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State Leg. Action on COVID Awaits Fed Analysis

April 02, 2020

WHA has been very active in sharing hospital and health system priorities needed to help combat the COVID-19 pandemic at both the state and federal policymaking levels. Three COVID-19 bills have already passed Congress and have been enacted by President Trump, with multiple WHA-pursued regulatory waivers having taken effect.

Activity continues at the state level to pursue government support for hospital efforts. Governor Tony Evers released proposed legislation including funding and state regulatory flexibility on March 28, followed by a second package of proposals April 1.

The initial Evers proposal included more than $700 million in funding, primarily to state and local government agencies, with $500 million specifically allocated to emergency response funds at the Departments of Administration and Military Affairs. In addition, the bill includes an unlimited appropriation for the Department of Health Services to respond to a public health emergency. The second package of proposals includes an additional $274 million in state and federal funding for health care providers, with $75 million targeted specifically to hospitals.

In addition to funding, the legislation would also create new public policies including provisions that would allow DHS to temporarily suspend Medicaid enrollee costsharing and other requirements to make Wisconsin eligible for enhanced Federal Medical Assistance Percentage (FMAP) funds.

The bill includes several insurance related provisions related to COVID-19 as well. Among these are: prohibiting policy cancellation within 90 days of premium non-payment; requiring COVID-19 cost-sharing for health plan enrollees; and requiring telehealth parity with in-person care for commercial health insurance plans. The bill would prohibit balance billing by out-of-network providers during a public health emergency for the duration of the emergency, This would apply to services for the condition causing the emergency or for other services resulting from limited provider availability due to the emergency, with out-of-network providers to be reimbursed at 250% of the Medicare rate.

Consistent with the Governor’s Emergency Order #16, the initial proposal delays renewal requirements for health care providers during the public health emergency and creates a temporary licensure process for former health care providers and health care providers in other states. The legislation also enables certified medical liability coverage in other states to fulfill Wisconsin’s practice liability insurance requirements.

Republican legislative leaders reacted to the first proposal with caution, citing funding concerns the state’s coffers are likely to experience in at least the next fiscal quarter. At a press event the morning of April 1 (just before Gov. Evers’ second proposal  as announced), Senate Majority Leader Scott Fitzgerald (R-Juneau) and Assembly Speaker Robin Vos (R-Rochester) said they would wait to make their own legislative proposals until after they received analysis from the nonpartisan Legislative Fiscal Bureau of the federal Coronavirus Aid, Relief, and Economic Security (CARES) Act. The CARES Act allocates about $150 billion to the states as part of the overall $2 trillion package, leaving to federal agencies the distribution of funds to the states.

“Certainly we want to know everything that’s in the federal bill before we decide if we’re going to spend precious state resources,” Speaker Vos said at the event.

The LFB released CARES Act analysis later on April 1, but included a significant caveat to its 15-page summary: “It is important to note that although this memorandum describes provisions of the federal legislation based upon materials currently available, the administration of and funding of the Act will be known once guidelines from the federal government have been promulgated.”

The LFB shared similar concerns about the ambiguity in the CARES Act’s $100 billion earmarked for health care. “The Secretary of the Department of Health and Human Services is responsible for developing criteria for distributing funds,” the memo says, “and it is unknown how much funding, if any, Wisconsin healthcare providers will receive from this source.”

WHA continues to work with leading state policymakers on the development of state proposals, stressing the urgent need for regulatory flexibility and funding support.

This story originally appeared in the April 02, 2020 edition of WHA Newsletter