitoes that could transmit the virus here in Wisconsin. Fewer than 20 people in Wisconsin have confirmed cases of Zika, and all of those people contracted the virus during recent travel to areas that do have mosquitoes that transmit the virus.
According to health officials, the two types of mosquitoes that transmit Zika virus, Aedes aegypti and Aedes albopictus, are not likely to make it as far north as Wisconsin, but DHS’ Division of Public Health (DPH) is actively collaborating with local health department partners to watch for them. DHS contracts with UW-Madison Medical Entomology Laboratory for the Mosquito Surveillance Project, monitoring and studying mosquito populations. To date, surveillance has not identified any of the mosquitoes that transmit Zika in Wisconsin.
DPH is also providing guidance to local health care partners on lab testing protocols for people who have traveled to Zika-affected areas, with a special focus on providing information to and testing pregnant women who may have been exposed to Zika virus. As of August 3, a total of 573 people have been tested in Wisconsin, resulting in 18 confirmed travel-related Zika virus cases. There are currently no cases, or suspected cases, of Zika virus contracted in Wisconsin.
The Centers for Disease Control and Prevention (CDC) is recommending pregnant women avoid travel to the Wynwood neighborhood near Miami, Florida. The Florida Department of Health has identified this neighborhood as an area where Zika has been spread by mosquitoes. Florida is currently the only state where locally-transmitted cases have been confirmed. Learn more about the CDC recommendation at www.cdc.gov/zika/intheus/florida-update.html.
In April, Gov. Scott Walker approved the addition of nine project positions in DPH to help with the response and prevention of outbreaks, including Elizabethkingia anophelis and also in anticipation of the presence of Zika.
Learn more about Zika virus at https://www.dhs.wisconsin.gov/arboviral/zika.htm.
While the types of mosquitoes that transmit Zika have not been found here, mosquitoes in Wisconsin can spread West Nile virus, La Crosse encephalitis, and other illnesses. People should take precautions to prevent bites.
WHA has dedicated a page to Zika in its emergency preparedness resources at www.wha.org/zika.aspx.
Top of page (8/12/16)