AB1: Bill Text

Child Care and Development Fund block grant funding

Under this bill, federal Child Care and Development Fund block grant funds received by the state under the federal Consolidated Appropriations Act of 2021 are credited to federal block grant appropriations, and the purposes for the expenditure of those funds are subject to passive review by the Joint Committee on Finance.

Nursing home or assisted living facility visitation by essential visitors

The bill allows a nursing home or assisted living facility resident to designate an essential visitor to visit and provide support for the resident. A health care agent under the resident's power of attorney for health care is also considered an essential visitor. A nursing home or assisted living facility must allow an essential visitor, who agrees to comply with the public health policies of the nursing home or assisted living facility, to enter the nursing home or assisted living facility to visit the resident in compassionate care situations. If the federal Centers for Medicare and Medicaid Services (CMS) issues guidance that restricts visitation more than this bill does, a nursing home or assisted living facility is allowed to comply with that guidance instead of the bill. The requirement to allow visitation of an essential visitor in this bill applies when the nursing home or assisted living facility limits visitors to the nursing home or assisted living facility due to an outbreak or epidemic of communicable disease in the community.

Hospital services provided in a home setting

This bill generally specifies standards for certain services provided by hospitals in a home setting and reimbursement under the Medical Assistance program for those services. These “hospital-associated services” are defined in the bill as health care services that are the same type of services as those provided by a hospital in an inpatient or outpatient facility, that are of the type for which a federal Medicare payment could be claimed as a hospital service, and that are provided in a home setting and not in a setting that is approved as a hospital by DHS. If CMS has approved a hospital to provide any hospital-associated service, DHS may apply and enforce the CMS rule or standard on the hospital as the state standard for the service. A hospital that complies with the bill is not required to be licensed as a home health agency to provide hospital-associated services.

The Medical Assistance program is a joint federal and state program that provides health services to individuals who have limited financial resources, and the Medical Assistance program certifies and provides reimbursement to providers, including hospitals, for those health services that are covered by the program. The bill specifies that hospital-associated services provided by a hospital in accordance with the bill and that are of the type for which Medicare payment could be claimed as inpatient hospital services must be included and reimbursed or paid as inpatient services under the Medical Assistance program.

Prescription order extensions

Current law allows a pharmacist to extend a prescription order under certain circumstances in the event that the prescription cannot otherwise be refilled, subject to certain criteria and limitations. However, current law also includes an alternative authorization for a pharmacist to extend a prescription during the public health emergency declared on March 12, 2020, by executive order 72, and for 30 days after the conclusion of that public health emergency. Under this alternative authorization, a pharmacist is exempt from having to contact the prescribing practitioner or his or her office, the pharmacist may extend the prescription by up to a 30-day supply, and certain other requirements also do not apply. The bill provides that this alternative authorization to extend a prescription order also applies beginning on the bill's effective date and continuing until the conclusion of a national emergency declared by the U.S. president in response to the 2019 novel coronavirus or until June 30, 2021, whichever is earlier.

Practice of emergency medical services personnel and providers with credentials from outside the state

Currently, with certain exceptions, an individual must have a certification as an emergency medical responder or a license as emergency medical services practitioner to provide emergency medical services in this state. “Emergency medical services practitioners” is the collective term for licensed emergency medical technicians, emergency medical technicians — intermediate, advanced emergency medical technicians, and paramedics. Also, with certain exceptions, a provider of ambulance services in this state must hold a license as an ambulance service provider. Each of the following are exceptions to the licensing or certification requirements: 1) if the individual or provider has a credential from another state and is involved in 10 or fewer patient transports or patient care episodes per year that begin and end in Wisconsin; 2) if the individual or provider has a credential from another state and is responding from that state in response to a request for mutual aid; and 3) the individual had a Wisconsin license as an emergency medical services practitioner or certification as an emergency medical responder at any time in the previous 10 years that was never revoked, limited, suspended, or denied or a valid, unexpired credential from another state and is acting during a state of emergency declared by the federal, the state, or a local government on behalf of a health care facility, mass clinic, or state or local health department as an emergency volunteer health care practitioner. Currently, DHS may issue a license as an emergency medical services practitioner or a certification as an emergency medical responder to an individual who holds a credential from another state if the credentialing standards are at least substantially equivalent to Wisconsin standards and the individual meets other qualifications, except the individual does not need to take an examination.

This bill allows individuals and providers who hold a current, valid credential from another state that allows them to perform substantially the same services as the applicable Wisconsin license or certification to practice or provide services in Wisconsin within the scope of that credential under criteria specified in the bill, if the individual or provider is not under investigation and there are no restrictions or limitations on the credential. Those criteria are the following: the practice or provision of services is necessary to ensure continued and safe delivery of emergency medical or health care services; the need for emergency medical services reasonably prevented obtaining a Wisconsin license or certification before beginning practice; the individual applies for a license or certification within 10 days of first practicing or providing services; and the provider or facility for which the individual or provider is providing services notifies DHS within five days. Individuals or providers who satisfy one of the current exceptions to licensure do not need to comply with the criteria specified in the bill in order to practice or provide services in Wisconsin. The authorization to practice or provide services under this bill applies through June 30, 2021.

Insurance

Liability insurance for physicians and nurse anesthetists

The bill specifies that, until the conclusion of a national emergency declared by the U.S. president in response to the 2019 novel coronavirus or until June 30, 2021, whichever is earlier, a physician or nurse anesthetist for whom Wisconsin is not a principal place of practice but who is temporarily authorized to practice in Wisconsin may fulfill financial responsibility requirements by filing with the commissioner of insurance a certificate of insurance for a policy of health care liability insurance issued by an insurer authorized in a certain jurisdiction specified in the bill. Additionally, under those same circumstances, the physician or nurse anesthetist may elect to be covered by Wisconsin's health care liability laws. These liability insurance provisions were enacted in 2019 Wisconsin Act 185 but expired with the expiration of the state of emergency related to public health declared on March 12, 2020, by the governor.

Out-of-network costs related to health coverage

The bill prohibits, until the conclusion of a national emergency declared by the U.S. president in response to the 2019 novel coronavirus or until June 30, 2021, whichever is earlier, a defined network plan, including a health maintenance organization, or preferred provider plan from requiring an enrollee of the plan to pay more for a service, treatment, or supply provided by an out-of-network provider than if the service, treatment, or supply is provided by an in-network provider. This prohibition applies to any service, treatment, or supply that is related to the diagnosis of or treatment for COVID-19 and that is provided by an out-of-network provider because a participating provider is unavailable due to the emergency. For a service, treatment, or supply provided under those circumstances, the bill requires the plan to reimburse the out-of-network provider at 225 percent of the federal Medicare program rate. Also, under those circumstances, any health care provider or facility that provides a service, treatment, or supply to an enrollee of a plan but is not a participating provider of that plan shall accept as payment in full any payment by a plan that is at least 225 percent of the federal Medicare program rate and may not charge the enrollee an amount that exceeds the amount that the provider or facility is reimbursed by the plan. Similar prohibitions and requirements to these were created in 2019 Wisconsin Act 185, but those prohibitions and requirements applied only during the state of emergency related to public health declared on March 12, 2020, by the governor and for 60 days following the termination of that state of emergency.

Coverage of COVID-19 testing and vaccination without cost sharing

Current law, as created in 2019 Wisconsin Act 185, requires health insurance policies and self-insured governmental health plans to cover, until March 13, 2021, testing for COVID-19 without imposing any copayment or coinsurance. A health insurance policy is referred to in the bill as a disability insurance policy. The bill extends the Act 185 coverage requirement for testing and adds a requirement to cover vaccines against SARS-CoV-2, which causes COVID-19, until the conclusion of a national emergency declared by the U.S. president in response to the 2019 novel coronavirus or until June 30, 2021, whichever is earlier.

Coverage limits on certain prescription drugs

The bill prohibits insurers that offer health insurance, self-insured governmental health plans, and pharmacy benefit managers from requiring, until the conclusion of a national emergency declared by the U.S. president in response to the 2019 novel coronavirus or until June 30, 2021, whichever is earlier, prior authorization for early refills of a prescription drug or otherwise restricting the period in which a prescription drug may be refilled and from imposing a limit on the quantity of prescription drugs that may be obtained if the quantity is no more than a 90-day supply. These prohibitions do not apply if the prescription drug is a controlled substance. The bill reinstates the prohibitions that were enacted in 2019 Wisconsin Act 185 but that expired with the termination of the state of emergency related to public health declared on March 12, 2020, by the governor.

legislature

Transfer of moneys from sum sufficient appropriations

JCF may currently transfer moneys between sum certain and continuing appropriations if JCF finds that unnecessary duplication of functions can be eliminated, more efficient and effective methods for performing programs will result, or legislative intent will be more effectively carried out because of the transfer.

The bill authorizes JCF to transfer moneys from sum sufficient appropriations until the conclusion of a national emergency declared by the U.S. president in response to the 2019 novel coronavirus or until June 30, 2021, whichever is earlier. The total amount that may be transferred from all sum sufficient appropriations may not exceed $100,000,000.

Public utilities

Loans to assist municipal utilities in maintaining liquidity

Under current law, the Board of Commissioners of Public Lands manages the common school fund, the normal school fund, the university fund, and the agricultural college fund (trust funds). Current law authorizes BCPL to manage and invest moneys belonging to the trust funds in good faith and with the care an ordinary prudent person in a like position would exercise under similar circumstances.

This bill authorizes BCPL to loan moneys belonging to the trust funds to cities, villages, and towns to ensure that a municipal utility under the control of the city, village, or town is able to maintain liquidity. A municipal utility is a public utility that is a city, village, or town, or that is wholly owned or operated by a city, village, or town. Each trust fund loan BCPL awards to a city, village, or town under the bill is secured in the same manner as other trust fund loans BCPL awards to cities, villages, and towns under current law. BCPL may not award a loan under the bill after April 15, 2021.

retirement and group insurance

WRS annuities for certain annuitants returning to work during national emergency

The bill allows an annuitant who is hired during the period of a national emergency declared by the U.S. president in response to the 2019 novel coronavirus and ending when the national emergency is no longer in effect or 60 days after the effective date of the bill, whichever is earlier, by a public employer as an employee or to provide employee services to elect to not suspend his or her annuity for the duration of the declared national emergency or until 60 days after the effective date of the bill, whichever is earlier, if the position for which the annuitant is hired is a critical position. Under current law, if a Wisconsin Retirement System annuitant, or a disability annuitant who has attained his or her normal retirement date, is appointed to a position with a WRS-participating employer, or provides employee services to a WRS-participating employer in which he or she is expected to work at least two-thirds of what is considered full-time employment by the Department of Employee Trust Funds, the annuity must be suspended and no annuity payment is payable until after the participant again terminates covered employment.

Also under current law, a WRS participant who has applied to receive a retirement annuity must wait at least 75 days between terminating covered employment with a WRS employer and returning to covered employment again as a participating employee. The bill reduces that period to 15 days for individuals who are hired to a critical position during the period of a national emergency declared by the U.S. president in response to the 2019 novel coronavirus and ending when the national emergency is no longer in effect or 60 days after the effective date of the bill, whichever is earlier.

safety and professional services

Occupancy permit when dwelling occupied before inspection

The bill specifies that a dwelling that is occupied before undergoing all inspections for compliance with the uniform dwelling code may be granted an occupancy permit if the dwelling later passes a uniform dwelling code final inspection. Also, if an occupancy permit for a dwelling is granted after it is occupied, any missed inspection of the dwelling may not be listed as a finding on the occupancy permit.

Current rules promulgated by the Department of Safety and Professional Services generally allow a dwelling to be occupied without a uniform dwelling code final inspection if the inspection is not completed by DSPS or a municipality within five business days of an applicant's notification.

Practice by health care providers from other states

The bill authorizes, in certain situations, health care providers licensed in another state or territory to provide services for which they are licensed or certified. Under the bill, a person who satisfies certain requirements and holds a valid, unexpired credential in another state or territory as any of the following may provide services in this state: 1) a physician, physician assistant, or perfusionist; 2) a nurse; 3) a dentist; 4) a pharmacist; 5) a psychologist; 6) a social worker, marriage and family therapist, professional counselor, or clinical substance abuse counselor; 7) a chiropractor; 8) a physical therapist; 9) a podiatrist; 10) a dietitian; 11) an athletic trainer; 12) an occupational therapist; 13) an optometrist; 14) an acupuncturist; 15) a speech-language pathologist or audiologist; or 16) a massage or bodywork therapist. Generally, these practitioners may practice in this state and DSPS must grant them a temporary credential if they apply for a temporary credential within 30 days of beginning to practice for a health care employer.

The bill also specifies that a health care provider granted a temporary credential under the bill may provide services through telehealth to a patient located in this state.

Current law generally prohibits a person from engaging in certain health care-related practices without holding a required credential.

Authorizing first- and second-year pharmacy students to administer vaccines

Current law authorizes pharmacy students who have completed two years of pharmacy school to administer vaccines under the supervision of a pharmacist. The bill authorizes pharmacy students in their first or second year of pharmacy school to administer vaccines under the supervision of a pharmacist. A first- or second-year pharmacy student must complete 12 hours of training in vaccine storage, protocols, administration technique, emergency procedures, and record keeping to administer vaccines under the bill.

Authorizing dentists to administer COVID-19 and flu vaccines

The bill authorizes dentists to administer COVID-19 and flu vaccines. Under current law, generally, vaccines may be administered only by physicians, physician assistants, nurses, pharmacists, and certain pharmacy students.

To administer COVID-19 and flu vaccines under the bill, a dentist must complete 12 hours of training on vaccine storage, protocols, administration technique, emergency procedures, and record keeping and must have in effect liability insurance meeting certain requirements. A dentist may not administer a COVID-19 or flu vaccine to a child under the age of six unless the vaccine is administered pursuant to a prescription order and the dentist completes training that includes administering vaccines to children under the age of six. The bill also requires a dentist who administers a COVID-19 or flu vaccine to update the Wisconsin Immunization Registry established by DHS within seven days of administering the vaccine.

Optional registration of third-party logistics providers

The bill creates an optional license for third-party logistics providers that are located in the state or are located outside the state but provide third-party logistics provider services in the state. A third-party logistics provider is defined under current law as a person that contracts with a prescription drug manufacturer to provide or coordinate warehousing, distribution, or other services on behalf of the manufacturer but that does not take title to the manufacturer's prescription drug or have general responsibility to direct the prescription drug's sale or disposition.

The bill requires an applicant for a third-party logistics provider license to submit certain information prior to licensure, including proof of a recent facility inspection, and a personal statement relating to a designated representative of the facility. The license created by this bill will no longer apply if the federal Food and Drug Administration establishes a licensing program for third-party logistics providers under federal law and the Pharmacy Examining Board determines that state licensure is not required for a resident third-party logistics provider to provide third-party logistics services in another state.

The bill also directs the Pharmacy Examining Board to promulgate rules that regulate third-party logistics providers and out-of-state third-party logistics providers consistent with federal law. The authority of the Pharmacy Examining Board to promulgate rules is restricted to only rules that are equivalent to requirements under federal law, and only rules that do not mandate licensing under state law.

The bill requires the Pharmacy Examining Board to issue interim licenses for third-party logistics providers and out-of-state third-party logistics providers between the date of enactment until permanent or emergency rules take effect, whichever is sooner, if, in the opinion of the board, the applicant is currently in compliance with federal law relating to third-party logistics providers. An interim license to act as a third-party logistics provider or out-of-state third-party logistics provider expires 90 days after the date that emergency rules take effect, or 90 days after the date that permanent rules take effect, whichever is sooner. No fee is required for an interim license to act as a third-party logistics provider or an out-of-state third-party logistics provider.

Finally, the bill requires third-party logistics providers, whether or not licensed under the bill, to cooperate with inspections of their facilities and delivery vehicles.

state and local government

Extension of term or duration of certain approvals

The bill extends the term or duration of certain approvals that are the subject of administrative or judicial proceedings that may result in the invalidation, reconsideration, or modification of the approval. The terms or durations are extended by an amount of time equal to 36 months plus the duration of the administrative or judicial proceeding to which the covered approval is subject. The approvals covered under the bill are, with certain exceptions, 1) unexpired permits or approvals for construction projects issued by DSPS, the Department of Natural Resources, the Department of Transportation, a political subdivision, or a special purpose district and 2) plats or certified survey map approvals. The extension is exercised by the holder of the approval notifying the governmental unit that issued the approval of the person's decision to exercise the extension not less than 90 days before the expiration of the unextended term or duration of the approval. In general, the laws, regulations, ordinances, rules, or other properly adopted requirements that were in effect at the time the approval was issued continue to apply to the construction project, plat, or certified survey map during the period of extension.

Legislative oversight of federal COVID-19 funds

Under current law, with exceptions, the governor is authorized to receive and direct the expenditure of all federal funds received by the state. The bill increases the legislature's role in approving the expenditure of federal funds that are received by the state between the effective date of this bill and June 30, 2021 that relate to COVID-19 activities. Under the bill, as soon as practical after the receipt of any federal funds related to COVID-19 that are made available to the state, the governor must submit to JCF for a 14-day passive review a plan for the expenditure of the funds.

Plan to reopen state capitol and for state employees to return to in-person employment

This bill requires the governor to submit to the legislature by January 31, 2021, a plan to open the state capitol to the public and to have state employees return to in-person employment.

taxation

Interest and penalties on late property tax payments

Under current law, a late installment payment of property taxes is subject to interest and penalties, with the interest accruing from February 1 of the year in which the taxes are due. For property taxes payable in 2020, if an installment payment due after April 1, 2020, is late, current law allows a municipality to temporarily waive the interest and penalties in cases of hardship. The entire amount due must be paid no later than October 1, 2020, and both the county and municipality must adopt resolutions authorizing the waiver.

The bill allows municipalities to similarly waive interest and penalties on late installment payments of property taxes payable in 2021. Under the bill, for an installment payment due after April 1, 2021, that is late, a municipality may waive the interest and penalties if the municipality makes a general or case-by-case finding of hardship and the total amount due is paid no later than October 1, 2021. A municipality may waive the interest and penalties only if the county first adopts a resolution authorizing the waiver and establishing criteria for determining hardship and the municipality then adopts a similar resolution. Under the bill, interest and penalties will accrue from October 1, 2021, for any property taxes payable in 2021 that are delinquent after that date.

The bill requires a county that adopts a waiver resolution to settle the taxes, interest, and penalties collected before August 1, 2021, on August 20, 2021, and to settle the remaining unpaid taxes, interest, and penalties on September 20, 2021. The August 20, 2021, settlement must be distributed proportionally to the underlying taxing jurisdictions.

Claims to recover property taxes

Current law allows a person to file a claim to recover the unlawful imposition of property taxes, a claim for the excessive assessment of property taxes, or a claim to recover property taxes paid in protest due to an outstanding contested assessment. However, no person may file a claim unless the person has paid his or her property taxes on time. Current law provides an exception from this requirement for taxes due and payable in 2020 if paid by October 1, 2020, or a later applicable installment date.

The bill creates a similar exception for property taxes due and payable in 2021. Under the bill, the timely payment requirement does not apply to these taxes if paid by October 1, 2021, or a later applicable installment date.

This proposal may contain a health insurance mandate requiring a social and financial impact report under s. 601.423, stats.

For further information see the state and local 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:

AB1,1 Section 1 . 13.101 (4d) of the statutes is amended to read:

AB1,18,2 13.101 (4d) During the public health emergency declared on March 12, 2020, by executive order 72, and for a period of 90 days after termination of the emergency Until the conclusion of a national emergency declared by the U.S. president under 50 USC 1621 in response to the 2019 novel coronavirus or June 30, 2021, whichever is earlier, the committee may transfer under sub. (4) an amount not to exceed $75,000,000 $100,000,000 from sum sufficient appropriations, as defined under s. 20.001 (3) (d), to be used for expenditures related to the emergency.

AB1,2 Section 2 . 40.26 (5m) of the statutes is amended to read:

AB1,18,11 40.26 (5m) During the public health a national emergency declared on March 12, 2020, by executive order 72 the U.S. president under 50 USC 1621 in response to the 2019 novel coronavirus and ending when the national emergency is no longer in effect or 60 days after the effective date of this subsection .... [LRB enters date], whichever is earlier, sub. (5) does not apply if at least 15 days have elapsed between the termination of employment with a participating employer and becoming a participating employee if the position for which the participant is hired is a critical position, as determined by the secretary of health services under s. 323.19 (3).

AB1,3 Section 3 . 40.26 (6) (intro.) of the statutes is amended to read:

AB1,18,19 40.26 (6) (intro.) A participant who is hired during the public health a national emergency declared on March 12, 2020, by executive order 72 the U.S. president under 50 USC 1621 in response to the 2019 novel coronavirus and ending when the national emergency is no longer in effect or 60 days after the effective date of this subsection .... [LRB enters date], whichever is earlier, may elect to not suspend his or her retirement annuity or disability annuity under sub. (1m) for the duration of the state of emergency that period if all of the following conditions are met:

AB1,4 Section 4 . 49.45 (3) (e) 9m. of the statutes is created to read:

AB1,18,22 49.45 (3) (e) 9m. a. In this subdivision, “hospital-associated service” has the meaning given in s. 50.33 (2d).

AB1,19,2 b. Any hospital-associated service that is provided by a hospital in accordance with s. 50.36 (5m) that is of the type for which payment could be claimed as an inpatient hospital service under the federal Medicare program, 42 USC 1395 et seq., shall be included as part of and reimbursed or paid as an inpatient service under this section.

AB1,5 Section 5 . 49.45 (4r) of the statutes is created to read:

AB1,19,7 49.45 (4r) Utilization data. (a) In this subsection, “health care data aggregator” means a data organization or entity that collects, analyzes, and disseminates health care information under subch. I of ch. 153 and that requests the department to provide data under this subsection.

AB1,19,10 (b) Semiannually, the department shall provide to any health care data aggregator all Medical Assistance program fee-for-service and managed care encounter claims data and data specifications maintained by the department.

AB1,19,19 (c) Within 5 business days or a longer period specified by the department, of the receipt of data under par. (b), a health care data aggregator shall create a data set from the data received that is de-identified health information, as described in 42 CFR 164.514 (a), and that meets the requirements for de-identification described in 42 CFR 164.514 (b) and then shall destroy the original data provided by the department under par. (b). The health care data aggregator shall make the de-identified data set available to the public and may disseminate custom data sets and reports if the data sets and reports contain only de-identified health information.

AB1,19,24 (d) Data provided by the department to a health care data aggregator under par. (b) is not subject to inspection or copying under s. 19.35. A health care data aggregator shall comply with the requirements under s. 153.50 (3) to ensure protection of patient identity with regard to data received and made available or disseminated under this subsection.

AB1,6 Section 6. 49.45 (39n) of the statutes is created to read:

AB1,20,10 49.45 (39n) Pharmacist reimbursement for vaccines and COVID-19 tests. The department shall ensure that any vaccine against SARS-CoV-2 coronavirus and any test for COVID-19, which is the infection caused by the SARS-CoV-2 coronavirus, that are covered under this subchapter and for which reimbursement for administration is made to any provider, are covered and reimbursed when the vaccine or test is administered by a pharmacist acting under his or her scope of practice, including under s. 450.035. As necessary to comply with this subsection, the department shall certify pharmacists as providers of Medical Assistance services for the purposes of covering and reimbursing pharmacists for administering vaccines and tests described in this subsection.

AB1,7 Section 7 . 50.083 of the statutes is created to read: