November 8, 2023 - Introduced by Representatives Tusler, Brandtjen, Hurd, S. Johnson, Murphy, Mursau, Nedweski, Ortiz-Velez, Plumer, Sinicki and Subeck, cosponsored by Senators Testin, Felzkowski, Ballweg, Bradley, Taylor and Tomczyk. Referred to Committee on Insurance.
AB630,,22An Act to create 49.45 (9r) (f) of the statutes; relating to: reimbursement under the Medical Assistance program for complex rehabilitation technology wheelchair repairs and accessories. AB630,,33Analysis by the Legislative Reference Bureau Under current law, the Department of Health Services uses a standardized coding system produced by the federal Centers for Medicare and Medicaid Services to describe certain products, supplies, and services for those submitting claims for reimbursement under the Medical Assistance program, which is known as the Healthcare Common Procedure Coding System (HCPCS). This bill requires DHS, for HCPCS codes relating to complex rehabilitation technology wheelchair repair and accessories, to apply a reimbursement rate under the Medical Assistance program equivalent to the maximum fee paid in Wisconsin under the federal Medicare program, including fees under the KU modifier, if applicable. Under the bill, “KU modifier” means a modifier used in the federal Medicare program related to an exemption from competitive bidding pricing. The Medical Assistance program is a joint federal and state program administered by DHS that provides health services to individuals who have limited financial resources.
For further information see the state fiscal estimate, which will be printed as an appendix to this bill.
AB630,,44The people of the state of Wisconsin, represented in senate and assembly, do enact as follows: AB630,15Section 1. 49.45 (9r) (f) of the statutes is created to read: AB630,,6649.45 (9r) (f) 1. In this paragraph, “KU modifier” means a modifier used in the federal Medicare program related to an exemption from competitive bidding pricing. AB630,,772. For dates of service beginning on the effective date of this subdivision .... [LRB inserts date], the department shall, for healthcare common procedure coding system codes relating to complex rehabilitation technology wheelchair repair and accessories, apply a reimbursement rate under the Medical Assistance program equivalent to the maximum fee paid in Wisconsin under the federal Medicare program, including fees under the KU modifier, if applicable.
