Category: Uncategorized

  • Case Closed? The Supreme Court Upholds Preventive Care Mandate

    Earlier this Summer, the US Supreme Court ruled that the Affordable Care Act’s requirement to cover certain preventive care services at no cost is constitutional. As a result, employers must continue to provide first-dollar coverage for all preventive care services that receive an “A” or “B” rating from any of three organizations: the U.S. Preventive…

  • Some Wins for Employer Benefits in State and Federal Budget Bills

    Over the past several weeks, we’ve been closely watching the Wisconsin state legislature and Congress work out agreements on omnibus budget packages that will have a significant impact on health policy in the years ahead. Both the state and federal packages were sent off for executive branch signature on the same day – July 3,…

  • State Legislature Reintroduces PBM Bill with Costly Provisions

    Advancing Free Market Healthcare sent a memo to Wisconsin legislators asking them not to support Senate Bill 203, otherwise known as the Pharmacy Benefit Manager (PBM) reform bill. Unfortunately, the proposed bill includes several provisions that would be costly for employers and employees if enacted into law: Advancing Free Market Healthcare worked with National CooperativeRx,…

  • AFMH Adopts Legislative Agenda

    Earlier this year, the Leadership Council of Advancing Free Market Healthcare, which includes leaders from eleven Wisconsin companies representing different regions of the state, has adopted the organization’s 2025-26 Legislative Agenda. The AFMH legislative agenda is being used during regional meetings with lawmakers and employers that are being held around the state in 2025 and…

  • Legislature Kicks Off New Session

    On January 6, 2025, 36 freshman Wisconsin lawmakers were sworn into office following the November elections. They joined 96 returning lawmakers to make up 99-member state Assembly and the 33-member state Senate. With freshman making up a quarter of the new legislature, employers who are part of Advancing Free Market Healthcare have a great opportunity…

  • Explaining the So-Called “Prompt Pay” Legislation

    Under current law, section 146.905 of the Wisconsin Statutes prevents Wisconsin healthcare providers from offering to reduce or eliminate copays, coinsurance, or deductibles that are required under an insurance policy. The Wisconsin Hospital Association says that this section of the statute prohibits healthcare providers from offering discounts to patients who pay their bills promptly. Legislation…

  • Will a Proposed Ban on White Bagging Rise from the Ashes?

    White bagging, or alternative sourcing of medications, is when employers work with their preferred pharmacy partners to send an enrollee’s clinician-administered medication directly to the site of care, when it is both safe and cost effective to do so. This allows employers to bypass hospital pharmacy markups on expensive specialty medications, which according to studies…

  • PBM Reforms Proposed in Madison and D.C.

    Pharmacy Benefit Manager (PBM) reform is a hot topic in Congress and in statehouses around the country. Several factors have led to the increased scrutiny. Numerous reports and investigations, including by the Federal Trade Commission and the US Department of Justice, conclude that PBM pricing strategies are inflating costs for consumers and employers. And, because…

  • Employers at the Table for Healthcare Price Transparency

    Phillip Blair, AFMH member and Gamber-Johnson’s HR Director, was recently invited to participate in a Wisconsin Health News event on healthcare price transparency. He was joined on the panel by State Senator Mary Felzkowski, CEO of the Wisconsin Hospital Association Eric Borgerding, Milliman actuary Mike Gaal and two Wisconsin hospital leaders. The discussion was largely…