Self-Funded Data Reporting Bill on the Fast Track, Amendment Offered to Address Employers' Concerns

Last week we asked you to provide input on draft legislation that would require self-funded plans to report to the Wisconsin Department of Health Services (DHS). This has now been introduced in the legislature as Assembly Bill 554 and Senate Bill 487.

The identical bills would enable coordination of benefits in compliance with current law making Medicaid the payor of last resort by requiring self-funded plans to report specific data on enrollees and their health coverage. Doing so would enable DHS to identify Medical Assistance recipients that are also covered under employer plans. DHS estimates that the expanded reporting by employers would help the agency achieve $3.6 million in savings for a program that is facing a budget shortfall of approximately $90 million.

On Monday, The Alliance^® received this document (.doc) that details the data that DHS would require employers to report on their plan enrollees, as well as the format employers (or their TPAs) would have to follow when providing the information. This data, which would be required monthly, includes the names of both the policyholder and insured, their Social Security numbers, dates of birth, policy number, group number, start date, end date and the type of coverage available (ie. drug, hospital, physician and so on). DHS provided this information because we offered to help the agency and the legislature understand employers' concerns about the requirements and how lawmakers might address those concerns.

Unfortunately, The Alliance also learned on Monday that the legislature was "fast tracking" the bills, meaning that lawmakers had scheduled both a hearing and vote at the committee level in both houses of the legislature with only two days advanced notice. After hearing from members last week and weighing those positions, The Alliance took a position against AB 554 and SB 487 because the timeline would preclude us from working with DHS on a well thought out process of obtaining data that would satisfy their requirements and avoid costly administrative hassles on the employer side.

In the hours leading up to the first committee hearing, The Alliance sat down with state Medicaid Director Brett Davis and his team to express the preliminary concerns we've heard from you over the past few days. At that meeting, DHS offered to amend the bills to address these concerns, and the amendment (.pdf) they crafted with our input would make the following changes to the bill:

	It would delay the bill's effective date by six months during which time DHS would convene a work group of employers to find an efficient and mutually agreeable method of sharing data;
	It would require DHS to seek the data first from TPAs and PBMs before seeking duplicative data from employers;
	It would prohibit DHS from using the data collected under this bill for any purpose other than the purpose stated; and
	It would specify that employer name would not be a required data element under the collection.

DHS and the legislature have delayed action on the bill by a few days to give The Alliance an opportunity to seek input from you on the proposed amendment. Now we need your input the following questions:

	What do you think about the prospect of this legislation becoming law in light of the amendment that has been offered by DHS?
	Would you be interested in serving on a task force to help DHS work out the details of data collection over the next six months?

If you have thoughts on this issue, I urge you to contact me, or call me at 800.223.4139 x 6621. Please provide feedback by noon, Tuesday, February 28, so that we may include your thoughts as this legislation progresses. Thank you for your input.

Kind regards,