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AB56-ASA1-AA2,43,17 12(2) Report required. Annually, at the time the insurer files its rate request
13with the commissioner, each insurer that offers a disability insurance policy that
14covers prescription drugs shall submit to the commissioner a report that identifies
15the 25 prescription drugs that are the highest cost to the insurer and the 25
16prescription drugs that have the highest cost increases over the 12 months before the
17submission of the report.
AB56-ASA1-AA2,2094k 18Section 2094k. 632.865 (3) of the statutes is created to read:
AB56-ASA1-AA2,43,2119 632.865 (3) Registration required. (a) No person may perform any activities
20of a pharmacy benefit manager in this state without first registering with the
21commissioner under this subsection.
AB56-ASA1-AA2,43,2422 (b) The commissioner shall establish a registration procedure for pharmacy
23benefit managers. The commissioner may promulgate any rules necessary to
24implement the registration procedure under this paragraph.
AB56-ASA1-AA2,2095k
1Section 2095k. 632.866 of the statutes is created to read:
AB56-ASA1-AA2,44,2 2632.866 Prescription drug cost reporting. (1) Definitions. In this section:
AB56-ASA1-AA2,44,43 (a) “Brand-name drug” means a prescription drug approved under 21 USC 355
4(b) or 42 USC 262.
AB56-ASA1-AA2,44,65 (b) “Covered hospital” means an entity described in 42 USC 256b (a) (4) (L) to
6(N) that participates in the federal drug-pricing program under 42 USC 256b.
AB56-ASA1-AA2,44,77 (c) “Disability insurance policy” has the meaning given in s. 632.895 (1) (a).
AB56-ASA1-AA2,44,88 (d) “Generic drug” means a prescription drug approved under 21 USC 355 (j).
AB56-ASA1-AA2,44,119 (e) “Manufacturer” has the meaning given in s. 450.01 (12). “Manufacturer”
10does not include an entity that is engaged only in the dispensing, as defined in s.
11450.01 (7), of a brand-name drug or a generic drug.
AB56-ASA1-AA2,44,1512 (f) “Manufacturer-sponsored assistance program” means a program offered by
13a manufacturer or an intermediary under contract with a manufacturer through
14which a brand-name drug or a generic drug is provided to a patient at no charge or
15at a discount.
AB56-ASA1-AA2,44,1916 (g) “Margin” means, for a covered hospital, the difference between the net cost
17of a brand-name drug or generic drug covered under the federal drug-pricing
18program under 42 USC 256b and the net payment by the covered hospital for that
19brand-name drug or generic drug.
AB56-ASA1-AA2,44,2120 (h) “Net payment” means the amount paid for a brand-name drug or generic
21drug after all discounts and rebates have been applied.
AB56-ASA1-AA2,44,2222 (i) “Pharmacy benefit manager” has the meaning given in s. 632.865 (1) (c).
AB56-ASA1-AA2,45,223 (j) “Wholesale acquisition cost” means the most recently reported
24manufacturer list or catalog price for a brand-name drug or a generic drug available

1to wholesalers or direct purchasers in the United States, before application of
2discounts, rebates, or reductions in price.
AB56-ASA1-AA2,45,8 3(2) Price increase or introduction notice; justification report. (a) A
4manufacturer shall notify the commissioner if it is increasing the wholesale
5acquisition cost of a brand-name drug on the market in this state by more than 10
6percent or by more than $10,000 during any 12-month period or if it intends to
7introduce to market in this state a brand-name drug that has an annual wholesale
8acquisition cost of $30,000 or more.
AB56-ASA1-AA2,45,129 (b) A manufacturer shall notify the commissioner if it is increasing the
10wholesale acquisition cost of a generic drug by more than 25 percent or by more than
11$300 during any 12-month period or if it intends to introduce to market a generic
12drug that has an annual wholesale acquisition cost of $3,000 or more.
AB56-ASA1-AA2,45,1813 (c) The manufacturer shall provide the notice under par. (a) or (b) in writing
14at least 30 days before the planned effective date of the cost increase or drug
15introduction with a justification that includes all documents and research related to
16the manufacturer's selection of the cost increase or introduction price and a
17description of life cycle management, market competition and context, and
18estimated value or cost-effectiveness of the product.
AB56-ASA1-AA2,45,22 19(3) Net prices paid by pharmacy benefit managers. By March 1 annually, the
20manufacturer shall report to the commissioner the value of price concessions,
21expressed as a percentage of the wholesale acquisition cost, provided to each
22pharmacy benefit manager for each drug sold in this state.
AB56-ASA1-AA2,46,2 23(4) Rebates and price concessions. By March 1 annually, each pharmacy
24benefit manager shall report to the commissioner the amount received from
25manufacturers as drug rebates and the value of price concessions, expressed as a

1percentage of the wholesale acquisition cost, provided by manufacturers for each
2drug.
AB56-ASA1-AA2,46,7 3(5) Hospital margin spending. By March 1 annually, each covered hospital
4operating in this state shall report to the commissioner the per unit margin for each
5drug covered under the federal drug pricing program under 42 USC 256b dispensed
6in the previous year multiplied by the number of units dispensed at that margin and
7how the margin revenue was used.
AB56-ASA1-AA2,46,11 8(6) Manufacturer-sponsored assistance programs. By March 1 annually,
9each manufacturer shall provide the commissioner with a description of each
10manufacturer-sponsored patient assistance program in effect during the previous
11year that includes all of the following:
AB56-ASA1-AA2,46,1212 (a) The terms of the programs.
AB56-ASA1-AA2,46,1313 (b) The number of prescriptions provided to state residents under the program.
AB56-ASA1-AA2,46,1514 (c) The total market value of assistance provided to residents of this state under
15the program.
AB56-ASA1-AA2,46,20 16(7) Certification and penalties for noncompliance. Each manufacturer and
17covered hospital that is required to report under this section shall certify each report
18as accurate under the penalty of perjury. A manufacturer or covered hospital that
19fails to submit a report required under this section is subject to a forfeiture of no more
20than $10,000 each day the report is overdue.
AB56-ASA1-AA2,46,24 21(8) Hearing and public reporting. (a) The commissioner shall publicly post
22manufacturer price justification documents and covered hospital documentation of
23how each hospital spends the margin revenue. The commissioner shall keep any
24trade secret or proprietary information confidential.
AB56-ASA1-AA2,47,8
1(b) The commissioner shall analyze data collected under this section and
2publish annually a report on emerging trends in prescription prices and price
3increases, and shall annually conduct a public hearing based on the analysis under
4this paragraph. The report under this paragraph shall include analysis of
5manufacturer prices and price increases, analysis of hospital-specific margins and
6how that revenue is spent or allocated on a hospital-specific basis, and analysis of
7how pharmacy benefit manager discounts and net costs compare to retail prices paid
8by patients.
AB56-ASA1-AA2,47,17 9(9) Allowing cost disclosure to insured. The commissioner shall ensure that
10every disability insurance policy that covers prescription drugs or biological products
11does not restrict a pharmacy or pharmacist that dispenses a prescription drug or
12biological product from informing and does not penalize a pharmacy or pharmacist
13for informing an insured under a policy of a difference between the negotiated price
14of, or copayment or coinsurance for, the drug or biological product under the policy
15and the price the insured would pay for the drug or biological product if the insured
16obtained the drug or biological product without using any health insurance
17coverage.”.
AB56-ASA1-AA2,47,18 1886. Page 460, line 2: after that line insert:
AB56-ASA1-AA2,47,19 19 Section 2264g. 2017 Wisconsin Act 370, Section 44 (2) and (3) are repealed.”.
AB56-ASA1-AA2,47,20 2087. Page 460, line 22: after that line insert:
AB56-ASA1-AA2,47,21 21“(4f) Psychiatric care technicians; pay increases.
AB56-ASA1-AA2,47,2222 (a) In this subsection:
AB56-ASA1-AA2,48,223 1. “Psychiatric care technician” means an individual classified as a psychiatric
24care technician who is employed by the state and whose principal duties are

1performing individual treatment programming and maintaining internal security
2among individuals who are committed to any of the following:
AB56-ASA1-AA2,48,33 a. The secure mental health facility established under s. 46.055.
AB56-ASA1-AA2,48,44 b. The Wisconsin Resource Center established under s. 46.056.
AB56-ASA1-AA2,48,55 c. The Mendota Juvenile Treatment Center established under s. 46.057.
AB56-ASA1-AA2,48,66 d. The Winnebago Mental Health Institute.
AB56-ASA1-AA2,48,117 2. “Psychiatric care technician-advanced” means an individual classified as a
8psychiatric care technician-advanced who is employed by the state and whose
9principal duties are performing individual treatment programming and
10maintaining internal security among individuals who are committed to any of the
11following:
AB56-ASA1-AA2,48,1212 a. The secure mental health facility established under s. 46.055.
AB56-ASA1-AA2,48,1313 b. The Wisconsin Resource Center established under s. 46.056.
AB56-ASA1-AA2,48,1414 c. The Mendota Juvenile Treatment Center established under s. 46.057.
AB56-ASA1-AA2,48,1515 d. The Winnebago Mental Health Institute.
AB56-ASA1-AA2,48,1916 (b) The administrator of the division of personnel management in the
17department of administration shall specify in the compensation plan under s. 230.12
18for the 2019-21 biennium that the minimum starting wage for psychiatric care
19technicians is $19 per hour.
AB56-ASA1-AA2,48,2320 (c) The administrator of the division of personnel management in the
21department of administration shall specify in the compensation plan under s. 230.12
22for the 2019-21 biennium that the minimum starting wage for psychiatric care
23technicians-advanced is $19.91 per hour.
AB56-ASA1-AA2,49,224 (d) The administrator of the division of personnel management shall specify in
25the compensation plan under s. 230.12 for the 2019-21 biennium that the wage for

1current psychiatric care technicians is increased by $2.35 per hour, and the wage for
2current psychiatric care technicians-advanced is increased by $2.46 per hour.
AB56-ASA1-AA2,49,93 (e) If, on the effective date of this paragraph, the compensation plan under s.
4230.12 has been adopted for the 2019-21 biennium and the compensation plan does
5not include the minimum hourly pay required under pars. (b) to (d), by no later than
630 days after the effective date of this paragraph, the administrator of the division
7of personnel management in the department of administration shall propose an
8amendment under s. 230.12 (3) (c) to include the minimum hourly pay required
9under pars. (b) to (d) in the compensation plan for the 2019-21 biennium.
AB56-ASA1-AA2,49,1010 (5f) Correctional officers and youth counselors; pay increases.
AB56-ASA1-AA2,49,1111 (a) In this section:
AB56-ASA1-AA2,49,1312 1. “Correctional officer” means an individual classified as a correctional officer
13who is employed by the state and whose principal duty is any of the following:
AB56-ASA1-AA2,49,1414 a. The supervision of inmates at a prison, as defined in s. 302.01.
AB56-ASA1-AA2,49,1715 b. The supervision of persons committed under s. 980.06 at the secure mental
16health facility established under s. 46.055 or the Wisconsin resource center
17established under s. 46.056.
AB56-ASA1-AA2,49,2018 2. “Correctional sergeant” means an individual classified as a correctional
19sergeant who is employed by the state and whose principal duty is any of the
20following:
AB56-ASA1-AA2,49,2121 a. The supervision of inmates at a prison, as defined in s. 302.01.
AB56-ASA1-AA2,49,2422 b. The supervision of persons committed under s. 980.06 at the secure mental
23health facility established under s. 46.055 or the Wisconsin resource center
24established under s. 46.056.
AB56-ASA1-AA2,50,3
13. “Youth counselor” means an individual classified as a youth counselor who
2is employed by the state and whose principal duty is the supervision of juveniles held
3in a juvenile correctional facility, as defined in s. 938.02 (10p).
AB56-ASA1-AA2,50,74 4. “Youth counselor-advanced” means an individual classified as a youth
5counselor-advanced who is employed by the state and whose principal duty is the
6supervision of juveniles held in a juvenile correctional facility, as defined in s. 938.02
7(10p).
AB56-ASA1-AA2,50,118 (b) The administrator of the division of personnel management in the
9department of administration shall specify in the compensation plan under s. 230.12
10for the 2019-21 biennium that the minimum wage for correctional officers and youth
11counselors is $19 per hour.
AB56-ASA1-AA2,50,1512 (c) The administrator of the division of personnel management in the
13department of administration shall specify in the compensation plan under s. 230.12
14for the 2019-21 biennium that the minimum wage for correctional sergeants and
15youth counselors-advanced is $19.91 per hour.
AB56-ASA1-AA2,50,2016 (d) The administrator of the division of personnel management shall specify in
17the compensation plan under s. 230.12 for the 2019-21 biennium that the wage for
18current correctional officers and youth counselors is increased by $2.35 per hour, and
19the wage for current correctional sergeants and youth counselors-advanced is
20increased by $2.46 per hour.
AB56-ASA1-AA2,51,221 (e) If, on the effective date of this paragraph, the compensation plan under s.
22230.12 has been adopted for the 2019-21 biennium and the compensation plan does
23not include the minimum hourly pay required under pars. (b) to (d), by no later than
2430 days after the effective date of this paragraph, the administrator of the division
25of personnel management in the department of administration shall propose an

1amendment under s. 230.12 (3) (c) to include the minimum hourly pay required
2under pars. (b) to (d) in the compensation plan for the 2019-21 biennium.
AB56-ASA1-AA2,51,83 (6f) Correctional officers and correctional sergeants and youth
4counselors and youth counselors-advanced and psychiatric care technicians;
5wage increases.
The amounts of the estimated expenditures in the compensation
6reserves general purpose revenue shown in the schedule under s. 20.005 (1) are
7increased by $8,000,000 in fiscal year 2019–20 and by $8,000,000 in fiscal year
82020-21.”.
AB56-ASA1-AA2,51,9 988. Page 488, line 8: after that line insert:
AB56-ASA1-AA2,51,17 10“(1t) Prescription drug pooling study. The department of employee trust
11funds, in consultation with the department of corrections, the department of health
12services, and the department of veterans affairs, shall study the options and
13opportunities for cost savings to state agencies through prescription drug pooling.
14No later than January 1, 2020, the department of employee trust funds shall submit
15a report of the study to the governor and the appropriate standing committees of the
16legislature, as determined by the speaker of the assembly and the president of the
17senate, in the manner provided under s. 13.172 (3).”.
AB56-ASA1-AA2,51,18 1889. Page 488, line 16: after that line insert:
AB56-ASA1-AA2,51,22 19(1s) Forensic unit expansion at Sand Ridge Secure Treatment Center. From
20the appropriation under s. 20.435 (2) (bm), the department shall allocate $3,430,900
21in fiscal year 2020-21 and create 36.50 FTE GPR positions to operate a 20-bed unit
22for forensic patients at the Sand Ridge Secure Treatment Center.”.
AB56-ASA1-AA2,52,2 23(1t) Youth crisis stabilization facilities and peer-run respite centers for
24veterans.
The department of health services shall award in each fiscal year $996,400

1in grants to youth crisis stabilization facilities and $450,000 in grants to a peer-run
2respite center for veterans.”.
AB56-ASA1-AA2,52,4 390. Page 488, line 17: delete the material beginning with that line and ending
4with page 489, line 3, and substitute:
AB56-ASA1-AA2,52,9 5“(2b) Medical Assistance reimbursement for services provided through
6telehealth.
The department of health services shall develop, by rule, a method of
7reimbursing providers under the Medical Assistance program for a service that is
8covered by the Medical Assistance program under subch. IV of ch. 49 and that
9satisfies any of the following:
AB56-ASA1-AA2,52,1210 (a) The service is a consultation between a provider at an originating site and
11a provider at a remote location using a combination of interactive video, audio, and
12externally acquired images through a networking environment.
AB56-ASA1-AA2,52,1513 (b) The service is an asynchronous transmission of digital clinical information
14through a secure electronic system from a Medical Assistance recipient or provider
15to a provider.”.
AB56-ASA1-AA2,52,16 1691. Page 489, line 3: after that line insert:
AB56-ASA1-AA2,52,20 17“(2g) Childless adults demonstration project reform waiver. The
18department of health services may submit a request to the federal department of
19health and human services to modify or withdraw the waiver granted under s. 49.45
20(23) (g), 2017 stats.
AB56-ASA1-AA2,52,2121 (3g) Academic detailing training program.
AB56-ASA1-AA2,53,222 (c) In this subsection, “academic detailing” means a teaching model under
23which health care experts are taught techniques for engaging in interactional
24educational outreach to other health care providers and clinical staff to provide

1information on evidence-based practices and successful therapeutic interventions
2with the goal of improving patient care.
AB56-ASA1-AA2,53,53 (d) The department of health services shall establish and implement a 2-year
4academic detailing primary care clinic dementia training program in 10 primary
5care clinics in the state through a contract with the Wisconsin Alzheimer's Institute.
AB56-ASA1-AA2,53,106 (e) The department shall, as part of the training program, provide primary care
7providers with clinical training and access to educational resources on best practices
8for diagnosis and management of common cognitive disorders, and referral
9strategies to dementia specialists for complicated or rare cognitive or behavioral
10disorders.
AB56-ASA1-AA2,53,1211 (f) The department shall ensure that the training program under this
12subsection includes at least the following three components:
AB56-ASA1-AA2,53,14 131. The most current research on effective clinical treatments and practices is
14systematically evaluated by the academic detailing team.
AB56-ASA1-AA2,53,17 152. Information gathered and evaluated under subd. 1. is packaged into an
16easily accessible format that is clinically relevant, rigorously sourced, and
17compellingly formatted.
AB56-ASA1-AA2,53,21 183. Training is provided for clinicians to serve as academic detailers that equips
19them with clinical expertise and proficiency in conducting an interactive educational
20exchange to facilitate individualized learning among participating primary care
21practitioners in the target clinics.”.
AB56-ASA1-AA2,53,22 2292. Page 489, line 14: after that line insert:
AB56-ASA1-AA2,54,6 23“(4c) Childless adults demonstration project. The department of health
24services shall submit any necessary request to the federal department of health and

1human services for a state plan amendment or waiver of federal Medicaid law or to
2modify or withdraw from any waiver of federal Medicaid law relating to the childless
3adults demonstration project under s. 49.45 (23), 2017 stats., to reflect the
4incorporation of recipients of Medical Assistance under the demonstration project
5into the BadgerCare Plus program under s. 49.471 and the termination of the
6demonstration project.”.
AB56-ASA1-AA2,54,7 793. Page 489, line 15: delete lines 15 to 20 and substitute:
AB56-ASA1-AA2,54,13 8“(6b) Evidence-based oral health grants and Seal-A-Smile program.
9Notwithstanding s. 250.10 (1m) (b), in fiscal year 2019-20, the department of health
10services shall, from the appropriation under s. 20.435 (1) (de), award to qualified
11applicants grants totaling $50,000 for fluoride varnish and other evidence-based
12oral health activities, $525,000 for school-based preventive dental services, and
13$100,000 for school-based restorative dental services.”.
AB56-ASA1-AA2,54,14 1494. Page 489, line 20: after that line insert:
AB56-ASA1-AA2,54,21 15“(6d) Prescription drug importation program. The department of health
16services shall submit the first report required under s. 250.048 (5) by the next
17January 1 or July 1, whichever is earliest, that is at least 180 days after the date the
18prescription drug importation program is fully operational under s. 250.048 (4). The
19department of health services shall include in the first 3 reports submitted under s.
20250.048 (5) information on the implementation of the audit functions under s.
21250.048 (1) (n).”.
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