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AB68-ASA2-AA2,28,98 49.45 (23b) (title) Childless adults demonstration project reform waiver
9implementation required.
AB68-ASA2-AA2,229g 10Section 229g. 49.45 (23b) (b) of the statutes is amended to read:
AB68-ASA2-AA2,28,1411 49.45 (23b) (b) Beginning as soon as practicable after October 31, 2018, and
12ending no sooner than December 31, 2023, the department shall do all of the
13following with regard to the childless adults demonstration project under sub. (23)
14s. 49.471 (4) (a) 8.:
AB68-ASA2-AA2,28,2015 1. Require in each month persons, except exempt individuals, who are eligible
16to receive Medical Assistance under sub. (23) s. 49.471 (4) (a) 8. and who are at least
1719 years of age but have not attained the age of 50 to participate in, document, and
18report 80 hours per calendar month of community engagement activities. The
19department, after finding good cause, may grant a temporary exemption from the
20requirement under this subdivision upon request of a Medical Assistance recipient.
AB68-ASA2-AA2,28,2321 2. Require persons with incomes of at least 50 percent of the poverty line to pay
22premiums in accordance with par. (c) as a condition of eligibility for Medical
23Assistance under sub. (23) s. 49.471 (4) (a) 8.
AB68-ASA2-AA2,28,2524 3. Require as a condition of eligibility for Medical Assistance under sub. (23)
25s. 49.471 (4) (a) 8. completion of a health risk assessment.
AB68-ASA2-AA2,29,3
14. Charge recipients of Medical Assistance under sub. (23) s. 49.471 (4) (a) 8.
2an $8 copayment for nonemergency use of the emergency department in accordance
3with 42 USC 1396o-1 (e) (1) and 42 CFR 447.54.
AB68-ASA2-AA2,29,84 5. Disenroll from Medical Assistance under sub. (23) s. 49.471 (4) (a) 8. for 6
5months any individual who does not pay a required premium under subd. 2. and any
6individual who is required under subd. 1. to participate in a community engagement
7activity but who does not participate for 48 aggregate months in the community
8engagement activity.
AB68-ASA2-AA2,229h 9Section 229h. 49.45 (23b) (c) of the statutes is amended to read:
AB68-ASA2-AA2,29,1510 49.45 (23b) (c) 1. Persons who are eligible for the demonstration project under
11sub. (23) s. 49.471 (4) (a) 8. and who have monthly household income that exceeds
1250 percent of the poverty line shall pay a monthly premium amount of $8 per
13household. A person who is eligible to receive an item or service furnished by an
14Indian health care provider is exempt from the premium requirement under this
15subdivision.
AB68-ASA2-AA2,29,2116 2. The department may disenroll under par. (b) 5. a person for nonpayment of
17a required monthly premium only at annual eligibility redetermination after
18providing notice and reasonable opportunity for the person to pay. If a person who
19is disenrolled for nonpayment of premiums pays all owed premiums or becomes
20exempt from payment of premiums, he or she may reenroll in Medical Assistance
21under sub. (23) s. 49.471 (4) (a) 8.
AB68-ASA2-AA2,29,2522 3. The department shall reduce the amount of the required household premium
23by up to half for a recipient of Medical Assistance under sub. (23) s. 49.471 (4) (a) 8.
24who does not engage in certain behaviors that increase health risks or who attests
25to actively managing certain unhealthy behaviors.
AB68-ASA2-AA2,229j
1Section 229j. 49.45 (23b) (e) of the statutes is amended to read:
AB68-ASA2-AA2,30,62 49.45 (23b) (e) Before December 31, 2023, the demonstration project
3requirements under this subsection may not be withdrawn and the department may
4not request from the federal government withdrawal, suspension, or termination of
5the demonstration project requirements under this subsection unless legislation has
6been enacted specifically allowing for the withdrawal, suspension, or termination.
AB68-ASA2-AA2,229m 7Section 229m. 49.45 (24L) of the statutes is created to read:
AB68-ASA2-AA2,30,118 49.45 (24L) Critical access reimbursement payments to dental providers. (a)
9Based on the criteria in pars. (b) and (c), the department shall increase
10reimbursements to dental providers that meet quality of care standards, as
11established by the department.
AB68-ASA2-AA2,30,1312 (b) In order to be eligible for enhanced reimbursement under this subsection,
13the provider must meet one of the following qualifications:
AB68-ASA2-AA2,30,1614 1. For a nonprofit or public provider, 50 percent or more of the individuals
15served by the provider are individuals who are without dental insurance or are
16enrolled in the Medical Assistance program.
AB68-ASA2-AA2,30,1817 2. For a for-profit provider, 5 percent or more of the individuals served by the
18provider are enrolled in the Medical Assistance program.
AB68-ASA2-AA2,31,419 (c) For dental services rendered on or after January 1, 2022, by a qualified
20nonprofit or public dental provider, the department shall increase reimbursement by
2150 percent above the reimbursement rate that would otherwise be paid to that
22provider. For dental services rendered on or after January 1, 2022, by a qualified
23for-profit dental provider, the department shall increase reimbursement by 30
24percent above the reimbursement rate that would otherwise be paid to that provider.
25For dental providers rendering services to individuals in managed care under the

1Medical Assistance program, for services rendered on or after January 1, 2022, the
2department shall increase reimbursement to pay an additional amount on the basis
3of the rate that would have been paid to the dental provider had the individual not
4been enrolled in managed care.
AB68-ASA2-AA2,31,75 (d) If a provider has more than one service location, the thresholds described
6under par. (b) apply to each location, and the department will determine the payment
7for each separate service location.
AB68-ASA2-AA2,31,98 (e) Any provider that receives reimbursement through the pilot project under
9sub. (24k) is not eligible for reimbursement under this subsection.
AB68-ASA2-AA2,229p 10Section 229p. 49.45 (25r) of the statutes is created to read:
AB68-ASA2-AA2,31,1111 49.45 (25r) Community health worker services. (a) In this subsection:
AB68-ASA2-AA2,31,1312 1. “Community health services” means services provided by a community
13health worker.
AB68-ASA2-AA2,31,2114 2. “Community health worker” means a front-line public health worker who
15is a trusted member of or has a close understanding of the community served,
16enabling the worker to serve as a liaison, link, or intermediary between health and
17social services and the community to facilitate access to services and improve the
18quality and cultural competence of service delivery, and who builds individual and
19community capacity by increasing health knowledge and self-sufficiency through a
20range of activities such as outreach, community education, informal counseling,
21social support, and advocacy.
AB68-ASA2-AA2,32,422 (b) The department shall request any necessary waiver from, or submit any
23necessary amendments to the state Medical Assistance plan to, the secretary of the
24federal department of health and human services to provide community health
25services to eligible Medical Assistance recipients. If the waiver or state plan

1amendment is granted, the department shall reimburse certified providers for those
2community health services approved by the federal department of health and human
3services for Medical Assistance coverage and as provided to Medical Assistance
4recipients under s. 49.46 (2) (b) 9m.
AB68-ASA2-AA2,229r 5Section 229r. 49.45 (30e) (a) 2. of the statutes is repealed.
AB68-ASA2-AA2,229s 6Section 229s. 49.45 (30e) (b) 3. of the statutes is amended to read:
AB68-ASA2-AA2,32,97 49.45 (30e) (b) 3. Requirements for certification of community-based
8psychosocial service programs. The department may certify county-based providers
9and providers that are not county-based providers.
AB68-ASA2-AA2,229t 10Section 229t. 49.45 (30e) (c) of the statutes is renumbered 49.45 (30e) (c) 1.
11and amended to read:
AB68-ASA2-AA2,32,1812 49.45 (30e) (c) 1. A The department shall reimburse a county that elects to
13make the provide services under s. 49.46 (2) (b) 6. Lm. available shall reimburse a
14provider of the services
for the amount of the allowable charges for those services
15under the medical assistance Medical Assistance program that is not provided by the
16federal government. The department shall reimburse the provider only for and the
17amount of the allowable charges for those services under the medical assistance
18Medical Assistance program that is provided by the federal government.
AB68-ASA2-AA2,229u 19Section 229u. 49.45 (30e) (c) 2. of the statutes is created to read:
AB68-ASA2-AA2,32,2220 49.45 (30e) (c) 2. The department shall reimburse to a provider that is not a
21county-based provider for services under s. 49.46 (2) (b) 6. Lm. for both the federal
22and nonfederal share of a fee schedule that is determined by the department.
AB68-ASA2-AA2,229v 23Section 229v. 49.45 (30e) (d) of the statutes is amended to read:
AB68-ASA2-AA2,33,624 49.45 (30e) (d) Provision of services on regional basis. Notwithstanding par.
25(c) 1. and subject to par. (e), in counties that elect to deliver provide the services under

1s. 49.46 (2) (b) 6. Lm. through the Medical Assistance program on a regional basis
2according to criteria established by the department, the department shall reimburse
3a provider of the services for the amount of the allowable charges for those services
4under the Medical Assistance program that is provided by the federal government
5and for the amount of the allowable charges that is not provided by the federal
6government.
AB68-ASA2-AA2,229x 7Section 229x. 49.45 (30t) of the statutes is created to read:
AB68-ASA2-AA2,33,88 49.45 (30t) Doula services. (a) In this subsection:
AB68-ASA2-AA2,33,109 1. “Certified doula” means an individual who has received certification from a
10doula certifying organization recognized by the department.
AB68-ASA2-AA2,33,1311 2. “Doula services” means childbirth education and support services, including
12emotional and physical support provided during pregnancy, labor, birth, and the
13postpartum period.
AB68-ASA2-AA2,33,1914 (b) The department shall request from the secretary of the federal department
15of health and human services any required waiver or any required amendment to the
16state plan for Medical Assistance to allow reimbursement for doula services provided
17by a certified doula. If the waiver or state plan amendment is granted, the
18department shall reimburse a certified doula under s. 49.46 (2) (b) 12p. for the
19allowable charges for doula services provided to Medical Assistance recipients.”.
AB68-ASA2-AA2,33,21 2089. Page 292, line 13: delete the material beginning with that line and ending
21with page 294, line 2, and substitute:
AB68-ASA2-AA2,33,22 22 Section 230b. 49.46 (1) (a) 1m. of the statutes is amended to read:
AB68-ASA2-AA2,34,223 49.46 (1) (a) 1m. Any pregnant woman whose income does not exceed the
24standard of need under s. 49.19 (11) and whose pregnancy is medically verified.

1Eligibility continues to the last day of the month in which the 60th 365th day after
2the last day of the pregnancy falls.
AB68-ASA2-AA2,230d 3Section 230d. 49.46 (1) (j) of the statutes is amended to read:
AB68-ASA2-AA2,34,74 49.46 (1) (j) An individual determined to be eligible for benefits under par. (a)
59. remains eligible for benefits under par. (a) 9. for the balance of the pregnancy and
6to the last day of the month in which the 60th 365th day after the last day of the
7pregnancy falls without regard to any change in the individual's family income.
AB68-ASA2-AA2,230f 8Section 230f. 49.46 (2) (b) 8m. of the statutes is created to read:
AB68-ASA2-AA2,34,109 49.46 (2) (b) 8m. Room and board for residential substance use disorder
10treatment.
AB68-ASA2-AA2,230h 11Section 230h. 49.46 (2) (b) 9m. of the statutes is created to read:
AB68-ASA2-AA2,34,1212 49.46 (2) (b) 9m. Community health services, as specified under s. 49.45 (25r).
AB68-ASA2-AA2,230j 13Section 230j. 49.46 (2) (b) 11m. of the statutes is created to read:
AB68-ASA2-AA2,34,1514 49.46 (2) (b) 11m. Subject to par. (bx), acupuncture provided by an
15acupuncturist who holds a certificate under ch. 451.
AB68-ASA2-AA2,230k 16Section 230k. 49.46 (2) (b) 12p. of the statutes is created to read:
AB68-ASA2-AA2,34,1817 49.46 (2) (b) 12p. Doula services provided by a certified doula, as specified
18under s. 49.45 (30t).
AB68-ASA2-AA2,230n 19Section 230n. 49.46 (2) (b) 24. of the statutes is created to read:
AB68-ASA2-AA2,34,2120 49.46 (2) (b) 24. Subject to par. (bv), nonmedical services that contribute to the
21determinants of health.
AB68-ASA2-AA2,230p 22Section 230p. 49.46 (2) (bv) of the statutes is created to read:
AB68-ASA2-AA2,35,423 49.46 (2) (bv) The department shall determine those services under par. (b) 24.
24that contribute to the determinants of health. The department shall seek any
25necessary state plan amendment or request any waiver of federal Medicaid law to

1implement this paragraph. The department is not required to provide the services
2under this paragraph as a benefit under the Medical Assistance program if the
3federal department of health and human services does not provide federal financial
4participation for the services under this paragraph.
AB68-ASA2-AA2,230r 5Section 230r. 49.46 (2) (bx) of the statutes is created to read:
AB68-ASA2-AA2,35,126 49.46 (2) (bx) The department shall submit to the federal department of health
7and human services any request for a state plan amendment, waiver, or other federal
8approval necessary to provide reimbursement for the benefit under par. (b) 11m. If
9the federal department approves the request or if no federal approval is necessary,
10the department shall provide the benefit and reimbursement under par. (b) 11m. If
11the federal department disapproves the request, the department may not provide the
12benefit or reimbursement for the benefit described under par. (b) 11m.
AB68-ASA2-AA2,230u 13Section 230u. 49.47 (4) (ag) 2. of the statutes is amended to read:
AB68-ASA2-AA2,35,1614 49.47 (4) (ag) 2. Pregnant and the woman's pregnancy is medically verified
15Eligibility continues to the last day of the month in which the 60th 365th day after
16the last day of the pregnancy falls.
AB68-ASA2-AA2,231b 17Section 231b. 49.471 (1) (cr) of the statutes is created to read:
AB68-ASA2-AA2,35,1918 49.471 (1) (cr) “Enhanced federal medical assistance percentage" means a
19federal medical assistance percentage described under 42 USC 1396d (y) or (z).
AB68-ASA2-AA2,231d 20Section 231d. 49.471 (4) (a) 4. b. of the statutes is amended to read:
AB68-ASA2-AA2,35,2321 49.471 (4) (a) 4. b. The individual's family income does not exceed 100 133
22percent of the poverty line before application of the 5 percent income disregard under
2342 CFR 435.603 (d)
.
AB68-ASA2-AA2,231f 24Section 231f. 49.471 (4) (a) 8. of the statutes is created to read:
AB68-ASA2-AA2,35,2525 49.471 (4) (a) 8. An individual who meets all of the following criteria:
AB68-ASA2-AA2,36,1
1a. The individual is an adult under the age of 65.
AB68-ASA2-AA2,36,32 b. The individual has a family income that does not exceed 133 percent of the
3poverty line, except as provided in sub. (4g).
AB68-ASA2-AA2,36,54 c. The individual is not otherwise eligible for the Medical Assistance program
5under this subchapter or the Medicare program under 42 USC 1395 et seq.
AB68-ASA2-AA2,231j 6Section 231j. 49.471 (4g) of the statutes is created to read:
AB68-ASA2-AA2,36,167 49.471 (4g) Medicaid expansion; federal medical assistance percentage. For
8services provided to individuals described under sub. (4) (a) 8., the department shall
9comply with all federal requirements to qualify for the highest available enhanced
10federal medical assistance percentage. The department shall submit any
11amendment to the state medical assistance plan, request for a waiver of federal
12Medicaid law, or other approval request required by the federal government to
13provide services to the individuals described under sub. (4) (a) 8. and qualify for the
14highest available enhanced federal medical assistance percentage. Sections 20.940
15and 49.45 (2t) do not apply to a submission to the federal government under this
16subsection.
AB68-ASA2-AA2,231m 17Section 231m. 49.471 (6) (b) of the statutes is amended to read:
AB68-ASA2-AA2,36,2218 49.471 (6) (b) A pregnant woman who is determined to be eligible for benefits
19under sub. (4) remains eligible for benefits under sub. (4) for the balance of the
20pregnancy and to the last day of the month in which the 60th 365th day after the last
21day of the pregnancy falls without regard to any change in the woman's family
22income.
AB68-ASA2-AA2,231p 23Section 231p. 49.471 (6) (L) of the statutes is created to read:
AB68-ASA2-AA2,37,924 49.471 (6) (L) The department shall request from the federal department of
25health and human services approval of a state plan amendment, a waiver of federal

1Medicaid law, or approval of a demonstration project to maintain eligibility for
2postpartum women to the last day of the month in which the 365th day after the last
3day of the pregnancy falls under ss. 49.46 (1) (a) 1m. and 9. and (j), 49.47 (4) (ag) 2.,
4and 49.471 (4) (a) 1g. and 1m., (6) (b), and (7) (b) 1. The department shall cover and
5provide reimbursement for services under ss. 49.46 (1) (a) 1m. and 9. and (j), 49.47
6(4) (ag) 2., and 49.471 (4) (a) 1g. and 1m., (6) (b), and (7) (b) 1. regardless of whether
7a state plan amendment, waiver of federal Medicaid law, or approval of a
8demonstration project related to coverage or reimbursement of these services is
9granted by the federal department of human services.
AB68-ASA2-AA2,231t 10Section 231t. 49.471 (7) (b) 1. of the statutes is amended to read:
AB68-ASA2-AA2,37,2111 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 365th
19day after the last day of the woman's pregnancy falls. Eligibility obtained by a
20pregnant woman under this subdivision extends to all pregnant women in the
21pregnant woman's family.
AB68-ASA2-AA2,231w 22Section 231w. 49.686 (3) (d) of the statutes is amended to read:
AB68-ASA2-AA2,38,323 49.686 (3) (d) Has applied for coverage under and has been denied eligibility
24for medical assistance within 12 months prior to application for reimbursement
25under sub. (2). This paragraph does not apply to an individual who is eligible for

1benefits under the demonstration project for childless adults under s. 49.45 (23) or
2to an individual who is eligible for benefits under BadgerCare Plus under s. 49.471
3(4) (a) 8. or (11).
AB68-ASA2-AA2,232d 4Section 232d. 49.79 (7r) (d) of the statutes is created to read:
AB68-ASA2-AA2,38,75 49.79 (7r) (d) The department may expend from the appropriation under s.
620.435 (4) (bt) no more than $425,000 per fiscal year for the pilot program under this
7subsection.
AB68-ASA2-AA2,232g 8Section 232g. 49.79 (9) (a) 1g. of the statutes is amended to read:
AB68-ASA2-AA2,38,179 49.79 (9) (a) 1g. Except as provided in subds. 2. and 3., beginning October 1,
102019,
the department shall require, to the extent allowed by the federal government,
11all
able-bodied adults without dependents in this state to participate in the
12employment and training program under this subsection, except for able-bodied
13adults without dependents who are employed, as determined by the department.
14The department may require other able individuals who are 18 to 60 years of age, or
15a subset of those individuals to the extent allowed by the federal government, who
16are not participants in a Wisconsin Works employment position to participate in the
17employment and training program under this subsection.
AB68-ASA2-AA2,232j 18Section 232j. 49.79 (9) (d) of the statutes is repealed.
AB68-ASA2-AA2,232L 19Section 232L. 49.79 (9) (f) of the statutes is repealed.
AB68-ASA2-AA2,232p 20Section 232p. 49.791 of the statutes is repealed.
AB68-ASA2-AA2,232v 21Section 232v. 51.035 of the statutes is created to read:
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