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AB64-ASA1,923g 8Section 923g. 49.34 (5m) (b) 5. of the statutes is created to read:
AB64-ASA1,515,119 49.34 (5m) (b) 5. The department, in consultation with the department of
10health services and the department of corrections, shall promulgate rules to
11implement this subsection including all of the following:
AB64-ASA1,515,1612 a. Requiring that contracts for rate-based services under this subsection allow
13a provider to retain from any surplus revenue up to 5 percent of the total revenue
14received under the contract, or a different percentage rate determined by the
15department. The percentage rate established under this subd. 5. a. shall apply
16uniformly to all rate-based service contracts under this subsection.
AB64-ASA1,515,1817 b. Establishing a procedure for reviewing rate-based service contracts to
18determine whether a contract complies with the provisions of this subsection.
AB64-ASA1,923h 19Section 923h. 49.34 (5m) (em) of the statutes is amended to read:
AB64-ASA1,516,220 49.34 (5m) (em) Notwithstanding par. (b) 1. and 2., a county department under
21s. 46.215, 51.42, or 51.437 providing client services in a county having a population
22of 750,000 or more or a nonstock, nonprofit corporation providing client services in
23such a county may not retain a surplus generated by a rate-based service or
24accumulate funds from more than one contract period for a rate-based service from

1revenues that are used to meet the maintenance-of-effort requirement under the
2federal temporary assistance for needy families program under 42 USC 601 to 619.
AB64-ASA1,923i 3Section 923i. 49.343 (5) (c) of the statutes is amended to read:
AB64-ASA1,516,54 49.343 (5) (c) The identification of the measurements specified in sub. (6) (a)
5and the development of the payment levels specified in sub. (6) (a).
AB64-ASA1,923j 6Section 923j. 49.343 (6) (a) (intro.) and 1. of the statutes are consolidated,
7renumbered 49.343 (6) (a) and amended to read:
AB64-ASA1,516,138 49.343 (6) (a) For purposes of implementing a performance-based contracting
9system, the department, in cooperation with the advisory committee created under
10sub. (5), shall do all of the following: 1. Identify identify measurements by which to
11evaluate the performance of providers in meeting both the goals for the children
12placed in their care and the goals for the out-of-home care system in this state and
13adjust, as needed, those measurements.
AB64-ASA1,923k 14Section 923k. 49.343 (6) (a) 2. of the statutes is repealed.
AB64-ASA1,923L 15Section 923L. 49.343 (6) (b) of the statutes is repealed.
AB64-ASA1,923m 16Section 923m. 49.343 (6) (c) and (d) of the statutes are amended to read:
AB64-ASA1,516,2117 49.343 (6) (c) Beginning on January 1, 2011, the department shall select a
18representative sample of providers and evaluate the performance of those providers
19in attaining the measurements identified under par. (a) 1. Based on that evaluation,
20the department, in consultation with the advisory committee created under sub. (5),
21shall adjust, as needed, those measurements by December 31, 2011.
AB64-ASA1,517,222 (d) Beginning on January 1, 2013, the department shall evaluate the
23performance of all providers in this state in attaining the measurements identified
24under par. (a) 1. Based on that evaluation, the department, in consultation with the
25advisory committee created under sub. (5), shall adjust, as needed, those

1measurements by December 31, 2013, and in subsequent years as determined
2necessary by the department.
AB64-ASA1,924 3Section 924 . 49.37 of the statutes is created to read:
AB64-ASA1,517,7 449.37 Offender reentry demonstration project. (1) Beginning in fiscal
5year 2017-18, the department of children and families shall establish a 5-year
6offender reentry demonstration project focused on noncustodial fathers in a 1st class
7city.
AB64-ASA1,517,10 8(2) Upon completion of the demonstration project under sub. (1) and by June
930, 2023, the department of children and families shall conduct an evaluation of the
10demonstration project.
AB64-ASA1,924p 11Section 924p. 49.45 (3m) (a) (intro.) and (b) 3. a. of the statutes are amended
12to read:
AB64-ASA1,517,1913 49.45 (3m) (a) (intro.) Subject to par. (c) and notwithstanding sub. (3) (e), from
14the appropriations under s. 20.435 (4) (b) and (o), in each fiscal year, the department
15shall pay to hospitals that serve a disproportionate share of low-income patients an
16amount equal to the sum of $15,000,000 $27,500,000, as the state share of payments,
17and the matching federal share of payments. The department may make a payment
18to a hospital under this subsection under the calculation method described in par. (b)
19if the hospital meets all of the following criteria:
AB64-ASA1,517,2020 (b) 3. a. No single hospital receives more than $2,500,000 $4,600,000.
AB64-ASA1,924r 21Section 924r. 49.45 (3p) of the statutes is created to read:
AB64-ASA1,518,622 49.45 (3p) Rural critical care access supplement. (a) Subject to par. (c) and
23notwithstanding sub. (3) (e), from the appropriations under s. 20.435 (4) (b) and (o),
24in each fiscal year, the department shall pay to hospitals that would meet the criteria
25under sub. (3m) (a) except that the hospitals do not provide obstetric services an

1amount equal to the sum of $250,000, as the state share of payments, and the
2matching federal share of payments. The department may make a payment to a
3hospital under this subsection under a calculation method determined by the
4department that provides a fee-for-service supplemental payment that increases as
5the hospital's percentage of inpatient days for Medical Assistance recipients at the
6hospital increases.
AB64-ASA1,518,87 (b) The department shall ensure that the total amount of moneys available to
8pay hospitals described under this subsection is distributed in each fiscal year.
AB64-ASA1,518,119 (c) The department shall limit the maximum payment to hospitals under this
10subsection such that the amount of payment is in accordance with federal rules
11concerning any hospital specific limit.
AB64-ASA1,518,1912 (d) The department shall seek any necessary approval from the federal
13department of health and human services to implement the hospital payment
14supplement described under par. (a). If approval is necessary and approval from the
15federal department of health and human services is received, the department shall
16implement the payment methodology described under par. (a). If approval is
17necessary and the federal department of health and human services does not
18approve, the department may not implement the hospital payment supplement
19under par. (a).
AB64-ASA1,926p 20Section 926p. 49.45 (9r) of the statutes is created to read:
AB64-ASA1,518,2121 49.45 (9r) Complex rehabilitation technology. (a) In this subsection:
AB64-ASA1,518,2322 1. “Complex needs patient" means an individual with a diagnosis or medical
23condition that results in significant physical impairment or functional limitation.
AB64-ASA1,519,324 2. “Complex rehabilitation technology" means items classified within Medicare
25as durable medical equipment that are individually configured for individuals to

1meet their specific and unique medical, physical, and functional needs and capacities
2for basic activities of daily living and instrumental activities of daily living identified
3as medically necessary.
AB64-ASA1,519,104 3. “Individually configured" means having a combination of sizes, features,
5adjustments, or modifications that a qualified complex rehabilitation technology
6supplier can customize to the specific individual by measuring, fitting,
7programming, adjusting, or adapting as appropriate so that the device operates in
8accordance with an assessment or evaluation of the individual by a qualified health
9care professional and is consistent with the individual's medical condition, physical
10and functional needs and capacities, body size, period of need, and intended use.
AB64-ASA1,519,1211 4. “Medicare" means coverage under Part A or Part B of Title XVIII of the
12federal Social Security Act, 42 USC 1395 et seq.
AB64-ASA1,519,1513 5. “Qualified complex rehabilitation technology professional" means an
14individual who is certified as an assistive technology professional by the
15Rehabilitation Engineering and Assistive Technology Society of North America.
AB64-ASA1,519,1716 6. “Qualified complex rehabilitation technology supplier" means a company or
17entity that meets all of the following criteria:
AB64-ASA1,519,1918 a. Is accredited by a recognized accrediting organization as a supplier of
19complex rehabilitation technology.
AB64-ASA1,519,2220 b. Is an enrolled supplier for purposes of Medicare reimbursement that meets
21the supplier and quality standards established for durable medical equipment
22suppliers, including those for complex rehabilitation technology under Medicare.
AB64-ASA1,520,323 c. Is an employer of at least one qualified complex rehabilitation technology
24professional to analyze the needs and capacities of the complex needs patient in
25consultation with qualified health care professionals, to participate in the selection

1of appropriate complex rehabilitation technology for those needs and capacities of
2the complex needs patient, and to provide training in the proper use of the complex
3rehabilitation technology.
AB64-ASA1,520,64 d. Requires a qualified complex rehabilitation technology professional to be
5physically present for the evaluation and determination of appropriate complex
6rehabilitation technology for a complex needs patient.
AB64-ASA1,520,87 e. Has the capability to provide service and repair by qualified technicians for
8all complex rehabilitation technology it sells.
AB64-ASA1,520,129 f. Provides written information at the time of delivery of the complex
10rehabilitation technology to the complex needs patient stating how the complex
11needs patient may receive service and repair for the complex rehabilitation
12technology.
AB64-ASA1,520,1313 7. “Qualified health care professional" means any of the following:
AB64-ASA1,520,1414 a. A physician or physician assistant licensed under subch. II of ch. 448.
AB64-ASA1,520,1515 b. A physical therapist licensed under subch. III of ch. 448.
AB64-ASA1,520,1616 c. An occupational therapist licensed under subch VII of ch. 448.
AB64-ASA1,520,1917 (b) The department shall promulgate rules and other policies for use of complex
18rehabilitation technology by recipients of Medical Assistance. The department shall
19include in the rules all of the following:
AB64-ASA1,520,2320 1. Designation of billing codes as complex rehabilitation technology including
21creation of new billing codes or modification of existing billing codes. The
22department shall include provisions allowing quarterly updates to the designations
23under this subdivision.
AB64-ASA1,521,3
12. Establishment of specific supplier standards for companies or entities that
2provide complex rehabilitation technology and limiting reimbursement only to
3suppliers that are qualified complex rehabilitation technology suppliers.
AB64-ASA1,521,64 3. A requirement that Medical Assistance recipients who need a manual
5wheelchair, power wheelchair, or other seating component to be evaluated by all of
6the following:
AB64-ASA1,521,87 a. A qualified health care professional who does not have a financial
8relationship with a qualified complex rehabilitation technology supplier.
AB64-ASA1,521,99 b. A qualified complex rehabilitation technology professional.
AB64-ASA1,521,1410 4. Establishment and maintenance of payment rates for complex rehabilitation
11technology that are adequate to ensure complex needs patients have access to
12complex rehabilitation technology, taking into account the significant resources,
13infrastructure, and staff needed to appropriately provide complex rehabilitation
14technology to meet the unique needs of complex needs patients.
AB64-ASA1,521,1715 5. A requirement for contracts with the department that managed care plans
16providing services to Medical Assistance recipients comply with this subsection and
17the rules promulgated under this subsection.
AB64-ASA1,521,1918 6. Protection of access to complex rehabilitation technology for complex needs
19patients.
AB64-ASA1,927 20Section 927 . 49.45 (23) (g) 1. f. of the statutes is created to read:
AB64-ASA1,521,2221 49.45 (23) (g) 1. f. Provide employment and training services to childless adults
22receiving Medical Assistance under this subsection.
AB64-ASA1,928b 23Section 928b. 49.45 (23) (g) 2. of the statutes is repealed.
AB64-ASA1,928d 24Section 928d. 49.45 (23) (g) 3. and 4. of the statutes are created to read:
AB64-ASA1,522,5
149.45 (23) (g) 3. If the secretary of the federal department of health and human
2services approves any portion of the waiver amendment requested under subd. 1.,
3the department shall, no later than the first day of the 4th month beginning after
4that approval, submit to the joint committee on finance a report that includes all of
5the following:
AB64-ASA1,522,76 a. A description of each component of the waiver amendment that is approved
7and any pertinent information on the department's plan for implementation.
AB64-ASA1,522,118 b. An estimate of the effect of implementation of the approved portions of the
9waiver amendment on enrollment in and the budget of the Medical Assistance
10program in the fiscal biennium in which approval occurs and in future fiscal
11bienniums.
AB64-ASA1,522,2412 4. The department may not implement any approved portion of the waiver
13amendment requested under subd. 1. unless the joint committee on finance meets
14under s. 13.10 and approves the implementation of that portion of the waiver
15amendment. In a meeting under s. 13.10 to review the report submitted under subd.
163., the joint committee on finance may approve or disapprove of the waiver
17amendment portions that are approved by the federal department of health and
18human services or may modify the waiver amendment only by removing one or more
19components of the waiver amendment. The department may implement the waiver
20amendment only as approved by the joint committee on finance, including any
21modifications. The department shall, if necessary to implement the waiver
22amendment as modified by the joint committee on finance, submit a subsequent
23waiver amendment request to the federal department of health and human services
24that is consistent with the committee's actions.
AB64-ASA1,928f 25Section 928f. 49.45 (24n) of the statutes is created to read:
AB64-ASA1,523,9
149.45 (24n) Reimbursement for dental services by facilities serving
2individuals with disabilities.
(a) Subject to approval of the federal department of
3health and human services under par. (b), the department shall distribute moneys
4in each fiscal year to increase the Medical Assistance reimbursement rates for all
5eligible dental services rendered by facilities that provide at least 90 percent of their
6dental services to individuals with cognitive and physical disabilities, as determined
7by the department. Under this subsection, the enhanced reimbursement rates for
8dental services would equal 200 percent of the Medical Assistance reimbursement
9rates that would otherwise be paid for these dental services.
AB64-ASA1,523,1510 (b) The department shall request any waiver from and submit any
11amendments to the state Medical Assistance plan to the federal department of health
12and human services necessary for the Medical Assistance reimbursement rate
13increase under par. (a). If any necessary waiver request or state plan amendment
14request is approved, the department shall implement par. (a) beginning on the
15effective date of the waiver or plan amendment.
AB64-ASA1,928g 16Section 928g. 49.45 (26g) of the statutes is created to read:
AB64-ASA1,523,2117 49.45 (26g) Intensive care coordination program. (a) Subject to par. (h), the
18department shall create and implement a program to reimburse hospitals and health
19care systems for intensive care coordination services provided to recipients of
20Medical Assistance under this subchapter who are not enrolled in coverage under
21Medicare, 42 USC 1395 et seq.
AB64-ASA1,523,2422 (b) The department shall select hospitals and health care systems to receive
23reimbursement under this subsection that submit to the department a description
24of their intensive care coordination program that includes all of the following:
AB64-ASA1,524,4
11. A statement that the hospital or health care system will use emergency
2department utilization data to identify recipients of Medical Assistance to receive
3intensive care coordination to reduce use of the emergency department by those
4Medical Assistance recipients.
AB64-ASA1,524,105 2. The method the hospital or health care system uses to identify for intensive
6care coordination a Medical Assistance recipient who uses the emergency
7department frequently. The hospital or health care system shall specify how it
8defines frequent emergency department use and may use criteria such as whether
9a recipient of Medical Assistance visits the emergency room 3 or more times within
1030 days, 6 or more times within 90 days, or 7 or more times within 12 months.
AB64-ASA1,524,1411 3. A description of the hospital's or health care system's intensive care
12coordination team consisting of health care providers other than solely physicians,
13such as nurses; social workers, case managers, or care coordinators ; behavioral
14health specialists; and schedulers.
AB64-ASA1,524,1715 4. That the hospital or health care system provides to a Medical Assistance
16recipient enrolled in intensive care coordination through the hospital or health care
17system all of the following, as appropriate to his or her care:
AB64-ASA1,524,1818 a. Discharge instructions and contacts for following up on care and treatment.
AB64-ASA1,524,1919 b. Referral information.
AB64-ASA1,524,2020 c. Appointment scheduling.
AB64-ASA1,524,2121 d. Medication instructions.
AB64-ASA1,524,2422 e. Intensive care coordination by a social worker, case manager, or care
23coordinator to connect the Medical Assistance recipient to a primary care provider
24or to a managed care organization.
AB64-ASA1,525,2
1f. Information about other health and social resources, such as transportation
2and housing.
AB64-ASA1,525,83 5. The outcomes intended to result from intensive care coordination by the
4hospital or health care system. Outcomes for a Medical Assistance recipient during
5a 6-month or 12-month period may include successful connection to primary care
6or the managed care organization as evidenced by 2 or 3 primary care appointments,
7successful connection to behavioral health resources and alcohol and other drug
8abuse resources, as needed, or a decrease in use of the emergency room.
AB64-ASA1,525,99 (c) The department shall do all of the following:
AB64-ASA1,525,1210 1. Respond to the hospital or health care system indicating if additional
11information is required to determine eligibility for the reimbursement program
12under this subsection.
AB64-ASA1,525,1513 2. If the hospital or health care system is eligible for the reimbursement
14program under this subsection, provide a description of the process for enrolling
15Medical Assistance recipients in intensive care coordination for reimbursement.
AB64-ASA1,525,2516 (d) The department shall provide as reimbursement for intensive care
17coordination to eligible hospitals and health care systems participating in the
18program under this subsection $500 for each Medical Assistance recipient who is not
19enrolled in coverage under Medicare, 42 USC 1395 et seq., the hospital or health care
20system enrolls in intensive care coordination. The initial enrollment for each
21recipient lasts for 6 months, and the health care provider may enroll the Medical
22Assistance recipient in one additional 6-month period for an additional $500
23reimbursement payment. The department shall pay no more than $1,500,000
24cumulatively in each fiscal year from all funding sources for reimbursements under
25this paragraph.
AB64-ASA1,526,3
1(e) Annually, each hospital and health care system that is eligible for the
2reimbursement program under this subsection shall submit a report to the
3department containing all of the following:
AB64-ASA1,526,54 1. The number of Medical Assistance recipients served by intensive care
5coordination.
AB64-ASA1,526,106 2. For each Medical Assistance recipient who is not enrolled in coverage under
7Medicare, 42 USC 1395 et seq., the number of emergency department visits for a
8period before enrollment of that recipient in intensive care coordination and the
9number of emergency department visits for the same recipient during the same
10period after enrollment in intensive care coordination.
AB64-ASA1,526,1211 3. Any demonstrated outcomes, such as those described in par. (b) 5., for
12Medical Assistance recipients.
AB64-ASA1,526,2013 (f) For each hospital or health care system eligible for the reimbursement
14program under this subsection, the department shall calculate the costs saved to the
15Medical Assistance program by avoiding emergency department visits by
16subtracting the sum of reimbursements made under par. (d) to the hospital or health
17care system from the sum of costs of visits to the emergency department as reported
18under par. (e) 2. that were expected to occur without intensive care coordination. If
19the result of the calculation is positive, the department shall distribute half of the
20amount saved to the hospital or health care system subject to par. (h).
AB64-ASA1,526,2521 (g) No later than 24 months after the date on which the first hospital or health
22care system is able to enroll individuals in the intensive care coordination program
23under this subsection, the department shall submit a report to the joint committee
24on finance summarizing the information reported under par. (e) including the costs
25saved by avoiding emergency department visits as calculated under par. (f).
AB64-ASA1,527,6
1(h) The department shall seek any necessary approval from the federal
2department of health and human services to implement the program under this
3subsection. If the federal department of health and human services disapproves the
4request for approval, the department may implement the reimbursement under par.
5(d), the savings distribution under par. (f), or both or any part of the program under
6this subsection.
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