This is the preview version of the Wisconsin State Legislature site.
Please see http://docs.legis.wisconsin.gov for the production version.
AB68,1019 23Section 1019. 49.45 (18) (b) 8. of the statutes is created to read:
AB68,749,2424 49.45 (18) (b) 8. Prescription drugs.
AB68,1020 25Section 1020. 49.45 (18) (d) of the statutes is repealed.
AB68,1021
1Section 1021. 49.45 (23) of the statutes is repealed.
AB68,1022 2Section 1022 . 49.45 (23b) of the statutes is repealed.
AB68,1023 3Section 1023 . 49.45 (24L) of the statutes is created to read:
AB68,750,74 49.45 (24L) Critical access reimbursement payments to dental providers. (a)
5Based on the criteria in pars. (b) and (c), the department shall increase
6reimbursements to dental providers that meet quality of care standards, as
7established by the department.
AB68,750,98 (b) In order to be eligible for enhanced reimbursement under this subsection,
9the provider must meet one of the following qualifications:
AB68,750,1210 1. For a nonprofit or public provider, 50 percent or more of the individuals
11served by the provider are individuals who are without dental insurance or are
12enrolled in the Medical Assistance program.
AB68,750,1413 2. For a for-profit provider, 5 percent or more of the individuals served by the
14provider are enrolled in the Medical Assistance program.
AB68,750,2515 (c) For dental services rendered on or after January 1, 2022, by a qualified
16nonprofit or public dental provider, the department shall increase reimbursement by
1750 percent above the reimbursement rate that would otherwise be paid to that
18provider. For dental services rendered on or after January 1, 2022, by a qualified
19for-profit dental provider, the department shall increase reimbursement by 30
20percent above the reimbursement rate that would otherwise be paid to that provider.
21For dental providers rendering services to individuals in managed care under the
22Medical Assistance program, for services rendered on or after January 1, 2022, the
23department shall increase reimbursement to pay an additional amount on the basis
24of the rate that would have been paid to the dental provider had the individual not
25been enrolled in managed care.
AB68,751,3
1(d) If a provider has more than one service location, the thresholds described
2under par. (b) apply to each location, and the department will determine the payment
3for each separate service location.
AB68,751,54 (e) Any provider that receives reimbursement through the pilot project under
5sub. (24k) is not eligible for reimbursement under this subsection.
AB68,1024 6Section 1024 . 49.45 (25) (bj) of the statutes is amended to read:
AB68,751,147 49.45 (25) (bj) The department of corrections may elect to provide case
8management services under this subsection to persons who are under the
9supervision of that department under s. 938.183, 938.34 (4h), (4m), or (4n), or
10938.357 (3) or (4), who are Medical Assistance beneficiaries, and who meet one or
11more of the conditions specified in par. (am). The amount of the allowable charges
12for those services under the Medical Assistance program that is not provided by the
13federal government shall be paid from the appropriation account under s. 20.410 (3)
14(hm), (ho), or (hr).
AB68,1025 15Section 1025 . 49.45 (25) (bj) of the statutes, as affected by 2019 Wisconsin Act
168
and 2021 Wisconsin Act .... (this act), is repealed and recreated to read:
AB68,751,2317 49.45 (25) (bj) The department of corrections may elect to provide case
18management services under this subsection to persons who are under the
19supervision of that department under s. 938.183, 938.34 (4m), or 938.357 (3) or (4),
20who are Medical Assistance beneficiaries, and who meet one or more of the conditions
21specified in par. (am). The amount of the allowable charges for those services under
22the Medical Assistance program that is not provided by the federal government shall
23be paid from the appropriation account under s. 20.410 (3) (hm), (ho), or (hr).
AB68,1026 24Section 1026. 49.45 (25r) of the statutes is created to read:
AB68,751,2525 49.45 (25r) Community health worker services. (a) In this subsection:
AB68,752,2
11. “Community health services” means services provided by a community
2health worker.
AB68,752,103 2. “Community health worker” means a frontline public health worker who is
4a trusted member of or has a close understanding of the community served, enabling
5the worker to serve as a liaison, link, or intermediary between health and social
6services and the community to facilitate access to services and improve the quality
7and cultural competence of service delivery, and who builds individual and
8community capacity by increasing health knowledge and self-sufficiency through a
9range of activities such as outreach, community education, informal counseling,
10social support, and advocacy.
AB68,752,1811 (b) The department shall request any necessary waiver from, or submit any
12necessary amendments to the state Medical Assistance plan to, the secretary of the
13federal department of health and human services to provide community health
14services to eligible Medical Assistance recipients. If the waiver or state plan
15amendment is granted, the department shall reimburse certified providers for those
16community health services approved by the federal department of health and human
17services for Medical Assistance coverage and as provided to Medical Assistance
18recipients under s. 49.46 (2) (b) 9m.
AB68,1027 19Section 1027. 49.45 (30e) (a) 2. of the statutes is repealed.
AB68,1028 20Section 1028. 49.45 (30e) (b) 3. of the statutes is amended to read:
AB68,752,2321 49.45 (30e) (b) 3. Requirements for certification of community-based
22psychosocial service programs. The department may certify county-based providers
23and providers that are not county-based providers.
AB68,1029 24Section 1029. 49.45 (30e) (c) of the statutes is renumbered 49.45 (30e) (c) 1.
25and amended to read:
AB68,753,7
149.45 (30e) (c) 1. A The department shall reimburse a county that elects to
2make the provide services under s. 49.46 (2) (b) 6. Lm. available shall reimburse a
3provider of the services
for the amount of the allowable charges for those services
4under the medical assistance Medical Assistance program that is not provided by the
5federal government. The department shall reimburse the provider only for and the
6amount of the allowable charges for those services under the medical assistance
7Medical Assistance program that is provided by the federal government.
AB68,1030 8Section 1030. 49.45 (30e) (c) 2. of the statutes is created to read:
AB68,753,119 49.45 (30e) (c) 2. The department shall reimburse to a provider that is not a
10county-based provider for services under s. 49.46 (2) (b) 6. Lm. for both the federal
11and nonfederal share of a fee schedule that is determined by the department.
AB68,1031 12Section 1031. 49.45 (30e) (d) of the statutes is amended to read:
AB68,753,2013 49.45 (30e) (d) Provision of services on regional basis. Notwithstanding par.
14(c) 1. and subject to par. (e), in counties that elect to deliver provide the services under
15s. 49.46 (2) (b) 6. Lm. through the Medical Assistance program on a regional basis
16according to criteria established by the department, the department shall reimburse
17a provider of the services for the amount of the allowable charges for those services
18under the Medical Assistance program that is provided by the federal government
19and for the amount of the allowable charges that is not provided by the federal
20government.
AB68,1032 21Section 1032. 49.45 (30t) of the statutes is created to read:
AB68,753,2222 49.45 (30t) Doula services. (a) In this subsection:
AB68,753,2423 1. “Certified doula” means an individual who has received certification from a
24doula certifying organization recognized by the department.
AB68,754,3
12. “Doula services” means childbirth education and support services, including
2emotional and physical support provided during pregnancy, labor, birth, and the
3postpartum period.
AB68,754,94 (b) The department shall request from the secretary of the federal department
5of health and human services any required waiver or any required amendment to the
6state plan for Medical Assistance to allow reimbursement for doula services provided
7by a certified doula. If the waiver or state plan amendment is granted, the
8department shall reimburse a certified doula under s. 49.46 (2) (b) 12p. for the
9allowable charges for doula services provided to Medical Assistance recipients.
AB68,1033 10Section 1033. 49.46 (1) (a) 1m. of the statutes is amended to read:
AB68,754,1411 49.46 (1) (a) 1m. Any pregnant woman whose income does not exceed the
12standard of need under s. 49.19 (11) and whose pregnancy is medically verified.
13Eligibility continues to the last day of the month in which the 60th 365th day after
14the last day of the pregnancy falls.
AB68,1034 15Section 1034. 49.46 (1) (j) of the statutes is amended to read:
AB68,754,1916 49.46 (1) (j) An individual determined to be eligible for benefits under par. (a)
179. remains eligible for benefits under par. (a) 9. for the balance of the pregnancy and
18to the last day of the month in which the 60th 365th day after the last day of the
19pregnancy falls without regard to any change in the individual's family income.
AB68,1035 20Section 1035. 49.46 (2) (b) 8m. of the statutes is created to read:
AB68,754,2221 49.46 (2) (b) 8m. Room and board for residential substance use disorder
22treatment.
AB68,1036 23Section 1036. 49.46 (2) (b) 9m. of the statutes is created to read:
AB68,754,2424 49.46 (2) (b) 9m. Community health services, as specified under s. 49.45 (25r).
AB68,1037 25Section 1037 . 49.46 (2) (b) 11m. of the statutes is created to read:
AB68,755,2
149.46 (2) (b) 11m. Subject to par. (bx), acupuncture provided by an
2acupuncturist who holds a certificate under ch. 451.
AB68,1038 3Section 1038. 49.46 (2) (b) 12p. of the statutes is created to read:
AB68,755,54 49.46 (2) (b) 12p. Doula services provided by a certified doula, as specified
5under s. 49.45 (30t).
AB68,1039 6Section 1039. 49.46 (2) (b) 24. of the statutes is created to read:
AB68,755,87 49.46 (2) (b) 24. Subject to par. (bv), nonmedical services that contribute to the
8determinants of health.
AB68,1040 9Section 1040. 49.46 (2) (bv) of the statutes is created to read:
AB68,755,1610 49.46 (2) (bv) The department shall determine those services under par. (b) 24.
11that contribute to the determinants of health. The department shall seek any
12necessary state plan amendment or request any waiver of federal Medicaid law to
13implement this paragraph. The department is not required to provide the services
14under this paragraph as a benefit under the Medical Assistance program if the
15federal department of health and human services does not provide federal financial
16participation for the services under this paragraph.
AB68,1041 17Section 1041 . 49.46 (2) (bx) of the statutes is created to read:
AB68,755,2418 49.46 (2) (bx) The department shall submit to the federal department of health
19and human services any request for a state plan amendment, waiver, or other federal
20approval necessary to provide reimbursement for the benefit under par. (b) 11m. If
21the federal department approves the request or if no federal approval is necessary,
22the department shall provide the benefit and reimbursement under par. (b) 11m. If
23the federal department disapproves the request, the department may not provide the
24benefit or reimbursement for the benefit described under par. (b) 11m.
AB68,1042 25Section 1042. 49.47 (4) (ag) 2. of the statutes is amended to read:
AB68,756,3
149.47 (4) (ag) 2. Pregnant and the woman's pregnancy is medically verified
2Eligibility continues to the last day of the month in which the 60th 365th day after
3the last day of the pregnancy falls.
AB68,1043 4Section 1043 . 49.471 (1) (b) 2. of the statutes is amended to read:
AB68,756,55 49.471 (1) (b) 2. A stepfather, stepmother stepparent, stepbrother, or stepsister.
AB68,1044 6Section 1044 . 49.471 (1) (cr) of the statutes is created to read:
AB68,756,87 49.471 (1) (cr) “Enhanced federal medical assistance percentage" means a
8federal medical assistance percentage described under 42 USC 1396d (y) or (z).
AB68,1045 9Section 1045 . 49.471 (4) (a) 4. b. of the statutes is amended to read:
AB68,756,1210 49.471 (4) (a) 4. b. The individual's family income does not exceed 100 133
11percent of the poverty line before application of the 5 percent income disregard under
1242 CFR 435.603 (d)
.
AB68,1046 13Section 1046 . 49.471 (4) (a) 8. of the statutes is created to read:
AB68,756,1414 49.471 (4) (a) 8. An individual who meets all of the following criteria:
AB68,756,1515 a. The individual is an adult under the age of 65.
AB68,756,1716 b. The adult has a family income that does not exceed 133 percent of the poverty
17line, except as provided in sub. (4g).
AB68,756,1918 c. The adult is not otherwise eligible for the Medical Assistance program under
19this subchapter or the Medicare program under 42 USC 1395 et seq.
AB68,1047 20Section 1047 . 49.471 (4g) of the statutes is created to read:
AB68,757,321 49.471 (4g) Medicaid expansion; federal medical assistance percentage. For
22services provided to individuals described under sub. (4) (a) 8., the department shall
23comply with all federal requirements to qualify for the highest available enhanced
24federal medical assistance percentage. The department shall submit any
25amendment to the state medical assistance plan, request for a waiver of federal

1Medicaid law, or other approval request required by the federal government to
2provide services to the individuals described under sub. (4) (a) 8. and qualify for the
3highest available enhanced federal medical assistance percentage.
AB68,1048 4Section 1048. 49.471 (6) (b) of the statutes is amended to read:
AB68,757,95 49.471 (6) (b) A pregnant woman who is determined to be eligible for benefits
6under sub. (4) remains eligible for benefits under sub. (4) for the balance of the
7pregnancy and to the last day of the month in which the 60th 365th day after the last
8day of the pregnancy falls without regard to any change in the woman's family
9income.
AB68,1049 10Section 1049. 49.471 (6) (L) of the statutes is created to read:
AB68,757,2111 49.471 (6) (L) The department shall request from the federal department of
12health and human services approval of a state plan amendment, a waiver of federal
13Medicaid law, or approval of a demonstration project to maintain eligibility for
14postpartum women to the last day of the month in which the 365th day after the last
15day of the pregnancy falls under ss. 49.46 (1) (a) 1m. and 9. and (j), 49.47 (4) (ag) 2.,
16and 49.471 (4) (a) 1g. and 1m., (6) (b), and (7) (b) 1. The department shall cover and
17provide reimbursement for services under ss. 49.46 (1) (a) 1m. and 9. and (j), 49.47
18(4) (ag) 2., and 49.471 (4) (a) 1g. and 1m., (6) (b), and (7) (b) 1. regardless of whether
19a state plan amendment, waiver of federal Medicaid law, or approval of a
20demonstration project related to coverage or reimbursement of these services is
21granted by the federal department of human services.
AB68,1050 22Section 1050. 49.471 (7) (b) 1. of the statutes is amended to read:
AB68,758,823 49.471 (7) (b) 1. A pregnant woman whose family income exceeds 300 percent
24of the poverty line may become eligible for coverage under this section if the
25difference between the pregnant woman's family income and the applicable income

1limit under sub. (4) (a) is obligated or expended for any member of the pregnant
2woman's family for medical care or any other type of remedial care recognized under
3state law or for personal health insurance premiums or for both. Eligibility obtained
4under this subdivision continues without regard to any change in family income for
5the balance of the pregnancy and to the last day of the month in which the 60th 365th
6day after the last day of the woman's pregnancy falls. Eligibility obtained by a
7pregnant woman under this subdivision extends to all pregnant women in the
8pregnant woman's family.
AB68,1051 9Section 1051 . 49.485 of the statutes is renumbered 20.9315 (19) and amended
10to read:
AB68,758,1611 20.9315 (19) Whoever knowingly presents or causes to be presented to any
12officer, employee, or agent of this state a false claim for medical assistance shall
13forfeit not less than $5,000 nor more than $10,000, plus 3 times the amount of the
14damages that were sustained by the state or would have been sustained by the state,
15whichever is greater, as a result of the false claim.
The attorney general may bring
16an action on behalf of the state to recover any forfeiture incurred under this section.
AB68,1052 17Section 1052 . 49.686 (3) (d) of the statutes is amended to read:
AB68,758,2318 49.686 (3) (d) Has applied for coverage under and has been denied eligibility
19for medical assistance within 12 months prior to application for reimbursement
20under sub. (2). This paragraph does not apply to an individual who is eligible for
21benefits under the demonstration project for childless adults under s. 49.45 (23) or
22to an individual
who is eligible for benefits under BadgerCare Plus under s. 49.471
23(4) (a) 8. or (11).
AB68,1053 24Section 1053 . 49.79 (1) (b) of the statutes is amended to read:
AB68,759,4
149.79 (1) (b) “Controlled substance" has the meaning given in 21 USC 802 (6),
2except “controlled substance” does not include tetrahydrocannabinols in any form,
3including tetrahydrocannabinols contained in marijuana, obtained from marijuana,
4or chemically synthesized
.
AB68,1054 5Section 1054. 49.79 (7r) (d) of the statutes is created to read:
AB68,759,86 49.79 (7r) (d) The department may expend from the appropriation under s.
720.435 (4) (bt) no more than $425,000 per fiscal year for the pilot program under this
8subsection.
AB68,1055 9Section 1055. 49.79 (9) (a) 1g. of the statutes is amended to read:
AB68,759,1810 49.79 (9) (a) 1g. Except as provided in subds. 2. and 3., beginning October 1,
112019,
the department shall require, to the extent allowed by the federal government,
12all
able-bodied adults without dependents in this state to participate in the
13employment and training program under this subsection, except for able-bodied
14adults without dependents who are employed, as determined by the department.
15The department may require other able individuals who are 18 to 60 years of age, or
16a subset of those individuals to the extent allowed by the federal government, who
17are not participants in a Wisconsin Works employment position to participate in the
18employment and training program under this subsection.
AB68,1056 19Section 1056. 49.79 (9) (d) of the statutes is repealed.
Loading...
Loading...