WI
Wisconsin Assembly Bill AB1087

Wisconsin 2023-2024 Regular Session

Wisconsin Assembly Bill AB1087

Introduced
2/13/24  
Refer
2/13/24  
Report Pass
2/19/24  
Refer
2/19/24  
Engrossed
2/22/24  
Refer
2/26/24  

Caption

Supplemental payments to hospitals with avoidable patient days and an enhanced rate to nursing homes for bariatric and extensive wound care under the Medical Assistance program. (FE)

Impact

The financial implications of AB1087 extend to nursing homes as well, as it mandates the development of an enhanced reimbursement rate specifically for patients with bariatric and extensive wound care needs. This adjustment to nursing home reimbursement rates aims to address the unique health care requirements of these residents, recognizing the additional costs associated with such care needs. The bill ensures that nursing homes can seek reimbursement for various expenses linked to these enhanced care requirements, which aligns with the intentions of improving care outcomes and financial sustainability for care facilities.

Summary

Assembly Bill 1087 is aimed at enhancing financial support to hospitals and nursing homes under the Medical Assistance program. The bill stipulates that the Department of Health Services (DHS) will provide supplemental payments to hospitals facing avoidable patient days, which are defined as days a high-acuity patient remains hospitalized despite being eligible for discharge, generally occurring after the seventh consecutive day of needing such care. Each quarter, starting July 1, 2024, the DHS is required to distribute a total of $5 million, alongside any federal matching funds, to hospitals based on their share of these qualifying avoidable patient days.

Contention

Notably, AB1087 establishes parameters for lead funding with a cap of $10 million for the enhanced reimbursement rates for nursing homes. Additionally, it specifies that nursing homes may only claim one type of enhanced rate per resident, preventing double funding for patients with both bariatric and wound care needs. This restriction has been a point of discussion among health care advocates, who argue that it may limit necessary funding and support for complex patient needs while emphasizing the importance of careful implementation to ensure that hospitals and nursing homes are adequately supported.

Latest AB1087 Activity

Companion Bills

No companion bills found.

Previously Filed As

WI SB1028

Supplemental payments to hospitals with avoidable patient days and an enhanced rate to nursing homes for bariatric and extensive wound care under the Medical Assistance program. (FE)

WI AB1086

Funding for supplemental payments to hospitals with avoidable patient days under the Medical Assistance program, for enhanced nursing home reimbursement rates under the Medical Assistance program for residents with bariatric and extensive wound care needs, and for the complex patient pilot program. (FE)

WI SB1029

Funding for supplemental payments to hospitals with avoidable patient days under the Medical Assistance program, for enhanced nursing home reimbursement rates under the Medical Assistance program for residents with bariatric and extensive wound care needs, and for the complex patient pilot program. (FE)

WI HF3342

Nursing facility workforce incentive program, nursing facility payments, and nursing facility temporary rate add-on provided; partial reimbursement to hospitals provided for qualifying avoidable patient days; and money appropriated.

WI S2714

Requires all hospitals to screen uninsured patients for eligibility for public health programs and financial assistance under Medicare and Medicaid.

WI SF3989

Medical assistance eligibility timeline modifications for certain hospital patients and providing supplemental payments for certain disability waiver services

WI AB1088

Consent to admissions to certain health care facilities by patient representatives, allocation of nursing beds for patients with certain complex needs, and a complex patient pilot program. (FE)

WI SB1027

Consent to admissions to certain health care facilities by patient representatives, allocation of nursing beds for patients with certain complex needs, and a complex patient pilot program. (FE)

WI HF2848

Temporary funding established for settings that receive high-acuity patients discharged from hospitals, grants established to reimburse hospitals for avoidable nonacute patient days, and money appropriated.

WI HF2057

Assessment on hospitals imposed, directed payments to hospitals in the medical assistance program required, and reports required.

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