2017 - 2018 LEGISLATURE
March 7, 2018 - Introduced by Senators Vinehout, Ringhand and L. Taylor,
cosponsored by Representatives
Barca, Spreitzer, Berceau, Subeck and
Sargent. Referred to Committee on Health and Human Services.
1An Act to create
13.94 (1) (nm) of the statutes; relating to: nonemergency
2medical transportation for Medical Assistance recipients in certain counties.
Analysis by the Legislative Reference Bureau
This bill requires the Department of Health Services, to the extent permitted
by the contract, to modify the current contract for the arrangement and
reimbursement of nonemergency medical transportation for Medical Assistance
recipients to exclude Medical Assistance recipients who reside in Buffalo, Eau
Claire, Jefferson, Kenosha, Milwaukee, Ozaukee, Pepin, Racine, Rock,
Trempealeau, Walworth, Washington, and Waukesha counties from the contract
unless the county chooses to remain under the original contract. If DHS modifies the
contract, it must make alternative arrangements with counties, health maintenance
organizations, or transportation providers to provided nonemergency medical
transportation services to Medical Assistance recipients residing in those counties.
Medical Assistance is administered by DHS and is a joint federal and state program
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:
13.94 (1) (nm) of the statutes is created to read:
(nm) No later than February 1, 2021, prepare a financial and 2
performance evaluation audit of the nonemergency medical transportation program 3
for Medical Assistance recipients including a comparison of services provided under 4
an alternative arrangement made under 2017 Wisconsin Act .... (this act), section 2, 5
to services provided under a contract other than the alternative arrangement.
(1) Medical Assistance nonemergency medical transportation.
(a) The department of health services shall, to the extent permitted by the 9
contract, modify the contract that is in effect on the effective date of this paragraph 10
for the arrangement and reimbursement of nonemergency medical transportation 11
services to recipients of Medical Assistance under subchapter IV of chapter 49 of the 12
statutes to exclude recipients of Medical Assistance residing in Buffalo, Eau Claire, 13
Jefferson, Kenosha, Milwaukee, Ozaukee, Pepin, Racine, Rock, Trempealeau, 14
Walworth, Washington, and Waukesha counties from that contract unless the county 15
chooses to remain under the original contract.
(b) If the department of health services modifies the contract under paragraph 17
(a), the department of health services shall make alternative arrangements with 18
counties, health maintenance organizations, or transportation providers to provide 19
nonemergency medical transportation services to Medical Assistance recipients who 20
reside in the counties specified in paragraph (a
), except any county that chooses to 21
remain under the original contract, no later than January 1, 2019. The department 22
of health services shall include in any contract for alternative arrangements under 23
this paragraph a requirement that the nonemergency medical transportation 24
provider submit to the department of health services information substantially 25
similar to the information required under the original contract including trip log
data, summary information on all calls for services and contacts with Medical 2
Assistance recipients, encounter data based on Centers for Medicare and Medicaid 3
Services 1500 claim form data, network provider information, accident and moving 4
violation reports, vehicle reports, complaint summary reports, telecommunications 5
system reports, annual fiscal audit reports, and daily reports including numbers of 6
trips, cancelled trips, denied trips, and complaints.