Amendment AA8-ASA2-AB50

AB50-ASA2-AA8,47,6 d. Maternity and newborn care.

AB50-ASA2-AA8,47,8 e. Mental health and substance use disorder services, including behavioral health treatment.

AB50-ASA2-AA8,47,9 f. Prescription drugs.

AB50-ASA2-AA8,47,10 g. Rehabilitative and habilitative services and devices.

AB50-ASA2-AA8,47,11 h. Laboratory services.

AB50-ASA2-AA8,47,12 i. Preventive and wellness services and chronic disease management.

AB50-ASA2-AA8,47,13 j. Pediatric services, including oral and vision care.

AB50-ASA2-AA8,47,18 2. Conduct a survey of employer-sponsored coverage to determine benefits typically covered by employers and ensure that the scope of essential health benefits for which coverage is required under this subsection is equal to the scope of benefits covered under a typical disability insurance policy offered by an employer to its employees.

AB50-ASA2-AA8,47,21 3. Ensure that essential health benefits reflect a balance among the categories described in subd. 1. such that benefits are not unduly weighted toward one category.

AB50-ASA2-AA8,47,23 4. Ensure that essential health benefit coverage is provided with no or limited cost-sharing requirements.

AB50-ASA2-AA8,48,4 5. Require that disability insurance policies and self-insured health plans do not make coverage decisions, determine reimbursement rates, establish incentive programs, or design benefits in ways that discriminate against individuals because of their age, disability, or expected length of life.

AB50-ASA2-AA8,48,7 6. Establish essential health benefits in a way that takes into account the health care needs of diverse segments of the population, including women, children, persons with disabilities, and other groups.

AB50-ASA2-AA8,48,11 7. Ensure that essential health benefits established under this subsection are not subject to a coverage denial based on an insured’s or plan participant’s age, expected length of life, present or predicted disability, degree of dependency on medical care, or quality of life.

AB50-ASA2-AA8,48,18 8. Require that disability insurance policies and self-insured health plans cover emergency department services that are essential health benefits without imposing any requirement to obtain prior authorization for those services and without limiting coverage for services provided by an emergency services provider that is not in the provider network of a policy or plan in a way that is more restrictive than requirements or limitations that apply to emergency services provided by a provider that is in the provider network of the policy or plan.

AB50-ASA2-AA8,48,23 9. Require a disability insurance policy or self-insured health plan to apply to emergency department services that are essential health benefits provided by an emergency department provider that is not in the provider network of the policy or plan the same copayment amount or coinsurance rate that applies if those services are provided by a provider that is in the provider network of the policy or plan.

AB50-ASA2-AA8,49,2 (d) The commissioner shall periodically update, by rule, the essential health benefits under this subsection to address any gaps in access to coverage.

AB50-ASA2-AA8,49,7 (e) If an essential health benefit is also subject to mandated coverage elsewhere under this section and the coverage requirements are not identical, the disability insurance policy or self-insured health plan shall provide coverage under whichever subsection provides the insured or plan participant with more comprehensive coverage of the medical condition, item, or service.

AB50-ASA2-AA8,49,11 (f) Nothing in this subsection or rules promulgated under this subsection prohibits a disability insurance policy or a self-insured health plan from providing benefits in excess of the essential health benefit coverage required under this subsection.

AB50-ASA2-AA8,49,13 (g) This subsection does not apply to any disability insurance policy that is described in s. 632.745 (11) (b) 1. to 12.

AB50-ASA2-AA8,56 Section 56. 632.895 (16m) (b) of the statutes is amended to read:

AB50-ASA2-AA8,49,19 632.895 (16m) (b) The coverage required under this subsection may be subject to any limitations, or exclusions, or cost-sharing provisions that apply generally under the disability insurance policy or self-insured health plan. The coverage required under this subsection may not be subject to any deductibles, copayments, or coinsurance.

AB50-ASA2-AA8,57 Section 57. 632.895 (17) (b) 2. of the statutes is amended to read:

AB50-ASA2-AA8,50,2 632.895 (17) (b) 2. Outpatient consultations, examinations, procedures, and medical services that are necessary to prescribe, administer, maintain, or remove a contraceptive, if covered for any other drug benefits under the policy or plan sterilization procedures, and patient education and counseling for all females with reproductive capacity.

AB50-ASA2-AA8,58 Section 58. 632.895 (17) (c) of the statutes is amended to read:

AB50-ASA2-AA8,50,18 632.895 (17) (c) Coverage under par. (b) may be subject only to the exclusions, and limitations, or cost-sharing provisions that apply generally to the coverage of outpatient health care services, preventive treatments and services, or prescription drugs and devices that is provided under the policy or self-insured health plan. A disability insurance policy or self-insured health plan may not apply a deductible or impose a copayment or coinsurance to at least one of each type of contraceptive method approved by the federal food and drug administration for which coverage is required under this subsection. The disability insurance policy or self-insured health plan may apply reasonable medical management to a method of contraception to limit coverage under this subsection that is provided without being subject to a deductible, copayment, or coinsurance to prescription drugs without a brand name. The disability insurance policy or self-insured health plan may apply a deductible or impose a copayment or coinsurance for coverage of a contraceptive that is prescribed for a medical need if the services for the medical need would otherwise be subject to a deductible, copayment, or coinsurance.

AB50-ASA2-AA8,59 Section 59. 632.897 (11) (a) of the statutes is amended to read:

AB50-ASA2-AA8,51,5 632.897 (11) (a) Notwithstanding subs. (2) to (10), the commissioner may promulgate rules establishing standards requiring insurers to provide continuation of coverage for any individual covered at any time under a group policy who is a terminated insured or an eligible individual under any federal program that provides for a federal premium subsidy for individuals covered under continuation of coverage under a group policy, including rules governing election or extension of election periods, notice, rates, premiums, premium payment, application of preexisting condition exclusions, election of alternative coverage, and status as an eligible individual, as defined in s. 149.10 (2t), 2011 stats.

AB50-ASA2-AA8,9323 Section 9323. Initial applicability; Insurance.

AB50-ASA2-AA8,51,8 (1) Coverage of individuals with preexisting conditions, essential health benefits, and preventive services.

AB50-ASA2-AA8,51,15 (a) For policies and plans containing provisions inconsistent with these sections, the treatment of ss. 632.728, 632.746 (1) (a) and (b), (2) (a), (c), (d), and (e), (3) (a) and (d) 1., 2., and 3., (5), and (8) (a) (intro.), 632.748 (2), 632.76 (2) (a) and (ac) 1. and 2., 632.795 (4) (a), 632.895 (8) (d), (13m), (14) (a) 1. i., j., and k. to o., (b), (c), and (d) 3., (14m), (16m) (b), and (17) (b) 2. and (c), and 632.897 (11) (a) first applies to policy or plan years beginning on January 1 of the year following the year in which this paragraph takes effect, except as provided in par. (b).

AB50-ASA2-AA8,52,2 (b) For policies and plans that are affected by a collective bargaining agreement containing provisions inconsistent with these sections, the treatment of ss. 632.728, 632.746 (1) (a) and (b), (2) (a), (c), (d), and (e), (3) (a) and (d) 1., 2., and 3., (5), and (8) (a) (intro.), 632.748 (2), 632.76 (2) (a) and (ac) 1. and 2., 632.795 (4) (a), 632.895 (8) (d), (13m), (14) (a) 1. i., j., and k. to o., (b), (c), and (d) 3., (14m), (16m) (b), and (17) (b) 2. and (c), and 632.897 (11) (a) first applies to policy or plan years beginning on the effective date of this paragraph or on the day on which the collective bargaining agreement is entered into, extended, modified, or renewed, whichever is later.

AB50-ASA2-AA8,9423 Section 9423. Effective dates; Insurance.

AB50-ASA2-AA8,52,10 (1) Coverage of individuals with preexisting conditions, essential health benefits, and preventive services. The treatment of ss. 632.728, 632.746 (1) (a) and (b), (2) (a), (c), (d), and (e), (3) (a) and (d) 1., 2., and 3., (5), and (8) (a) (intro.), 632.748 (2), 632.76 (2) (a) and (ac) 1. and 2., 632.795 (4) (a), 632.895 (8) (d), (13m), (14) (a) 1. i., j., and k. to o., (b), (c), and (d) 3., (14m), (16m) (b), and (17) (b) 2. and (c), and 632.897 (11) (a) and Section 9323 (1) of this act take effect on the first day of the 4th month beginning after publication.”.

AB50-ASA2-AA8,52,11 13. At the appropriate places, insert all of the following:

AB50-ASA2-AA8,52,12 “Section 60. 20.145 (1) (g) 5. of the statutes is created to read:

AB50-ASA2-AA8,52,16 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.”.

AB50-ASA2-AA8,52,17 14. At the appropriate places, insert all of the following:

AB50-ASA2-AA8,52,18 “Section 61. 231.03 (6) (L) of the statutes is created to read:

AB50-ASA2-AA8,52,23 231.03 (6) (L) Finance working capital needs of any participating health institution, participating educational institution, participating nonprofit institution, or participating research institution in an amount not to exceed that approved by the authority. Bonds issued for purposes of this paragraph are not exempt from taxation under s. 71.05 (1) (c) 14., 71.26 (1m) (o), or 71.45 (1t) (n).

AB50-ASA2-AA8,62 Section 62. 231.03 (13) of the statutes is amended to read:

AB50-ASA2-AA8,53,16 231.03 (13) Make loans to any participating health institution, participating educational institution, participating nonprofit institution, or participating research institution for the cost of a project or to finance working capital under sub. (6) (L) in accordance with an agreement between the authority and the participating health institution, participating educational institution, participating nonprofit institution, or participating research institution. The authority may secure the loan by a mortgage or other security arrangement on the health facility, educational facility, nonprofit facility, or research facility granted by the participating health institution, participating educational institution, participating nonprofit institution, or participating research institution to the authority. The loan may not exceed, as applicable, the total cost of the project as determined by the participating health institution, participating educational institution, participating nonprofit institution, or participating research institution and approved by the authority or the amount of working capital approved by the authority under sub. (6) (L).”.

AB50-ASA2-AA8,53,17 15. At the appropriate places, insert all of the following:

AB50-ASA2-AA8,53,18 “Section 63. 13.48 (26m) of the statutes is created to read:

AB50-ASA2-AA8,53,24 13.48 (26m) Lead service line replacement. The legislature finds and determines that the prevalence of lead service lines in connections to public water systems poses a public health hazard and that processes for reducing lead entering drinking water from such pipes requires additional treatment of wastewater. It is therefore in the public interest, and it is the public policy of this state, to assist private users of public water systems in replacing lead service lines.

AB50-ASA2-AA8,64 Section 64. 20.005 (3) (schedule) of the statutes: at the appropriate place, insert the following amounts for the purposes indicated:

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AB50-ASA2-AA8,65 Section 65. 20.320 (2) (a) of the statutes is created to read:

AB50-ASA2-AA8,54,10 20.320 (2) (a) Lead service line replacement. As a continuing appropriation, the amounts in the schedule for lead service line replacement loans under s. 281.61 (8) (b).

AB50-ASA2-AA8,66 Section 66. 281.61 (8) (b) of the statutes is created to read:

AB50-ASA2-AA8,54,14 281.61 (8) (b) The department of administration shall allocate the amount appropriated under s. 20.320 (2) (a) to projects involving forgivable loans to private users of public water systems to replace lead service lines.”.

AB50-ASA2-AA8,54,15 16. At the appropriate places, insert all of the following:

AB50-ASA2-AA8,54,16 “Section 9248. Fiscal changes; Veterans Affairs.

AB50-ASA2-AA8,55,3 (1) Veterans outreach and recovery program. In the schedule under s. 20.005 (3) for the appropriation to the department of veterans affairs under s. 20.485 (2) (qs), the dollar amount for fiscal year 2025-26 is increased by $512,900 to increase the authorized FTE positions to the department of veterans affairs by 7.0 SEG positions to increase services under the veterans outreach and recovery program. In the schedule under s. 20.005 (3) for the appropriation to the department of veterans affairs under s. 20.485 (2) (qs), the dollar amount for fiscal year 2026-27 is increased by $602,800 to provide funding for the positions authorized under this subsection to increase services under the veterans outreach and recovery program.”.

AB50-ASA2-AA8,55,4 17. At the appropriate places, insert all of the following:

AB50-ASA2-AA8,55,11 “Section 1. 20.005 (3) (schedule) of the statutes: at the appropriate place, insert the following amounts for the purposes indicated:

- See PDF for table

AB50-ASA2-AA8,2 Section 2. 20.435 (4) (bu) of the statutes is created to read:

AB50-ASA2-AA8,55,16 20.435 (4) (bu) Payment processing program for farmers. Biennially, the amounts in the schedule to provide electronic benefit transfer and credit and debit card processing equipment and services to farmers’ markets and farmers who sell directly to consumers under s. 49.79 (7s).

AB50-ASA2-AA8,3 Section 3. 49.79 (7s) of the statutes is created to read:

AB50-ASA2-AA8,56,2 49.79 (7s) Payment processing program. The department shall administer a payment processing program to provide to farmers’ markets and farmers who sell directly to consumers electronic benefit transfer and credit and debit card processing equipment and services, including electronic benefit transfer for the food stamp program. To participate in the payment processing program, the vendor that is under contract to process the electronic benefit transfer and credit and debit card transactions shall also process any local purchasing incentives, even if those local purchasing incentives are funded by a local 3rd-party entity.”.

AB50-ASA2-AA8,56,3 18. At the appropriate places, insert all of the following:

AB50-ASA2-AA8,56,5 “Section 67. 20.485 (2) (vm) (title) of the statutes is repealed and recreated to read:

AB50-ASA2-AA8,56,6 20.485 (2) (vm) (title) Veterans assistance grants.

AB50-ASA2-AA8,68 Section 68. 45.40 (title) of the statutes is repealed and recreated to read:

AB50-ASA2-AA8,56,8 45.40 (title) Veterans assistance grants.

AB50-ASA2-AA8,69 Section 69. 45.40 (1g) (intro.) and (a) of the statutes are consolidated, renumbered 45.40 (1g) and amended to read:

AB50-ASA2-AA8,56,18 45.40 (1g) Definitions. In this section: (a) “Health, “health care provider” means an advanced practice nurse prescriber who is certified under s. 441.16 (2), an audiologist who is licensed under subch. II of ch. 459 or who holds a compact privilege under subch. III of ch. 459, a dentist who is licensed under subch. I of ch. 447 or who holds a compact privilege under subch. II of ch. 447, an optometrist who is licensed under ch. 449, a physician who is licensed under s. 448.02, or a podiatrist who is licensed under s. 448.63 has the meaning given in s. 146.81 (1) and includes an ambulatory surgery center.

AB50-ASA2-AA8,70 Section 70. 45.40 (1g) (b) of the statutes is repealed.

AB50-ASA2-AA8,71 Section 71. 45.40 (1m) (a) of the statutes is amended to read:

AB50-ASA2-AA8,57,12 45.40 (1m) (a) The department may provide subsistence payments to a veteran on a month-to-month basis or for a 3-month period. The department may pay subsistence aid for a 3-month period if the veteran will be incapacitated for more than 3 months and if earned or unearned income or aid from sources other than those listed in the application will not be available in the 3-month period. The department may provide subsistence payments only to a veteran who has suffered a loss of income due to illness, injury, or natural disaster. The department may grant subsistence aid under this subsection to a veteran whose loss of income is the result of abuse of alcohol or other drugs only if the veteran is participating in an alcohol and other drug abuse treatment program that is approved by the department. No payment may be made under this subsection if the veteran has other assets or income available to meet basic subsistence needs or if the veteran is eligible to receive aid from other sources to meet those needs. When determining the assets available to the veteran, the department may not include the first $50,000 of cash surrender value of any life insurance.

AB50-ASA2-AA8,72 Section 72. 45.40 (1m) (b) of the statutes is amended to read:

AB50-ASA2-AA8,57,16 45.40 (1m) (b) The maximum amount that any veteran may receive under this subsection per occurrence during a consecutive 12-month period may not exceed $3,000 $5,000.

AB50-ASA2-AA8,73 Section 73. 45.40 (2) (a) of the statutes is amended to read:

AB50-ASA2-AA8,57,21 45.40 (2) (a) The department may provide health care aid to a veteran for dental care, including dentures; vision care, including eyeglass frames and lenses; and hearing care, including hearing aids; and any other medical device prescribed by a health care provider.

AB50-ASA2-AA8,74 Section 74. 45.40 (2m) (a) of the statutes is amended to read:

AB50-ASA2-AA8,58,5 45.40 (2m) (a) The unremarried spouse and dependent children of a veteran who died on active duty, or in the line of duty while on active or inactive duty for training purposes, in the U.S. armed forces or forces incorporated in the U.S. armed forces are eligible to receive payments under subs. (1m) and (2) if the household income of those persons does not exceed the income limitations established under sub. (3m).

AB50-ASA2-AA8,75 Section 75. 45.40 (3) of the statutes is amended to read:

AB50-ASA2-AA8,58,8 45.40 (3) Limitations. The total cumulative amount that any veteran may receive under this section may not exceed $7,500 $10,000.”.

AB50-ASA2-AA8,58,9 19. At the appropriate places, insert all of the following:

AB50-ASA2-AA8,58,10 “Section 76. 36.27 (2) (b) 5. of the statutes is created to read:

AB50-ASA2-AA8,58,13 36.27 (2) (b) 5. A person who is a resident of and living in this state at the time of registering at an institution and who is a veteran described under s. 45.01 (12) (fm) is entitled to the exemption under par. (a).

AB50-ASA2-AA8,77 Section 77. 36.27 (3p) (a) 1r. g. of the statutes is created to read:

AB50-ASA2-AA8,58,16 36.27 (3p) (a) 1r. g. The person meets the criteria described under s. 45.01 (12) (fm).

AB50-ASA2-AA8,78 Section 78. 38.24 (8) (a) 1r. g. of the statutes is created to read:

AB50-ASA2-AA8,58,19 38.24 (8) (a) 1r. g. The person meets the criteria described under s. 45.01 (12) (fm).

AB50-ASA2-AA8,79 Section 79. 45.01 (12) (fm) of the statutes is created to read:

AB50-ASA2-AA8,58,22 45.01 (12) (fm) A person who resides in this state, if any of the following applies:

AB50-ASA2-AA8,59,2 1. The person was naturalized pursuant to section 2 (1) of the federal Hmong Veterans’ Naturalization Act of 2000, P.L. 106-207.

AB50-ASA2-AA8,59,7 2. The person is a U.S. citizen or a lawful permanent resident of the United States and the secretary has determined that the person served honorably with a special guerrilla unit or irregular forces operating from a base in Laos in support of the armed forces of the United States at any time during the period beginning February 28, 1961, and ending September 18, 1978.