Amendment SA2-AB56

AB56-SA2,34,19 49.471 (1) (cr) “Enhanced federal medical assistance percentage" means a federal medical assistance percentage described under 42 USC 1396d (y) or (z).

AB56-SA2,700c Section 700c. 49.471 (4) (a) 4. b. of the statutes is amended to read:

AB56-SA2,34,23 49.471 (4) (a) 4. b. The individual's family income does not exceed 100 133 percent of the poverty line before application of the 5 percent income disregard under 42 CFR 435.603 (d).

AB56-SA2,701c Section 701c. 49.471 (4) (a) 8. of the statutes is created to read:

AB56-SA2,35,1 49.471 (4) (a) 8. An individual who meets all of the following criteria:

AB56-SA2,35,2 a. The individual is an adult under the age of 65.

AB56-SA2,35,4 b. The adult has a family income that does not exceed 133 percent of the poverty line, except as provided in sub. (4g).

AB56-SA2,35,6 c. The adult is not otherwise eligible for the Medical Assistance program under this subchapter or the Medicare program under 42 USC 1395 et seq.

AB56-SA2,702c Section 702c. 49.471 (4g) of the statutes is created to read:

AB56-SA2,35,15 49.471 (4g) Medicaid expansion; federal medical assistance percentage. For services provided to individuals described under sub. (4) (a) 8., the department shall comply with all federal requirements to qualify for the highest available enhanced federal medical assistance percentage. The department shall submit any amendment to the state medical assistance plan, request for a waiver of federal Medicaid law, or other approval request required by the federal government to provide services to the individuals described under sub. (4) (a) 8. and qualify for the highest available enhanced federal medical assistance percentage.

AB56-SA2,703b Section 703b. 49.471 (6) (b) of the statutes is amended to read:

AB56-SA2,35,21 49.471 (6) (b) A pregnant woman who is determined to be eligible for benefits under sub. (4) remains eligible for benefits under sub. (4) for the balance of the pregnancy and to the last day of the month in which the 60th day or, if approved by the federal government, the 365th day after the last day of the pregnancy falls without regard to any change in the woman's family income.

AB56-SA2,704b Section 704b. 49.471 (6) (L) of the statutes is created to read:

AB56-SA2,36,3 49.471 (6) (L) The department shall request from the federal department of health and human services approval of a state plan amendment, a waiver of federal Medicaid law, or approval of a demonstration project to maintain eligibility for post-partum women to the last day of the month in which the 365th day after the last day of the pregnancy falls under ss. 49.46 (1) (a) 1m. and 9. and (j), 49.47 (4) (ag) 2., and 49.471 (4) (a) 1g. and 1m., (6) (b), and (7) (b) 1.

AB56-SA2,705b Section 705b. 49.471 (7) (b) 1. of the statutes is amended to read:

AB56-SA2,36,15 49.471 (7) (b) 1. A pregnant woman whose family income exceeds 300 percent of the poverty line may become eligible for coverage under this section if the difference between the pregnant woman's family income and the applicable income limit under sub. (4) (a) is obligated or expended for any member of the pregnant woman's family for medical care or any other type of remedial care recognized under state law or for personal health insurance premiums or for both. Eligibility obtained under this subdivision continues without regard to any change in family income for the balance of the pregnancy and to the last day of the month in which the 60th day or, if approved by the federal government, the 365th day after the last day of the woman's pregnancy falls. Eligibility obtained by a pregnant woman under this subdivision extends to all pregnant women in the pregnant woman's family.”.

AB56-SA2,36,16 85. Page 357, line 18: after that line insert:

AB56-SA2,36,17 “ Section 711c. 49.686 (3) (d) of the statutes is amended to read:

AB56-SA2,36,23 49.686 (3) (d) Has applied for coverage under and has been denied eligibility for medical assistance within 12 months prior to application for reimbursement under sub. (2). This paragraph does not apply to an individual who is eligible for benefits under the demonstration project for childless adults under s. 49.45 (23) BadgerCare Plus under s. 49.471 (4) (a) 8. or to an individual who is eligible for benefits under BadgerCare Plus under s. 49.471 (11).”.

AB56-SA2,36,24 86. Page 358, line 10: after that line insert:

AB56-SA2,37,1 “ Section 726m. 49.855 (3) of the statutes is amended to read:

AB56-SA2,37,25 49.855 (3) Receipt of a certification by the department of revenue shall constitute a lien, equal to the amount certified, on any state tax refunds or credits owed to the obligor. The lien shall be foreclosed by the department of revenue as a setoff under s. 71.93 (3), (6), and (7). When the department of revenue determines that the obligor is otherwise entitled to a state tax refund or credit, it shall notify the obligor that the state intends to reduce any state tax refund or credit due the obligor by the amount the obligor is delinquent under the support, maintenance, or receiving and disbursing fee order or obligation, by the outstanding amount for past support, or medical expenses, or birth expenses under the court order, or by the amount due under s. 46.10 (4), 49.345 (4), or 301.12 (4). The notice shall provide that within 20 days the obligor may request a hearing before the circuit court rendering the order under which the obligation arose. Within 10 days after receiving a request for hearing under this subsection, the court shall set the matter for hearing. Pending further order by the court or a circuit court commissioner, the department of children and families or its designee, whichever is appropriate, is prohibited from disbursing the obligor's state tax refund or credit. A circuit court commissioner may conduct the hearing. The sole issues at that hearing shall be whether the obligor owes the amount certified and, if not and it is a support or maintenance order, whether the money withheld from a tax refund or credit shall be paid to the obligor or held for future support or maintenance, except that the obligor's ability to pay shall also be an issue at the hearing if the obligation relates to an order under s. 767.805 (4) (d) 1. or 767.89 (3) (e) 1. regarding birth expenses and the order specifies that the court found that the obligor's income was at or below the poverty line established under 42 USC 9902 (2).

AB56-SA2,727m Section 727m. 49.855 (4m) (b) of the statutes is amended to read:

AB56-SA2,39,5 49.855 (4m) (b) The department of revenue may provide a certification that it receives under sub. (1), (2m), (2p), or (2r) to the department of administration. Upon receipt of the certification, the department of administration shall determine whether the obligor is a vendor or is receiving any other payments from this state, except for wages, retirement benefits, or assistance under s. 45.352, 1971 stats., s. 45.40 (1m), this chapter, or ch. 46, 108, or 301. If the department of administration determines that the obligor is a vendor or is receiving payments from this state, except for wages, retirement benefits, or assistance under s. 45.352, 1971 stats., s. 45.40 (1m), this chapter, or ch. 46, 108, or 301, it shall begin to withhold the amount certified from those payments and shall notify the obligor that the state intends to reduce any payments due the obligor by the amount the obligor is delinquent under the support, maintenance, or receiving and disbursing fee order or obligation, by the outstanding amount for past support, or medical expenses, or birth expenses under the court order, or by the amount due under s. 46.10 (4), 49.345 (4), or 301.12 (4). The notice shall provide that within 20 days after receipt of the notice the obligor may request a hearing before the circuit court rendering the order under which the obligation arose. An obligor may, within 20 days after receiving notice, request a hearing under this paragraph. Within 10 days after receiving a request for hearing under this paragraph, the court shall set the matter for hearing. A circuit court commissioner may conduct the hearing. Pending further order by the court or circuit court commissioner, the department of children and families or its designee, whichever is appropriate, may not disburse the payments withheld from the obligor. The sole issues at the hearing are whether the obligor owes the amount certified and, if not and it is a support or maintenance order, whether the money withheld shall be paid to the obligor or held for future support or maintenance, except that the obligor's ability to pay is also an issue at the hearing if the obligation relates to an order under s. 767.805 (4) (d) 1. or 767.89 (3) (e) 1. regarding birth expenses and the order specifies that the court found that the obligor's income was at or below the poverty line established under 42 USC 9902 (2).”.

AB56-SA2,39,7 87. Page 358, line 11: delete the material beginning with that line and ending with page 359, line 11, and substitute:

AB56-SA2,39,8 “ Section 728b. 50.03 (3) (b) (intro.) of the statutes is amended to read:

AB56-SA2,39,13 50.03 (3) (b) (intro.) The application for a license and, except as otherwise provided in this subchapter, the report of a licensee shall be in writing upon forms provided by the department and shall contain such information as the department requires, including the name, address and type and extent of interest of each of the following persons:

AB56-SA2,729b Section 729b. 50.03 (4) (c) 1. of the statutes is amended to read:

AB56-SA2,39,24 50.03 (4) (c) 1. A community-based residential facility license is valid until it is revoked or suspended under this section. Every 24 months, on a schedule determined by the department, a community-based residential facility licensee shall submit through an online system prescribed by the department a biennial report in the form and containing the information that the department requires, including payment of the fees required any fee due under s. 50.037 (2) (a). If a complete biennial report is not timely filed, the department shall issue a warning to the licensee. The department may revoke a community-based residential facility license for failure to timely and completely report within 60 days after the report date established under the schedule determined by the department.

AB56-SA2,730b Section 730b. 50.033 (2m) of the statutes is amended to read:

AB56-SA2,40,9 50.033 (2m) Reporting. Every 24 months, on a schedule determined by the department, a licensed adult family home shall submit through an online system prescribed by the department a biennial report in the form and containing the information that the department requires, including payment of the any fee required due under sub. (2). If a complete biennial report is not timely filed, the department shall issue a warning to the licensee. The department may revoke the license for failure to timely and completely report within 60 days after the report date established under the schedule determined by the department.”.

AB56-SA2,40,11 88. Page 359, line 22: delete the material beginning with that line and ending with page 360, line 9, and substitute:

AB56-SA2,40,12 “ Section 732b. 50.034 (2m) of the statutes is created to read:

AB56-SA2,40,21 50.034 (2m) Reporting. Every 24 months, on a schedule determined by the department, a residential care apartment complex shall submit through an online system prescribed by the department a report in the form and containing the information that the department requires, including payment of any fee required under sub. (1). If a complete report is not timely filed, the department shall issue a warning to the operator of the residential care apartment complex. The department may revoke a residential care apartment complex's certification or registration for failure to timely and completely report within 60 days after the report date established under the schedule determined by the department.”.

AB56-SA2,40,22 89. Page 363, line 8: after that line insert:

AB56-SA2,40,23 “ Section 746t. 51.03 (7) of the statutes is created to read:

AB56-SA2,41,4 51.03 (7) From the appropriation under s. 20.435 (5) (dg), the department shall award grants to regional crisis stabilization facilities for adults. The department shall establish criteria for a regional crisis stabilization facility to receive a grant under this subsection.”.

AB56-SA2,41,6 90. Page 364, line 14: delete the material beginning with that line and ending with page 365, line 8, and substitute:

AB56-SA2,41,7 “ Section 750b. 51.422 (1) of the statutes is amended to read:

AB56-SA2,41,15 51.422 (1) Program creation. The department shall create 2 or 3 new, regional comprehensive opioid treatment programs, and in the 2017-19 fiscal biennium, shall create 2 or 3 additional regional comprehensive opioid and methamphetamine treatment programs, to provide treatment for opioid and opiate addiction and methamphetamine addiction in underserved, high-need areas. The department shall obtain and review proposals for opioid and methamphetamine treatment programs in accordance with its request-for-proposal procedures. A program under this section may not offer methadone treatment.

AB56-SA2,751b Section 751b. 51.422 (2) of the statutes is amended to read:

AB56-SA2,42,2 51.422 (2) Program components. An opioid or methamphetamine treatment program created under this section shall offer an assessment to individuals in need of service to determine what type of treatment is needed. The program shall transition individuals to a certified residential program, if that level of treatment is necessary. The program shall provide counseling, medication-assisted treatment, including both long-acting opioid antagonist and partial agonist medications that have been approved by the federal food and drug administration if for treating opioid addiction, and abstinence-based treatment. The program shall transition individuals who have completed treatment to county-based or private post-treatment care.”.

AB56-SA2,42,3 91. Page 365, line 9: delete lines 9 to 16 and substitute:

AB56-SA2,42,4 “ Section 752b. 51.441 of the statutes is created to read:

AB56-SA2,42,11 51.441 Comprehensive mental health consultation program. The department shall convene a statewide group of interested persons, including at least one representative of the Medical College of Wisconsin, to develop a concept paper, business plan, and standards for a comprehensive mental health consultation program that incorporates general psychiatry, geriatric psychiatry, addiction medicine and psychiatry, a perinatal psychiatry consultation program, and the child psychiatry consultation program under s. 51.442.”.

AB56-SA2,42,12 92. Page 369, line 19: after that line insert:

AB56-SA2,42,13 “ Section 775i. 66.0137 (4) of the statutes is amended to read:

AB56-SA2,42,20 66.0137 (4) Self-insured health plans. If a city, including a 1st class city, or a village provides health care benefits under its home rule power, or if a town provides health care benefits, to its officers and employees on a self-insured basis, the self-insured plan shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.728, 632.746 (1) and (10) (a) 2. and (b) 2., 632.747 (3), 632.798, 632.85, 632.853, 632.855, 632.867, 632.87 (4) to (6), 632.885, 632.89, 632.895 (9) (8) to (17), 632.896, and 767.513 (4).”.

AB56-SA2,42,21 93. Page 418, line 7: after that line insert:

AB56-SA2,42,22 “ Section 1686i. 120.13 (2) (g) of the statutes is amended to read:

AB56-SA2,43,2 120.13 (2) (g) Every self-insured plan under par. (b) shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.728, 632.746 (1) and (10) (a) 2. and (b) 2., 632.747 (3), 632.798, 632.85, 632.853, 632.855, 632.867, 632.87 (4) to (6), 632.885, 632.89, 632.895 (9) (8) to (17), 632.896, and 767.513 (4).”.

AB56-SA2,43,4 94. Page 427, line 19: delete the material beginning with that line and ending with page 428, line 18, and substitute:

AB56-SA2,43,5 “ Section 1764b. 146.63 (2) (a) of the statutes is amended to read:

AB56-SA2,43,13 146.63 (2) (a) Subject to subs. (4) and (5), the department shall distribute grants from the appropriation under s. 20.435 (1) (fj) (4) (bf) to assist rural hospitals and groups of rural hospitals in procuring infrastructure and increasing case volume to the extent necessary to develop accredited graduate medical training programs. The department shall distribute the grants under this paragraph to rural hospitals and groups of rural hospitals that apply to receive a grant under sub. (3) and that satisfy the criteria established by the department under par. (b) and the eligibility requirement under sub. (6).

AB56-SA2,1765b Section 1765b. 146.63 (6) (intro.) of the statutes is amended to read:

AB56-SA2,43,18 146.63 (6) Eligibility. (intro.) A rural hospital or group of rural hospitals may only receive a grant under sub. (3) if the plan to use the funds involves developing an accredited graduate medical training program in any of the following specialties a specialty, including any of the following:

AB56-SA2,1766b Section 1766b. 146.64 (2) (c) 1. of the statutes is amended to read:

AB56-SA2,44,2 146.64 (2) (c) 1. The department shall distribute funds for grants under par. (a) from the appropriation under s. 20.435 (4) (b) (bf). The department may not distribute more than $225,000 from the appropriation under s. 20.435 (4) (b) (bf) to a particular hospital in a given state fiscal year and may not distribute more than $75,000 from the appropriation under s. 20.435 (4) (b) (bf) to fund a given position in a graduate medical training program in a given state fiscal year.

AB56-SA2,1767b Section 1767b. 146.64 (4) (intro.) of the statutes is amended to read:

AB56-SA2,44,6 146.64 (4) Eligibility. (intro.) A hospital that has an accredited graduate medical training program in any of the following specialties a specialty, including any of the following, may apply to receive a grant under sub. (3):”.

AB56-SA2,44,7 95. Page 430, line 15: after that line insert:

AB56-SA2,44,8 “ Section 1801i. 185.983 (1) (intro.) of the statutes is amended to read:

AB56-SA2,44,16 185.983 (1) (intro.) Every voluntary nonprofit health care plan operated by a cooperative association organized under s. 185.981 shall be exempt from chs. 600 to 646, with the exception of ss. 601.04, 601.13, 601.31, 601.41, 601.42, 601.43, 601.44, 601.45, 611.26, 611.67, 619.04, 623.11, 623.12, 628.34 (10), 631.17, 631.89, 631.93, 631.95, 632.72 (2), 632.728, 632.745 to 632.749, 632.775, 632.79, 632.795, 632.798, 632.85, 632.853, 632.855, 632.867, 632.87 (2) to (6), 632.885, 632.89, 632.895 (5) and (8) to (17), 632.896, and 632.897 (10) and chs. 609, 620, 630, 635, 645, and 646, but the sponsoring association shall:”.

AB56-SA2,44,17 96. Page 433, line 4: after that line insert:

AB56-SA2,44,18 “ Section 1891b. 250.048 of the statutes is created to read:

AB56-SA2,44,24 250.048 Prescription drug importation program. (1) Importation program requirements. The department, in consultation with persons interested in the sale and pricing of prescription drugs and appropriate officials and agencies of the federal government, shall design and implement a prescription drug importation program for the benefit of residents of this state, that generates savings for residents, and that satisfies all of the following:

AB56-SA2,45,3 (a) The department shall designate a state agency to become a licensed wholesale distributor or to contract with a licensed wholesale distributor and shall seek federal certification and approval to import prescription drugs.

AB56-SA2,45,6 (b) The prescription drug importation program under this section shall comply with relevant requirements of 21 USC 384, including safety and cost savings requirements.

AB56-SA2,45,9 (c) The prescription drug importation program under this section shall import prescription drugs from Canadian suppliers regulated under any appropriate Canadian or provincial laws.

AB56-SA2,45,12 (d) The prescription drug importation program under this section shall have a process to sample the purity, chemical composition, and potency of imported prescription drugs.

AB56-SA2,45,16 (e) The prescription drug importation program under this section shall import only those prescription drugs for which importation creates substantial savings for residents of the state and only those prescription drugs that are not brand-name drugs and that have fewer than 4 competitor prescription drugs in the United States.

AB56-SA2,45,19 (f) The department shall ensure that prescription drugs imported under the program under this section are not distributed, dispensed, or sold outside of the state.

AB56-SA2,45,21 (g) The prescription drug importation program under this section shall ensure all of the following:

AB56-SA2,45,23 1. Participation by any pharmacy or health care provider in the program is voluntary.

AB56-SA2,45,25 2. Any pharmacy or health care provider participating in the program has the appropriate license or other credential in this state.

AB56-SA2,46,3 3. Any pharmacy or health care provider participating in the program charges a consumer or health plan the actual acquisition cost of the imported prescription drug that is dispensed.

AB56-SA2,46,7 (h) The prescription drug importation program under this section shall ensure that a payment by a health plan or health insurance policy for a prescription drug imported under the program reimburses no more than the actual acquisition cost of the imported prescription drug that is dispensed.

AB56-SA2,46,10 (i) The prescription drug importation program under this section shall ensure that any health plan or health insurance policy participating in the program does all of the following:

AB56-SA2,46,12 1. Maintains a formulary and claims payment system with current information on prescription drugs imported under the program.

AB56-SA2,46,15 2. Bases cost-sharing amounts for participants or insureds under the plan or policy on no more than the actual acquisition cost of the prescription drug imported under the program that is dispensed to the participant or insured.

AB56-SA2,46,18 3. Demonstrates to the department or a state agency designated by the department how premiums under the policy or plan are affected by savings on prescription drugs imported under the program.

AB56-SA2,46,21 (j) Any wholesale distributor importing prescription drugs under the program under this section shall limit its profit margin to the amount established by the department or a state agency designated by the department.

AB56-SA2,46,24 (k) The prescription drug importation program under this section may not import any generic prescription drug that would violate federal patent laws on branded products in this country.

AB56-SA2,47,5 (L) The prescription drug importation program under this section shall comply to the extent practical and feasible before the prescription drug to be imported comes into possession of the state's wholesale distributor and fully after the prescription drug to be imported is in possession of the state's wholesale distributor with tracking and tracing requirements of 21 USC 360eee to 360eee-1.

AB56-SA2,47,8 (m) The prescription drug importation program under this section shall establish a fee or other approach to finance the program that does not jeopardize significant savings to residents of the state.

AB56-SA2,47,10 (n) The prescription drug importation program under this section shall have an audit function that ensures all of the following:

AB56-SA2,47,13 1. The department has a sound methodology to determine the most cost-effective prescription drugs to include in the importation program under this section.

AB56-SA2,47,15 2. The department has a process in place to select Canadian suppliers that are high quality, high performing, and in full compliance with Canadian laws.

AB56-SA2,47,17 3. Prescription drugs imported under the program are pure, unadulterated, potent, and safe.