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AB68-ASA2-AA2,191s 19Section 191s. 46.977 (2) (b) (intro.) of the statutes is amended to read:
AB68-ASA2-AA2,23,2120 46.977 (2) (b) (intro.) Organizations awarded grants under par. (a) (am) shall
21do all of the following:
AB68-ASA2-AA2,191u 22Section 191u. 46.977 (2) (c) of the statutes is amended to read:
AB68-ASA2-AA2,23,2523 46.977 (2) (c) In reviewing applications for grants under par. (am), the
24department shall consider the extent to which the proposed program will effectively
25train and assist guardians for individuals found incompetent under ch. 54.
AB68-ASA2-AA2,191w
1Section 191w. 46.977 (3) of the statutes is created to read:
AB68-ASA2-AA2,24,32 46.977 (3) Grant for initial training. (a) The department shall award a grant
3to develop, administer, and conduct the guardian training required under s. 54.26.
AB68-ASA2-AA2,24,74 (b) The department shall require the grantee to have expertise in state
5guardianship law, experience with technical assistance and support to guardians
6and wards, and knowledge of common challenges and questions encountered by
7guardians and wards.
AB68-ASA2-AA2,24,128 (c) The grantee selected to develop training that meets the requirements under
9s. 54.26 (1) shall develop plain-language, web-based training modules using
10adult-learning design principles that can be accessed for free by training topic and
11in formats that maximize accessibility, with printed versions available for free upon
12request.
AB68-ASA2-AA2,191y 13Section 191y. 46.995 (4) of the statutes is created to read:
AB68-ASA2-AA2,24,1714 46.995 (4) The department shall ensure that any child who is eligible and who
15applies for the disabled children's long-term support program that is operating
16under a waiver of federal law receives services under the disabled children's
17long-term support program that is operating under a waiver of federal law.”.
AB68-ASA2-AA2,24,18 1885. Page 290, line 22: after that line insert:
AB68-ASA2-AA2,24,19 19 Section 226g. 49.45 (2p) of the statutes is repealed.
AB68-ASA2-AA2,226m 20Section 226m. 49.45 (3) (e) 11. of the statutes is amended to read:
AB68-ASA2-AA2,25,1121 49.45 (3) (e) 11. The department shall use a portion of the moneys collected
22under s. 50.38 (2) (a) to pay for services provided by eligible hospitals, as defined in
23s. 50.38 (1), other than critical access hospitals, under the Medical Assistance
24Program under this subchapter, including services reimbursed on a fee-for-service

1basis and services provided under a managed care system. For state fiscal year
22008-09, total payments required under this subdivision, including both the federal
3and state share of Medical Assistance, shall equal the amount collected under s.
450.38 (2) (a) for fiscal year 2008-09 divided by 57.75 percent. For each state fiscal
5year after state fiscal year 2008-09, 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) (a) for the fiscal year divided by 61.68 percent,
8except that if the department has expanded eligibility under section 2001 (a) (1) (C)
9of the Patient Protection and Affordable Care Act, P.L. 111-148, for the Medical
10Assistance program under this subchapter, the amount collected for the fiscal year
11shall be divided by 53.69 percent
.
AB68-ASA2-AA2,226r 12Section 226r. 49.45 (3) (e) 12. of the statutes is amended to read:
AB68-ASA2-AA2,25,2313 49.45 (3) (e) 12. The department shall use a portion of the moneys collected
14under s. 50.38 (2) (b) to pay for services provided by critical access hospitals under
15the Medical Assistance Program under this subchapter, including services
16reimbursed on a fee-for-service basis and services provided under a managed care
17system. For each state fiscal year, total payments required under this subdivision,
18including both the federal and state share of Medical Assistance, shall equal the
19amount collected under s. 50.38 (2) (b) for the fiscal year divided by 61.68 percent,
20except that if the department has expanded eligibility under section 2001 (a) (1) (C)
21of the Patient Protection and Affordable Care Act, P.L. 111-148, for the Medical
22Assistance program under this subchapter, the amount collected for the fiscal year
23shall be divided by 53.69 percent
.”.
AB68-ASA2-AA2,25,24 2486. Page 291, line 7: delete lines 7 to 10 and substitute:
AB68-ASA2-AA2,26,4
1“49.45 (3m) (b) 3. a. No single hospital receives more than $4,600,000
2$7,950,000, except that in the 2021-23 fiscal biennium the department may increase
3proportionately the maximum a single hospital may receive if the state is eligible for
4an enhanced federal medical assistance percentage under federal law
.” .
AB68-ASA2-AA2,26,6 587. Page 291, line 11: delete the material beginning with that line and ending
6with page 292, line 12, and substitute:
AB68-ASA2-AA2,26,7 7 Section 229. 49.45 (5g) of the statutes is created to read:
AB68-ASA2-AA2,26,178 49.45 (5g) Payments to tribes. (a) Tribal care coordination agreements. A
9tribal health care provider's care coordination agreement with a nontribal health
10care provider shall meet federal requirements, including that a service provided by
11the nontribal health care provider be at the request of the tribal health care provider
12on behalf of a tribal member who remains in the tribal health care provider's care
13according to the care coordination agreement; that both the tribal health care
14provider and nontribal health care provider are providers, as defined in s. 49.43 (10);
15that an established relationship exists between the tribal health care provider and
16the tribal member; and that the care be provided pursuant to a written care
17coordination agreement.
AB68-ASA2-AA2,27,318 (b) Amount and distribution of payments. 1. From the appropriation account
19under s. 20.435 (4) (b), the department shall make payments to eligible governing
20bodies of federally recognized American Indian tribes or bands or tribal health care
21providers in an amount and manner determined by the department. The
22department shall determine payment amounts on the basis of the difference between
23the state share of medical assistance payments paid for services rendered to tribal
24members for whom a care coordination agreement with nontribal health care

1providers is in place and the state share of medical assistance payments that would
2have been paid for those services absent a care coordination agreement with
3nontribal partners.
AB68-ASA2-AA2,27,64 2. The department shall withhold from the payments under subd. 1. the state
5share of administrative costs associated with carrying out this subsection, not to
6exceed 10 percent of the amounts calculated in subd. 1.
AB68-ASA2-AA2,27,97 3. Federally recognized American Indian tribes or bands may use funds paid
8under this subsection for health-related purposes. The department shall consult
9biennially with tribes to determine the timing and distribution of payments.”.
AB68-ASA2-AA2,27,10 1088. Page 292, line 12: after that line insert:
AB68-ASA2-AA2,27,11 11 Section 229c. 49.45 (6xm) of the statutes is created to read:
AB68-ASA2-AA2,27,1512 49.45 (6xm) Pediatric inpatient supplement. (a) From the appropriations
13under s. 20.435 (4) (b), (o), and (w), the department shall, using a method determined
14by the department, distribute a total sum of $2,000,000 each state fiscal year to
15hospitals that meet all of the following criteria:
AB68-ASA2-AA2,27,1616 1. The hospital is an acute care hospital located in this state.
AB68-ASA2-AA2,27,2117 2. During the hospital's fiscal year, the inpatient days in the hospital's acute
18care pediatric units and intensive care pediatric units totaled more than 12,000 days,
19not including neonatal intensive care units. For purposes of this subsection, the
20hospital's fiscal year is the hospital's fiscal year that ended in the 2nd calendar year
21preceding the beginning of the state fiscal year.
AB68-ASA2-AA2,28,522 (b) Notwithstanding par. (a), from the appropriations under s. 20.435 (4) (b),
23(o), and (w), if the department has expanded eligibility under section 2001 (a) (1) (C)
24of the Patient Protection and Affordable Care Act, P.L. 111-148, for the Medical

1Assistance program under this subchapter, then the department may, using a
2method determined by the department, distribute an additional total sum of
3$7,500,000 in each state fiscal year to hospitals that are free-standing pediatric
4teaching hospitals located in Wisconsin that have a percentage calculated under s.
549.45 (3m) (b) 1. a. greater than 45 percent.
AB68-ASA2-AA2,229d 6Section 229d. 49.45 (23) of the statutes is repealed.
AB68-ASA2-AA2,229f 7Section 229f. 49.45 (23b) (title) of the statutes is amended to read:
AB68-ASA2-AA2,28,98 49.45 (23b) (title) Childless adults demonstration project reform waiver
9implementation required.
AB68-ASA2-AA2,229g 10Section 229g. 49.45 (23b) (b) of the statutes is amended to read:
AB68-ASA2-AA2,28,1411 49.45 (23b) (b) Beginning as soon as practicable after October 31, 2018, and
12ending no sooner than December 31, 2023, the department shall do all of the
13following with regard to the childless adults demonstration project under sub. (23)
14s. 49.471 (4) (a) 8.:
AB68-ASA2-AA2,28,2015 1. Require in each month persons, except exempt individuals, who are eligible
16to receive Medical Assistance under sub. (23) s. 49.471 (4) (a) 8. and who are at least
1719 years of age but have not attained the age of 50 to participate in, document, and
18report 80 hours per calendar month of community engagement activities. The
19department, after finding good cause, may grant a temporary exemption from the
20requirement under this subdivision upon request of a Medical Assistance recipient.
AB68-ASA2-AA2,28,2321 2. Require persons with incomes of at least 50 percent of the poverty line to pay
22premiums in accordance with par. (c) as a condition of eligibility for Medical
23Assistance under sub. (23) s. 49.471 (4) (a) 8.
AB68-ASA2-AA2,28,2524 3. Require as a condition of eligibility for Medical Assistance under sub. (23)
25s. 49.471 (4) (a) 8. completion of a health risk assessment.
AB68-ASA2-AA2,29,3
14. Charge recipients of Medical Assistance under sub. (23) s. 49.471 (4) (a) 8.
2an $8 copayment for nonemergency use of the emergency department in accordance
3with 42 USC 1396o-1 (e) (1) and 42 CFR 447.54.
AB68-ASA2-AA2,29,84 5. Disenroll from Medical Assistance under sub. (23) s. 49.471 (4) (a) 8. for 6
5months any individual who does not pay a required premium under subd. 2. and any
6individual who is required under subd. 1. to participate in a community engagement
7activity but who does not participate for 48 aggregate months in the community
8engagement activity.
AB68-ASA2-AA2,229h 9Section 229h. 49.45 (23b) (c) of the statutes is amended to read:
AB68-ASA2-AA2,29,1510 49.45 (23b) (c) 1. Persons who are eligible for the demonstration project under
11sub. (23) s. 49.471 (4) (a) 8. and who have monthly household income that exceeds
1250 percent of the poverty line shall pay a monthly premium amount of $8 per
13household. A person who is eligible to receive an item or service furnished by an
14Indian health care provider is exempt from the premium requirement under this
15subdivision.
AB68-ASA2-AA2,29,2116 2. The department may disenroll under par. (b) 5. a person for nonpayment of
17a required monthly premium only at annual eligibility redetermination after
18providing notice and reasonable opportunity for the person to pay. If a person who
19is disenrolled for nonpayment of premiums pays all owed premiums or becomes
20exempt from payment of premiums, he or she may reenroll in Medical Assistance
21under sub. (23) s. 49.471 (4) (a) 8.
AB68-ASA2-AA2,29,2522 3. The department shall reduce the amount of the required household premium
23by up to half for a recipient of Medical Assistance under sub. (23) s. 49.471 (4) (a) 8.
24who does not engage in certain behaviors that increase health risks or who attests
25to actively managing certain unhealthy behaviors.
AB68-ASA2-AA2,229j
1Section 229j. 49.45 (23b) (e) of the statutes is amended to read:
AB68-ASA2-AA2,30,62 49.45 (23b) (e) Before December 31, 2023, the demonstration project
3requirements under this subsection may not be withdrawn and the department may
4not request from the federal government withdrawal, suspension, or termination of
5the demonstration project requirements under this subsection unless legislation has
6been enacted specifically allowing for the withdrawal, suspension, or termination.
AB68-ASA2-AA2,229m 7Section 229m. 49.45 (24L) of the statutes is created to read:
AB68-ASA2-AA2,30,118 49.45 (24L) Critical access reimbursement payments to dental providers. (a)
9Based on the criteria in pars. (b) and (c), the department shall increase
10reimbursements to dental providers that meet quality of care standards, as
11established by the department.
AB68-ASA2-AA2,30,1312 (b) In order to be eligible for enhanced reimbursement under this subsection,
13the provider must meet one of the following qualifications:
AB68-ASA2-AA2,30,1614 1. For a nonprofit or public provider, 50 percent or more of the individuals
15served by the provider are individuals who are without dental insurance or are
16enrolled in the Medical Assistance program.
AB68-ASA2-AA2,30,1817 2. For a for-profit provider, 5 percent or more of the individuals served by the
18provider are enrolled in the Medical Assistance program.
AB68-ASA2-AA2,31,419 (c) For dental services rendered on or after January 1, 2022, by a qualified
20nonprofit or public dental provider, the department shall increase reimbursement by
2150 percent above the reimbursement rate that would otherwise be paid to that
22provider. For dental services rendered on or after January 1, 2022, by a qualified
23for-profit dental provider, the department shall increase reimbursement by 30
24percent above the reimbursement rate that would otherwise be paid to that provider.
25For dental providers rendering services to individuals in managed care under the

1Medical Assistance program, for services rendered on or after January 1, 2022, the
2department shall increase reimbursement to pay an additional amount on the basis
3of the rate that would have been paid to the dental provider had the individual not
4been enrolled in managed care.
AB68-ASA2-AA2,31,75 (d) If a provider has more than one service location, the thresholds described
6under par. (b) apply to each location, and the department will determine the payment
7for each separate service location.
AB68-ASA2-AA2,31,98 (e) Any provider that receives reimbursement through the pilot project under
9sub. (24k) is not eligible for reimbursement under this subsection.
AB68-ASA2-AA2,229p 10Section 229p. 49.45 (25r) of the statutes is created to read:
AB68-ASA2-AA2,31,1111 49.45 (25r) Community health worker services. (a) In this subsection:
AB68-ASA2-AA2,31,1312 1. “Community health services” means services provided by a community
13health worker.
AB68-ASA2-AA2,31,2114 2. “Community health worker” means a front-line public health worker who
15is a trusted member of or has a close understanding of the community served,
16enabling the worker to serve as a liaison, link, or intermediary between health and
17social services and the community to facilitate access to services and improve the
18quality and cultural competence of service delivery, and who builds individual and
19community capacity by increasing health knowledge and self-sufficiency through a
20range of activities such as outreach, community education, informal counseling,
21social support, and advocacy.
AB68-ASA2-AA2,32,422 (b) The department shall request any necessary waiver from, or submit any
23necessary amendments to the state Medical Assistance plan to, the secretary of the
24federal department of health and human services to provide community health
25services to eligible Medical Assistance recipients. If the waiver or state plan

1amendment is granted, the department shall reimburse certified providers for those
2community health services approved by the federal department of health and human
3services for Medical Assistance coverage and as provided to Medical Assistance
4recipients under s. 49.46 (2) (b) 9m.
AB68-ASA2-AA2,229r 5Section 229r. 49.45 (30e) (a) 2. of the statutes is repealed.
AB68-ASA2-AA2,229s 6Section 229s. 49.45 (30e) (b) 3. of the statutes is amended to read:
AB68-ASA2-AA2,32,97 49.45 (30e) (b) 3. Requirements for certification of community-based
8psychosocial service programs. The department may certify county-based providers
9and providers that are not county-based providers.
AB68-ASA2-AA2,229t 10Section 229t. 49.45 (30e) (c) of the statutes is renumbered 49.45 (30e) (c) 1.
11and amended to read:
AB68-ASA2-AA2,32,1812 49.45 (30e) (c) 1. A The department shall reimburse a county that elects to
13make the provide services under s. 49.46 (2) (b) 6. Lm. available shall reimburse a
14provider of the services
for the amount of the allowable charges for those services
15under the medical assistance Medical Assistance program that is not provided by the
16federal government. The department shall reimburse the provider only for and the
17amount of the allowable charges for those services under the medical assistance
18Medical Assistance program that is provided by the federal government.
AB68-ASA2-AA2,229u 19Section 229u. 49.45 (30e) (c) 2. of the statutes is created to read:
AB68-ASA2-AA2,32,2220 49.45 (30e) (c) 2. The department shall reimburse to a provider that is not a
21county-based provider for services under s. 49.46 (2) (b) 6. Lm. for both the federal
22and nonfederal share of a fee schedule that is determined by the department.
AB68-ASA2-AA2,229v 23Section 229v. 49.45 (30e) (d) of the statutes is amended to read:
AB68-ASA2-AA2,33,624 49.45 (30e) (d) Provision of services on regional basis. Notwithstanding par.
25(c) 1. and subject to par. (e), in counties that elect to deliver provide the services under

1s. 49.46 (2) (b) 6. Lm. through the Medical Assistance program on a regional basis
2according to criteria established by the department, the department shall reimburse
3a provider of the services for the amount of the allowable charges for those services
4under the Medical Assistance program that is provided by the federal government
5and for the amount of the allowable charges that is not provided by the federal
6government.
AB68-ASA2-AA2,229x 7Section 229x. 49.45 (30t) of the statutes is created to read:
AB68-ASA2-AA2,33,88 49.45 (30t) Doula services. (a) In this subsection:
AB68-ASA2-AA2,33,109 1. “Certified doula” means an individual who has received certification from a
10doula certifying organization recognized by the department.
AB68-ASA2-AA2,33,1311 2. “Doula services” means childbirth education and support services, including
12emotional and physical support provided during pregnancy, labor, birth, and the
13postpartum period.
AB68-ASA2-AA2,33,1914 (b) The department shall request from the secretary of the federal department
15of health and human services any required waiver or any required amendment to the
16state plan for Medical Assistance to allow reimbursement for doula services provided
17by a certified doula. If the waiver or state plan amendment is granted, the
18department shall reimburse a certified doula under s. 49.46 (2) (b) 12p. for the
19allowable charges for doula services provided to Medical Assistance recipients.”.
AB68-ASA2-AA2,33,21 2089. Page 292, line 13: delete the material beginning with that line and ending
21with page 294, line 2, and substitute:
AB68-ASA2-AA2,33,22 22 Section 230b. 49.46 (1) (a) 1m. of the statutes is amended to read:
AB68-ASA2-AA2,34,223 49.46 (1) (a) 1m. Any pregnant woman whose income does not exceed the
24standard of need under s. 49.19 (11) and whose pregnancy is medically verified.

1Eligibility continues to the last day of the month in which the 60th 365th day after
2the last day of the pregnancy falls.
AB68-ASA2-AA2,230d 3Section 230d. 49.46 (1) (j) of the statutes is amended to read:
AB68-ASA2-AA2,34,74 49.46 (1) (j) An individual determined to be eligible for benefits under par. (a)
59. remains eligible for benefits under par. (a) 9. for the balance of the pregnancy and
6to the last day of the month in which the 60th 365th day after the last day of the
7pregnancy falls without regard to any change in the individual's family income.
AB68-ASA2-AA2,230f 8Section 230f. 49.46 (2) (b) 8m. of the statutes is created to read:
AB68-ASA2-AA2,34,109 49.46 (2) (b) 8m. Room and board for residential substance use disorder
10treatment.
AB68-ASA2-AA2,230h 11Section 230h. 49.46 (2) (b) 9m. of the statutes is created to read:
AB68-ASA2-AA2,34,1212 49.46 (2) (b) 9m. Community health services, as specified under s. 49.45 (25r).
AB68-ASA2-AA2,230j 13Section 230j. 49.46 (2) (b) 11m. of the statutes is created to read:
AB68-ASA2-AA2,34,1514 49.46 (2) (b) 11m. Subject to par. (bx), acupuncture provided by an
15acupuncturist who holds a certificate under ch. 451.
AB68-ASA2-AA2,230k 16Section 230k. 49.46 (2) (b) 12p. of the statutes is created to read:
AB68-ASA2-AA2,34,1817 49.46 (2) (b) 12p. Doula services provided by a certified doula, as specified
18under s. 49.45 (30t).
AB68-ASA2-AA2,230n 19Section 230n. 49.46 (2) (b) 24. of the statutes is created to read:
AB68-ASA2-AA2,34,2120 49.46 (2) (b) 24. Subject to par. (bv), nonmedical services that contribute to the
21determinants of health.
AB68-ASA2-AA2,230p 22Section 230p. 49.46 (2) (bv) of the statutes is created to read:
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