— Sen. Andre Jacque is seeking cosponsors for a bill that would require health insurers to cover certain costs related to participating in a clinical trial.
In a memo sent to other lawmakers, the De Pere Republican says the legislation aims to ensure clinical trial participants don’t face “unnecessary denial and interruption of coverage and delays in life-saving care” due to their insurer not covering related costs.
He notes these patients may need to see out-of-network specialists during clinical trials, and denial of coverage can lead to them missing out on participating and receiving potentially lifesaving treatment.
“The Clinical Trial Coverage Act would address this problem by requiring insurers to cover out-of-network routine care costs for clinical trial participants if no in-network provider is available, ensuring families have at least some peace of mind at a time of great stress and access to clinical trials without paying significant out-of-pocket costs for physician services,” Jacque wrote in the memo.
Federal law currently requires private insurers to cover “routine services” for these trials from in-network providers, the memo shows. But some patients’ networks may not include the correct providers, leaving them to pay the full price for clinical trial-related services.
The bill would bar health insurance policies from discriminating against anyone based on their participation in an approved clinical trial, according to the Legislative Reference Bureau.
And it would require insurers covered under the bill to impose the same cost-sharing requirements for a given item or service from an out-of-network provider as would apply for in-network providers, and pay the provider for the difference between the total cost and the cost-sharing amount, LRB wrote.
The legislation has the support of the American Cancer Society and the Leukemia and Lymphoma Society, the memo shows.
“An already overwhelmed family facing one of life’s most daunting challenges should be given every opportunity to participate in clinical trials that can truly make a difference, without worrying about out–of-network costs,” Jacque said. “By increasing participation and access to clinical trials, cures and effective treatments will be discovered benefiting generations of future patients.”
The cosponsorship deadline is 5 p.m. Monday.
— State health officials are touting health insurance options available to consumers during this year’s open enrollment period, which started yesterday and runs through Jan. 15, 2024.
State residents will be able to choose between individual health plans from at least three different insurance carriers at HealthCare.gov, according to a recent release from the state Office of the Commissioner of Insurance. With 14 insurers, Wisconsin has the second-most insurers among U.S. states, OCI says.
Speaking during a news conference ahead of open enrollment starting, Gov. Tony Evers said “we have more work to do” to ensure every state resident can access needed health care, including reproductive health care, mental and behavioral health resources, and “life-saving” prescriptions.
“We encourage people to take advantage of open enrollment,” Evers said. “You’ve got some great navigators out there to make that happen.”
Adam VanSpankeren, manager of the Covering Wisconsin navigator program, highlighted the group’s role in guiding people through the process of securing health coverage.
“Health insurance, if nothing else, it can invoke a sense of anxiety, and it doesn’t have to,” he said during the news conference. “Navigators are here to help people for free. We make it really, really easy.”
In a separate release, State Insurance Commissioner Nathan Houdek noted 89% of state residents who enrolled in a HealthCare.gov plan last year qualified for extended cost savings, provided through the Inflation Reduction Act. And the average state resident qualifying for a premium tax credit saved about $563 on monthly premiums last year, the release shows.
“Shop around on the marketplace to find a high-quality plan that covers doctor visits, prescriptions, hospital stays, and more,” Houdek said in a statement. “There are a lot of options out there, and you might even qualify for a health insurance plan at low or no cost.”
During last year’s open enrollment period, 221,128 people signed up for health coverage in Wisconsin. That’s the highest total for the state since 2018, according to a release from the guv.
State officials are also promoting the WisCovered site, which launched in 2020 to provide health coverage guidance and information for consumers: https://wiscovered.com/
Watch a video of the news conference: https://wiseye.org/2023/10/31/news-conference-open-enrollment-kickoff/
See a map of the state’s health insurance market landscape: https://oci.wi.gov/Pages/Consumers/FindHealthInsurer.aspx
Listen to an earlier podcast with VanSpankeren: https://www.wisbusiness.com/2022/wisbusiness-the-podcast-with-adam-vanspankeren-manager-of-the-covering-wisconsin-navigator-program/
<br><b><i>Top headlines from the Health Care Report…</b></i>
— Vin Baker Recovery of Milwaukee has been selected to join a pilot “hub and spoke” model for treating addiction and other health issues affecting Medicaid recipients.
<i>For more of the most relevant news on COVID-19, reports on groundbreaking health research in Wisconsin, links to top stories and more, sign up today for the free daily Health Care Report from WisPolitics.com and WisBusiness.com.</i>
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— An Assembly committee gave bipartisan support to legislation that would give utilities a leg up on building new transmission lines, even as those on both sides of the vote said they may switch their position on the floor depending on what changes are made.
State Rep. Paul Tittl, R-Manitowoc, said the bill — dubbed right of first refusal — “is in need of some fixing.” But he voted yes yesterday to help advance it out of the Assembly Energy and Utilities Committee.
“I’m hoping it gets fixed before we go to the floor,” Tittl said without offering specifics.
Wisconsin is expected to see at least $2 billion worth of transmission lines built over the next decade under a plan approved by the Midcontinent Independent System Operator, the regional electric grid that covers the upper Midwest.
AB 470, which the committee approved 12-4, would give utilities already doing business in Wisconsin the right of first refusal to construct, own and maintain a new transmission line that connects to one of their existing ones. Wisconsin is currently served by three transmission utilities: American Transmission Co., Xcel Energy and Dairyland Power Cooperative.
Dairyland has registered against the bill, as has the conservative Americans for Prosperity. The legislation has pitted those who argue it would bring continued stability to the state’s transmission system against those who believe it would stifle competition and lead to higher costs for ratepayers.
See more at WisPolitics: https://www.wispolitics.com/2023/wed-pm-update-assembly-committee-backs-utility-bill-though-some-lawmakers-looking-for-changes/
— The 2024 Milwaukee RNC Host Committee has announced former GOP Govs. Scott Walker and Tommy Thompson will serve as honorary co-chairs.
“Scott Walker and Tommy Thompson are two of the best ambassadors Wisconsin has ever had,” Committee Chair Reince Priebus said. “In just under a year, they will help us welcome visitors from around the world to Milwaukee. Having them involved with the Host Committee will help us throw a great convention in 2024.”
See the announcement:
— Batteries Plus, a Hartland-based provider of specialty batteries and other products, is exploring possible uses of AI in its business operations.
The company yesterday announced an effort focused on using AI technology to “provide enhanced support for franchise owners, stores and associates.” Some goals include improving the customer experience, increasing productivity, enhancing training and support, and more.
“Much like the early years of social media when companies incorporated those systems into their marketing strategy to gain huge reach at a relatively low cost, we’re now in an advantageous period where we want to make sure we’re uncovering all the benefits AI can provide,” Chief Business Officer Jon Sica said in a statement.
Batteries Plus currently has more than 800 store locations operating or in development around the country, according to the release. While headquartered in Hartland, the business is owned by Freeman Spogli, a private equity firm based in Los Angeles and New York City.
See more on AI in Wisconsin: https://www.wisbusiness.com/2023/evers-task-force-on-workforce-ai-holds-first-meeting/
#TOP STORIES#
# Wisconsin pharmacists say they need more help to keep up with increasing demands
# Metering change would kill badly needed rooftop solar, critics say
# WEC accelerates plan to stop burning coal, reaffirms Oak Creek shutdown
#TOPICS#
# AGRIBUSINESS
– Dairy insights summit 2023 to focus on market access
http://wisconsinagconnection.com/story-state.php?Id=969&yr=2023
# CONSTRUCTION
– VJS Construction will help build Waukesha parade memorial at Grede Park
– Revitalize Milwaukee seeks co-host for next Block Build event
– What to know about youth prison construction in Milwaukee, including when demolition starts
# ECONOMY
– Biden admin to highlight rural economic Dev. in WI
http://wisconsinagconnection.com/story-state.php?Id=970&yr=2023
– Report: Wisconsin needs smaller houses to match shrinking households
# ENTERTAINMENT & THE ARTS
– Madison Opera prepares for a vengeful, dramatic ‘Tosca’
– Blockbuster films drove Marcus Corp. earnings in Q3
– Milwaukee Rep to name new studio theater for David Herro and Jay Franke
# FOOD AND BEVERAGE
– Milwaukee Rep lands naming rights partners with ties to Bartolotta Restaurants, Saz’s
# LEGAL
– Waupaca Foundry faces $234K fine after 2 employees had fingertips amputated
# MANAGEMENT
– Gale Klappa teases possible extension of his WEC Energy role
# MANUFACTURING
– Generac nearing return to normal despite 15% drop in residential sales in Q3
– Q&A: Sargento leadership details plan to grow to $2 billion in revenue
# POLITICS
– Nursing home voting would be more tightly regulated under GOP proposal
# REAL ESTATE
– Washington County expanding starter-home push as work begins on 101-unit subdivision
– In Brown, Outagamie counties, 13% of homes are multigenerational
# PRESS RELEASES
<i>See these and other press releases:
https://www.wisbusiness.com/press-releases/ </i>
