Amendment AA3-SB70

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.

SB70-AA3,112,11 (k) The program may not import any generic prescription drug that would violate federal patent laws on branded products in the United States.

SB70-AA3,112,16 (L) The program shall comply with tracking and tracing requirements of 21 USC 360eee and 360eee-1, to the extent practical and feasible, before the prescription drug to be imported comes into the possession of this state's wholesale distributor and fully after the prescription drug to be imported is in the possession of this state's wholesale distributor.

SB70-AA3,112,18 (m) The program shall establish a fee or other mechanism to finance the program that does not jeopardize significant savings to residents of this state.

SB70-AA3,112,19 (n) The program shall have an audit function that ensures all of the following:

SB70-AA3,112,21 1. The commissioner has a sound methodology to determine the most cost-effective prescription drugs to include in the program.

SB70-AA3,112,23 2. The commissioner has a process in place to select Canadian suppliers that are high quality, high performing, and in full compliance with Canadian laws.

SB70-AA3,112,25 3. Prescription drugs imported under the program are pure, unadulterated, potent, and safe.

SB70-AA3,113,1 4. The program is complying with the requirements of this subsection.

SB70-AA3,113,3 5. The program is adequately financed to support administrative functions of the program while generating significant cost savings to residents of this state.

SB70-AA3,113,5 6. The program does not put residents of this state at a higher risk than if the program did not exist.

SB70-AA3,113,7 7. The program provides and is projected to continue to provide substantial cost savings to residents of this state.

SB70-AA3,113,10 (2) Anticompetitive behavior. The commissioner, in consultation with the attorney general, shall identify the potential for and monitor anticompetitive behavior in industries affected by a prescription drug importation program.

SB70-AA3,113,20 (3) Approval of program design; certification. No later than the first day of the 7th month beginning after the effective date of this subsection .... [LRB inserts date], the commissioner shall submit to the joint committee on finance a report that includes the design of the prescription drug importation program in accordance with this section. The commissioner may not submit the proposed program to the federal department of health and human services unless the joint committee on finance approves the proposed program. Within 14 days of the date of approval by the joint committee on finance of the proposed program, the commissioner shall submit to the federal department of health and human services a request for certification of the approved program.

SB70-AA3,114,3 (4) Implementation of certified program. After the federal department of health and human services certifies the prescription drug importation program submitted under sub. (3), the commissioner shall begin implementation of the program, and the program shall be fully operational by 180 days after the date of certification by the federal department of health and human services. The commissioner shall do all of the following to implement the program to the extent the action is in accordance with other state laws and the certification by the federal department of health and human services:

SB70-AA3,114,6 (a) Become a licensed wholesale distributor, designate another state agency to become a licensed wholesale distributor, or contract with a licensed wholesale distributor.

SB70-AA3,114,8 (b) Contract with one or more Canadian suppliers that meet the criteria in sub. (1) (c) and (n).

SB70-AA3,114,11 (c) Create an outreach and marketing plan to communicate with and provide information to health plans and health insurance policies, employers, pharmacies, health care providers, and residents of this state on participating in the program.

SB70-AA3,114,14 (d) Develop and implement a registration process for health plans and health insurance policies, pharmacies, and health care providers interested in participating in the program.

SB70-AA3,114,16 (e) Create a publicly accessible source for listing prices of prescription drugs imported under the program.

SB70-AA3,114,19 (f) Create, publicize, and implement a method of communication to promptly answer questions from and address the needs of persons affected by the implementation of the program before the program is fully operational.

SB70-AA3,114,21 (g) Establish the audit functions under sub. (1) (n) with a timeline to complete each audit function every 2 years.

SB70-AA3,114,23 (h) Conduct any other activities determined by the commissioner to be important to successful implementation of the program.

SB70-AA3,114,25 (5) Report. By January 1 and July 1 of each year, the commissioner shall submit to the joint committee on finance a report including all of the following:

SB70-AA3,115,2 (a) A list of prescription drugs included in the prescription drug importation program under this section.

SB70-AA3,115,5 (b) The number of pharmacies, health care providers, and health plans and health insurance policies participating in the prescription drug importation program under this section.

SB70-AA3,115,10 (c) The estimated amount of savings to residents of this state, health plans and health insurance policies, and employers resulting from the implementation of the prescription drug importation program under this section reported from the date of the previous report under this subsection and from the date the program was fully operational.

SB70-AA3,115,12 (d) Findings of any audit functions under sub. (1) (n) completed since the date of the previous report under this subsection.

SB70-AA3,115,14 (6) Rulemaking. The commissioner may promulgate any rules necessary to implement this section.

SB70-AA3,131 Section 131. 601.59 of the statutes is created to read:

SB70-AA3,115,16 601.59 State-based exchange. (1) Definitions. In this section:

SB70-AA3,115,17 (a) “Exchange” has the meaning given in 45 CFR 155.20.

SB70-AA3,115,20 (b) “State-based exchange on the federal platform” means an exchange that is described in and meets the requirements of 45 CFR 155.200 (f) and is approved by the federal secretary of health and human services under 45 CFR 155.106.