Medical Assistance Update!
For information on the Medical Assistance Update please click here:

Dental Utilization Data by County:
Due to the volumn of requests we get for Medicaid dental utilization
data by county, we recently published this information to the Medicaid
website.  It includes data for both Medicaid and BadgerCare and both FFS
and HMO utilization for recipients and by provider.

http://dhfs.wisconsin.gov/medicaid4/dental_utilz/index.htm

Legislative Advisories:
National Provider Identifier Number Required in '07
In 2007, any dental hygienist who is self-employed, an independent contractor, the proprietor of a dental hygiene business, or has any reason to file an insurance or Medicaid form, will need to obtain a National Provider Identifier (NPI) number. Entities which provide and bill for services will need an NPI as well.  The NPI will replace health care identifiers, such as Medicaid provider numbers, in use today in electronic transactions governed by the Health Insurance Portability and Accountability Act (HIPAA).   (http://www.adha.org/enews/12192006.htm#leg )

WDHA Legislative Report
January 20, 2007
MA Reimbursement for ALL Licensed Procedures!
What a great start to the New Year! With the unbelievable success we had in 2006, it was hard to imagine matching or even coming close to achieving the same excitement once again. However, the WDHA’s Cinderella Story continued.
Recall, last year the Department of Health and Family services introduced a rule allowing hygienists to become certified as MA providers. When the rule came before the Joint Committee for Review of Administrative Rules (JCRAR), the Wisconsin Dental Association (WDA) lobbied hard to have the rule defeated. However, the Senate Co-Chairman at that time, Senator Glenn Grothman (R-West Bend) recognized the value of having hygienists provide care to the MA population and offered a compromise amendment. This is when restrictions were placed on which services hygienists could submit reimbursed for under the MA program. At that time, it was clear that JCRAR was either going to kill the entire rule or push through the rule with these restrictions.
Fast forward to this year. In order for the restrictions on MA reimbursed services to continue, the proponents of that action (WDA) had to introduce legislation in the JCRAR again this year. During Wednesday’s committee hearing on that proposal, the new Senate Co-Chair, Senator Bob Jauch (D-Superior) offered an amendment to this proposal that would have continued with the current restrictions until July of this year. This would have pushed forward implementation of the full rules by 10 to 12 months. However, in an unusual and unexplainable move, the Republicans on the committee rejected that amendment. They felt this was going back on the agreement the committee made last year.
However, this was a strategic error on their past. By failing to support Jauch’s compromise, the committee split on their support (5-5) to continue with the restrictions. A split vote means the proposal fails. Therefore, the full rule, as originally introduced by the Department last year went into effect immediately! No restriction.
This victory is very exciting. One of the WDHA’s top legislative priorities for this session was to remove some or all of the limitations on MA reimbursement. We can now check this one off our list.

Next Step:
As we discussed last year, now more than ever, it is important for the WDHA to educate our members on how to become effective MA providers. I guarantee you the WDA will not sit back on this loss. They will continue to try and reverse JCRAR’s latest decision. Our best defense is to have as many licensed hygienists become MA certified, see patients and submit reimbursement for those services. We told everyone that would listen to us last year that hygienists can and will help solve Wisconsin’s oral health access problems. It’s now time for us to prove it!
Congratulations!
Peter Theo
WDHA Lobbies

Access to Oral Health Care Legislation:
As I reported in January, discussions between the WDHA, DHAW, CHAW and the WHA regarding access to oral health legislation have been suspended. I remain in contact with the WHA’s lobbyist, Mr. Bill Bazan. In our last communication, we agreed to schedule a meeting sometime following the end of session, likely in June.

Wisconsin Dental Examining Board Membership Status:
The WDHA and DHAW sent a joint letter to the Senate Majority Leader Dale Schultz asking that the new appointees to the DEB be given a vote on the Senate floor. Nominees must be confirmed by the Senate in order to officially sit on a Board. These nominations have made their way through the Senate Health Committee hearings and were unanimously recommended for confirmation. I met with Senator Schultz last week to discuss the nominations. He told me he must juggle several interests on all the nominations, not just those for the DEB. This round of nominations has become extremely political as we move into the election season. The WDHA will continue to pursue this effort until the end of session.
 
Political Update:
The Wisconsin Legislature is currently on a spring break and will return to Madison next month. The two year legislative session is scheduled to officially end in early May. 2006 is an election year, all 99 members of the State Assembly and one half of the 33 State Senators are up for election. Given the limited funds available for campaign contributions, we must be extremely judicious in how and where we spend our resources. Most importantly, we must find a way to inspire hygienists’ across the state to get involved in political campaigns in their areas and be willing to meet with their legislators. This is not rhetoric. This has become a serious issue for the WDHA. It is a direct result of your legislative successes and must be addressed.
Respectfully Submitted by:

Peter J. Theo
WDHA Lobbyist