Click here to access the Change Cyber Response Resources
In response to active exploitation of a cybersecurity vulnerability, the Cybersecurity and Infrastructure Security Agency (CISA), the Federal Bureau of Investigation (FBI), and the Department of Health and Human Services (HHS) released an update to the joint advisory #StopRansomware: ALPHV Blackcat to provide new indicators of compromise (IOCs) and tactics, techniques, and procedures (TTPs) associated with the ALPHV Blackcat ransomware as a service (RaaS). ALPHV Blackcat affiliates have been observed primarily targeting the healthcare sector. Please make sure the attached message is seen and acted upon by the appropriate members of your organization, such as the IT department. We encourage those with networks to distribute this message to your networks.
The 2023-24 legislative has come to an end, and legislators are shifting their focus to the upcoming election season and the need to connect with voters. With that in mind, it is more important than ever for WISCA members to strengthen their relationships with their state lawmakers (and new legislative candidates) to educate them on the ASC model of care, the regulatory challenges we face, and the legislative solutions we need to increase access to affordable, quality care provided in the ASC setting. Remember, decisions state legislators make in the Capitol can have a significant impact on the ASC industry, your organization, and your profession.
One of the best ways you as a WISCA member can engage your local legislators is to invite them to tour your ASCs to illustrate firsthand the many benefits of surgery center care. These visits provide a tremendous advocacy opportunity, which is why WISCA members across the state have already hosted numerous successful legislative tours. But we need to maintain the enthusiasm for this critical grassroots advocacy program, and WISCA is excited and ready to set-up additional tours today.
If you would like to host a legislative tour at your site, please contact the WISCA office at WISCA@badgerbay.co. We will work with you and your legislators to coordinate the meetings and will provide participating members with full support, including legislator bios, advocacy tips, issue briefings, and supporting documents.
WISCA works closely with our national association partner – the Ambulatory Surgery Center Association (ASCA) – on advocacy and other issues important to our members. In fact, the WISCA Government Affairs Team joins a national ASCA state chapter call twice a month for a federal regulatory and legislative briefing and closely follows their published Government Affairs Updates. Here is the latest federal government affairs news from ASCA:
It’s been nearly a year since Janet Protasiewicz was elected to the Wisconsin Supreme Court flipping it from a 4-3 conservative court to a 4-3 liberal court. Since that time there has been constant speculation as to what that result would mean for Wisconsin’s legislative district boundaries and a potential new redistricting process. It appears that we now know the answer. In late December, the Court found that the lines as constructed resulted in an unconstitutional partisan gerrymander and requested from the legislature and Governor that they present them with new maps that better fit their definition of “fair” maps.
The maps in question currently yield a 22-11 majority for republicans in the state senate and a 64-35 majority for republicans in the assembly. Nearly two-thirds of all legislators are republican even though democrats have won fourteen of the last seventeen statewide elections. Democrats have said that the districts are gerrymandered and should be redrawn to better reflect Wisconsin’s electorate.
Republicans have countered that the maps were constructed in accordance with the law and that Wisconsin’s population makes it such that democrats are more concentrated in certain areas of the state which gives republicans a natural geopolitical advantage. They also argue Republicans do better in down ballot races so that the top of the ticket performance shouldn’t be the primary factor in assessing whether or not maps are fair.
The Supreme Court requested that parties submit new maps by January 12th and appointed two nonpartisan consultants to review the maps and make suggestions by February 1st. Various entities including republicans and democrats in the legislature, the Governor, the plaintiffs in the case and others did submit maps. On February 1st, the consultants found that of the six maps in consideration, the two republican maps did not “deserve further consideration” because they were considered “partisan gerrymanders”. According to the consultants, the four remaining maps fit the criteria sought by the Court and could be considered for the final maps. All four of these maps would have the very likely result of pushing the Senate and Assembly to a more evenly balanced partisan split.
While the Supreme Court was considering how to determine final maps, Republicans in the legislature surprisingly made the decision to pass the exact maps that Evers submitted. Surprising because under the Evers version of the maps many current republican incumbents would either be paired with other incumbents or drawn into districts that are more favorable to democrats. By the numbers alone the Evers maps would significantly bridge the partisan gap in both the Senate and Assembly and would give democrats a chance at some point to win the majority in one of the houses. Something they haven’t done since they lost both houses in the 2010 elections. Governor Evers signed his maps (sent to him by the legislature) and barring a court challenge Wisconsin will indeed have new maps going in to the 2024 elections.
The new maps still lean slightly republican, but democrats will have more representation in both houses and have an outside chance to gain the majority in both the Senate and the Assembly. Regardless of whether the houses flip, the margins will certainly be compressed, and the overall dynamics will shift next session.
On Tuesday, March 12th the State Senate had what is expected to be its final session day of the year. All that remains now is the Governor’s action on a number of bills. It is possible the legislature returns for a veto override attempt, but for most legislative activity the session is over.
There were a handful of bills WISCA was tracking until the end. Here is how they ended up:
*Join us April 4 for the next Online Legislative Update*
WISCA legislative updates are open to all members and held monthly. The next update is Thursday, April 4 at 12pm by Zoom. Sign up today (register here).
The APRN bill still sits in a stalemate with no movement since our last report, although some action in the Assembly is expected soon. The APRN bill establishes an Advance Practice Registered Nurse credential in Wisconsin. WISCA has been closely monitoring AB 154/SB 145, as one of the biggest sticking points within that new credential relates to pain management procedures and the collaborative agreements surrounding nurse anesthetists.
An amendment to the bill was introduced requiring CRNA’s have a collaborative agreement with a physician who has a pain management background. WISCA has pushed back against this amendment arguing that it would hurt our ability to provide services, especially in more rural areas, where there are fewer physicians with a pain management background. The bill has passed the Senate without this amendment and is being considered in the Assembly. In addition to our concerns, it appears the Governor still has certain issues with the bill, and it is unclear how and if it will become law.
Outside of APRN legislation, bills related to price and access have been introduced by Republicans and Democrats that are making their way through the legislative process. Most of them are unlikely to find consensus and become law without compromise. These include a price transparency bill to align Wisconsin law with the federal law as it relates to hospitals posting their pricing; a proposal to make several changes to how pharmacy benefit managers (PBMs) are regulated; legislation to allow for direct primary care in Wisconsin; and a bill to create a provisional license for international physicians.
Lastly, the Surgical Black Box bill has been introduced in the Assembly. AB 870 would allow for patients to have their surgeries recorded. WISCA has opposed this bill in the past and will do so this session.
In what many predicted after Wisconsin’s Supreme Court flipped from conservative to liberal in April of 2023, the new State Supreme Court found Wisconsin’s current maps unconstitutional and ordered new legislative maps to be drawn in time for the 2024 elections.
The court set a deadline of January 12 for the various parties to the case to submit proposed remedial maps. The court also appointed two “referees,” political science academics who have worked as redistricting consultants in other states, to help the court evaluate the proposals. In a letter to the court, the referees explain how they will analyze the proposals by using demographic and election data to assess the following factors based on the court’s directive:
· Population equality
· Political subdivision splits
· Contiguity
· Compactness
· Federal law compliance
· Community considerations
· Political neutrality
The referees are to return their evaluations to the court by February 1.
While there are only a few months left in Wisconsin’s 2023-24 biannual legislative session, there could be a lot packed into the remaining calendar days before both houses wrap-up their work for the year in March.
One of the most pressing issues will be whether the Legislature and Governor Evers can come to an agreement on Wisconsin’s $7 billion budget surplus. They failed to come to an agreement during state budget negotiations and have yet to make progress since. The legislature wants to fund a significant tax cut while the Governor wants to see money go toward childcare and a smaller tax cut. There are other spending priorities for both sides, but a deal will have to be cut or we can expect to start the next budget process with a fat surplus once again.
In addition to the surplus, some other hot-button issues remain. Speaker Robin Vos has said he is going to bring a medical marijuana bill to the floor. Wisconsin is nearly surrounded by states that have legalized recreational marijuana, but most legislators in the Badger State are not supportive of full legalization. Vos’s bill could be a compromise.
In recent interviews, Majority Leader Devin LeMahieu has mentioned two of his priorities being a bill that would allow Wisconsin to access $84 million in federal funding to build Electric Vehicle Infrastructure, as well as a bill that would give Wisconsin companies the first option to build transmission lines in Wisconsin. As of today, each of these proposals has had at least one public hearing with more action in both houses expected soon.
Other issues that the legislature may address include PFAS (forever chemicals), abortion, election reform and artificial intelligence. On the health care front, we’ll expect to see some activity surrounding the Advanced Practice Registered Nurse (APRN) bill and price transparency and pharmacy benefit manager bills.
*Next Legislative Update February 1*
WISCA legislative updates are open to all members and held monthly. The next update is Thursday, February 1 at 12pm by Zoom. Sign up today (register here).
Visit ASCA's ASCQR Program requirements webpage for information on changes to ASCQR Program requirements in 2024, and the Ambulatory Surgical Center Quality Reporting Specifications Manual for more information on all measures. Additional resources, such as reporting dates and measure resources, can be found on CMS' ASCQR Program Resources webpage.
Association of Wisconsin Surgery Centers 563 Carter Court, Suite B Kimberly WI 54136 920-560-5627 I WISCA@badgerbay.co