Valued Voice

UW Health's Ryan Klein and WHA's Christian Moran testifying Jan. 29 before the Senate Health CommitteeThis week, two legislative committees voted unanimously in support of WHA-championed legislation to allow discounts for prompt payment of health care co-payments, deductibles and other out-pocket expenses, setting up a likely vote by the full Legislature before the lawmakers adjourn in a few weeks.

The “yes” vote by all lawmakers on both the Assembly Insurance Committee and the Senate Health Committee comes after WHA and UW Health testified last month in support of the bill before both legislative panels. 

Authored by Rep. Clint Moses (R-Menomonie), Sen. Rachael Cabral-Guevara (R-Fox Crossing) and a bipartisan group of legislators, Assembly Bill 819/Senate Bill 822 would clarify in Wisconsin law the ability for hospitals and other health care providers to offer prompt-pay discounts to patients on cost-sharing amounts, under certain conditions.

In his testimony before the Senate Health Committee on January 29, WHA Vice President of Medicaid and Payer Reimbursement Christian Moran explained to lawmakers why the prompt-pay discount bill is needed.

“As providers have weighed offering prompt-pay discounts to their patients, providers have considered the applicability of federal and state laws, guidance and other factors,” said Moran. “For example, there is an unpublished 2004 Wisconsin Attorney General opinion that stated, if certain conditions are met, prompt-pay discounts are allowed under Wisconsin law. Other views, however, have discouraged the practice.”

Moran said Assembly Bill 819/Senate Bill 822 would create legal certainty around these legal and regulatory issues by clarifying in state law when providers can offer patients a discount and under what conditions, while also conforming with federal requirements and guidance relating to prompt pay discounts.

Ryan Klein, UW Health’s Senior Director Patient Access and Financial Experience, shared data with the Senate Health Committee from the Kaiser Family Foundation, a nonpartisan health policy research firm, showing how health insurance companies are shifting more of their financial responsibility on to patients through higher out-of-pocket costs like deductibles.

“These high deductibles require patients to pay thousands of dollars out-of-pocket before insurance begins paying a substantial share of costs,” said Klein.

As reported in The Valued Voice on January 15, Rep. Moses highlighted the significant impact cost-shifting and more negative practices by insurers and other middlemen have on the overall cost of health care, when he testified in support of the prompt-pay discount bill before the Assembly Insurance Committee.

“The administrative cost associated with delivering health care now accounts for 40% of overall hospital or health systems costs, according to a report from the American Hospital Association,” said Rep. Moses. “These are costs that are borne by providers but ultimately paid by patients, as providers must hire staff and invest in software systems that help them collect amounts owed by insurance companies and patients.”

This week’s committee action advanced the prompt-pay discount bill to the full Legislature, setting up a likely vote in both the Senate and Assembly before the legislative session ends in a few weeks. Passage of bill by both houses of the Legislature would then send the bill to the Governor for his signature.

Contact WHA Vice President of Medicaid and Payer Reimbursement Christian Moran with any questions.