LRB-3883/1
SWB:cdc
2023 - 2024 LEGISLATURE
October 30, 2023 - Introduced by Senators Testin,
Felzkowski, Ballweg, Bradley,
Taylor and Tomczyk, cosponsored by Representatives Tusler,
Brandtjen,
Hurd, S. Johnson, Murphy, Mursau, Nedweski, Ortiz-Velez, Plumer, Sinicki
and Subeck. Referred to Committee on Insurance and Small Business.
SB592,1,3
1An Act to create 49.45 (9r) (f) of the statutes;
relating to: reimbursement under
2the Medical Assistance program for complex rehabilitation technology
3wheelchair repairs and accessories.
Analysis by the Legislative Reference Bureau
Under current law, the Department of Health Services uses a standardized
coding system produced by the federal Centers for Medicare and Medicaid Services
to describe certain products, supplies, and services for those submitting claims for
reimbursement under the Medical Assistance program, which is known as the
Healthcare Common Procedure Coding System (HCPCS). This bill requires DHS,
for HCPCS codes relating to complex rehabilitation technology wheelchair repair
and accessories, to apply a reimbursement rate under the Medical Assistance
program equivalent to the maximum fee paid in Wisconsin under the federal
Medicare program, including fees under the KU modifier, if applicable. Under the
bill, “KU modifier” means a modifier used in the federal Medicare program related
to an exemption from competitive bidding pricing. The Medical Assistance program
is a joint federal and state program administered by DHS that provides health
services to individuals who have limited financial resources.
For further information see the state fiscal estimate, which will be printed as
an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SB592,1
1Section
1. 49.45 (9r) (f) of the statutes is created to read:
SB592,2,32
49.45
(9r) (f) 1. In this paragraph, “KU modifier” means a modifier used in the
3federal Medicare program related to an exemption from competitive bidding pricing.
SB592,2,94
2. For dates of service beginning on the effective date of this subdivision ....
5[LRB inserts date], the department shall, for healthcare common procedure coding
6system codes relating to complex rehabilitation technology wheelchair repair and
7accessories, apply a reimbursement rate under the Medical Assistance program
8equivalent to the maximum fee paid in Wisconsin under the federal Medicare
9program, including fees under the KU modifier, if applicable.
