Amendment AA3-SB70

SB70-AA3,226 Section 226. 632.895 (6) of the statutes is renumbered 632.895 (6) (a) and amended to read:

SB70-AA3,194,4 632.895 (6) (a) Every disability insurance policy which that provides coverage of expenses incurred for treatment of diabetes shall provide coverage for expenses incurred by the installation and use of an insulin infusion pump, coverage for all other equipment and supplies, including insulin or any other prescription medication, used in the treatment of diabetes, and coverage of diabetic self-management education programs. Coverage Except as provided in par. (b), coverage required under this subsection shall be subject to the same exclusions, limitations, deductibles, and coinsurance provisions of the policy as other covered expenses, except that insulin infusion pump coverage may be limited to the purchase of one pump per year and the insurer may require the insured to use a pump for 30 days before purchase.

SB70-AA3,227 Section 227. 632.895 (6) (b) of the statutes is created to read:

SB70-AA3,194,6 632.895 (6) (b) 1. In this paragraph:

SB70-AA3,194,8 a. “Cost sharing” means the total of any deductible, copayment, or coinsurance amounts imposed on a person covered under a policy or plan.

SB70-AA3,194,9 b. “Self-insured health plan” has the meaning given in s. 632.85 (1) (c).

SB70-AA3,194,12 2. Every disability insurance policy and self-insured health plan that cover insulin and impose cost sharing on prescription drugs may not impose cost sharing on insulin in an amount that exceeds $35 for a one-month supply of insulin.

SB70-AA3,194,17 3. Nothing in this paragraph prohibits a disability insurance policy or self-insured health plan from imposing cost sharing on insulin in an amount less than the amount specified under subd. 2. Nothing in this paragraph requires a disability insurance policy or self-insured health plan to impose any cost sharing on insulin.

SB70-AA3,9423 Section 9423. Effective dates; Insurance.

SB70-AA3,194,22 (1) Cost-sharing cap on insulin. The treatment of ss. 609.83 and 632.895 (6) (title), the renumbering and amendment of s. 632.895 (6), and the creation of s. 632.895 (6) (b) take effect on the first day of the 4th month beginning after publication.”.

SB70-AA3,194,23 230. Page 374, line 11: after that line insert:

SB70-AA3,194,24 “ Section 228. 20.435 (4) (bm) of the statutes is amended to read:

SB70-AA3,195,18 20.435 (4) (bm) Medical Assistance, food stamps, and Badger Care administration; contract costs, insurer reports, and resource centers. Biennially, the amounts in the schedule to provide a portion of the state share of administrative contract costs for the Medical Assistance program under subch. IV of ch. 49 and the Badger Care health care program under s. 49.665 and to provide the state share of administrative costs for the food stamp program under s. 49.79, other than payments under s. 49.78 (8), to develop and implement a registry of recipient immunizations, to reimburse 3rd parties for their costs under s. 49.475, for costs associated with outreach activities, for state administration of state supplemental grants to supplemental security income recipients under s. 49.77, for grants under s. 46.73, and for services of resource centers under s. 46.283. No state positions may be funded in the department of health services from this appropriation, except positions for the performance of duties under a contract in effect before January 1, 1987, related to the administration of the Medical Assistance program between the subunit of the department primarily responsible for administering the Medical Assistance program and another subunit of the department. Total administrative funding authorized for the program under s. 49.665 may not exceed 10 percent of the amounts budgeted under pars. (p) and (x).

SB70-AA3,229 Section 229. 20.435 (4) (pa) of the statutes is amended to read:

SB70-AA3,195,25 20.435 (4) (pa) Federal aid; Medical Assistance and food stamp contracts administration. All federal moneys received for the federal share of the cost of contracting for payment and services administration and reporting, other than moneys received under pars. (nn) and (np), to reimburse 3rd parties for their costs under s. 49.475, for administrative contract costs for the food stamp program under s. 49.79, for grants under s. 46.73, and for services of resource centers under s. 46.283.

SB70-AA3,230 Section 230. 46.73 of the statutes is created to read:

SB70-AA3,196,4 46.73 Community dental health coordinators. From the appropriations under s. 20.435 (4) (bm) and (pa), the department shall award grants to support community dental health coordinators.”.

SB70-AA3,196,5 231. Page 374, line 11: after that line insert:

SB70-AA3,196,6 “ Section 231. 46.482 (1) (a) of the statutes is renumbered 46.482 (1) (bm).

SB70-AA3,232 Section 232. 46.482 (1) (am) of the statutes is created to read:

SB70-AA3,196,10 46.482 (1) (am) “Certified peer specialist” means an individual described under s. 49.45 (30j) (a) 1m. who has met the certification requirements established by the department.

SB70-AA3,233 Section 233. 46.482 (1) (b) of the statutes is renumbered 46.482 (1) (c) and amended to read:

SB70-AA3,196,15 46.482 (1) (c) “Peer recovery coach” means an individual described under s. 49.45 (30j) (a) 2. 3. who has completed the training requirements specified under s. 49.45 (30j) (b) 4.

SB70-AA3,234 Section 234. 46.482 (2) (a) of the statutes is amended to read:

SB70-AA3,196,19 46.482 (2) (a) Use peer recovery coaches and certified peer specialists to encourage individuals to seek treatment for a substance use disorder following an overdose.

SB70-AA3,235 Section 235. 46.482 (2) (f) of the statutes is amended to read:

SB70-AA3,196,23 46.482 (2) (f) Collect and evaluate data on the outcomes of patients receiving peer recovery coach or certified peer specialist services and coordination and continuation of care services under this section.

SB70-AA3,236 Section 236. 49.45 (30j) (title) of the statutes is amended to read:

SB70-AA3,197,2 49.45 (30j) (title) Reimbursement for peer recovery coach and certified peer specialist services.

SB70-AA3,237 Section 237. 49.45 (30j) (a) 1. and 2. of the statutes are renumbered 49.45 (30j) (a) 2m. and 3.

SB70-AA3,238 Section 238. 49.45 (30j) (a) 1m. of the statutes is created to read:

SB70-AA3,197,9 49.45 (30j) (a) 1m. “Certified peer specialist” means an individual who has experience in the mental health and substance use services system, who is trained to provide support to others, and who has received peer specialist or parent peer specialist certification under the rules established by the department.

SB70-AA3,239 Section 239. 49.45 (30j) (bm) of the statutes is created to read:

SB70-AA3,197,13 49.45 (30j) (bm) The department shall reimburse under the Medical Assistance program under this subchapter any service provided by a certified peer specialist if the service satisfies all of the following conditions:

SB70-AA3,197,15 1. The recipient of the service provided by a certified peer specialist is in treatment for or recovery from a mental illness or a substance use disorder.

SB70-AA3,197,17 2. The certified peer specialist provides the service under the supervision of a competent mental health professional.

SB70-AA3,197,20 3. The certified peer specialist provides the service in coordination with the Medical Assistance recipient's individual treatment plan and in accordance with the recipient's individual treatment goals.

SB70-AA3,197,23 4. The certified peer specialist providing the service has completed training requirements, as established by the department by rule, after consulting with members of the recovery community.

SB70-AA3,240 Section 240. 49.45 (30j) (c) of the statutes is amended to read:

SB70-AA3,198,3 49.45 (30j) (c) The department shall certify under Medical Assistance peer recovery coaches and certified peer specialists to provide services in accordance with this subsection.

SB70-AA3,241 Section 241. 49.46 (2) (b) 14p. of the statutes is amended to read:

SB70-AA3,198,6 49.46 (2) (b) 14p. Subject to s. 49.45 (30j), services provided by a peer recovery coach or a certified peer specialist.

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

SB70-AA3,198,17 (1) Rules regarding training of certified peer specialists. The department of health services may promulgate the rules required under s. 49.45 (30j) (bm) 4. as emergency rules under s. 227.24. Notwithstanding s. 227.24 (1) (a) and (3), the department of health services is not required to provide evidence that promulgating a rule under this subsection as an emergency rule is necessary for the preservation of the public peace, health, safety, or welfare and is not required to provide a finding of emergency for a rule promulgated under this subsection. Notwithstanding s. 227.24 (1) (c) and (2), emergency rules promulgated under this subsection remain in effect until January 1, 2025, or the date the permanent rules take effect, whichever is sooner.”.

SB70-AA3,198,18 232. Page 374, line 11: after that line insert:

SB70-AA3,198,19 “ Section 242. 46.854 of the statutes is created to read:

SB70-AA3,198,22 46.854 Healthy aging grant program. From the appropriation under s. 20.435 (1) (b), the department shall award in each fiscal year a grant of $600,000 to an entity that conducts programs in healthy aging.”.

SB70-AA3,198,23 233. Page 374, line 11: after that line insert:

SB70-AA3,198,24 “ Section 243. 20.145 (1) (g) 5. of the statutes is created to read:

SB70-AA3,199,4 20.145 (1) (g) 5. All moneys received from the regulation of pharmacy benefit managers, pharmacy benefit management brokers, pharmacy benefit management consultants, pharmacy services administration organizations, and pharmaceutical representatives.”.

SB70-AA3,199,5 234. Page 374, line 11: after that line insert:

SB70-AA3,199,6 “ Section 244. 256.158 of the statutes is created to read:

SB70-AA3,199,7 256.158 Epinephrine for ambulances. (1) In this section:

SB70-AA3,199,9 (a) “Ambulance service provider” means an ambulance service provider that is a public agency, volunteer fire department, or nonprofit corporation.

SB70-AA3,199,11 (b) “Draw-up epinephrine” means epinephrine that is administered intramuscularly using a needle and syringe and drawn up from a vial or ampule.

SB70-AA3,199,13 (c) “Draw-up epinephrine kit” means a single-use vial or ampule of draw-up epinephrine and a syringe for administration to a patient.

SB70-AA3,199,15 (d) “Epinephrine auto-injector" means a device for the automatic injection of epinephrine into the human body.

SB70-AA3,200,2 (2) From the appropriation under s. 20.435 (1) (b), the department shall reimburse ambulance service providers for a set of 2 epinephrine auto-injectors or a set of 2 draw-up epinephrine kits for each ambulance operating in the state. On an ongoing basis, the department shall, upon request from an ambulance service provider, reimburse the ambulance service provider for a replacement set of 2 epinephrine auto-injectors or a set of 2 draw-up epinephrine kits. The department shall allow the ambulance service provider to choose between epinephrine auto-injectors and draw-up epinephrine kits. The department may not reimburse an ambulance service provider for epinephrine unless each ambulance for which the ambulance service provider is reimbursed is staffed with an emergency medical services practitioner who is qualified to administer the provided epinephrine.”.

SB70-AA3,200,3 235. Page 374, line 11: after that line insert:

SB70-AA3,200,4 “ Section 245. 253.19 of the statutes is created to read:

SB70-AA3,200,12 253.19 Grants to free-standing pediatric teaching hospitals. From the appropriation under s. 20.435 (1) (b), the department shall award grants to free-standing pediatric teaching hospitals to fund programming related to parenting, educational needs of and supports for chronically ill children, and case management for children with asthma. A free-standing pediatric teaching hospital is eligible for a grant under this section only if the percentage of Medical Assistance recipient inpatient days at the free-standing pediatric teaching hospital calculated under s. 49.45 (3m) (b) 1. a. is greater than 45 percent.”.

SB70-AA3,200,13 236. Page 374, line 11: after that line insert:

SB70-AA3,200,14 “ Section 9119. Nonstatutory provisions; Health Services.

SB70-AA3,200,22 (1w) Electrocardiogram screening pilot program. The department of health services shall develop a pilot program to provide electrocardiogram screenings for participants in middle school and high school athletics programs in Milwaukee and Waukesha Counties. From the appropriation under s. 20.435 (1) (b), in fiscal year 2024-25, the department shall award $4,172,000 in grants to local health departments, as defined under s. 250.01 (4), to implement the pilot program under this subsection. Participation in the pilot program by participants in middle school and high school athletics programs shall be optional.”.

SB70-AA3,200,23 237. Page 374, line 11: after that line insert:

SB70-AA3,200,24 “ Section 246. 51.44 (5) (bm) of the statutes is created to read:

SB70-AA3,201,3 51.44 (5) (bm) Ensure that any child with a level of lead in his or her blood that is 3.5 or more micrograms per 100 milliliters of blood, as confirmed by one venous blood test, is eligible for services under the program under this section.

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

SB70-AA3,201,7 (1u) Early intervention services. The department of health services may develop a methodology to allocate moneys under s. 20.435 (7) (bt) across county programs.”.

SB70-AA3,201,8 238. Page 374, line 11: after that line insert:

SB70-AA3,201,9 “ Section 247. 46.995 (4) of the statutes is created to read:

SB70-AA3,201,13 46.995 (4) The department shall ensure that any child who is eligible and who applies for the disabled children's long-term support program that is operating under a waiver of federal law receives services under the disabled children's long-term support program that is operating under a waiver of federal law.”.

SB70-AA3,201,14 239. Page 374, line 11: after that line insert:

SB70-AA3,201,15 “ Section 248. 49.45 (30t) of the statutes is created to read:

SB70-AA3,201,16 49.45 (30t) Doula services. (a) In this subsection:

SB70-AA3,201,18 1. “Certified doula” means an individual who has received certification from a doula certifying organization recognized by the department.

SB70-AA3,201,21 2. “Doula services” means childbirth education and support services, including emotional and physical support provided during pregnancy, labor, birth, and the postpartum period.

SB70-AA3,202,3 (b) The department shall request from the secretary of the federal department of health and human services any required waiver or any required amendment to the state plan for Medical Assistance to allow reimbursement for doula services provided by a certified doula. If the waiver or state plan amendment is granted, the department shall reimburse a certified doula under s. 49.46 (2) (b) 12p. for the allowable charges for doula services provided to Medical Assistance recipients.

SB70-AA3,249 Section 249. 49.46 (2) (b) 12p. of the statutes is created to read:

SB70-AA3,202,6 49.46 (2) (b) 12p. Doula services provided by a certified doula, as specified under s. 49.45 (30t).”.

SB70-AA3,202,7 240. Page 374, line 11: after that line insert:

SB70-AA3,202,8 “ Section 250. 49.45 (39) (b) 1. of the statutes is amended to read:

SB70-AA3,203,17 49.45 (39) (b) 1. `Payment for school medical services.' If a school district or a cooperative educational service agency elects to provide school medical services and meets all requirements under par. (c), the department shall reimburse the school district or the cooperative educational service agency for 60 100 percent of the federal share of allowable charges for the school medical services that it provides and, as specified in subd. 2., for allowable administrative costs. If the Wisconsin Center for the Blind and Visually Impaired or the Wisconsin Educational Services Program for the Deaf and Hard of Hearing elects to provide school medical services and meets all requirements under par. (c), the department shall reimburse the department of public instruction for 60 100 percent of the federal share of allowable charges for the school medical services that the Wisconsin Center for the Blind and Visually Impaired or the Wisconsin Educational Services Program for the Deaf and Hard of Hearing provides and, as specified in subd. 2., for allowable administrative costs. A school district, cooperative educational service agency, the Wisconsin Center for the Blind and Visually Impaired, or the Wisconsin Educational Services Program for the Deaf and Hard of Hearing may submit, and the department shall allow, claims for common carrier transportation costs as a school medical service unless the department receives notice from the federal health care financing administration that, under a change in federal policy, the claims are not allowed. If the department receives the notice, a school district, cooperative educational service agency, the Wisconsin Center for the Blind and Visually Impaired, or the Wisconsin Educational Services Program for the Deaf and Hard of Hearing may submit, and the department shall allow, unreimbursed claims for common carrier transportation costs incurred before the date of the change in federal policy. The department shall promulgate rules establishing a methodology for making reimbursements under this paragraph. All other expenses for the school medical services provided by a school district or a cooperative educational service agency shall be paid for by the school district or the cooperative educational service agency with funds received from state or local taxes. The school district, the Wisconsin Center for the Blind and Visually Impaired, the Wisconsin Educational Services Program for the Deaf and Hard of Hearing, or the cooperative educational service agency shall comply with all requirements of the federal department of health and human services for receiving federal financial participation.

SB70-AA3,251 Section 251. 49.45 (39) (b) 2. of the statutes is amended to read:

SB70-AA3,204,3 49.45 (39) (b) 2. `Payment for school medical services administrative costs.' The department shall reimburse a school district or a cooperative educational service agency specified under subd. 1. and shall reimburse the department of public instruction on behalf of the Wisconsin Center for the Blind and Visually Impaired or the Wisconsin Educational Services Program for the Deaf and Hard of Hearing for 90 100 percent of the federal share of allowable administrative costs, using time studies, beginning in fiscal year 1999-2000. A school district or a cooperative educational service agency may submit, and the department of health services shall allow, claims for administrative costs incurred during the period that is up to 24 months before the date of the claim, if allowable under federal law.”.

SB70-AA3,204,4 241. Page 374, line 11: after that line insert:

SB70-AA3,204,5 “ Section 252. 49.46 (2) (b) 24. of the statutes is created to read:

SB70-AA3,204,7 49.46 (2) (b) 24. Subject to par. (by), nonmedical services that contribute to the determinants of health.

SB70-AA3,253 Section 253. 49.46 (2) (by) of the statutes is created to read: