Amendment AA2-ASA1-AB56

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.

AB56-ASA1-AA2,48,5 c. The Mendota Juvenile Treatment Center established under s. 46.057.

AB56-ASA1-AA2,48,6 d. The Winnebago Mental Health Institute.

AB56-ASA1-AA2,48,11 2. “Psychiatric care technician-advanced” means an individual classified as a psychiatric care technician-advanced 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-AA2,48,12 a. The secure mental health facility established under s. 46.055.

AB56-ASA1-AA2,48,13 b. The Wisconsin Resource Center established under s. 46.056.

AB56-ASA1-AA2,48,14 c. The Mendota Juvenile Treatment Center established under s. 46.057.

AB56-ASA1-AA2,48,15 d. The Winnebago Mental Health Institute.

AB56-ASA1-AA2,48,19 (b) The administrator of the division of personnel management in the department of administration shall specify in the compensation plan under s. 230.12 for the 2019-21 biennium that the minimum starting wage for psychiatric care technicians is $19 per hour.

AB56-ASA1-AA2,48,23 (c) The administrator of the division of personnel management in the department of administration shall specify in the compensation plan under s. 230.12 for the 2019-21 biennium that the minimum starting wage for psychiatric care technicians-advanced is $19.91 per hour.

AB56-ASA1-AA2,49,2 (d) The administrator of the division of personnel management shall specify in the compensation plan under s. 230.12 for the 2019-21 biennium that the wage for current psychiatric care technicians is increased by $2.35 per hour, and the wage for current psychiatric care technicians-advanced is increased by $2.46 per hour.

AB56-ASA1-AA2,49,9 (e) If, on the effective date of this paragraph, the compensation plan under s. 230.12 has been adopted for the 2019-21 biennium and the compensation plan does not include the minimum hourly pay required under pars. (b) to (d), by no later than 30 days after the effective date of this paragraph, the administrator of the division of personnel management in the department of administration shall propose an amendment under s. 230.12 (3) (c) to include the minimum hourly pay required under pars. (b) to (d) in the compensation plan for the 2019-21 biennium.

AB56-ASA1-AA2,49,10 (5f) Correctional officers and youth counselors; pay increases.

AB56-ASA1-AA2,49,11 (a) In this section:

AB56-ASA1-AA2,49,13 1. “Correctional officer” means an individual classified as a correctional officer who is employed by the state and whose principal duty is any of the following:

AB56-ASA1-AA2,49,14 a. The supervision of inmates at a prison, as defined in s. 302.01.

AB56-ASA1-AA2,49,17 b. The supervision of persons committed under s. 980.06 at the secure mental health facility established under s. 46.055 or the Wisconsin resource center established under s. 46.056.

AB56-ASA1-AA2,49,20 2. “Correctional sergeant” means an individual classified as a correctional sergeant who is employed by the state and whose principal duty is any of the following:

AB56-ASA1-AA2,49,21 a. The supervision of inmates at a prison, as defined in s. 302.01.

AB56-ASA1-AA2,49,24 b. The supervision of persons committed under s. 980.06 at the secure mental health facility established under s. 46.055 or the Wisconsin resource center established under s. 46.056.

AB56-ASA1-AA2,50,3 3. “Youth counselor” means an individual classified as a youth counselor who is employed by the state and whose principal duty is the supervision of juveniles held in a juvenile correctional facility, as defined in s. 938.02 (10p).

AB56-ASA1-AA2,50,7 4. “Youth counselor-advanced” means an individual classified as a youth counselor-advanced who is employed by the state and whose principal duty is the supervision of juveniles held in a juvenile correctional facility, as defined in s. 938.02 (10p).

AB56-ASA1-AA2,50,11 (b) The administrator of the division of personnel management in the department of administration shall specify in the compensation plan under s. 230.12 for the 2019-21 biennium that the minimum wage for correctional officers and youth counselors is $19 per hour.

AB56-ASA1-AA2,50,15 (c) The administrator of the division of personnel management in the department of administration shall specify in the compensation plan under s. 230.12 for the 2019-21 biennium that the minimum wage for correctional sergeants and youth counselors-advanced is $19.91 per hour.

AB56-ASA1-AA2,50,20 (d) The administrator of the division of personnel management shall specify in the compensation plan under s. 230.12 for the 2019-21 biennium that the wage for current correctional officers and youth counselors is increased by $2.35 per hour, and the wage for current correctional sergeants and youth counselors-advanced is increased by $2.46 per hour.

AB56-ASA1-AA2,51,2 (e) If, on the effective date of this paragraph, the compensation plan under s. 230.12 has been adopted for the 2019-21 biennium and the compensation plan does not include the minimum hourly pay required under pars. (b) to (d), by no later than 30 days after the effective date of this paragraph, the administrator of the division of personnel management in the department of administration shall propose an amendment under s. 230.12 (3) (c) to include the minimum hourly pay required under pars. (b) to (d) in the compensation plan for the 2019-21 biennium.

AB56-ASA1-AA2,51,8 (6f) Correctional officers and correctional sergeants and youth counselors and youth counselors-advanced and psychiatric care technicians; wage increases. The amounts of the estimated expenditures in the compensation reserves general purpose revenue shown in the schedule under s. 20.005 (1) are increased by $8,000,000 in fiscal year 2019–20 and by $8,000,000 in fiscal year 2020-21.”.

AB56-ASA1-AA2,51,9 88. Page 488, line 8: after that line insert:

AB56-ASA1-AA2,51,17 “(1t) Prescription drug pooling study. The department of employee trust funds, in consultation with the department of corrections, the department of health services, and the department of veterans affairs, shall study the options and opportunities for cost savings to state agencies through prescription drug pooling. No later than January 1, 2020, the department of employee trust funds shall submit a report of the study to the governor and the appropriate standing committees of the legislature, as determined by the speaker of the assembly and the president of the senate, in the manner provided under s. 13.172 (3).”.

AB56-ASA1-AA2,51,18 89. Page 488, line 16: after that line insert:

AB56-ASA1-AA2,51,22 “(1s) Forensic unit expansion at Sand Ridge Secure Treatment Center. From the appropriation under s. 20.435 (2) (bm), the department shall allocate $3,430,900 in fiscal year 2020-21 and create 36.50 FTE GPR positions to operate a 20-bed unit for forensic patients at the Sand Ridge Secure Treatment Center.”.

AB56-ASA1-AA2,52,2 (1t) Youth crisis stabilization facilities and peer-run respite centers for veterans. The department of health services shall award in each fiscal year $996,400 in grants to youth crisis stabilization facilities and $450,000 in grants to a peer-run respite center for veterans.”.

AB56-ASA1-AA2,52,4 90. Page 488, line 17: delete the material beginning with that line and ending with page 489, line 3, and substitute:

AB56-ASA1-AA2,52,9 “(2b) Medical Assistance reimbursement for services provided through telehealth. The department of health services shall develop, by rule, a method of reimbursing providers under the Medical Assistance program for a service that is covered by the Medical Assistance program under subch. IV of ch. 49 and that satisfies any of the following:

AB56-ASA1-AA2,52,12 (a) The service is a consultation between a provider at an originating site and a provider at a remote location using a combination of interactive video, audio, and externally acquired images through a networking environment.

AB56-ASA1-AA2,52,15 (b) The service is an asynchronous transmission of digital clinical information through a secure electronic system from a Medical Assistance recipient or provider to a provider.”.

AB56-ASA1-AA2,52,16 91. Page 489, line 3: after that line insert:

AB56-ASA1-AA2,52,20 “(2g) Childless adults demonstration project reform waiver. The department of health services may submit a request to the federal department of health and human services to modify or withdraw the waiver granted under s. 49.45 (23) (g), 2017 stats.

AB56-ASA1-AA2,52,21 (3g) Academic detailing training program.

AB56-ASA1-AA2,53,2 (c) In this subsection, “academic detailing” means a teaching model under which health care experts are taught techniques for engaging in interactional educational outreach to other health care providers and clinical staff to provide information on evidence-based practices and successful therapeutic interventions with the goal of improving patient care.

AB56-ASA1-AA2,53,5 (d) The department of health services shall establish and implement a 2-year academic detailing primary care clinic dementia training program in 10 primary care clinics in the state through a contract with the Wisconsin Alzheimer's Institute.

AB56-ASA1-AA2,53,10 (e) The department shall, as part of the training program, provide primary care providers with clinical training and access to educational resources on best practices for diagnosis and management of common cognitive disorders, and referral strategies to dementia specialists for complicated or rare cognitive or behavioral disorders.

AB56-ASA1-AA2,53,12 (f) The department shall ensure that the training program under this subsection includes at least the following three components:

AB56-ASA1-AA2,53,14 1. The most current research on effective clinical treatments and practices is systematically evaluated by the academic detailing team.

AB56-ASA1-AA2,53,17 2. Information gathered and evaluated under subd. 1. is packaged into an easily accessible format that is clinically relevant, rigorously sourced, and compellingly formatted.

AB56-ASA1-AA2,53,21 3. Training is provided for clinicians to serve as academic detailers that equips them with clinical expertise and proficiency in conducting an interactive educational exchange to facilitate individualized learning among participating primary care practitioners in the target clinics.”.

AB56-ASA1-AA2,53,22 92. Page 489, line 14: after that line insert:

AB56-ASA1-AA2,54,6 “(4c) Childless adults demonstration project. The department of health services shall submit any necessary request to the federal department of health and human services for a state plan amendment or waiver of federal Medicaid law or to modify or withdraw from any waiver of federal Medicaid law relating to the childless adults demonstration project under s. 49.45 (23), 2017 stats., to reflect the incorporation of recipients of Medical Assistance under the demonstration project into the BadgerCare Plus program under s. 49.471 and the termination of the demonstration project.”.

AB56-ASA1-AA2,54,7 93. Page 489, line 15: delete lines 15 to 20 and substitute:

AB56-ASA1-AA2,54,13 “(6b) Evidence-based oral health grants and Seal-A-Smile program. Notwithstanding s. 250.10 (1m) (b), in fiscal year 2019-20, the department of health services shall, from the appropriation under s. 20.435 (1) (de), award to qualified applicants grants totaling $50,000 for fluoride varnish and other evidence-based oral health activities, $525,000 for school-based preventive dental services, and $100,000 for school-based restorative dental services.”.

AB56-ASA1-AA2,54,14 94. Page 489, line 20: after that line insert:

AB56-ASA1-AA2,54,21 “(6d) Prescription drug importation program. The department of health services shall submit the first report required under s. 250.048 (5) by the next January 1 or July 1, whichever is earliest, that is at least 180 days after the date the prescription drug importation program is fully operational under s. 250.048 (4). The department of health services shall include in the first 3 reports submitted under s. 250.048 (5) information on the implementation of the audit functions under s. 250.048 (1) (n).”.