Amendment AA16-ASA2-AB50

AB50-ASA2-AA16,7,1 “Section 9219. Fiscal changes; Health Services.

AB50-ASA2-AA16,7,7 (1) Aging and disability resource centers and tribal resource specialists. In the schedule under s. 20.005 (3) for the appropriation to the department of health services under s. 20.435 (4) (b), the dollar amount for fiscal year 2025-26 is increased by $1,615,200 and the dollar amount for fiscal year 2026- 27 is increased by $3,230,500 to increase base allocations for aging and disability resource centers and tribal aging and disability resource specialists.”.

AB50-ASA2-AA16,7,8 9. At the appropriate places, insert all of the following:

AB50-ASA2-AA16,7,9 “Section 9219. Fiscal changes; Health Services.

AB50-ASA2-AA16,7,16 (1) Adult protective services. In the schedule under s. 20.005 (3) for the appropriation to the department of health services under s. 20.435 (7) (b), the dollar amount for fiscal year 2025-26 is increased by $2,569,800 and the dollar amount for fiscal year 2026-27 is increased by $5,089,700 to increase funding for adult protective services and to increase the authorized FTE positions for the department by 1.0 GPR position beginning in fiscal year 2025-26 to facilitate tribal nation adult protective services coordination.”.

AB50-ASA2-AA16,7,17 10. At the appropriate places, insert all of the following:

AB50-ASA2-AA16,7,18 “Section 9219. Fiscal changes; Health Services.

AB50-ASA2-AA16,7,23 (1) Home and community based services. In the schedule under s. 20.005 (3) for the appropriation to the department of health services under s. 20.435 (4) (bd), the dollar amount for fiscal year 2025-26 is increased by $2,596,300 and the dollar amount for fiscal year 2026-27 is increased by $2,608,100 to provide ongoing funding for all of the following:

AB50-ASA2-AA16,8,4 (a) Aging and disability resource centers information technology projects focused on client-tracking and a searchable public-facing provider directory, as well as a centralized, statewide toll-free phone number and reception service to connect people with their local aging and disability resource center.

AB50-ASA2-AA16,8,7 (b) The No Wrong Door - Supporting Kids Together Wisconsin initiative, through which parents with children who are disabled can access services and referrals from a single toll-free phone line and website.

AB50-ASA2-AA16,8,9 (c) The resident and assisted living facility assessment tool, which allows for data collection and reporting relating to resident acuity and other factors.”.

AB50-ASA2-AA16,8,10 11. At the appropriate places, insert all of the following:

AB50-ASA2-AA16,8,11 “Section 9219. Fiscal changes; Health Services.

AB50-ASA2-AA16,8,19 (1) Supplemental security income state benefit increase. In the schedule under s. 20.005 (3) for the appropriation to the department of health services under s. 20.435 (4) (ed), the dollar amount for fiscal year 2025-26 is increased by $714,000 and the dollar amount for fiscal year 2026-27 is increased by $14,933,500 to increase monthly state supplements to the federal supplemental security income case benefit from $83.78 to $100 per month for the standard state supplement, and from $179.77 per month to $214.57 for “exceptional expense” state supplements.”.

AB50-ASA2-AA16,8,20 12. At the appropriate places, insert all of the following:

AB50-ASA2-AA16,8,21 “Section 10. 71.54 (1) (g) (intro.) of the statutes is amended to read:

AB50-ASA2-AA16,9,2 71.54 (1) (g) 2012 and thereafter to 2025. (intro.) The amount of any claim filed in 2012 and thereafter to 2025 and based on property taxes accrued or rent constituting property taxes accrued during the previous year is limited as follows:

AB50-ASA2-AA16,11 Section 11. 71.54 (1) (g) 4. of the statutes is amended to read:

AB50-ASA2-AA16,9,10 71.54 (1) (g) 4. Except as provided in subds. 5. and 7., for For claims filed in 2018 and thereafter and based on property taxes accrued or rent constituting property taxes accrued during the previous year, no credit may be allowed under this paragraph if the claimant has no earned income in the taxable year to which the claim relates unless the claimant is disabled and provides the proof required under subd. 6. or the claimant or the claimant’s spouse is over the age of 61 at the close of the year to which the claim relates.

AB50-ASA2-AA16,12 Section 12. 71.54 (1) (g) 5. of the statutes is repealed.

AB50-ASA2-AA16,13 Section 13. 71.54 (1) (g) 6. (intro.) of the statutes is amended to read:

AB50-ASA2-AA16,9,16 71.54 (1) (g) 6. (intro.) With regard to a claimant who is disabled, the A claimant who is disabled shall provide with his or her return proof that his or her disability is in effect for the taxable year to which the claim relates. Proof of disability may be demonstrated by any of the following:

AB50-ASA2-AA16,14 Section 14. 71.54 (1) (g) 7. of the statutes is repealed.

AB50-ASA2-AA16,15 Section 15. 71.54 (1) (h) of the statutes is created to read:

AB50-ASA2-AA16,9,21 71.54 (1) (h) 2026 and thereafter. Subject to sub. (2m), the amount of any claim filed in 2026 and thereafter and based on property taxes accrued or rent constituting property taxes accrued during the previous year is limited as follows:

AB50-ASA2-AA16,9,23 1. If the household income was $19,000 or less in the year to which the claim relates, the claim is limited to 80 percent of the property taxes accrued or rent constituting property taxes accrued or both in that year on the claimant’s homestead.

AB50-ASA2-AA16,10,7 2. If the household income was more than $19,000 in the year to which the claim relates, the claim is limited to 80 percent of the amount by which the property taxes accrued or rent constituting property taxes accrued or both in that year on the claimant’s homestead exceeds 7.891 percent of the household income exceeding $19,000.

AB50-ASA2-AA16,10,8 3. No credit may be allowed if the household income exceeds $37,500.

AB50-ASA2-AA16,10,10 4. Notwithstanding the time limitations described in par. (g) (intro.), the provisions of par. (g) 4. apply to claims filed under this paragraph.

AB50-ASA2-AA16,16 Section 16. 71.54 (2) (b) 4. of the statutes is amended to read:

AB50-ASA2-AA16,10,13 71.54 (2) (b) 4. In calendar years 2011 or any subsequent calendar year to 2024, $1,460.

AB50-ASA2-AA16,17 Section 17. 71.54 (2) (b) 5. of the statutes is created to read:

AB50-ASA2-AA16,10,16 71.54 (2) (b) 5. Subject to sub. (2m), in calendar year 2025 or any subsequent calendar year, $1,460.

AB50-ASA2-AA16,18 Section 18. 71.54 (2m) of the statutes is amended to read:

AB50-ASA2-AA16,11,12 71.54 (2m) Indexing for inflation; 2010 2026 and thereafter. (a) For calendar years beginning after December 31, 2009, and before January 1, 2011 2025, the dollar amounts of the threshold income under sub. (1) (f) (h) 1. and 2., the maximum household income under sub. (1) (f) (h) 3., and the maximum property taxes under sub. (2) (b) 3. 5. shall be increased each year by a percentage equal to the percentage change between the U.S. consumer price index for all urban consumers, U.S. city average, for the 12-month average of the U.S. consumer price index for the month of August of the year before the previous year through the month of July of the previous year and the U.S. consumer price index for all urban consumers, U.S. city average, for the 12-month average of the U.S. consumer price index for August 2007 through July 2008 2024, as determined by the federal department of labor, except that the adjustment may occur only if the percentage is a positive number. Each amount that is revised under this paragraph shall be rounded to the nearest multiple of $10 if the revised amount is not a multiple of $10 or, if the revised amount is a multiple of $5, such an amount shall be increased to the next higher multiple of $10. The department of revenue shall annually adjust the changes in dollar amounts required under this paragraph and incorporate the changes into the income tax forms and instructions.

AB50-ASA2-AA16,11,18 (b) The department of revenue shall annually adjust the slope under sub. (1) (f) (h) 2. such so that, as a claimant’s income increases from the threshold income as calculated adjusted under par. (a), to an amount that exceeds the maximum household income as calculated adjusted under par. (a), the credit that may be claimed is reduced to $0, and the department of revenue shall incorporate the changes into the income tax forms and instructions.

AB50-ASA2-AA16,9337 Section 9337. Initial applicability; Revenue.

AB50-ASA2-AA16,11,21 (1) Homestead tax credit. The treatment of s. 71.54 (1) (h) first applies to claims filed for taxable years beginning after December 31, 2024.”.

AB50-ASA2-AA16,11,22 13. At the appropriate places, insert all of the following:

AB50-ASA2-AA16,11,23 “Section 9123. Nonstatutory provisions; Insurance.

AB50-ASA2-AA16,12,3 (1) Prescription drug purchasing entity. During the 2025-27 fiscal biennium, the office of the commissioner of insurance shall conduct a study on the viability of creating or implementing a state prescription drug purchasing entity.”.

AB50-ASA2-AA16,12,4 14. At the appropriate places, insert all of the following:

AB50-ASA2-AA16,12,5 “Section 19. 601.41 (14) of the statutes is created to read:

AB50-ASA2-AA16,12,11 601.41 (14) Value-based diabetes medication pilot project. The commissioner shall develop a pilot project to direct a pharmacy benefit manager, as defined in s. 632.865 (1) (c), and a pharmaceutical manufacturer to create a value- based, sole-source arrangement to reduce the costs of prescription medication used to treat diabetes. The commissioner may promulgate rules to implement this subsection.”.

AB50-ASA2-AA16,12,12 15. At the appropriate places, insert all of the following:

AB50-ASA2-AA16,12,13 “Section 20. 632.868 of the statutes is created to read:

AB50-ASA2-AA16,12,14 632.868 Insulin safety net programs. (1) Definitions. In this section:

AB50-ASA2-AA16,12,16 (a) “Manufacturer” means a person engaged in the manufacturing of insulin that is self-administered on an outpatient basis.

AB50-ASA2-AA16,12,17 (b) “Navigator” has the meaning given in s. 628.90 (3).

AB50-ASA2-AA16,12,19 (c) “Patient assistance program” means a program established by a manufacturer under sub. (3) (a).

AB50-ASA2-AA16,12,20 (d) “Pharmacy” means an entity licensed under s. 450.06 or 450.065.

AB50-ASA2-AA16,12,23 (e) “Urgent need of insulin” means having less than a 7-day supply of insulin readily available for use and needing insulin in order to avoid the likelihood of suffering a significant health consequence.

AB50-ASA2-AA16,13,2 (f) “Urgent need safety net program” means a program established by a manufacturer under sub. (2) (a).

AB50-ASA2-AA16,13,6 (2) Urgent need safety net program. (a) Establishment of program. No later than July 1, 2026, each manufacturer shall establish an urgent need safety net program to make insulin available in accordance with this subsection to individuals who meet the eligibility requirements under par. (b).

AB50-ASA2-AA16,13,8 (b) Eligible individual. An individual is eligible to receive insulin under an urgent need safety net program if all of the following conditions are met:

AB50-ASA2-AA16,13,9 1. The individual is in urgent need of insulin.

AB50-ASA2-AA16,13,10 2. The individual is a resident of this state.

AB50-ASA2-AA16,13,11 3. The individual is not receiving public assistance under ch. 49.

AB50-ASA2-AA16,13,16 4. The individual is not enrolled in prescription drug coverage through an individual or group health plan that limits the total cost sharing amount, including copayments, deductibles, and coinsurance, that an enrollee is required to pay for a 30-day supply of insulin to no more than $75, regardless of the type or amount of insulin prescribed.

AB50-ASA2-AA16,13,18 5. The individual has not received insulin under an urgent need safety net program within the previous 12 months, except as allowed under par. (d).

AB50-ASA2-AA16,13,22 (c) Provision of insulin under an urgent need safety net program. 1. In order to receive insulin under an urgent need safety net program, an individual who meets the eligibility requirements under par. (b) shall provide a pharmacy with all of the following:

AB50-ASA2-AA16,14,3 a. A completed application, on a form prescribed by the commissioner that includes an attestation by the individual, or the individual’s parent or legal guardian if the individual is under the age of 18, that the individual meets all of the eligibility requirements under par. (b).

AB50-ASA2-AA16,14,4 b. A valid insulin prescription.

AB50-ASA2-AA16,14,7 c. A valid Wisconsin driver’s license or state identification card. If the individual is under the age of 18, the individual’s parent or legal guardian shall meet this requirement.

AB50-ASA2-AA16,14,15 2. Upon receipt of the information described in subd. 1. a. to c., the pharmacist shall dispense a 30-day supply of the prescribed insulin to the individual. The pharmacy shall also provide the individual with the information sheet described in sub. (8) (b) 2. and the list of navigators described in sub. (8) (c). The pharmacy may collect a copayment, not to exceed $35, from the individual to cover the pharmacy’s costs of processing and dispensing the insulin. The pharmacy shall notify the health care practitioner who issued the prescription no later than 72 hours after the insulin is dispensed.

AB50-ASA2-AA16,14,23 3. A pharmacy that dispenses insulin under subd. 2. may submit to the manufacturer, or the manufacturer’s vendor, a claim for payment that is in accordance with the national council for prescription drug programs’ standards for electronic claims processing, except that no claim may be submitted if the manufacturer agrees to send the pharmacy a replacement of the same insulin in the amount dispensed. If the pharmacy submits an electronic claim, the manufacturer or vendor shall reimburse the pharmacy in an amount that covers the pharmacy’s acquisition cost.

AB50-ASA2-AA16,15,2 4. A pharmacy that dispenses insulin under subd. 2. shall retain a copy of the application form described in subd. 1. a.

AB50-ASA2-AA16,15,9 (d) Eligibility of certain individuals. An individual who has applied for public assistance under ch. 49 but for whom a determination of eligibility has not been made or whose coverage has not become effective or an individual who has an appeal pending under sub. (3) (c) 4. may access insulin under this subsection if the individual is in urgent need of insulin. To access a 30-day supply of insulin, the individual shall attest to the pharmacy that the individual is described in this paragraph and comply with par. (c) 1.

AB50-ASA2-AA16,15,14 (3) Patient assistance program. (a) Establishment of program. No later than July 1, 2026, each manufacturer shall establish a patient assistance program to make insulin available in accordance with this subsection to individuals who meet the eligibility requirements under par. (b). Under the patient assistance program, the manufacturer shall do all of the following:

AB50-ASA2-AA16,15,17 1. Provide the commissioner with information regarding the patient assistance program, including contact information for individuals to call for assistance in accessing the patient assistance program.

AB50-ASA2-AA16,15,19 2. Provide a hotline for individuals to call or access between 8 a.m. and 10 p.m. on weekdays and between 10 a.m. and 6 p.m. on Saturdays.

AB50-ASA2-AA16,15,21 3. List the eligibility requirements under par. (b) on the manufacturer’s website.

AB50-ASA2-AA16,16,2 4. Maintain the privacy of all information received from an individual applying for or participating in the patient assistance program and not sell, share, or disseminate the information unless required under this section or authorized, in writing, by the individual.

AB50-ASA2-AA16,16,4 (b) Eligible individual. An individual shall be eligible to receive insulin under a patient assistance program if all of the following conditions are met:

AB50-ASA2-AA16,16,5 1. The individual is a resident of this state.

AB50-ASA2-AA16,16,8 2. The individual, or the individual’s parent or legal guardian if the individual is under the age of 18, has a valid Wisconsin driver’s license or state identification card.

AB50-ASA2-AA16,16,9 3. The individual has a valid insulin prescription.

AB50-ASA2-AA16,16,12 4. The family income of the individual does not exceed 400 percent of the poverty line as defined and revised annually under 42 USC 9902 (2) for a family the size of the individual’s family.

AB50-ASA2-AA16,16,13 5. The individual is not receiving public assistance under ch. 49.

AB50-ASA2-AA16,16,19 6. The individual is not eligible to receive health care through a federally funded program or receive prescription drug benefits through the U.S. department of veterans affairs, except that this subdivision does not apply to an individual who is enrolled in a policy under Part D of Medicare under 42 USC 1395w-101 et seq. if the individual has spent at least $1,000 on prescription drugs in the current calendar year.

AB50-ASA2-AA16,17,2 7. The individual is not enrolled in prescription drug coverage through an individual or group health plan that limits the total cost sharing amount, including copayments, deductibles, and coinsurance, that an enrollee is required to pay for a 30-day supply of insulin to no more than $75, regardless of the type or amount of insulin needed.

AB50-ASA2-AA16,17,12 (c) Application for patient assistance program. 1. An individual may apply to participate in a patient assistance program by filing an application with the manufacturer that established the patient assistance program, the individual’s health care practitioner if the practitioner participates in the patient assistance program, or a navigator included on the list under sub. (8) (c). A health care practitioner or navigator shall immediately submit the application to the manufacturer. Upon receipt of an application, the manufacturer shall determine the individual’s eligibility under par. (b) and, except as provided in subd. 2., notify the individual of the determination no later than 10 days after receipt of the application.

AB50-ASA2-AA16,17,18 2. If necessary to determine the individual’s eligibility under par. (b), the manufacturer may request additional information from an individual who has filed an application under subd. 1. no later than 5 days after receipt of the application. Upon receipt of the additional information, the manufacturer shall determine the individual’s eligibility under par. (b) and notify the individual of the determination no later than 3 days after receipt of the requested information.

AB50-ASA2-AA16,18,2 3. Except as provided in subd. 5., if the manufacturer determines under subd. 1. or 2. that the individual is eligible for the patient assistance program, the manufacturer shall provide the individual with a statement of eligibility. The statement of eligibility shall be valid for 12 months and may be renewed upon a determination by the manufacturer that the individual continues to meet the eligibility requirements under par. (b).

AB50-ASA2-AA16,18,13 4. If the manufacturer determines under subd. 1. or 2. that the individual is not eligible for the patient assistance program, the manufacturer shall provide the reason for the determination in the notification under subd. 1. or 2. The individual may appeal the determination by filing an appeal with the commissioner that shall include all of the information provided to the manufacturer under subds. 1. and 2. The commissioner shall establish procedures for deciding appeals under this subdivision. The commissioner shall issue a decision no later than 10 days after the appeal is filed, and the commissioner’s decision shall be final. If the commissioner determines that the individual meets the eligibility requirements under par. (b), the manufacturer shall provide the individual with the statement of eligibility described in subd. 3.

AB50-ASA2-AA16,18,22 5. In the case of an individual who has prescription drug coverage through an individual or group health plan, if the manufacturer determines under subd. 1. or 2. that the individual is eligible for the patient assistance program but also determines that the individual’s insulin needs are better addressed through the use of the manufacturer’s copayment assistance program rather than the patient assistance program, the manufacturer shall inform the individual of the determination and provide the individual with the necessary coupons to submit to a pharmacy. The individual may not be required to pay more than the copayment amount specified in par. (d) 2.

AB50-ASA2-AA16,19,6 (d) Provision of insulin under a patient assistance program. 1. Upon receipt from an individual of the eligibility statement described in par. (c) 3. and a valid insulin prescription, a pharmacy shall submit an order containing the name of the insulin and daily dosage amount to the manufacturer. The pharmacy shall include with the order the pharmacy’s name, shipping address, office telephone number, fax number, email address, and contact name, as well as any days or times when deliveries are not accepted by the pharmacy.

AB50-ASA2-AA16,19,15 2. Upon receipt of an order meeting the requirements under subd. 1., the manufacturer shall send the pharmacy a 90-day supply of insulin, or lesser amount if requested in the order, at no charge to the individual or pharmacy. The pharmacy shall dispense the insulin to the individual associated with the order. The insulin shall be dispensed at no charge to the individual, except that the pharmacy may collect a copayment from the individual to cover the pharmacy’s costs for processing and dispensing in an amount not to exceed $50 for each 90-day supply of insulin. The pharmacy may not seek reimbursement from the manufacturer or a 3rd-party payer.

AB50-ASA2-AA16,19,18 3. The pharmacy may submit a reorder to the manufacturer if the individual’s eligibility statement described in par. (c) 3. has not expired. The reorder shall be treated as an order for purposes of subd. 2.