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AB56-SA2,42,12 1292. Page 369, line 19: after that line insert:
AB56-SA2,42,13 13 Section 775i. 66.0137 (4) of the statutes is amended to read:
AB56-SA2,42,2014 66.0137 (4) Self-insured health plans. If a city, including a 1st class city, or
15a village provides health care benefits under its home rule power, or if a town
16provides health care benefits, to its officers and employees on a self-insured basis,
17the self-insured plan shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2),
18632.728, 632.746 (1) and (10) (a) 2. and (b) 2., 632.747 (3), 632.798, 632.85, 632.853,
19632.855, 632.867, 632.87 (4) to (6), 632.885, 632.89, 632.895 (9) (8) to (17), 632.896,
20and 767.513 (4).”.
AB56-SA2,42,21 2193. Page 418, line 7: after that line insert:
AB56-SA2,42,22 22 Section 1686i. 120.13 (2) (g) of the statutes is amended to read:
AB56-SA2,43,223 120.13 (2) (g) Every self-insured plan under par. (b) shall comply with ss.
2449.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.728, 632.746 (1) and (10) (a) 2. and (b)

12., 632.747 (3), 632.798, 632.85, 632.853, 632.855, 632.867, 632.87 (4) to (6), 632.885,
2632.89, 632.895 (9) (8) to (17), 632.896, and 767.513 (4).”.
AB56-SA2,43,4 394. Page 427, line 19: delete the material beginning with that line and ending
4with page 428, line 18, and substitute:
AB56-SA2,43,5 5 Section 1764b. 146.63 (2) (a) of the statutes is amended to read:
AB56-SA2,43,136 146.63 (2) (a) Subject to subs. (4) and (5), the department shall distribute
7grants from the appropriation under s. 20.435 (1) (fj) (4) (bf) to assist rural hospitals
8and groups of rural hospitals in procuring infrastructure and increasing case volume
9to the extent necessary to develop accredited graduate medical training programs.
10The department shall distribute the grants under this paragraph to rural hospitals
11and groups of rural hospitals that apply to receive a grant under sub. (3) and that
12satisfy the criteria established by the department under par. (b) and the eligibility
13requirement under sub. (6).
AB56-SA2,1765b 14Section 1765b. 146.63 (6) (intro.) of the statutes is amended to read:
AB56-SA2,43,1815 146.63 (6) Eligibility. (intro.) A rural hospital or group of rural hospitals may
16only receive a grant under sub. (3) if the plan to use the funds involves developing
17an accredited graduate medical training program in any of the following specialties
18a specialty, including any of the following:
AB56-SA2,1766b 19Section 1766b. 146.64 (2) (c) 1. of the statutes is amended to read:
AB56-SA2,44,220 146.64 (2) (c) 1. The department shall distribute funds for grants under par.
21(a) from the appropriation under s. 20.435 (4) (b) (bf). The department may not
22distribute more than $225,000 from the appropriation under s. 20.435 (4) (b) (bf) to
23a particular hospital in a given state fiscal year and may not distribute more than

1$75,000 from the appropriation under s. 20.435 (4) (b) (bf) to fund a given position
2in a graduate medical training program in a given state fiscal year.
AB56-SA2,1767b 3Section 1767b. 146.64 (4) (intro.) of the statutes is amended to read:
AB56-SA2,44,64 146.64 (4) Eligibility. (intro.) A hospital that has an accredited graduate
5medical training program in any of the following specialties a specialty, including
6any of the following,
may apply to receive a grant under sub. (3):”.
AB56-SA2,44,7 795. Page 430, line 15: after that line insert:
AB56-SA2,44,8 8 Section 1801i. 185.983 (1) (intro.) of the statutes is amended to read:
AB56-SA2,44,169 185.983 (1) (intro.) Every voluntary nonprofit health care plan operated by a
10cooperative association organized under s. 185.981 shall be exempt from chs. 600 to
11646, with the exception of ss. 601.04, 601.13, 601.31, 601.41, 601.42, 601.43, 601.44,
12601.45, 611.26, 611.67, 619.04, 623.11, 623.12, 628.34 (10), 631.17, 631.89, 631.93,
13631.95, 632.72 (2), 632.728, 632.745 to 632.749, 632.775, 632.79, 632.795, 632.798,
14632.85, 632.853, 632.855, 632.867, 632.87 (2) to (6), 632.885, 632.89, 632.895 (5) and
15(8) to (17), 632.896, and 632.897 (10) and chs. 609, 620, 630, 635, 645, and 646, but
16the sponsoring association shall:”.
AB56-SA2,44,17 1796. Page 433, line 4: after that line insert:
AB56-SA2,44,18 18 Section 1891b. 250.048 of the statutes is created to read:
AB56-SA2,44,24 19250.048 Prescription drug importation program. (1) Importation
20program requirements.
The department, in consultation with persons interested in
21the sale and pricing of prescription drugs and appropriate officials and agencies of
22the federal government, shall design and implement a prescription drug importation
23program for the benefit of residents of this state, that generates savings for residents,
24and that satisfies all of the following:
AB56-SA2,45,3
1(a) The department shall designate a state agency to become a licensed
2wholesale distributor or to contract with a licensed wholesale distributor and shall
3seek federal certification and approval to import prescription drugs.
AB56-SA2,45,64 (b) The prescription drug importation program under this section shall comply
5with relevant requirements of 21 USC 384, including safety and cost savings
6requirements.
AB56-SA2,45,97 (c) The prescription drug importation program under this section shall import
8prescription drugs from Canadian suppliers regulated under any appropriate
9Canadian or provincial laws.
AB56-SA2,45,1210 (d) The prescription drug importation program under this section shall have
11a process to sample the purity, chemical composition, and potency of imported
12prescription drugs.
AB56-SA2,45,1613 (e) The prescription drug importation program under this section shall import
14only those prescription drugs for which importation creates substantial savings for
15residents of the state and only those prescription drugs that are not brand-name
16drugs and that have fewer than 4 competitor prescription drugs in the United States.
AB56-SA2,45,1917 (f) The department shall ensure that prescription drugs imported under the
18program under this section are not distributed, dispensed, or sold outside of the
19state.
AB56-SA2,45,2120 (g) The prescription drug importation program under this section shall ensure
21all of the following:
AB56-SA2,45,2322 1. Participation by any pharmacy or health care provider in the program is
23voluntary.
AB56-SA2,45,2524 2. Any pharmacy or health care provider participating in the program has the
25appropriate license or other credential in this state.
AB56-SA2,46,3
13. Any pharmacy or health care provider participating in the program charges
2a consumer or health plan the actual acquisition cost of the imported prescription
3drug that is dispensed.
AB56-SA2,46,74 (h) The prescription drug importation program under this section shall ensure
5that a payment by a health plan or health insurance policy for a prescription drug
6imported under the program reimburses no more than the actual acquisition cost of
7the imported prescription drug that is dispensed.
AB56-SA2,46,108 (i) The prescription drug importation program under this section shall ensure
9that any health plan or health insurance policy participating in the program does all
10of the following:
AB56-SA2,46,1211 1. Maintains a formulary and claims payment system with current information
12on prescription drugs imported under the program.
AB56-SA2,46,1513 2. Bases cost-sharing amounts for participants or insureds under the plan or
14policy on no more than the actual acquisition cost of the prescription drug imported
15under the program that is dispensed to the participant or insured.
AB56-SA2,46,1816 3. Demonstrates to the department or a state agency designated by the
17department how premiums under the policy or plan are affected by savings on
18prescription drugs imported under the program.
AB56-SA2,46,2119 (j) Any wholesale distributor importing prescription drugs under the program
20under this section shall limit its profit margin to the amount established by the
21department or a state agency designated by the department.
AB56-SA2,46,2422 (k) The prescription drug importation program under this section may not
23import any generic prescription drug that would violate federal patent laws on
24branded products in this country.
AB56-SA2,47,5
1(L) The prescription drug importation program under this section shall comply
2to the extent practical and feasible before the prescription drug to be imported comes
3into possession of the state's wholesale distributor and fully after the prescription
4drug to be imported is in possession of the state's wholesale distributor with tracking
5and tracing requirements of 21 USC 360eee to 360eee-1.
AB56-SA2,47,86 (m) The prescription drug importation program under this section shall
7establish a fee or other approach to finance the program that does not jeopardize
8significant savings to residents of the state.
AB56-SA2,47,109 (n) The prescription drug importation program under this section shall have
10an audit function that ensures all of the following:
AB56-SA2,47,1311 1. The department has a sound methodology to determine the most
12cost-effective prescription drugs to include in the importation program under this
13section.
AB56-SA2,47,1514 2. The department has a process in place to select Canadian suppliers that are
15high quality, high performing, and in full compliance with Canadian laws.
AB56-SA2,47,1716 3. Prescription drugs imported under the program are pure, unadulterated,
17potent, and safe.
AB56-SA2,47,1918 4. The prescription drug importation program is complying with the
19requirements of this subsection.
AB56-SA2,47,2220 5. The prescription drug importation program under this section is adequately
21financed to support administrative functions of the program while generating
22significant cost savings to residents of the state.
AB56-SA2,47,2423 6. The prescription drug importation program under this section does not put
24residents of the state at a higher risk than if the program did not exist.
AB56-SA2,48,2
17. The prescription drug importation program under this section provides and
2is projected to continue to provide substantial cost savings to residents of the state.
AB56-SA2,48,5 3(2) Anticompetitive behavior. The department, in consultation with the
4attorney general, shall identify the potential for and monitor anticompetitive
5behavior in industries affected by a prescription drug importation program.
AB56-SA2,48,16 6(3) Approval of program design; certification. No later than the first day of
7the 7th month beginning after the effective date of this subsection .... [LRB inserts
8date], the department shall submit to the joint committee on finance a report that
9includes the design of the prescription drug importation program in accordance with
10this section. The department may not submit the proposed prescription drug
11importation program to the federal department of health and human services unless
12the joint committee on finance approves the proposed prescription drug
13implementation program. Within 14 days of the date of approval by the joint
14committee on finance of the proposed prescription drug importation program, the
15department shall submit to the federal department of health and human services a
16request for certification of the approved prescription drug importation program.
AB56-SA2,48,24 17(4) Implementation of certified program. After the federal department of
18health and human services certifies the prescription drug importation program
19submitted under sub. (3), the department shall begin implementation of the program
20and the program shall be fully operational by 180 days after the date of certification
21by the federal department of health and human services. The department shall do
22all of the following to implement the prescription drug importation program to the
23extent the action is in accordance with other state laws and the certification by the
24federal department of health and human services:
AB56-SA2,49,3
1(a) Become a licensed wholesale distributor, designate another state agency to
2become a licensed wholesale distributor, or contract with a licensed wholesale
3distributor.
AB56-SA2,49,54 (b) Contract with one or more Canadian suppliers that meet the criteria in sub.
5(1) (c).
AB56-SA2,49,96 (c) Create an outreach and marketing plan to communicate with and provide
7information to health plans and health insurance policies, employers, pharmacies,
8health care providers, and residents of the state on participating in the prescription
9drug importation program.
AB56-SA2,49,1210 (d) Develop and implement a registration process for health plans and health
11insurance policies, pharmacies, and health care providers interested in participating
12in the prescription drug importation program.
AB56-SA2,49,1413 (e) Create a publicly accessible source for listing prices of prescription drugs
14imported under the program.
AB56-SA2,49,1715 (f) Create, publicize, and implement a method of communication to promptly
16answer questions from and address the needs of persons affected by the
17implementation of the program before the program is fully operational.
AB56-SA2,49,1918 (g) Establish the audit functions under sub. (1) (n) with a timeline to complete
19each audit function every 2 years.
AB56-SA2,49,2220 (h) Conduct any other activities determined by the department to be important
21to successful implementation of the prescription drug importation program under
22this section.
AB56-SA2,49,24 23(5) Report. By January 1 and July 1 of each year, the department shall submit
24to the joint committee on finance a report including all of the following:
AB56-SA2,50,2
1(a) A list of prescription drugs included in the importation program under this
2section.
AB56-SA2,50,53 (b) The number of pharmacies, health care providers, and health plans and
4health insurance policies participating in the prescription drug importation program
5under this section.
AB56-SA2,50,106 (c) The estimated amount of savings to residents of the state, health plans and
7health insurance policies, and employers resulting from the implementation of the
8prescription drug importation program under this section reported from the date of
9the previous report under this subsection and from the date the program was fully
10operational.
AB56-SA2,50,1211 (d) Findings of any audit functions under sub. (1) (n) completed since the date
12of the previous report under this subsection.”.
AB56-SA2,50,13 1397. Page 433, line 5: delete lines 5 to 11 and substitute:
AB56-SA2,50,14 14 Section 1892b. 250.10 (1m) (b) of the statutes is amended to read:
AB56-SA2,50,2015 250.10 (1m) (b) Award in each fiscal year to qualified applicants grants totaling
16$25,000 no less than $50,000 for fluoride supplements, $25,000 for a fluoride
17mouth-rinse program
varnish and other evidence-based oral health activities,
18$700,000 for school-based preventive dental services
, and $120,000 for a
19school-based dental sealant program
$100,000 for school-based restorative dental
20services
.”.
AB56-SA2,50,22 2198. Page 433, line 12: delete the material beginning with that line and ending
22with page 434, line 2, and substitute:
AB56-SA2,50,23 23 Section 1893b. 250.20 (3) of the statutes is amended to read:
AB56-SA2,51,10
1250.20 (3) From the appropriation account under s. 20.435 (1) (kb) (cr), the
2department shall annually award grants for activities to improve the health status
3of economically disadvantaged minority group members. A person may apply, in the
4manner specified by the department, for a grant of up to $50,000 in each fiscal year
5to conduct these activities. An awardee of a grant under this subsection shall
6provide, for at least 50 percent of the grant amount, matching funds that may consist
7of funding or an in-kind contribution. An applicant that is not a federally qualified
8health center, as defined under 42 CFR 405.2401 (b) shall receive priority for grants
9awarded under this subsection. An applicant that provides maternal and child
10health services shall receive priority for grants awarded under this subsection.
AB56-SA2,1894b 11Section 1894b. 250.20 (4) of the statutes is amended to read:
AB56-SA2,51,1512 250.20 (4) From the appropriation account under s. 20.435 (1) (kb) (cr), the
13department shall award a grant of up to $50,000 in each fiscal year to a private
14nonprofit corporation that applies, in the manner specified by the department, to
15conduct a public information campaign on minority health.”.
AB56-SA2,51,17 1699. Page 434, line 3: delete the material beginning with that line and ending
17with page 445, line 17, and substitute:
AB56-SA2,51,19 18 Section 1896b. 253.06 (1) (a) of the statutes is renumbered 253.06 (1) (am)
19and amended to read:
AB56-SA2,51,2320 253.06 (1) (am) “Authorized Approved food" means food identified by the
21department as an authorized food in accordance with 7 CFR 246.10 as acceptable for
22use under the federal special supplemental food nutrition program for women,
23infants and children under 42 USC 1786.
AB56-SA2,1897b 24Section 1897b. 253.06 (1) (ag) of the statutes is created to read:
AB56-SA2,52,4
1253.06 (1) (ag) “Alternate participant” means a person who has been
2authorized by a participant to request benefits, participate in nutrition education,
3bring an infant or child to a Women, Infants, and Children program appointment,
4and have access to information in the participant's file.
AB56-SA2,1898b 5Section 1898b. 253.06 (1) (b) of the statutes is repealed.
AB56-SA2,1899b 6Section 1899b. 253.06 (1) (br) of the statutes is created to read:
AB56-SA2,52,107 253.06 (1) (br) “Cardholder” means a participant; alternate participant;
8parent, legal guardian, or caretaker of a participant; or another person in possession
9of a Women, Infants, and Children program electronic benefit transfer card and the
10personal identification number for the card.
AB56-SA2,1900b 11Section 1900b. 253.06 (1) (c) of the statutes is repealed.
AB56-SA2,1901b 12Section 1901b. 253.06 (1) (cm) of the statutes is amended to read:
AB56-SA2,52,1513 253.06 (1) (cm) “Food Direct distribution center" means an entity, other than
14a vendor, that is under contract with the department under sub. (3m) to distribute
15authorized approved food to participants.
AB56-SA2,1902b 16Section 1902b. 253.06 (1) (cp), (cr), (ct) and (cv) of the statutes are created to
17read:
AB56-SA2,52,2018 253.06 (1) (cp) “Electronic benefit transfer” means a method that permits
19electronic access to Women, Infants, and Children program benefits using a device,
20approved by the department, with payments made in accordance with ch. 410.
AB56-SA2,52,2421 (cr) “Food instrument” means a voucher, check, electronic benefit transfer card,
22electronic benefit transfer card number and personal identification number, coupon,
23or other method used by a participant to obtain Women, Infants, and Children
24program approved foods.
AB56-SA2,53,2
1(ct) “Infant formula supplier” means a wholesaler, distributor, retailer, or
2manufacturer of infant formula.
AB56-SA2,53,63 (cv) “Local agency” means an entity that has a contract with the department
4to provide services under the Women, Infants, and Children program such as
5eligibility determination, benefit issuance, and nutritional counseling for
6participants.
AB56-SA2,1903b 7Section 1903b. 253.06 (1) (dm) of the statutes is repealed.
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