Amendment AA3-SB70

SB70-AA3,102,5 49.471 (4) (a) 8. An individual who meets all of the following criteria:

SB70-AA3,102,6 a. The individual is an adult under the age of 65.

SB70-AA3,102,8 b. The adult has a family income that does not exceed 133 percent of the poverty line, except as provided in sub. (4g).

SB70-AA3,102,10 c. The adult is not otherwise eligible for the Medical Assistance program under this subchapter or the Medicare program under 42 USC 1395 et seq.

SB70-AA3,105 Section 105. 49.471 (4g) of the statutes is created to read:

SB70-AA3,102,19 49.471 (4g) Medicaid expansion; federal medical assistance percentage. For services provided to individuals described under sub. (4) (a) 8., the department shall comply with all federal requirements to qualify for the highest available enhanced federal medical assistance percentage. The department shall submit any amendment to the state medical assistance plan, request for a waiver of federal Medicaid law, or other approval request required by the federal government to provide services to the individuals described under sub. (4) (a) 8. and qualify for the highest available enhanced federal medical assistance percentage.

SB70-AA3,106 Section 106. 49.686 (3) (d) of the statutes is amended to read:

SB70-AA3,103,2 49.686 (3) (d) Has applied for coverage under and has been denied eligibility for medical assistance within 12 months prior to application for reimbursement under sub. (2). This paragraph does not apply to an individual who is eligible for benefits under the demonstration project for childless adults under s. 49.45 (23) or to an individual who is eligible for benefits under BadgerCare Plus under s. 49.471 (4) (a) 8. or (11).

SB70-AA3,107 Section 107. 2017 Wisconsin Act 370, section 44 (2) and (3) are repealed.

SB70-AA3,9119 Section 9119. Nonstatutory provisions; Health Services.

SB70-AA3,103,12 (2h) Childless adults demonstration project. The department of health services shall submit any necessary request to the federal department of health and human services for a state plan amendment or waiver of federal Medicaid law or to modify or withdraw from any waiver of federal Medicaid law relating to the childless adults demonstration project under s. 49.45 (23), 2021 stats., to reflect the incorporation of recipients of Medical Assistance under the demonstration project into the BadgerCare Plus program under s. 49.471 and the termination of the demonstration project.

SB70-AA3,9419 Section 9419. Effective dates; Health Services.

SB70-AA3,103,17 (2r) Medicaid expansion. The treatment of ss. 20.435 (4) (jw), 49.45 (2p), 49.45 (23) and (23b), 49.471 (1) (cr), (4) (a) 4. b. and 8., and (4g), and 49.686 (3) (d), and 2017 Wisconsin Act 370, section 44 (2) and (3), and Section 9119 (2h) of this act take effect on July 1, 2023.”.

SB70-AA3,103,18 217. Page 374, line 11: after that line insert:

SB70-AA3,103,20 “ Section 108. 20.005 (3) (schedule) of the statutes: at the appropriate place, insert the following amounts for the purposes indicated: - See PDF for table - See PDF for table

SB70-AA3,109 Section 109. 20.435 (1) (bc) of the statutes is created to read:

SB70-AA3,104,4 20.435 (1) (bc) Emergency medical services grants. As a continuing appropriation, the amounts in the schedule for grants to providers of emergency medical services under s. 256.42.

SB70-AA3,110 Section 110. 256.42 of the statutes is created to read:

SB70-AA3,104,10 256.42 Emergency medical services grants. From the appropriation under s. 20.435 (1) (bc), the department may award grants to providers of emergency medical services for reasonable operating expenses related to emergency medical services, including expenses related to supplies, equipment, training, staffing, and vehicles.”.

SB70-AA3,104,11 218. Page 374, line 11: after that line insert:

SB70-AA3,104,12 “ Section 9119. Nonstatutory provisions; Health Services.

SB70-AA3,104,17 (1) Office of Caregiver Quality position increase. The authorized FTE positions for the department of health services are increased by 2.8 FED positions, beginning in fiscal year 2023-24, to be funded from the appropriation under s. 20.435 (6) (n) for the purpose of increasing staffing in the division of the department responsible for caregiver quality.”.

SB70-AA3,104,18 219. Page 374, line 11: after that line insert:

SB70-AA3,104,19 “ Section 1. 252.12 (2) (a) 8. (intro.) of the statutes is amended to read:

SB70-AA3,105,9 252.12 (2) (a) 8. `Mike Johnson life care and early intervention services grants.' (intro.) The department shall award not more than $4,000,000 $5,000,000 in each fiscal year in grants to applying AIDS service organizations for the provision of needs assessments; assistance in procuring financial, medical, legal, social and pastoral services; counseling and therapy; homecare services and supplies; advocacy; and case management services. These services shall include early intervention services. The department shall also award not more than $74,000 in each year from the appropriation account under s. 20.435 (5) (md) for the services under this subdivision. The state share of payment for case management services that are provided under s. 49.45 (25) (be) to recipients of medical assistance shall be paid from the appropriation account under s. 20.435 (1) (am). All of the following apply to grants awarded under this subdivision:”.

SB70-AA3,105,10 220. Page 374, line 11: after that line insert:

SB70-AA3,105,12 “ Section 111. 20.005 (3) (schedule) of the statutes: at the appropriate place, insert the following amounts for the purposes indicated: - See PDF for table - See PDF for table

SB70-AA3,112 Section 112. 20.435 (1) (ew) of the statutes is created to read:

SB70-AA3,106,2 20.435 (1) (ew) Congenital disorders; general purpose revenue. The amounts in the schedule to provide diagnostic services, special dietary treatment, and follow-up counseling for congenital disorders and periodic evaluation of infant screening programs as specified under s. 253.13, to provide referrals under s. 253.115, to administer the programs under ss. 253.115 and 253.13, and for the costs of consulting with appropriate experts as specified in s. 253.13 (5).”.

SB70-AA3,106,3 221. Page 374, line 11: after that line insert:

SB70-AA3,106,4 “ Section 113. 20.250 (2) (title) of the statutes is amended to read:

SB70-AA3,106,5 20.250 (2) (title) Research and community support.

SB70-AA3,114 Section 114. 20.250 (2) (a) of the statutes is created to read:

SB70-AA3,106,10 20.250 (2) (a) Violence prevention grants. Biennially, the amounts in the schedule to make violence prevention grants supporting local, evidence-informed activities that enhance the safety and well-being of children, youth, and families throughout this state.”.

SB70-AA3,106,11 222. Page 374, line 11: after that line insert:

SB70-AA3,106,13 “ Section 115. 20.005 (3) (schedule) of the statutes: at the appropriate place, insert the following amounts for the purposes indicated: - See PDF for table - See PDF for table

SB70-AA3,116 Section 116. 20.435 (1) (fL) of the statutes is created to read:

SB70-AA3,106,17 20.435 (1) (fL) Nurse aide training and recruitment grants. The amounts in the schedule for grants to train and recruit individuals to work as nurse aides in nursing homes under s. 146.41.

SB70-AA3,117 Section 117. 146.41 of the statutes is created to read:

SB70-AA3,107,1 146.41 Nurse aide training and recruitment grants. (1) In this section:

SB70-AA3,107,2 (a) “Nurse aide” has the meaning given in s. 146.40 (1) (d).

SB70-AA3,107,3 (b) “Nursing home" has the meaning given in s. 50.01 (3).

SB70-AA3,107,6 (2) Beginning in fiscal year 2024-25, the department shall award grants to train and recruit individuals to work as nurse aides in nursing homes. The grants awarded under this subsection shall include grants for all of the following:

SB70-AA3,107,8 (a) The cost for an individual to complete an instructional program for nurse aides in a program approved under s. 146.40 (3) and (3g).

SB70-AA3,107,10 (b) The cost for an individual to complete a competency evaluation for nurse aides in a program approved under s. 146.40 (3m).

SB70-AA3,107,12 (c) A retention bonus for an individual who has worked for at least 6 months as a nurse aide in a nursing home.

SB70-AA3,107,16 (3) The department may partner with nonprofit organizations, private entities, the board on aging and long term care, and the technical college system board to award the grants under sub. (2) and recruit individuals to work as nurse aides in nursing homes.”.

SB70-AA3,107,17 223. Page 374, line 11: after that line insert:

SB70-AA3,107,19 “ Section 118. 20.005 (3) (schedule) of the statutes: at the appropriate place, insert the following amounts for the purposes indicated: - See PDF for table

SB70-AA3,119 Section 119. 20.145 (1) (a) of the statutes is created to read:

SB70-AA3,108,2 20.145 (1) (a) State operations. The amounts in the schedule for general program operations.

SB70-AA3,120 Section 120. 20.145 (1) (g) (intro.) of the statutes is amended to read:

SB70-AA3,108,13 20.145 (1) (g) General program operations. (intro.) The amounts in the schedule for general program operations, including organizational support services and, oversight of care management organizations, development of a public option health insurance plan, and operation of a state-based exchange under s. 601.59, and for transferring to the appropriation account under s. 20.435 (4) (kv) the amount allocated by the commissioner of insurance. Notwithstanding s. 20.001 (3) (a), at the end of each fiscal year, the unencumbered balance in this appropriation account that exceeds 10 percent of that fiscal year's expenditure under this appropriation shall lapse to the general fund. All of the following shall be credited to this appropriation account:

SB70-AA3,121 Section 121. 20.145 (1) (g) 4. of the statutes is created to read:

SB70-AA3,108,15 20.145 (1) (g) 4. All moneys received under s. 601.59.

SB70-AA3,122 Section 122. 40.51 (8) of the statutes is amended to read:

SB70-AA3,108,21 40.51 (8) Every health care coverage plan offered by the state under sub. (6) shall comply with ss. 631.89, 631.90, 631.93 (2), 631.95, 632.72 (2), 632.728, 632.729, 632.746 (1) to (8) and (10), 632.747, 632.748, 632.798, 632.83, 632.835, 632.85, 632.853, 632.855, 632.861, 632.862, 632.867, 632.87 (3) to (6) (8), 632.871, 632.885, 632.89, 632.895 (5m) and (8) to (17), and 632.896.

SB70-AA3,123 Section 123. 40.51 (8m) of the statutes is amended to read:

SB70-AA3,109,2 40.51 (8m) Every health care coverage plan offered by the group insurance board under sub. (7) shall comply with ss. 631.95, 632.728, 632.729, 632.746 (1) to (8) and (10), 632.747, 632.748, 632.798, 632.83, 632.835, 632.85, 632.853, 632.855, 632.861, 632.862, 632.867, 632.87 (7) and (8), 632.871, 632.885, 632.89, and 632.895 (11) (8) and (10) to (17).

SB70-AA3,124 Section 124. 66.0137 (4) of the statutes is amended to read:

SB70-AA3,109,10 66.0137 (4) Self-insured health plans. If a city, including a 1st class city, or a village provides health care benefits under its home rule power, or if a town provides health care benefits, to its officers and employees on a self-insured basis, the self-insured plan shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.728, 632.729, 632.746 (1) and (10) (a) 2. and (b) 2., 632.747 (3), 632.798, 632.85, 632.853, 632.855, 632.861, 632.862, 632.867, 632.87 (4) to (6) (8), 632.871, 632.885, 632.89, 632.895 (9) (8) to (17), 632.896, and 767.513 (4).

SB70-AA3,125 Section 125. 120.13 (2) (g) of the statutes is amended to read:

SB70-AA3,109,16 120.13 (2) (g) Every self-insured plan under par. (b) shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.728, 632.729, 632.746 (1) and (10) (a) 2. and (b) 2., 632.747 (3), 632.798, 632.85, 632.853, 632.855, 632.861, 632.862, 632.867, 632.87 (4) to (6) (8), 632.871, 632.885, 632.89, 632.895 (9) (8) to (17), 632.896, and 767.513 (4).

SB70-AA3,126 Section 126. 185.983 (1) (intro.) of the statutes is amended to read:

SB70-AA3,109,25 185.983 (1) (intro.) Every voluntary nonprofit health care plan operated by a cooperative association organized under s. 185.981 shall be exempt from chs. 600 to 646, with the exception of ss. 601.04, 601.13, 601.31, 601.41, 601.42, 601.43, 601.44, 601.45, 611.26, 611.67, 619.04, 623.11, 623.12, 628.34 (10), 631.17, 631.89, 631.93, 631.95, 632.72 (2), 632.728, 632.729, 632.745 to 632.749, 632.775, 632.79, 632.795, 632.798, 632.85, 632.853, 632.855, 632.861, 632.862, 632.867, 632.87 (2) to (6) (8), 632.871, 632.885, 632.89, 632.895 (5) and (8) to (17), 632.896, and 632.897 (10) and chs. 609, 620, 630, 635, 645, and 646, but the sponsoring association shall:

SB70-AA3,127 Section 127. 601.31 (1) (mv) of the statutes is created to read:

SB70-AA3,110,4 601.31 (1) (mv) For initial issuance or renewal of a license as a pharmacy benefit management broker or consultant under s. 628.495, amounts to be set by the commissioner by rule.

SB70-AA3,128 Section 128. 601.31 (1) (nv) of the statutes is created to read:

SB70-AA3,110,7 601.31 (1) (nv) For issuing or renewing a license as a pharmaceutical representative under s. 632.863, an amount to be set by the commissioner by rule.

SB70-AA3,129 Section 129. 601.31 (1) (nw) of the statutes is created to read:

SB70-AA3,110,11 601.31 (1) (nw) For issuing or renewing a license as a pharmacy services administrative organization under s. 632.864, an amount to be set by the commissioner by rule.

SB70-AA3,130 Section 130. 601.575 of the statutes is created to read:

SB70-AA3,110,18 601.575 Prescription drug importation program. (1) Importation program requirements. The commissioner, in consultation with persons interested in the sale and pricing of prescription drugs and appropriate officials and agencies of the federal government, shall design and implement a prescription drug importation program for the benefit of residents of this state, that generates savings for residents, and that satisfies all of the following:

SB70-AA3,110,21 (a) The commissioner shall designate a state agency to become a licensed wholesale distributor or to contract with a licensed wholesale distributor and shall seek federal certification and approval to import prescription drugs.

SB70-AA3,110,23 (b) The program shall comply with relevant requirements of 21 USC 384, including safety and cost savings requirements.

SB70-AA3,110,25 (c) The program shall import prescription drugs from Canadian suppliers regulated under any appropriate Canadian or provincial laws.

SB70-AA3,111,2 (d) The program shall have a process to sample the purity, chemical composition, and potency of imported prescription drugs.

SB70-AA3,111,6 (e) The program shall import only those prescription drugs for which importation creates substantial savings for residents of this state and only those prescription drugs that are not brand-name drugs and that have fewer than 4 competitor prescription drugs in the United States.

SB70-AA3,111,8 (f) The commissioner shall ensure that prescription drugs imported under the program are not distributed, dispensed, or sold outside of this state.

SB70-AA3,111,9 (g) The program shall ensure all of the following:

SB70-AA3,111,11 1. Participation by any pharmacy or health care provider in the program is voluntary.

SB70-AA3,111,13 2. Any pharmacy or health care provider participating in the program has the appropriate license or other credential in this state.

SB70-AA3,111,16 3. Any pharmacy or health care provider participating in the program charges a consumer or health plan the actual acquisition cost of the imported prescription drug that is dispensed.

SB70-AA3,111,20 (h) The program shall ensure that a payment by a health plan or health insurance policy for a prescription drug imported under the program reimburses no more than the actual acquisition cost of the imported prescription drug that is dispensed.

SB70-AA3,111,22 (i) The program shall ensure that any health plan or health insurance policy participating in the program does all of the following:

SB70-AA3,111,24 1. Maintains a formulary and claims payment system with current information on prescription drugs imported under the program.

SB70-AA3,112,3 2. Bases cost-sharing amounts for participants or insureds under the plan or policy on no more than the actual acquisition cost of the prescription drug imported under the program that is dispensed to the participant or insured.

SB70-AA3,112,6 3. Demonstrates to the commissioner or a state agency designated by the commissioner how premiums under the plan or policy are affected by savings on prescription drugs imported under the program.

SB70-AA3,112,9 (j) Any wholesale distributor importing prescription drugs under the program shall limit its profit margin to the amount established by the commissioner or a state agency designated by the commissioner.