Amendment SA4-SSA2-SB70

SB70-SSA2-SA4,144,3 (e) If a person brings a valid action under this subsection, no person other than the state may intervene or bring a related action based upon the same facts underlying the original action while the original action is pending.

SB70-SSA2-SA4,144,6 (f) In any action brought under this subsection or other proceeding under sub. (10), the plaintiff is required to prove all essential elements of the cause of action or complaint, including damages, by a preponderance of the evidence.

SB70-SSA2-SA4,144,10 (6) If the state proceeds with an action under sub. (5) or an alternate remedy under sub. (10), the state has primary responsibility for prosecuting the action under sub. (5) or proceeding under sub. (10). The state is not bound by any act of the person bringing the action, but that person has the right to continue as a party to the action.

SB70-SSA2-SA4,144,18 (7) (b) With the approval of the governor, the attorney general may compromise and settle an action under sub. (5) or an administrative proceeding under sub. (10) to which the state is a party, notwithstanding objection of the person bringing the action, if the court determines, after affording to the person bringing the action the right to a hearing at which the person is afforded the opportunity to present evidence in opposition to the proposed settlement, that the proposed settlement is fair, adequate, and reasonable considering the relevant circumstances pertaining to the violation.

SB70-SSA2-SA4,144,25 (c) Upon a showing by the state that unrestricted participation in the prosecution of an action under sub. (5) or an alternate proceeding under sub. (10) to which the state is a party by the person bringing the action would interfere with or unduly delay the prosecution of the action or proceeding, or would result in consideration of repetitious or irrelevant evidence or evidence presented for purposes of harassment, the court may limit the person's participation in the prosecution, such as:

SB70-SSA2-SA4,145,1 1. Limiting the number of witnesses that the person may call.

SB70-SSA2-SA4,145,2 2. Limiting the length of the testimony of the witnesses.

SB70-SSA2-SA4,145,3 3. Limiting the cross-examination of witnesses by the person.

SB70-SSA2-SA4,145,5 4. Otherwise limiting the participation by the person in the prosecution of the action or proceeding.

SB70-SSA2-SA4,145,10 (d) Upon a showing by a defendant that unrestricted participation in the prosecution of an action under sub. (5) or alternate proceeding under sub. (10) to which the state is a party by the person bringing the action would result in harassment or would cause the defendant undue burden or unnecessary expense, the court may limit the person's participation in the prosecution.

SB70-SSA2-SA4,145,17 (8) Except as provided in sub. (7), if the state elects not to participate in an action filed under sub. (5), the person bringing the action may prosecute the action. If the attorney general so requests, the attorney general shall, at the state's expense, be served with copies of all pleadings and deposition transcripts in the action. If the person bringing the action initiates prosecution of the action, the court, without limiting the status and rights of that person, may permit the state to intervene at a later date upon a showing by the state of good cause for the proposed intervention.

SB70-SSA2-SA4,146,2 (9) Whether or not the state participates in an action under sub. (5), upon a showing in camera by the attorney general that discovery by the person bringing the action would interfere with the state's ongoing investigation or prosecution of a criminal or civil matter arising out of the same facts as the facts upon which the action is based, the court may stay such discovery in whole or in part for a period of not more than 60 days. The court may extend the period of any such stay upon a further showing in camera by the attorney general that the state has pursued the criminal or civil investigation of the matter with reasonable diligence and the proposed discovery in the action brought under sub. (5) will interfere with the ongoing criminal or civil investigation or prosecution.

SB70-SSA2-SA4,146,14 (10) The attorney general may pursue a claim relating to an alleged violation of sub. (2) through an alternate remedy available to the state or any state agency, including an administrative proceeding to assess a civil forfeiture. If the attorney general elects any such alternate remedy, the attorney general shall serve timely notice of his or her election upon the person bringing the action under sub. (5), and that person has the same rights in the alternate venue as the person would have had if the action had continued under sub. (5). Any finding of fact or conclusion of law made by a court or by a state agency in the alternate venue that has become final is conclusive upon all parties named in an action under sub. (5). For purposes of this subsection, a finding or conclusion is final if it has been finally determined on appeal, if all time for filing an appeal or petition for review with respect to the finding or conclusion has expired, or if the finding or conclusion is not subject to judicial review.

SB70-SSA2-SA4,146,20 (11) (a) Except as provided in pars. (b) and (e), if the state proceeds with an action brought by a person under sub. (5) or the state pursues an alternate remedy relating to the same acts under sub. (10), the person who brings the action shall receive at least 15 percent but not more than 25 percent of the proceeds of the action or settlement of the claim, depending upon the extent to which the person contributed to the prosecution of the action or claim.

SB70-SSA2-SA4,147,5 (b) Except as provided in par. (e), if an action or claim is one that the court or other adjudicator finds to be based primarily upon disclosures of specific information not provided by the person who brings the action or claim under sub. (5) relating to allegations or transactions specifically disclosed in a criminal, civil, or administrative hearing; legislative or administrative report, hearing, audit, or investigation; or report made by the news media, the court or other adjudicator may award an amount to the person as it considers appropriate, but not more than 10 percent of the proceeds of the action or settlement of the claim, depending upon the significance of the information and the role of the person bringing the action in advancing the prosecution of the action or claim.

SB70-SSA2-SA4,147,10 (c) Except as provided in par. (e), in addition to any amount received under par. (a) or (b), a person bringing an action under sub. (5) shall be awarded his or her reasonable expenses necessarily incurred in bringing the action together with the person's costs and reasonable actual attorney fees. The court or other adjudicator shall assess any award under this paragraph against the defendant.

SB70-SSA2-SA4,147,17 (d) Except as provided in par. (e), if the state does not proceed with an action under sub. (5) or an alternate proceeding under sub. (10), the person bringing the action shall receive an amount that the court decides is reasonable for collection of the civil penalty and damages. The amount shall be not less than 25 percent and not more than 30 percent of the proceeds of the action and shall be paid from the proceeds. In addition, the person shall be paid his or her expenses, costs, and fees under par. (c).

SB70-SSA2-SA4,148,4 (e) Whether or not the state proceeds with an action under sub. (5) or an alternate proceeding under sub. (10), if the court or other adjudicator finds that an action under sub. (5) was brought by a person who planned or initiated the violation upon which the action or proceeding is based, then the court may, to the extent that the court considers appropriate, reduce the share of the proceeds of the action that the person would otherwise receive under par. (a), (b), or (d), taking into account the role of that person in advancing the prosecution of the action or claim and any other relevant circumstance pertaining to the violation, except that if the person bringing the action is convicted of criminal conduct arising from his or her role in a violation of sub. (2), the court or other adjudicator shall dismiss the person as a party and the person shall not receive any share of the proceeds of the action or claim or any expenses, costs, or fees under par. (c).

SB70-SSA2-SA4,148,9 (12) Except if the action is brought by the attorney general or the person bringing the action is an original source of the information, the court shall dismiss an action or claim under this section, unless opposed by the state, if substantially the same allegations or transactions as alleged in the action or claim were publicly disclosed in any of the following ways:

SB70-SSA2-SA4,148,11 (a) In a federal criminal, civil, or administrative hearing in which the state or its agent is a party.

SB70-SSA2-SA4,148,13 (b) In a congressional, government accountability office, or other federal report, hearing, audit, or investigation.

SB70-SSA2-SA4,148,14 (c) From the news media.

SB70-SSA2-SA4,148,16 (13) The state is not liable for any expenses incurred by a private person in bringing an action under sub. (5).

SB70-SSA2-SA4,149,6 (14) Any employee, contractor, or agent who is discharged, demoted, suspended, threatened, harassed, or in any other manner discriminated against in the terms and conditions of employment because of lawful actions taken by the employee, contractor, or agent or by others in furtherance of an action or claim filed under this section or on behalf of the employee, contractor, or agent, including investigation for, initiation of, testimony for, or assistance in an action or claim filed or to be filed under sub. (5), is entitled to all necessary relief to make the employee, contractor, or agent whole. Such relief shall in each case include reinstatement with the same seniority status that the employee, contractor, or agent would have had but for the discrimination, 2 times the amount of back pay, interest on the back pay at the legal rate, and compensation for any special damages sustained as a result of the discrimination, including costs and reasonable attorney fees. An employee, contractor, or agent may bring an action to obtain the relief to which the employee, contractor, or agent is entitled under this subsection within 3 years after the date the retaliation occurred.

SB70-SSA2-SA4,149,9 (15) A civil action may be brought under sub. (5) based upon acts occurring prior to the effective date of this subsection .... [LRB inserts date], if the action is brought within the period specified in s. 893.9815.

SB70-SSA2-SA4,149,13 (16) A judgment of guilty entered against a defendant in a criminal action in which the defendant is charged with fraud or making false statements estops the defendant from denying the essential elements of the offense in any action under sub. (5) that involves the same elements as in the criminal action.

SB70-SSA2-SA4,149,15 (17) The remedies provided for under this section are in addition to any other remedies provided for under any other law or available under the common law.

SB70-SSA2-SA4,149,18 (18) This section shall be liberally construed and applied to promote the public interest and to effect the congressional intent in enacting 31 USC 3729 to 3733, as reflected in the federal False Claims Act and the legislative history of the act.

SB70-SSA2-SA4,169 Section 169. 49.485 of the statutes is renumbered 20.9315 (19) and amended to read:

SB70-SSA2-SA4,150,2 20.9315 (19) Whoever knowingly presents or causes to be presented to any officer, employee, or agent of this state a false claim for medical assistance shall forfeit not less than $5,000 nor more than $10,000, plus 3 times the amount of the damages that were sustained by the state or would have been sustained by the state, whichever is greater, as a result of the false claim. The attorney general may bring an action on behalf of the state to recover any forfeiture incurred under this section.

SB70-SSA2-SA4,170 Section 170. 165.25 (11m) of the statutes is created to read:

SB70-SSA2-SA4,150,6 165.25 (11m) False claims. Diligently investigate possible violations of s. 20.9315 and, if the department determines that a person has committed an act that is punishable under s. 20.9315, may bring a civil action against that person.

SB70-SSA2-SA4,171 Section 171. 801.02 (1) of the statutes is amended to read:

SB70-SSA2-SA4,150,12 801.02 (1) A Except as provided in s. 20.9315 (5) (b), a civil action in which a personal judgment is sought is commenced as to any defendant when a summons and a complaint naming the person as defendant are filed with the court, provided service of an authenticated copy of the summons and of the complaint is made upon the defendant under this chapter within 90 days after filing.

SB70-SSA2-SA4,172 Section 172 . 803.09 (1) of the statutes is amended to read:

SB70-SSA2-SA4,150,19 803.09 (1) Upon Except as provided in s. 20.9315, upon timely motion anyone shall be permitted to intervene in an action when the movant claims an interest relating to the property or transaction which is the subject of the action and the movant is so situated that the disposition of the action may as a practical matter impair or impede the movant's ability to protect that interest, unless the movant's interest is adequately represented by existing parties.

SB70-SSA2-SA4,173 Section 173 . 803.09 (2) of the statutes is amended to read:

SB70-SSA2-SA4,151,5 803.09 (2) Upon Except as provided in s. 20.9315, upon timely motion anyone may be permitted to intervene in an action when a movant's claim or defense and the main action have a question of law or fact in common. When a party to an action relies for ground of claim or defense upon any statute or executive order or rule administered by a federal or state governmental officer or agency or upon any regulation, order, rule, requirement or agreement issued or made pursuant to the statute or executive order, the officer or agency upon timely motion may be permitted to intervene in the action. In exercising its discretion the court shall consider whether the intervention will unduly delay or prejudice the adjudication of the rights of the original parties.

SB70-SSA2-SA4,174 Section 174. 804.01 (2) (intro.) of the statutes is amended to read:

SB70-SSA2-SA4,151,9 804.01 (2) Scope of discovery. (intro.) Unless Except as provided in s. 20.9315 (9), and unless otherwise limited by order of the court in accordance with the provisions of this chapter, the scope of discovery is as follows:

SB70-SSA2-SA4,175 Section 175. 805.04 (1) of the statutes is amended to read:

SB70-SSA2-SA4,151,18 805.04 (1) By plaintiff; by stipulation. An Except as provided in sub. (2p), an action may be dismissed by the plaintiff without order of court by serving and filing a notice of dismissal at any time before service by an adverse party of responsive pleading or motion or by the filing of a stipulation of dismissal signed by all parties who have appeared in the action. Unless otherwise stated in the notice of dismissal or stipulation, the dismissal is not on the merits, except that a notice of dismissal operates as an adjudication on the merits when filed by a plaintiff who has once dismissed in any court an action based on or including the same claim.

SB70-SSA2-SA4,176 Section 176. 805.04 (2p) of the statutes is created to read:

SB70-SSA2-SA4,151,23 805.04 (2p) False claims. An action filed under s. 20.9315 may be dismissed only by order of the court. In determining whether to dismiss the action filed under s. 20.9315, the court shall take into account the best interests of the parties and the purposes of s. 20.9315.

SB70-SSA2-SA4,177 Section 177. 893.9815 of the statutes is created to read:

SB70-SSA2-SA4,152,3 893.9815 False claims. An action or claim under s. 20.9315 shall be commenced within 10 years after the cause of the action or claim accrues or be barred.”.

SB70-SSA2-SA4,152,4 187. Page 374, line 11: after that line insert:

SB70-SSA2-SA4,152,5 “ Section 9119. Nonstatutory provisions; Health Services.

SB70-SSA2-SA4,152,6 (4u) Complex patient pilot program.

SB70-SSA2-SA4,152,7 (a) In this subsection, “department” means the department of health services.

SB70-SSA2-SA4,152,12 (b) The department shall form an advisory group to assist with development and implementation of a complex patient pilot program. The secretary of health services, or his or her designee, shall be the chair of the advisory group. Members of the advisory group under this paragraph shall have clinical, financial, or administrative expertise in government programs, acute care, or post-acute care.

SB70-SSA2-SA4,152,15 (c) The department shall use its request-for-proposal procedure to select partnership groups to be designated as participating sites for the complex patient pilot program under this subsection.

SB70-SSA2-SA4,152,21 (d) The advisory group formed under this subsection shall develop a request for proposal for the complex patient pilot program that includes eligibility requirements. For purposes of the pilot program under this subsection, only partnerships of hospitals and post-acute facilities are eligible to submit proposals. An eligible partnership shall include at least one hospital and at least one post-acute facility, but may include more than one hospital or post-acute facility.

SB70-SSA2-SA4,152,24 (e) Each partnership group that applies to the department to be designated as a site for the complex patient pilot program shall specifically address all of the following issues:

SB70-SSA2-SA4,153,1 1. The number of beds that would be set aside in the post-acute facility.

SB70-SSA2-SA4,153,3 2. The goals of the partnership during the pilot program and after the pilot program.

SB70-SSA2-SA4,153,4 3. The types of complex patients for whom care would be provided.

SB70-SSA2-SA4,153,6 4. Expertise to successfully implement the proposal, including a discussion of at least all of the following issues:

SB70-SSA2-SA4,153,7 a. Experience of the partners working together.

SB70-SSA2-SA4,153,8 b. Plan for staffing the unit.

SB70-SSA2-SA4,153,9 c. Ability to electronically exchange health information.

SB70-SSA2-SA4,153,10 d. Clinical expertise.

SB70-SSA2-SA4,153,11 e. Hospital and post-acute facility survey history over the past 3 years.

SB70-SSA2-SA4,153,12 f. Acute care partner readmissions history over the past 3 years.

SB70-SSA2-SA4,153,13 g. Discharge planning and patient intake resources.

SB70-SSA2-SA4,153,18 h. Stability of finances to support the proposal, including matching funds that could be dedicated to the pilot program under this subsection. No applicant is required to provide matching funds or a contribution, but the advisory group and the department of health services may take into consideration the availability of matching funds or a contribution in evaluating an application.

SB70-SSA2-SA4,153,20 5. The per diem rate requested to adequately compensate the hospital or hospitals and the post-acute facility or facilities.

SB70-SSA2-SA4,153,21 6. A post-acute bed reserve rate.

SB70-SSA2-SA4,153,23 7. Anticipated impediments to successful implementation and how the applicant partnership group intends to overcome the anticipated impediments.

SB70-SSA2-SA4,153,24 (f) The advisory group formed under this subsection shall do all of the following:

SB70-SSA2-SA4,154,4 1. Determine and recommend to the department an amount of the funding budgeted for the complex patient pilot program under s. 20.435 (7) (d) to be reserved for reconciliation to ensure that participants in the pilot program are held harmless from unanticipated financial loss.

SB70-SSA2-SA4,154,11 2. Develop a methodology to evaluate the complex patient pilot program, including a recommendation on whether the department should contract with an independent organization to evaluate the complex patient pilot program. The department may contract with an independent organization to complete the evaluation described under this subdivision and, if the department does so, the department may pay the fee of the organization selected from the appropriation under s. 20.435 (7) (d).

SB70-SSA2-SA4,154,14 3. Make recommendations to the secretary of health services regarding which partnership groups should receive designation as a participating site for the complex patient pilot program.

SB70-SSA2-SA4,154,18 (g) 1. No later than 90 days after the effective date of this subdivision, the advisory group shall complete development of the request for proposal for partnership groups to be designated as participating sites in the complex patient pilot program and provide its recommendations to the secretary of health services.

SB70-SSA2-SA4,154,23 2. No later than 150 days after the effective date of this subdivision, the advisory group shall review all applications submitted in response to the request for proposal and select up to 4 partnership groups to recommend to the secretary of health services for designation as participating sites for the complex patient pilot program under this subsection.

SB70-SSA2-SA4,155,7 3. Between 6 months and 18 months after the effective date of this subdivision, the partnership groups designated by the department as participating sites in the complex patient pilot program shall implement the pilot program and meet quarterly with both the department and the advisory group or any independent organization hired by the department for the purpose of evaluating the pilot program to discuss experiences relating to the pilot program. From the appropriation under s. 20.435 (7) (d), the department shall provide payments to partnership groups designated as participating sites for care provided during the course of the pilot program under this subsection.

SB70-SSA2-SA4,155,12 4. No later than June 30, 2025, the advisory group or any independent organization hired by the department for the purpose of evaluating the complex patient pilot program shall complete and submit to the secretary of health services an evaluation of the complex patient pilot program under this subsection, including a written report and recommendations.

SB70-SSA2-SA4,9419 Section 9419. Effective dates; Health Services.

SB70-SSA2-SA4,155,15 (1u) Complex patient pilot program. The repeal of s. 20.435 (7) (d) takes effect on July 1, 2025.”.

SB70-SSA2-SA4,155,16 188. Page 374, line 11: after that line insert:

SB70-SSA2-SA4,155,18 “ Section 178. 49.45 (41) (a) of the statutes is renumbered 49.45 (41) (a) (intro.) and amended to read:

SB70-SSA2-SA4,155,21 49.45 (41) (a) (intro.) In this subsection, “crisis intervention services" means crisis intervention services for the treatment of mental illness, intellectual disability, substance abuse, and dementia that are provided by a any of the following:

SB70-SSA2-SA4,155,23 2. A crisis intervention program operated by, or under contract with, a county, if the county is certified as a medical assistance provider.

SB70-SSA2-SA4,179 Section 179. 49.45 (41) (a) 1. of the statutes is created to read:

SB70-SSA2-SA4,156,2 49.45 (41) (a) 1. A crisis urgent care and observation facility certified under s. 51.036.

SB70-SSA2-SA4,180 Section 180. 49.45 (41) (b) of the statutes is amended to read:

SB70-SSA2-SA4,156,12 49.45 (41) (b) If a county elects to become certified as a provider of crisis intervention services under par. (a) 2., the county may provide crisis intervention services under this subsection in the county to medical assistance recipients through the medical assistance program. A county that elects to provide the services shall pay the amount of the allowable charges for the services under the medical assistance program that is not provided by the federal government. The department shall reimburse the county under this subsection only for the amount of the allowable charges for those services under the medical assistance program that is provided by the federal government.

SB70-SSA2-SA4,181 Section 181. 49.45 (41) (c) (intro.) of the statutes is amended to read:

SB70-SSA2-SA4,156,17 49.45 (41) (c) (intro.) Notwithstanding par. (b), if a county elects, pursuant to par. (a) 2., to deliver crisis intervention services under the Medical Assistance program on a regional basis according to criteria established by the department, all of the following apply: