AB56-ASA1-AA2,9,2
2“
Section 201c. 20.435 (4) (jw) of the statutes is amended to read:
AB56-ASA1-AA2,9,103
20.435
(4) (jw)
BadgerCare Plus and hospital assessment. All
moneys received
4from payment of enrollment fees under the program under s. 49.45 (23), all moneys
5transferred under s. 50.38 (9), all moneys transferred from the appropriation account
6under par. (jz), and 10 percent of all moneys received from penalty assessments
7under s. 49.471 (9) (c),
for administration of the program under s. 49.45 (23), to
8provide a portion of the state share of administrative costs for the BadgerCare Plus
9Medical Assistance program under s. 49.471
, and for administration of the hospital
10assessment under s. 50.38.”.
AB56-ASA1-AA2,9,1613
20.435
(5) (cf)
Mobile crisis team Crisis program enhancement grants. 14Biennially, the amounts in the schedule for awarding grants to counties or regions
15to establish
certified or enhance crisis programs
that create mental health mobile
16crisis teams under s. 46.536.”.
AB56-ASA1-AA2,9,2119
20.435
(5) (ct)
Mental health consultation program. The amounts in the
20schedule for developing a plan for a mental health consultation program under s.
2151.441. No moneys may be encumbered under this paragraph after June 30, 2021.”.
AB56-ASA1-AA2,10,3
120.435
(5) (dg)
Regional crisis stabilization facilities. The amounts in the
2schedule to provide grants to regional crisis stabilization facilities under s. 51.03
3(7).”.
AB56-ASA1-AA2,10,15
846.536 Mobile crisis team Crisis program enhancement grants. From
9the appropriation under s. 20.435 (5) (cf), the department shall award grants in the
10total amount of $250,000 in each fiscal biennium to counties or regions comprised of
11multiple counties to establish
certified or enhance crisis programs
that create mental
12health mobile crisis teams to serve individuals having
mental health crises in rural
13areas. The department shall award a grant under this section in an amount equal
14to one-half the amount of money the county or region provides to establish
certified 15or enhance crisis programs
that create mobile crisis teams.”.
AB56-ASA1-AA2,10,20
1846.854 Healthy aging grant program. From the appropriation under s.
1920.435 (1) (bk), the department shall award in each fiscal year a grant of $250,000
20to an entity that conducts programs in healthy aging.”.
AB56-ASA1-AA2,11,223
46.995
(4) The department shall ensure that any child who is eligible and who
24applies for the disabled children's long-term support program that is operating
1under a waiver of federal law receives services under the disabled children's
2long-term support program that is operating under a waiver of federal law.”.
AB56-ASA1-AA2,11,6
4“(u)
Prevention services. For services to prevent child abuse or neglect,
5$5,289,600 in each fiscal year $6,302,100 in fiscal year 2019-20 and $7,464,600 in
6fiscal year 2020-21.”.
AB56-ASA1-AA2,11,2211
49.45
(3) (e) 11. The department shall use a portion of the moneys collected
12under s. 50.38 (2) (a) to pay for services provided by eligible hospitals, as defined in
13s. 50.38 (1), other than critical access hospitals, under the Medical Assistance
14Program under this subchapter, including services reimbursed on a fee-for-service
15basis and services provided under a managed care system. For state fiscal year
162008-09, total payments required under this subdivision, including both the federal
17and state share of Medical Assistance, shall equal the amount collected under s.
1850.38 (2) (a) for fiscal year 2008-09 divided by 57.75 percent. For each state fiscal
19year after state fiscal year 2008-09, total payments required under this subdivision,
20including both the federal and state share of Medical Assistance, shall equal the
21amount collected under s. 50.38 (2) (a) for the fiscal year divided by
61.68 53.69 22percent.
AB56-ASA1-AA2,12,8
149.45
(3) (e) 12. The department shall use a portion of the moneys collected
2under s. 50.38 (2) (b) to pay for services provided by critical access hospitals under
3the Medical Assistance Program under this subchapter, including services
4reimbursed on a fee-for-service basis and services provided under a managed care
5system. For each state fiscal year, total payments required under this subdivision,
6including both the federal and state share of Medical Assistance, shall equal the
7amount collected under s. 50.38 (2) (b) for the fiscal year divided by
61.68 53.69 8percent.”.
AB56-ASA1-AA2,12,10
10“
Section 657b. 49.45 (3m) (a) (intro.) of the statutes is amended to read:
AB56-ASA1-AA2,12,1711
49.45
(3m) (a) (intro.) Subject to par. (c) and notwithstanding sub. (3) (e), from
12the appropriations under s. 20.435 (4) (b) and (o), in each fiscal year, the department
13shall pay to hospitals that serve a disproportionate share of low-income patients an
14amount equal to the sum of
$27,500,000 $56,500,000, as the state share of payments,
15and the matching federal share of payments. The department may make a payment
16to a hospital under this subsection under the calculation method described in par. (b)
17if the hospital meets all of the following criteria:
AB56-ASA1-AA2,658b
18Section 658b. 49.45 (3m) (b) 3. a. of the statutes is amended to read:
AB56-ASA1-AA2,12,2219
49.45
(3m) (b) 3. a. No single hospital receives more than
$4,600,000 20$9,200,000, except that a hospital that is a free-standing pediatric teaching hospital
21located in Wisconsin that has a percentage calculated under subd. 1. a. greater than
2250 percent may receive up to $12,000,000 each fiscal year.”.
AB56-ASA1-AA2,13,14
1“49.45
(3p) (a) Subject to par. (c) and notwithstanding sub. (3) (e), from the
2appropriations under s. 20.435 (4) (b) and (o), in each fiscal year, the department
3shall pay to hospitals that
would are not eligible for payments under sub. (3m) but
4that meet the criteria under sub. (3m) (a)
except that the hospitals do not provide
5obstetric services 1. and 2. and that, in the most recent year for which information
6is available, charged at least 6 percent of overall charges for services to the Medical
7Assistance program for services provided to Medical Assistance recipients an
8amount equal to the sum of
$250,000 $500,000, as the state share of payments, and
9the matching federal share of payments. The department may make a payment to
10a hospital under this subsection under a calculation method determined by the
11department that provides a fee-for-service supplemental payment that increases as
12the
hospital's percentage of
inpatient days for Medical Assistance recipients at the
13hospital the total amount of the hospital's overall charges for services that are
14charges to the Medical Assistance program increases.”.
AB56-ASA1-AA2,13,2017
49.45
(6xm) Pediatric inpatient supplement. (a) From the appropriations
18under s. 20.435 (4) (b), (o), and (w), the department shall, using a method determined
19by the department, distribute a total sum of $2,000,000 each state fiscal year to
20hospitals that meet all of the following criteria:
AB56-ASA1-AA2,13,2121
1. The hospital is an acute care hospital located in this state.
AB56-ASA1-AA2,14,222
2. During the hospital's fiscal year, the inpatient days in the hospital's acute
23care pediatric units and intensive care pediatric units totaled more than 12,000 days,
24not including neonatal intensive care units. For purposes of this subsection, the
1hospital's fiscal year is the hospital's fiscal year that ended in the 2nd calendar year
2preceding the beginning of the state fiscal year.
AB56-ASA1-AA2,14,73
(b) Notwithstanding par. (a), from the appropriations under s. 20.435 (4) (b),
4(o), and (w), the department may, using a method determined by the department,
5distribute an additional total sum of $10,000,000 in each state fiscal year to hospitals
6that are free-standing pediatric teaching hospitals located in Wisconsin that have
7a percentage calculated under s. 49.45 (3m) (b) 1. a. greater than 45 percent.
AB56-ASA1-AA2,14,1512
49.45
(24L) Critical access reimbursement payments to dental providers. (a)
13Based on the criteria in pars. (b) and (c), the department shall increase
14reimbursements to dental providers that meet quality of care standards, as
15established by the department.
AB56-ASA1-AA2,14,1716
(b) In order to be eligible for enhanced reimbursement under this subsection,
17the provider must meet one of the following qualifications:
AB56-ASA1-AA2,14,2018
1. For a nonprofit or public provider, 50 percent or more of the individuals
19served by the provider are individuals who are without dental insurance or are
20enrolled in the Medical Assistance program.
AB56-ASA1-AA2,14,2221
2. For a for-profit provider, 5 percent or more of the individuals served by the
22provider are enrolled in the Medical Assistance program.
AB56-ASA1-AA2,15,823
(c) For dental services rendered on or after January 1, 2020, by a qualified
24nonprofit critical access dental provider, the department shall increase
25reimbursement by 50 percent above the reimbursement rate that would otherwise
1be paid to that provider. For dental services rendered on or after January 1, 2020,
2by a qualified for-profit critical access dental provider, the department shall increase
3reimbursement by 30 percent above the reimbursement rate that would otherwise
4be paid to that provider. For dental providers rendering services to individuals in
5managed care under the Medical Assistance program, for services rendered on or
6after January 1, 2020, the department shall increase reimbursement to pay an
7additional amount on the basis of the rate that would have been paid to the dental
8provider had the individual not been enrolled in managed care.
AB56-ASA1-AA2,15,119
(d) If a provider has more than one service location, the thresholds described
10under par. (b) apply to each location, and payment for each service location would be
11determined separately.”.
AB56-ASA1-AA2,15,23
14“49.45
(29w) (b) 1. b. “Telehealth"
is means a service provided from a remote
15location using a combination of interactive video, audio, and externally acquired
16images through a networking environment between an individual
or a provider at
17an originating site and a provider at a remote location with the service being of
18sufficient audio and visual fidelity and clarity as to be functionally equivalent to
19face-to-face contact
; or, in circumstances determined by the department, an
20asynchronous transmission of digital clinical information through a secure
21electronic communications system from one provider to another provider.
22“Telehealth" does not include telephone conversations or Internet-based
23communications between providers or between providers and individuals.”.
AB56-ASA1-AA2,16,53
49.45
(30y) Certified doula services; pilot project. (a) In this subsection,
4“certified doula" means an individual who has received certification from a doula
5certifying organization recognized by the department.
AB56-ASA1-AA2,16,86
(b) For purposes of this subsection, services provided by certified doulas include
7continuous emotional and physical support during labor and birth of a child and
8intermittent services during the prenatal and postpartum periods.
AB56-ASA1-AA2,16,139
(c) Subject to par. (d), the department shall reimburse under the Medical
10Assistance program benefits as provided under this subsection for pregnant women
11enrolled in the Medical Assistance program who reside in the counties of Brown,
12Dane, Milwaukee, Rock, or Sheboygan, or another county as determined by the
13department.
AB56-ASA1-AA2,16,1914
(d) The department shall request from the secretary of the federal department
15of health and human services any approval necessary to allow reimbursement under
16the Medical Assistance program for services provided by a certified doula. The
17department may not pay reimbursement unless federal approval is not required or
18any required federal approval allowing reimbursement under s. 49.46 (2) (b) 12p. is
19approved and in effect.”.
AB56-ASA1-AA2,17,3
22“49.45
(41) Mental health crisis Crisis intervention services. (a) In this
23subsection, “
mental health crisis intervention services" means
crisis intervention 24services
for the treatment of mental illness, intellectual disability, substance abuse,
1and dementia that are provided by a
mental health crisis intervention program
2operated by, or under contract with, a county, if the county is certified as a medical
3assistance provider.
AB56-ASA1-AA2,17,124
(b) If a county elects to become certified as a provider of
mental health crisis
5intervention services, the county may provide
mental health crisis intervention
6services under this subsection in the county to medical assistance recipients through
7the medical assistance program. A county that elects to provide the services shall
8pay the amount of the allowable charges for the services under the medical
9assistance program that is not provided by the federal government. The department
10shall reimburse the county under this subsection only for the amount of the allowable
11charges for those services under the medical assistance program that is provided by
12the federal government.
AB56-ASA1-AA2,17,1614
49.45
(41) (c) Notwithstanding par. (b), if a county elects to deliver crisis
15intervention services under the Medical Assistance program on a regional basis
16according to criteria established by the department, all of the following apply:
AB56-ASA1-AA2,17,2117
1. After January 1, 2020, the department shall require the county to annually
18contribute for the crisis intervention services an amount equal to 75 percent of the
19annual average of the county's expenditures for crisis intervention services under
20this subsection in calendar years 2016, 2017, and 2018, as determined by the
21department.
AB56-ASA1-AA2,17,2522
2. The department shall reimburse the provider of crisis intervention services
23in the county the amount of allowable charges for those services under the Medical
24Assistance program, including both the federal share and nonfederal share of those
25charges, that exceeds the amount of the county contribution required under subd. 1.
AB56-ASA1-AA2,18,4
13. If a county submits a certified cost report under s. 49.45 (52) (b) to claim
2federal medical assistance funds, the claim based on certified costs made by a county
3for amounts under subd. 2. may not include any part of the nonfederal share of the
4amount under subd. 2.”.
AB56-ASA1-AA2,18,107
49.46
(1) (a) 1m. Any pregnant woman whose income does not exceed the
8standard of need under s. 49.19 (11) and whose pregnancy is medically verified.
9Eligibility continues to the last day of the month in which the 60th day
or, if approved
10by the federal government, the 365th day after the last day of the pregnancy falls.”.
AB56-ASA1-AA2,18,1713
49.46
(1) (j) An individual determined to be eligible for benefits under par. (a)
149. remains eligible for benefits under par. (a) 9. for the balance of the pregnancy and
15to the last day of the month in which the 60th day
or, if approved by the federal
16government, the 365th day after the last day of the pregnancy falls without regard
17to any change in the individual's family income.”.
AB56-ASA1-AA2,18,2120
49.46
(2) (b) 12p. Subject to the limitations under s. 49.45 (30y), services
21provided by a certified doula.”.
AB56-ASA1-AA2,18,24
23“49.46
(2) (b) 15.
Mental health crisis Crisis intervention services under s.
2449.45 (41).”.
AB56-ASA1-AA2,19,43
49.46
(2) (b) 21. Subject to par. (bv), nonmedical services that contribute to the
4determinants of health.
AB56-ASA1-AA2,19,126
49.46
(2) (bv) The department shall determine those services under par. (b) 21.
7that contribute to the determinants of health. The department shall seek any
8necessary state plan amendment or request any waiver of federal Medicaid law to
9implement this paragraph. The department is not required to provided the services
10under this paragraph as a benefit under the Medical Assistance program if the
11federal department of health and human services does not provide federal financial
12participation for the services under this paragraph.”.
