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AB56-ASA1-AA2,14,1512 49.45 (24L) Critical access reimbursement payments to dental providers. (a)
13Based on the criteria in pars. (b) and (c), the department shall increase
14reimbursements to dental providers that meet quality of care standards, as
15established by the department.
AB56-ASA1-AA2,14,1716 (b) In order to be eligible for enhanced reimbursement under this subsection,
17the provider must meet one of the following qualifications:
AB56-ASA1-AA2,14,2018 1. For a nonprofit or public provider, 50 percent or more of the individuals
19served by the provider are individuals who are without dental insurance or are
20enrolled in the Medical Assistance program.
AB56-ASA1-AA2,14,2221 2. For a for-profit provider, 5 percent or more of the individuals served by the
22provider are enrolled in the Medical Assistance program.
AB56-ASA1-AA2,15,823 (c) For dental services rendered on or after January 1, 2020, by a qualified
24nonprofit critical access dental provider, the department shall increase
25reimbursement by 50 percent above the reimbursement rate that would otherwise

1be paid to that provider. For dental services rendered on or after January 1, 2020,
2by a qualified for-profit critical access dental provider, the department shall increase
3reimbursement by 30 percent above the reimbursement rate that would otherwise
4be paid to that provider. For dental providers rendering services to individuals in
5managed care under the Medical Assistance program, for services rendered on or
6after January 1, 2020, the department shall increase reimbursement to pay an
7additional amount on the basis of the rate that would have been paid to the dental
8provider had the individual not been enrolled in managed care.
AB56-ASA1-AA2,15,119 (d) If a provider has more than one service location, the thresholds described
10under par. (b) apply to each location, and payment for each service location would be
11determined separately.”.
AB56-ASA1-AA2,15,13 1263. Page 352, line 24: delete the material beginning with that line and ending
13with page 353, line 8, and substitute:
AB56-ASA1-AA2,15,23 14“49.45 (29w) (b) 1. b. “Telehealth" is means a service provided from a remote
15location using a combination of interactive video, audio, and externally acquired
16images through a networking environment between an individual or a provider at
17an originating site and a provider at a remote location with the service being of
18sufficient audio and visual fidelity and clarity as to be functionally equivalent to
19face-to-face contact; or, in circumstances determined by the department, an
20asynchronous transmission of digital clinical information through a secure
21electronic communications system from one provider to another provider
.
22“Telehealth" does not include telephone conversations or Internet-based
23communications between providers or between providers and individuals.”.
AB56-ASA1-AA2,15,24 2464. Page 353, line 9: delete that line and substitute:
AB56-ASA1-AA2,16,1
1 Section 678b. 49.45 (29y) (d) of the statutes is repealed.
AB56-ASA1-AA2,679p 2Section 679p. 49.45 (30y) of the statutes is created to read:
AB56-ASA1-AA2,16,53 49.45 (30y) Certified doula services; pilot project. (a) In this subsection,
4“certified doula" means an individual who has received certification from a doula
5certifying organization recognized by the department.
AB56-ASA1-AA2,16,86 (b) For purposes of this subsection, services provided by certified doulas include
7continuous emotional and physical support during labor and birth of a child and
8intermittent services during the prenatal and postpartum periods.
AB56-ASA1-AA2,16,139 (c) Subject to par. (d), the department shall reimburse under the Medical
10Assistance program benefits as provided under this subsection for pregnant women
11enrolled in the Medical Assistance program who reside in the counties of Brown,
12Dane, Milwaukee, Rock, or Sheboygan, or another county as determined by the
13department.
AB56-ASA1-AA2,16,1914 (d) The department shall request from the secretary of the federal department
15of health and human services any approval necessary to allow reimbursement under
16the Medical Assistance program for services provided by a certified doula. The
17department may not pay reimbursement unless federal approval is not required or
18any required federal approval allowing reimbursement under s. 49.46 (2) (b) 12p. is
19approved and in effect.”.
AB56-ASA1-AA2,16,21 2065. Page 353, line 11: delete the material beginning with that line and ending
21with page 354, line 17, and substitute:
AB56-ASA1-AA2,17,3 22“49.45 (41) Mental health crisis Crisis intervention services. (a) In this
23subsection, “mental health crisis intervention services" means crisis intervention
24services for the treatment of mental illness, intellectual disability, substance abuse,

1and dementia
that are provided by a mental health crisis intervention program
2operated by, or under contract with, a county, if the county is certified as a medical
3assistance provider.
AB56-ASA1-AA2,17,124 (b) If a county elects to become certified as a provider of mental health crisis
5intervention services, the county may provide mental health crisis intervention
6services under this subsection in the county to medical assistance recipients through
7the medical assistance program. A county that elects to provide the services shall
8pay the amount of the allowable charges for the services under the medical
9assistance program that is not provided by the federal government. The department
10shall reimburse the county under this subsection only for the amount of the allowable
11charges for those services under the medical assistance program that is provided by
12the federal government.
AB56-ASA1-AA2,681b 13Section 681b. 49.45 (41) (c) of the statutes is created to read:
AB56-ASA1-AA2,17,1614 49.45 (41) (c) Notwithstanding par. (b), if a county elects to deliver crisis
15intervention services under the Medical Assistance program on a regional basis
16according to criteria established by the department, all of the following apply:
AB56-ASA1-AA2,17,2117 1. After January 1, 2020, the department shall require the county to annually
18contribute for the crisis intervention services an amount equal to 75 percent of the
19annual average of the county's expenditures for crisis intervention services under
20this subsection in calendar years 2016, 2017, and 2018, as determined by the
21department.
AB56-ASA1-AA2,17,2522 2. The department shall reimburse the provider of crisis intervention services
23in the county the amount of allowable charges for those services under the Medical
24Assistance program, including both the federal share and nonfederal share of those
25charges, that exceeds the amount of the county contribution required under subd. 1.
AB56-ASA1-AA2,18,4
13. If a county submits a certified cost report under s. 49.45 (52) (b) to claim
2federal medical assistance funds, the claim based on certified costs made by a county
3for amounts under subd. 2. may not include any part of the nonfederal share of the
4amount under subd. 2.”.
AB56-ASA1-AA2,18,5 566. Page 355, line 6: after that line insert:
AB56-ASA1-AA2,18,6 6 Section 685b. 49.46 (1) (a) 1m. of the statutes is amended to read:
AB56-ASA1-AA2,18,107 49.46 (1) (a) 1m. Any pregnant woman whose income does not exceed the
8standard of need under s. 49.19 (11) and whose pregnancy is medically verified.
9Eligibility continues to the last day of the month in which the 60th day or, if approved
10by the federal government, the 365th day
after the last day of the pregnancy falls.”.
AB56-ASA1-AA2,18,11 1167. Page 355, line 21: after that line insert:
AB56-ASA1-AA2,18,12 12 Section 688b. 49.46 (1) (j) of the statutes is amended to read:
AB56-ASA1-AA2,18,1713 49.46 (1) (j) An individual determined to be eligible for benefits under par. (a)
149. remains eligible for benefits under par. (a) 9. for the balance of the pregnancy and
15to the last day of the month in which the 60th day or, if approved by the federal
16government, the 365th day
after the last day of the pregnancy falls without regard
17to any change in the individual's family income.”.
AB56-ASA1-AA2,18,18 1868. Page 356, line 2: after that line insert:
AB56-ASA1-AA2,18,19 19 Section 690p. 49.46 (2) (b) 12p. of the statutes is created to read:
AB56-ASA1-AA2,18,2120 49.46 (2) (b) 12p. Subject to the limitations under s. 49.45 (30y), services
21provided by a certified doula.”.
AB56-ASA1-AA2,18,22 2269. Page 356, line 4: delete lines 4 and 5 and substitute:
AB56-ASA1-AA2,18,24 23“49.46 (2) (b) 15. Mental health crisis Crisis intervention services under s.
2449.45 (41).”.
AB56-ASA1-AA2,19,1
170. Page 356, line 5: after that line insert:
AB56-ASA1-AA2,19,2 2 Section 691d. 49.46 (2) (b) 21. of the statutes is created to read:
AB56-ASA1-AA2,19,43 49.46 (2) (b) 21. Subject to par. (bv), nonmedical services that contribute to the
4determinants of health.
AB56-ASA1-AA2,691g 5Section 691g. 49.46 (2) (bv) of the statutes is created to read:
AB56-ASA1-AA2,19,126 49.46 (2) (bv) The department shall determine those services under par. (b) 21.
7that contribute to the determinants of health. The department shall seek any
8necessary state plan amendment or request any waiver of federal Medicaid law to
9implement this paragraph. The department is not required to provided the services
10under this paragraph as a benefit under the Medical Assistance program if the
11federal department of health and human services does not provide federal financial
12participation for the services under this paragraph.”.
AB56-ASA1-AA2,19,13 1371. Page 356, line 5: after that line insert:
AB56-ASA1-AA2,19,14 14 Section 695b. 49.47 (4) (ag) 2. of the statutes is amended to read:
AB56-ASA1-AA2,19,1715 49.47 (4) (ag) 2. Pregnant and the woman's pregnancy is medically verified
16Eligibility continues to the last day of the month in which the 60th day or, if approved
17by the federal government, the 365th day
after the last day of the pregnancy falls.”.
AB56-ASA1-AA2,19,18 1872. Page 356, line 23: after that line insert:
AB56-ASA1-AA2,19,19 19 Section 699c. 49.471 (1) (cr) of the statutes is created to read:
AB56-ASA1-AA2,19,2120 49.471 (1) (cr) “Enhanced federal medical assistance percentage" means a
21federal medical assistance percentage described under 42 USC 1396d (y) or (z).
AB56-ASA1-AA2,700c 22Section 700c. 49.471 (4) (a) 4. b. of the statutes is amended to read:
AB56-ASA1-AA2,20,3
149.471 (4) (a) 4. b. The individual's family income does not exceed 100 133
2percent of the poverty line before application of the 5 percent income disregard under
342 CFR 435.603 (d)
.
AB56-ASA1-AA2,701c 4Section 701c. 49.471 (4) (a) 8. of the statutes is created to read:
AB56-ASA1-AA2,20,55 49.471 (4) (a) 8. An individual who meets all of the following criteria:
AB56-ASA1-AA2,20,66 a. The individual is an adult under the age of 65.
AB56-ASA1-AA2,20,87 b. The adult has a family income that does not exceed 133 percent of the poverty
8line, except as provided in sub. (4g).
AB56-ASA1-AA2,20,109 c. The adult is not otherwise eligible for the Medical Assistance program under
10this subchapter or the Medicare program under 42 USC 1395 et seq.
AB56-ASA1-AA2,702c 11Section 702c. 49.471 (4g) of the statutes is created to read:
AB56-ASA1-AA2,20,1912 49.471 (4g) Medicaid expansion; federal medical assistance percentage. For
13services provided to individuals described under sub. (4) (a) 8., the department shall
14comply with all federal requirements to qualify for the highest available enhanced
15federal medical assistance percentage. The department shall submit any
16amendment to the state medical assistance plan, request for a waiver of federal
17Medicaid law, or other approval request required by the federal government to
18provide services to the individuals described under sub. (4) (a) 8. and qualify for the
19highest available enhanced federal medical assistance percentage.”.
AB56-ASA1-AA2,20,20 2073. Page 356, line 23: after that line insert:
AB56-ASA1-AA2,20,21 21 Section 703b. 49.471 (6) (b) of the statutes is amended to read:
AB56-ASA1-AA2,21,222 49.471 (6) (b) A pregnant woman who is determined to be eligible for benefits
23under sub. (4) remains eligible for benefits under sub. (4) for the balance of the
24pregnancy and to the last day of the month in which the 60th day or, if approved by

1the federal government, the 365th day
after the last day of the pregnancy falls
2without regard to any change in the woman's family income.
AB56-ASA1-AA2,704b 3Section 704b. 49.471 (6) (L) of the statutes is created to read:
AB56-ASA1-AA2,21,94 49.471 (6) (L) The department shall request from the federal department of
5health and human services approval of a state plan amendment, a waiver of federal
6Medicaid law, or approval of a demonstration project to maintain eligibility for
7post-partum women to the last day of the month in which the 365th day after the
8last day of the pregnancy falls under ss. 49.46 (1) (a) 1m. and 9. and (j), 49.47 (4) (ag)
92., and 49.471 (4) (a) 1g. and 1m., (6) (b), and (7) (b) 1.
AB56-ASA1-AA2,705b 10Section 705b. 49.471 (7) (b) 1. of the statutes is amended to read:
AB56-ASA1-AA2,21,2111 49.471 (7) (b) 1. A pregnant woman whose family income exceeds 300 percent
12of the poverty line may become eligible for coverage under this section if the
13difference between the pregnant woman's family income and the applicable income
14limit under sub. (4) (a) is obligated or expended for any member of the pregnant
15woman's family for medical care or any other type of remedial care recognized under
16state law or for personal health insurance premiums or for both. Eligibility obtained
17under this subdivision continues without regard to any change in family income for
18the balance of the pregnancy and to the last day of the month in which the 60th day
19or, if approved by the federal government, the 365th day after the last day of the
20woman's pregnancy falls. Eligibility obtained by a pregnant woman under this
21subdivision extends to all pregnant women in the pregnant woman's family.”.
AB56-ASA1-AA2,21,22 2274. Page 357, line 18: after that line insert:
AB56-ASA1-AA2,21,23 23 Section 711c. 49.686 (3) (d) of the statutes is amended to read:
AB56-ASA1-AA2,22,6
149.686 (3) (d) Has applied for coverage under and has been denied eligibility
2for medical assistance within 12 months prior to application for reimbursement
3under sub. (2). This paragraph does not apply to an individual who is eligible for
4benefits under the demonstration project for childless adults under s. 49.45 (23)
5BadgerCare Plus under s. 49.471 (4) (a) 8. or to an individual who is eligible for
6benefits under BadgerCare Plus under s. 49.471 (11).”.
AB56-ASA1-AA2,22,7 775. Page 363, line 8: after that line insert:
AB56-ASA1-AA2,22,8 8 Section 746t. 51.03 (7) of the statutes is created to read:
AB56-ASA1-AA2,22,129 51.03 (7) From the appropriation under s. 20.435 (5) (dg), the department shall
10award grants to regional crisis stabilization facilities for adults. The department
11shall establish criteria for a regional crisis stabilization facility to receive a grant
12under this subsection.”.
AB56-ASA1-AA2,22,14 1376. Page 364, line 14: delete the material beginning with that line and ending
14with page 365, line 8, and substitute:
AB56-ASA1-AA2,22,15 15 Section 750b. 51.422 (1) of the statutes is amended to read:
AB56-ASA1-AA2,22,2316 51.422 (1) Program creation. The department shall create 2 or 3 new, regional
17comprehensive opioid treatment programs, and in the 2017-19 fiscal biennium,
18shall create 2 or 3 additional regional comprehensive opioid and methamphetamine
19treatment programs, to provide treatment for opioid and opiate addiction and
20methamphetamine addiction in underserved, high-need areas. The department
21shall obtain and review proposals for opioid and methamphetamine treatment
22programs in accordance with its request-for-proposal procedures. A program under
23this section may not offer methadone treatment.
AB56-ASA1-AA2,751b 24Section 751b. 51.422 (2) of the statutes is amended to read:
AB56-ASA1-AA2,23,10
151.422 (2) Program components. An opioid or methamphetamine treatment
2program created under this section shall offer an assessment to individuals in need
3of service to determine what type of treatment is needed. The program shall
4transition individuals to a certified residential program, if that level of treatment is
5necessary. The program shall provide counseling, medication-assisted treatment,
6including both long-acting opioid antagonist and partial agonist medications that
7have been approved by the federal food and drug administration if for treating opioid
8addiction, and abstinence-based treatment. The program shall transition
9individuals who have completed treatment to county-based or private
10post-treatment care.”.
AB56-ASA1-AA2,23,11 1177. Page 365, line 9: delete lines 9 to 16 and substitute:
AB56-ASA1-AA2,23,12 12 Section 752b. 51.441 of the statutes is created to read:
AB56-ASA1-AA2,23,19 1351.441 Comprehensive mental health consultation program. The
14department shall convene a statewide group of interested persons, including at least
15one representative of the Medical College of Wisconsin, to develop a concept paper,
16business plan, and standards for a comprehensive mental health consultation
17program that incorporates general psychiatry, geriatric psychiatry, addiction
18medicine and psychiatry, a perinatal psychiatry consultation program, and the child
19psychiatry consultation program under s. 51.442.”.
AB56-ASA1-AA2,23,20 2078. Page 433, line 4: after that line insert:
AB56-ASA1-AA2,23,21 21 Section 1891b. 250.048 of the statutes is created to read:
AB56-ASA1-AA2,24,3 22250.048 Prescription drug importation program. (1) Importation
23program requirements.
The department, in consultation with persons interested in
24the sale and pricing of prescription drugs and appropriate officials and agencies of

1the federal government, shall design and implement a prescription drug importation
2program for the benefit of residents of this state, that generates savings for residents,
3and that satisfies all of the following:
AB56-ASA1-AA2,24,64 (a) The department shall designate a state agency to become a licensed
5wholesale distributor or to contract with a licensed wholesale distributor and shall
6seek federal certification and approval to import prescription drugs.
AB56-ASA1-AA2,24,97 (b) The prescription drug importation program under this section shall comply
8with relevant requirements of 21 USC 384, including safety and cost savings
9requirements.
AB56-ASA1-AA2,24,1210 (c) The prescription drug importation program under this section shall import
11prescription drugs from Canadian suppliers regulated under any appropriate
12Canadian or provincial laws.
AB56-ASA1-AA2,24,1513 (d) The prescription drug importation program under this section shall have
14a process to sample the purity, chemical composition, and potency of imported
15prescription drugs.
AB56-ASA1-AA2,24,1916 (e) The prescription drug importation program under this section shall import
17only those prescription drugs for which importation creates substantial savings for
18residents of the state and only those prescription drugs that are not brand-name
19drugs and that have fewer than 4 competitor prescription drugs in the United States.
AB56-ASA1-AA2,24,2220 (f) The department shall ensure that prescription drugs imported under the
21program under this section are not distributed, dispensed, or sold outside of the
22state.
AB56-ASA1-AA2,24,2423 (g) The prescription drug importation program under this section shall ensure
24all of the following:
AB56-ASA1-AA2,25,2
11. Participation by any pharmacy or health care provider in the program is
2voluntary.
AB56-ASA1-AA2,25,43 2. Any pharmacy or health care provider participating in the program has the
4appropriate license or other credential in this state.
AB56-ASA1-AA2,25,75 3. Any pharmacy or health care provider participating in the program charges
6a consumer or health plan the actual acquisition cost of the imported prescription
7drug that is dispensed.
AB56-ASA1-AA2,25,118 (h) The prescription drug importation program under this section shall ensure
9that a payment by a health plan or health insurance policy for a prescription drug
10imported under the program reimburses no more than the actual acquisition cost of
11the imported prescription drug that is dispensed.
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