Amendment AA2-ASA1-AB56

AB56-ASA1-AA2,36,11 2. Standards of operation for authorized vendors and infant formula suppliers and food direct distribution centers, including prohibited practices.

AB56-ASA1-AA2,1927b Section 1927b. 253.06 (5) (b) 1. to 3. of the statutes are amended to read:

AB56-ASA1-AA2,36,14 253.06 (5) (b) 1. Denial of the application to be a participant or authorized vendor or infant formula supplier.

AB56-ASA1-AA2,36,17 2. Suspension Summary suspension or termination of authorization for an authorized vendor or infant formula supplier or, in the case of a food direct distribution center, termination of the contract.

AB56-ASA1-AA2,36,19 3. Disqualification from the program under this section for a vendor, infant formula supplier, or participant.

AB56-ASA1-AA2,1928b Section 1928b. 253.06 (5) (b) 6. to 8. of the statutes are created to read:

AB56-ASA1-AA2,36,21 253.06 (5) (b) 6. Civil monetary penalty.

AB56-ASA1-AA2,36,22 7. Warning letter.

AB56-ASA1-AA2,36,23 8. Implementation of a corrective action plan.

AB56-ASA1-AA2,1929b Section 1929b. 253.06 (5) (d) (intro.) and 6. of the statutes are amended to read:

AB56-ASA1-AA2,37,10 253.06 (5) (d) (intro.) The department may directly assess a forfeiture provided for under par. (b) 4., recoupment provided for under par. (b) 5. and an enforcement assessment provided for under par. (c). If the department determines that a forfeiture, recoupment or enforcement assessment should be levied, or that authorization or eligibility should be summarily suspended or terminated, for a particular violation or for failure to correct it, the department shall send a notice of assessment, summary suspension or termination to the vendor, food infant formula supplier, direct distribution center or participant. The notice shall inform the vendor, food infant formula supplier, direct distribution center or participant of the right to a hearing under sub. (6) and shall specify all of the following:

AB56-ASA1-AA2,37,13 6. If applicable, that the suspension or termination of authorization of the vendor or eligibility of the participant is effective beginning on the 15th day after receipt date of the notice of summary suspension or termination.

AB56-ASA1-AA2,1930b Section 1930b. 253.06 (5) (e) of the statutes is renumbered 253.06 (5) (e) 1. and amended to read:

AB56-ASA1-AA2,37,19 253.06 (5) (e) 1. The suspension or termination of authorization of a vendor, infant formula supplier, or direct distribution center or eligibility of a participant shall be effective beginning on the 15th day after receipt of the notice of suspension or termination.

AB56-ASA1-AA2,38,3 2. All forfeitures, recoupments, and enforcement assessments shall be paid to the department within 15 days after receipt of notice of assessment or, if the forfeiture, recoupment, or enforcement assessment is contested under sub. (6), within 10 days after receipt of the final decision after exhaustion of administrative review, unless the final decision is adverse to the department or unless the final decision is appealed and the decision is stayed by court order under sub. (7). The department shall remit all forfeitures paid to the secretary of administration for deposit in the school fund. The department shall deposit all enforcement assessments in the appropriation under s. 20.435 (1) (gr).

AB56-ASA1-AA2,1931b Section 1931b. 253.06 (5) (e) 3. of the statutes is created to read:

AB56-ASA1-AA2,38,7 253.06 (5) (e) 3. The summary suspension of authorization of a vendor, infant formula supplier, or direct distribution center shall be effective immediately upon receipt of the notice under par. (d).

AB56-ASA1-AA2,1932b Section 1932b. 253.06 (6) (b) of the statutes is amended to read:

AB56-ASA1-AA2,38,24 253.06 (6) (b) A person may contest an assessment of forfeiture, recoupment or enforcement assessment, a denial, suspension or termination of authorization, a civil monetary penalty assessed in lieu of disqualification, a summary suspension, or a suspension or termination of eligibility by sending a written request for hearing under s. 227.44 to the division of hearings and appeals in the department of administration within 10 days after the receipt of the notice issued under sub. (3) (bm) or (5) (d). The administrator of the division of hearings and appeals may designate a hearing examiner to preside over the case and recommend a decision to the administrator under s. 227.46. The decision of the administrator of the division of hearings and appeals shall be the final administrative decision. The division of hearings and appeals shall commence the hearing and issue a final decision within 60 days after receipt of the request for hearing unless all of the parties consent to a later date. Proceedings before the division of hearings and appeals are governed by ch. 227. In any petition for judicial review of a decision by the division of hearings and appeals, the department, if not the petitioner who was in the proceeding before the division of hearings and appeals, shall be the named respondent.

AB56-ASA1-AA2,1933b Section 1933b. 253.06 (8) of the statutes is amended to read:

AB56-ASA1-AA2,39,4 253.06 (8) Inspection of premises. The department may visit and inspect each authorized vendor and infant formula supplier and each food direct distribution center, and for such purpose shall be given unrestricted access to the premises described in the authorization or contract.

AB56-ASA1-AA2,1934b Section 1934b. 253.06 (9) and (10) of the statutes are created to read:

AB56-ASA1-AA2,39,10 253.06 (9) Confidentiality of applicant and participant information. (a) Any information about an applicant or participant, whether it is obtained from the applicant or participant or another source or is generated as a result of application for the Women, Infants, and Children program, that identifies the applicant or participant or a family member of the applicant or participant is confidential.

AB56-ASA1-AA2,39,20 (b) Except as explicitly permitted under this section, the department shall restrict the use and disclosure of confidential applicant and participant information to any person directly connected with the administration or enforcement of the Women, Infants, and Children program that the department determines has a need to know the information for Women, Infants, and Children program purposes. Persons who may be allowed to access confidential information under this paragraph include personnel from the local agencies, persons under contract with the department to perform research regarding the Women, Infants, and Children program, and persons that are investigating or prosecuting Women, Infants, and Children program violations of federal, state, or local law.

AB56-ASA1-AA2,39,24 (c) The department or any local agency may use or disclose to public organizations confidential applicant and participant information for the administration of other programs that serve individuals eligible for the Women, Infants, and Children program in accordance with 7 CFR 246.26 (h).

AB56-ASA1-AA2,40,4 (d) Staff of the department and local agencies who are required by state law to report known or suspected child abuse or neglect may disclose confidential applicant and participant information without the consent of the participant or applicant to the extent necessary to comply with the law.

AB56-ASA1-AA2,40,18 (e) Except in the case of subpoenas or search warrants, the department and local agencies may disclose confidential applicant and participant information to individuals or entities not listed in this section only if the affected applicant or participant signs a release form authorizing the disclosure and specifying the parties to which the information may be disclosed. The department or local agency shall allow applicants and participants to refuse to sign the release form and shall notify the applicant or participant that signing the form is not a condition of eligibility and refusing to sign the form will not affect the applicant's or participant's application or participation in the Women, Infants, and Children program. Release forms authorizing disclosure to private physicians or other health care providers may be included as part of the Women, Infants, and Children program application or certification process. All other requests for applicants or participants to sign voluntary release forms may occur only after the application and certification process is complete.

AB56-ASA1-AA2,41,4 (f) The department or local agency shall provide to an applicant or participant access to all information he or she has provided to the Women, Infants, and Children program. In the case of an applicant or participant who is an infant or child, the access may be provided to a parent or guardian of the infant or child, assuming that any issues regarding custody or guardianship have been settled. The department or local agency is not required to provide the applicant or participant or parent or guardian of an infant or child applicant or participant access to any other information in the file or record, including documentation of income provided by a 3rd party and staff assessments of an applicant or participant's condition or behavior, unless required by law or unless the information supports a state or local agency decision being appealed under 7 CFR 246.9.

AB56-ASA1-AA2,41,10 (10) Confidentiality of vendor information. (a) Any information about a vendor, whether it is obtained from the vendor or another source, that individually identifies the vendor except for the vendor's name, address, telephone number, Internet or electronic mail address, store type, and Women, Infants, and Children program authorization status is confidential. The department shall restrict the use or disclosure of confidential vendor information to any of the following:

AB56-ASA1-AA2,41,16 1. Persons directly connected with the administration or enforcement of the Women, Infants, and Children program or the food stamp program under s. 49.79 that the department determines has a need to know the information for purposes of these programs. These persons may include personnel from local agencies and persons investigating or prosecuting violations of Women, Infants, and Children program or food stamp program federal, state, or local laws.

AB56-ASA1-AA2,41,22 2. Persons directly connected with the administration or enforcement of any federal or state law or local ordinance. Before releasing information to a state or local entity, the department shall enter into a written agreement with the requesting party specifying that the information may not be used or redisclosed except for purposes directly connected with the administration or enforcement of the federal or state law or local ordinance.

AB56-ASA1-AA2,41,25 3. A vendor that is subject to an adverse action under sub. (5), including a claim, to the extent that the confidential information concerns the vendor that is subject to the adverse action and is related to the adverse action.

AB56-ASA1-AA2,42,8 (b) The department may disclose to all authorized vendors and applicants to be a vendor sanctions that have been imposed on vendors if the disclosure identifies only the vendor's name, address, length of the disqualification or amount of the monetary penalty, and a summary of the reason for the sanction provided in the notice of adverse action under sub. (5). The information under this paragraph may be disclosed only after all administrative and judicial review is exhausted and the department has prevailed regarding the sanction imposed on the vendor or after the time period for requesting administrative and judicial review has expired.”.

AB56-ASA1-AA2,42,9 82. Page 445, line 17: after that line insert:

AB56-ASA1-AA2,42,10 “ Section 1935w. 253.07 (1) (a) 3. of the statutes is created to read:

AB56-ASA1-AA2,42,11 253.07 (1) (a) 3. Pregnancy termination.

AB56-ASA1-AA2,1936w Section 1936w. 253.07 (1) (b) 3. of the statutes is created to read:

AB56-ASA1-AA2,42,13 253.07 (1) (b) 3. Pregnancy termination.

AB56-ASA1-AA2,1937w Section 1937w. 253.07 (5) (b) (intro.) of the statutes is renumbered 253.07 (5) (b) and amended to read:

AB56-ASA1-AA2,42,19 253.07 (5) (b) Subject to par. (c), a A public entity that receives women's health funds under this section may provide some or all of the funds to other public or private entities provided that the recipient of the funds does not do any of the following:.

AB56-ASA1-AA2,1938w Section 1938w. 253.07 (5) (b) 1. to 3. of the statutes are repealed.

AB56-ASA1-AA2,1939w Section 1939w. 253.07 (5) (c) of the statutes is repealed.

AB56-ASA1-AA2,1940w Section 1940w. 253.075 of the statutes is repealed.”.

AB56-ASA1-AA2,42,23 83. Page 446, line 1: delete lines 1 and 2 and substitute:

AB56-ASA1-AA2,43,2 “254.151 (2m) Award grants for residential lead hazard abatement, residential lead hazard reduction, and lead abatement worker training.”.

AB56-ASA1-AA2,43,4 84. Page 448, line 25: delete the material beginning with that line and ending with page 449, line 2, and substitute:

AB56-ASA1-AA2,43,5 “ Section 1950m. 255.06 (2) (i) of the statutes is amended to read:

AB56-ASA1-AA2,43,7 255.06 (2) (i) Multiple sclerosis services. Allocate and expend at least up to $60,000 as reimbursement for the provision of multiple sclerosis services to women.”.

AB56-ASA1-AA2,43,8 85. Page 454, line 12: after that line insert:

AB56-ASA1-AA2,43,9 “ Section 2093k. 632.796 of the statutes is created to read:

AB56-ASA1-AA2,43,11 632.796 Drug cost report. (1) Definition. In this section, “disability insurance policy” has the meaning given in s. 632.895 (1) (a).

AB56-ASA1-AA2,43,17 (2) Report required. Annually, at the time the insurer files its rate request with the commissioner, each insurer that offers a disability insurance policy that covers prescription drugs shall submit to the commissioner a report that identifies the 25 prescription drugs that are the highest cost to the insurer and the 25 prescription drugs that have the highest cost increases over the 12 months before the submission of the report.

AB56-ASA1-AA2,2094k Section 2094k. 632.865 (3) of the statutes is created to read:

AB56-ASA1-AA2,43,21 632.865 (3) Registration required. (a) No person may perform any activities of a pharmacy benefit manager in this state without first registering with the commissioner under this subsection.

AB56-ASA1-AA2,43,24 (b) The commissioner shall establish a registration procedure for pharmacy benefit managers. The commissioner may promulgate any rules necessary to implement the registration procedure under this paragraph.

AB56-ASA1-AA2,2095k Section 2095k. 632.866 of the statutes is created to read:

AB56-ASA1-AA2,44,2 632.866 Prescription drug cost reporting. (1) Definitions. In this section:

AB56-ASA1-AA2,44,4 (a) “Brand-name drug” means a prescription drug approved under 21 USC 355 (b) or 42 USC 262.

AB56-ASA1-AA2,44,6 (b) “Covered hospital” means an entity described in 42 USC 256b (a) (4) (L) to (N) that participates in the federal drug-pricing program under 42 USC 256b.

AB56-ASA1-AA2,44,7 (c) “Disability insurance policy” has the meaning given in s. 632.895 (1) (a).

AB56-ASA1-AA2,44,8 (d) “Generic drug” means a prescription drug approved under 21 USC 355 (j).

AB56-ASA1-AA2,44,11 (e) “Manufacturer” has the meaning given in s. 450.01 (12). “Manufacturer” does not include an entity that is engaged only in the dispensing, as defined in s. 450.01 (7), of a brand-name drug or a generic drug.

AB56-ASA1-AA2,44,15 (f) “Manufacturer-sponsored assistance program” means a program offered by a manufacturer or an intermediary under contract with a manufacturer through which a brand-name drug or a generic drug is provided to a patient at no charge or at a discount.

AB56-ASA1-AA2,44,19 (g) “Margin” means, for a covered hospital, the difference between the net cost of a brand-name drug or generic drug covered under the federal drug-pricing program under 42 USC 256b and the net payment by the covered hospital for that brand-name drug or generic drug.

AB56-ASA1-AA2,44,21 (h) “Net payment” means the amount paid for a brand-name drug or generic drug after all discounts and rebates have been applied.

AB56-ASA1-AA2,44,22 (i) “Pharmacy benefit manager” has the meaning given in s. 632.865 (1) (c).

AB56-ASA1-AA2,45,2 (j) “Wholesale acquisition cost” means the most recently reported manufacturer list or catalog price for a brand-name drug or a generic drug available to wholesalers or direct purchasers in the United States, before application of discounts, rebates, or reductions in price.

AB56-ASA1-AA2,45,8 (2) Price increase or introduction notice; justification report. (a) A manufacturer shall notify the commissioner if it is increasing the wholesale acquisition cost of a brand-name drug on the market in this state by more than 10 percent or by more than $10,000 during any 12-month period or if it intends to introduce to market in this state a brand-name drug that has an annual wholesale acquisition cost of $30,000 or more.

AB56-ASA1-AA2,45,12 (b) A manufacturer shall notify the commissioner if it is increasing the wholesale acquisition cost of a generic drug by more than 25 percent or by more than $300 during any 12-month period or if it intends to introduce to market a generic drug that has an annual wholesale acquisition cost of $3,000 or more.

AB56-ASA1-AA2,45,18 (c) The manufacturer shall provide the notice under par. (a) or (b) in writing at least 30 days before the planned effective date of the cost increase or drug introduction with a justification that includes all documents and research related to the manufacturer's selection of the cost increase or introduction price and a description of life cycle management, market competition and context, and estimated value or cost-effectiveness of the product.

AB56-ASA1-AA2,45,22 (3) Net prices paid by pharmacy benefit managers. By March 1 annually, the manufacturer shall report to the commissioner the value of price concessions, expressed as a percentage of the wholesale acquisition cost, provided to each pharmacy benefit manager for each drug sold in this state.

AB56-ASA1-AA2,46,2 (4) Rebates and price concessions. By March 1 annually, each pharmacy benefit manager shall report to the commissioner the amount received from manufacturers as drug rebates and the value of price concessions, expressed as a percentage of the wholesale acquisition cost, provided by manufacturers for each drug.

AB56-ASA1-AA2,46,7 (5) Hospital margin spending. By March 1 annually, each covered hospital operating in this state shall report to the commissioner the per unit margin for each drug covered under the federal drug pricing program under 42 USC 256b dispensed in the previous year multiplied by the number of units dispensed at that margin and how the margin revenue was used.

AB56-ASA1-AA2,46,11 (6) Manufacturer-sponsored assistance programs. By March 1 annually, each manufacturer shall provide the commissioner with a description of each manufacturer-sponsored patient assistance program in effect during the previous year that includes all of the following:

AB56-ASA1-AA2,46,12 (a) The terms of the programs.

AB56-ASA1-AA2,46,13 (b) The number of prescriptions provided to state residents under the program.

AB56-ASA1-AA2,46,15 (c) The total market value of assistance provided to residents of this state under the program.

AB56-ASA1-AA2,46,20 (7) Certification and penalties for noncompliance. Each manufacturer and covered hospital that is required to report under this section shall certify each report as accurate under the penalty of perjury. A manufacturer or covered hospital that fails to submit a report required under this section is subject to a forfeiture of no more than $10,000 each day the report is overdue.

AB56-ASA1-AA2,46,24 (8) Hearing and public reporting. (a) The commissioner shall publicly post manufacturer price justification documents and covered hospital documentation of how each hospital spends the margin revenue. The commissioner shall keep any trade secret or proprietary information confidential.

AB56-ASA1-AA2,47,8 (b) The commissioner shall analyze data collected under this section and publish annually a report on emerging trends in prescription prices and price increases, and shall annually conduct a public hearing based on the analysis under this paragraph. The report under this paragraph shall include analysis of manufacturer prices and price increases, analysis of hospital-specific margins and how that revenue is spent or allocated on a hospital-specific basis, and analysis of how pharmacy benefit manager discounts and net costs compare to retail prices paid by patients.

AB56-ASA1-AA2,47,17 (9) Allowing cost disclosure to insured. The commissioner shall ensure that every disability insurance policy that covers prescription drugs or biological products does not restrict a pharmacy or pharmacist that dispenses a prescription drug or biological product from informing and does not penalize a pharmacy or pharmacist for informing an insured under a policy of a difference between the negotiated price of, or copayment or coinsurance for, the drug or biological product under the policy and the price the insured would pay for the drug or biological product if the insured obtained the drug or biological product without using any health insurance coverage.”.

AB56-ASA1-AA2,47,18 86. Page 460, line 2: after that line insert:

AB56-ASA1-AA2,47,19 “ Section 2264g. 2017 Wisconsin Act 370, Section 44 (2) and (3) are repealed.”.

AB56-ASA1-AA2,47,20 87. Page 460, line 22: after that line insert:

AB56-ASA1-AA2,47,21 “(4f) Psychiatric care technicians; pay increases.

AB56-ASA1-AA2,47,22 (a) In this subsection:

AB56-ASA1-AA2,48,2 1. “Psychiatric care technician” means an individual classified as a psychiatric care technician who is employed by the state and whose principal duties are performing individual treatment programming and maintaining internal security among individuals who are committed to any of the following:

AB56-ASA1-AA2,48,3 a. The secure mental health facility established under s. 46.055.

AB56-ASA1-AA2,48,4 b. The Wisconsin Resource Center established under s. 46.056.