AB43: Bill Text

AB43,3025 Section 3025. 460.10 (1) (a) of the statutes is amended to read:

AB43,,8338 460.10 (1) (a) Requirements and procedures for a license holder to complete continuing education programs or courses of study to qualify for renewal of his or her license. The rules promulgated under this paragraph may not require a license holder to complete more than 24 hours of continuing education programs or courses of study in order to qualify for renewal of his or her license per 2-year period.

AB43,3026 Section 3026. 462.02 (2) (d) of the statutes is amended to read:

AB43,,8340 462.02 (2) (d) A dentist licensed under s. 447.04 (1), a dental therapist licensed under s. 447.04 (1m), a dental hygienist licensed under s. 447.04 (2), a person certified as an expanded function dental auxiliary under s. 447.04 (3), or a person under the direct supervision of a dentist.

AB43,3027 Section 3027. 462.04 of the statutes, as affected by 2021 Wisconsin Act 251, is amended to read:

AB43,,8342 462.04 Prescription or order required. A person who holds a license or limited X-ray machine operator permit under this chapter may not use diagnostic X-ray equipment on humans for diagnostic purposes unless authorized to do so by prescription or order of a physician licensed under s. 448.04 (1) (a), a naturopathic doctor licensed under s. 466.04 (1), a dentist licensed under s. 447.04 (1), a dental therapist licensed under s. 447.04 (1m), a podiatrist licensed under s. 448.63, a chiropractor licensed under s. 446.02, an advanced practice nurse certified under s. 441.16 (2), a physician assistant licensed under s. 448.974, or, subject to s. 448.56 (7) (a), a physical therapist who is licensed under s. 448.53 or who holds a compact privilege under subch. XI of ch. 448.

AB43,3028 Section 3028. 462.04 of the statutes, as affected by 2021 Wisconsin Act 251 and 2023 Wisconsin Act .... (this act), is amended to read:

AB43,,8344 462.04 Prescription or order required. A person who holds a license or limited X-ray machine operator permit under this chapter may not use diagnostic X-ray equipment on humans for diagnostic purposes unless authorized to do so by prescription or order of a physician licensed under s. 448.04 (1) (a), a naturopathic doctor licensed under s. 466.04 (1), a dentist licensed under s. 447.04 (1), a dental therapist licensed under s. 447.04 (1m), a podiatrist licensed under s. 448.63, a chiropractor licensed under s. 446.02, an advanced practice registered nurse certified licensed under s. 441.16 (2) 441.09, a physician assistant licensed under s. 448.974, or, subject to s. 448.56 (7) (a), a physical therapist who is licensed under s. 448.53 or who holds a compact privilege under subch. XI of ch. 448.

****Note: This is reconciled s. 462.04. This Section has been affected by drafts with the following LRB numbers: -1105/P2 and -1910/P2.

AB43,3029 Section 3029. 462.05 (1) of the statutes is amended to read:

AB43,,8346 462.05 (1) The renewal date for licenses and limited X-ray machine operator permits granted under this chapter is specified in shall be as determined by the department under s. 440.08 (2) (a). Renewal applications shall be submitted to the department on a form provided by the department and shall include the renewal fee determined by the department under s. 440.03 (9) (a).

AB43,3030 Section 3030. 463.10 (5) of the statutes is amended to read:

AB43,,8348 463.10 (5) Exception. Subsections (2) to (4m) do not apply to a dentist who is licensed under s. 447.03 (1) or to a , dental therapist, or physician who tattoos or offers to tattoo a person in the course of the dentist’s, dental therapist’s, or physician’s professional practice.

AB43,3031 Section 3031. 463.12 (5) of the statutes is amended to read:

AB43,,8350 463.12 (5) Exception. Subsections (2) to (4m) do not apply to a dentist who is licensed under s. 447.03 (1) or to a , dental therapist, or physician who pierces the body of or offers to pierce the body of a person in the course of the dentist’s, dental therapist’s, or physician’s professional practice.

AB43,3032 Section 3032. 466.04 (3) (a) (intro.) of the statutes is amended to read:

AB43,,8352 466.04 (3) (a) (intro.) The renewal date for licenses granted under this chapter is specified shall be as determined by the department under s. 440.08 (2) (a). Renewal applications shall be submitted to the department on a form provided by the department. The application shall include all of the following in order for the license to be renewed:

AB43,3033 Section 3033. 470.045 (3) (b) of the statutes is amended to read:

AB43,,8354 470.045 (3) (b) The renewal date for certificates of authorization under this section is specified shall be as determined by the department under s. 440.08 (2) (a), and the renewal fee for such certificates is determined by the department under s. 440.03 (9) (a).

AB43,3034 Section 3034. 470.07 of the statutes is amended to read:

AB43,,8356 470.07 Renewal of licenses. The renewal dates for licenses granted under this chapter are specified shall be as determined by the department under s. 440.08 (2) (a). Renewal applications shall be submitted to the department on a form provided by the department and shall include the renewal fee determined by the department under s. 440.03 (9) (a) and evidence satisfactory to the appropriate section of the examining board that the applicant has completed any continuing education requirements specified in rules promulgated under s. 470.03 (2).

AB43,3035 Section 3035. 480.08 (5) of the statutes is amended to read:

AB43,,8358 480.08 (5) Expiration and renewal. The renewal date for certificates granted under this chapter, other than temporary certificates granted under sub. (7), is specified shall be as determined by the department under s. 440.08 (2) (a), and the renewal fee for certificates granted under this chapter, other than temporary certificates granted under sub. (7), is determined by the department under s. 440.03 (9) (a). Renewal applications shall include evidence satisfactory to the department that the applicant holds a current permit issued under s. 77.52 (9). A renewal application for an auctioneer certificate shall be accompanied by proof of completion of continuing education requirements under sub. (6).

AB43,3036 Section 3036. 601.31 (1) (mv) of the statutes is created to read:

AB43,,8360 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.

AB43,3037 Section 3037. 601.31 (1) (nv) of the statutes is created to read:

AB43,,8362 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.

AB43,3038 Section 3038. 601.31 (1) (nw) of the statutes is created to read:

AB43,,8364 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.

AB43,3039 Section 3039. 601.41 (13) of the statutes is created to read:

AB43,,8366 601.41 (13) Value-based diabetes medication pilot project. The commissioner shall develop a pilot project to direct a pharmacy benefit manager, as defined in s. 632.865 (1) (c), and a pharmaceutical manufacturer to create a value-based, sole-source arrangement to reduce the costs of prescription medication used to treat diabetes. The commissioner may promulgate rules to implement this subsection.

AB43,3040 Section 3040. 601.575 of the statutes is created to read:

AB43,,8368 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:

AB43,,8369 (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.

AB43,,8370 (b) The program shall comply with relevant requirements of 21 USC 384, including safety and cost savings requirements.

AB43,,8371 (c) The program shall import prescription drugs from Canadian suppliers regulated under any appropriate Canadian or provincial laws.

AB43,,8372 (d) The program shall have a process to sample the purity, chemical composition, and potency of imported prescription drugs.

AB43,,8373 (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.

AB43,,8374 (f) The commissioner shall ensure that prescription drugs imported under the program are not distributed, dispensed, or sold outside of this state.

AB43,,8375 (g) The program shall ensure all of the following:

AB43,,8376 1. Participation by any pharmacy or health care provider in the program is voluntary.

AB43,,8377 2. Any pharmacy or health care provider participating in the program has the appropriate license or other credential in this state.

AB43,,8378 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.

AB43,,8379 (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.

AB43,,8380 (i) The program shall ensure that any health plan or health insurance policy participating in the program does all of the following:

AB43,,8381 1. Maintains a formulary and claims payment system with current information on prescription drugs imported under the program.

AB43,,8382 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.

AB43,,8383 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.

AB43,,8384 (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.

AB43,,8385 (k) The program may not import any generic prescription drug that would violate federal patent laws on branded products in the United States.

AB43,,8386 (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.

AB43,,8387 (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.

AB43,,8388 (n) The program shall have an audit function that ensures all of the following:

AB43,,8389 1. The commissioner has a sound methodology to determine the most cost-effective prescription drugs to include in the program.

AB43,,8390 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.

AB43,,8391 3. Prescription drugs imported under the program are pure, unadulterated, potent, and safe.

AB43,,8392 4. The program is complying with the requirements of this subsection.

AB43,,8393 5. The program is adequately financed to support administrative functions of the program while generating significant cost savings to residents of this state.

AB43,,8394 6. The program does not put residents of this state at a higher risk than if the program did not exist.

AB43,,8395 7. The program provides and is projected to continue to provide substantial cost savings to residents of this state.

AB43,,8396 (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.

AB43,,8397 (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.

AB43,,8398 (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:

AB43,,8399 (a) Become a licensed wholesale distributor, designate another state agency to become a licensed wholesale distributor, or contract with a licensed wholesale distributor.

AB43,,8400 (b) Contract with one or more Canadian suppliers that meet the criteria in sub. (1) (c) and (n).

AB43,,8401 (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.

AB43,,8402 (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.

AB43,,8403 (e) Create a publicly accessible source for listing prices of prescription drugs imported under the program.

AB43,,8404 (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.

AB43,,8405 (g) Establish the audit functions under sub. (1) (n) with a timeline to complete each audit function every 2 years.

AB43,,8406 (h) Conduct any other activities determined by the commissioner to be important to successful implementation of the program.

AB43,,8407 (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:

AB43,,8408 (a) A list of prescription drugs included in the prescription drug importation program under this section.

AB43,,8409 (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.

AB43,,8410 (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.

AB43,,8411 (d) Findings of any audit functions under sub. (1) (n) completed since the date of the previous report under this subsection.

AB43,,8412 (6) Rulemaking. The commissioner may promulgate any rules necessary to implement this section.

AB43,3041 Section 3041. 601.59 of the statutes is created to read:

AB43,,8414 601.59 State-based exchange. (1) Definitions. In this section:

AB43,,8415 (a) “Exchange” has the meaning given in 45 CFR 155.20.

AB43,,8416 (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.

AB43,,8417 (c) “State-based exchange without the federal platform” means an exchange, other than one described in 45 CFR 155.200 (f), that performs all the functions described in 45 CFR 155.200 (a) and is approved by the federal secretary of health and human services under 45 CFR 155.106.

AB43,,8418 (2) Establishment and operation of state-based exchange. The commissioner shall establish and operate an exchange that at first is a state-based exchange on the federal platform and then subsequently transitions to a state-based exchange without the federal platform. The commissioner shall develop procedures to address the transition from the state-based exchange on the federal platform to the state-based exchange without the federal platform, including the circumstances that shall be met in order for the transition to occur.

AB43,,8419 (3) Agreement with federal government. The commissioner may enter into any agreement with the federal government necessary to facilitate the implementation of this section.

AB43,,8420 (4) User fees. The commissioner shall impose a user fee, as authorized under 45 CFR 155.160 (b) (1), on each insurer that offers a health plan through the state-based exchange on the federal platform or the state-based exchange without the federal platform. The user fee shall be applied at one of the following rates on the total monthly premiums charged by an insurer for each policy under the plan for which enrollment is through the exchange:

AB43,,8421 (a) For any plan year for which the commissioner operates a state-based exchange on the federal platform, the rate is 0.5 percent.

AB43,,8422 (b) For the first 2 plan years for which the commissioner operates a state-based exchange without the federal platform, the rate is equal to the user fee rate the federal department of health and human services specifies under 45 CFR 156.50 (c) (1) for the federally facilitated exchanges for the applicable plan year.

AB43,,8423 (c) Beginning with the 3rd plan year for which the commissioner operates a state-based exchange without the federal platform and for each plan year thereafter, the rate shall be set by the commissioner by rule.

AB43,,8424 (5) Rules. The commissioner may promulgate rules necessary to implement this section.