AB50-ASA2-AA8,256,1919a. Health care costs, prices, and affordability. AB50-ASA2-AA8,256,2120b. The availability or accessibility of health care services to the affected 21community. AB50-ASA2-AA8,256,2322c. Health care provider cost trends and containment of total state health care 23spending. AB50-ASA2-AA8,256,2424d. Access to services in medically underserved areas. AB50-ASA2-AA8,257,2
1e. Rectifying historical and contemporary factors contributing to a lack of 2health equities or access to services. AB50-ASA2-AA8,257,43f. The functioning and competitiveness of the markets for health care and 4health insurance. AB50-ASA2-AA8,257,65g. The potential effects of the material change transaction on health 6outcomes, quality, access, equity, or workforce for residents of this state. AB50-ASA2-AA8,257,77h. The potential loss of or change in access to essential services. AB50-ASA2-AA8,257,1082. Whether the material change transaction is contrary to or violates any 9applicable law, including state antitrust laws, laws restricting the corporate 10practice of medicine, or consumer protection laws. AB50-ASA2-AA8,257,12113. Whether the benefits of the transaction are likely to outweigh any 12anticompetitive effect from the transaction. AB50-ASA2-AA8,257,13134. Whether the transaction is in the public interest. AB50-ASA2-AA8,257,1614(d) This subsection does not limit or alter any existing authority of the 15attorney general or any state agency to enforce any other law, including state or 16federal antitrust law, or to review nonprofit transactions. AB50-ASA2-AA8,257,2017(5) Post-transaction oversight. (a) Enforcement by the attorney general. 181. The attorney general may subpoena any records necessary to enforce any 19provisions of this section or to investigate suspected violations of any provisions of 20this section or any conditions imposed by conditional approval pursuant to sub. (4). AB50-ASA2-AA8,258,4212. The attorney general may enforce any requirement of this section and any 22conditions imposed by a conditional approval pursuant to sub. (4) to the fullest 23extent provided by law, including damages. In addition to any legal remedies the 24attorney general may have, the attorney general shall be entitled to specific
1performance, injunctive relief, and other equitable remedies a court deems 2appropriate for any violations or imminent violation of any requirement of this 3section or breach of any of the conditions and shall be entitled to recover its attorney 4fees and costs incurred in remedying each violation. AB50-ASA2-AA8,258,1053. In addition to the remedies set forth in subd. 2., any person who violates 6this section or of any conditions imposed pursuant to a conditional approval under 7sub. (4) is subject to a forfeiture of $10,000 per day, which the attorney general may 8seek to recover by action on behalf of the state. The attorney general may also 9rescind or deny approval for any other past, pending, or future material change 10transactions involving the health care entity or an affiliate. AB50-ASA2-AA8,258,13114. Nothing in this paragraph shall narrow, abrogate, or otherwise alter the 12authority of the attorney general to prosecute violations of antitrust or consumer 13protection requirements. AB50-ASA2-AA8,258,1614(b) Enforcement by the department. 1. The department may audit the books, 15documents, records, and data of any entity that is subject to a conditional approval 16under sub. (4) to monitor compliance with the conditions. AB50-ASA2-AA8,258,20172. Any entity that violates any provision of this section, any rules adopted 18pursuant thereto, or any condition imposed pursuant to a conditional approval 19under sub. (4) shall be subject to a forfeiture of $10,000 per day for any violation of 20this section. AB50-ASA2-AA8,258,23213. The department may refer any entity to the attorney general to review for 22enforcement of any noncompliance with this section and any conditions imposed by 23conditional approval pursuant to sub. (4). AB50-ASA2-AA8,259,424(c) Monitoring. In order to effectively monitor ongoing compliance with the
1terms and conditions of any material change transaction subject to prior notice, 2approval, or conditional approval under sub. (4), the department may, in its sole 3discretion, conduct a review or audit and may contract with experts and 4consultants to assist in this regard. AB50-ASA2-AA8,259,115(d) Reporting. One year, 2 years, and 5 years following the completion of the 6material change transaction approved or conditionally approved by the department 7after a comprehensive review under sub. (3), and upon future intervals determined 8at the discretion of the department, the health care entity or any person, 9corporation, partnership, or other entity that acquired direct or indirect control over 10the health care entity shall submit reports to the department that do all of the 11following: AB50-ASA2-AA8,259,13121. Demonstrate compliance with conditions placed on the material change 13transaction, if any. AB50-ASA2-AA8,259,14142. Analyze cost trends and cost growth trends of the transacting parties. AB50-ASA2-AA8,259,16153. Analyze any changes or effects of the material change transaction on 16patient access, availability of services, workforce, quality, or equity. AB50-ASA2-AA8,259,2017(e) Costs. The department shall be entitled to charge costs to the transacting 18parties for all actual, reasonable, and direct costs incurred in monitoring ongoing 19compliance with the terms and conditions of the sale or transfer of assets, including 20contractor and administrative costs. AB50-ASA2-AA8,259,2121(6) Rules. The department may promulgate rules to implement this section. AB50-ASA2-AA8,260,223150.994 Corporate practice of medicine. The corporate practice of
1medicine is prohibited. The department shall promulgate rules to define what 2conduct constitutes the corporate practice of medicine for purposes of this section. AB50-ASA2-AA8,260,94150.996 Transparency in ownership and control of health care 5entities. (1) Reporting of ownership and control. Each health care entity 6shall report to the department on an annual basis and upon the consummation of a 7material change transaction involving the entity as set forth in s. 150.992, in a form 8and manner required by the department, all of the following information, as 9applicable: AB50-ASA2-AA8,260,1010(a) Legal name of entity. AB50-ASA2-AA8,260,1111(b) Business address of entity. AB50-ASA2-AA8,260,1212(c) Locations of operations. AB50-ASA2-AA8,260,1413(d) Business identification numbers of the entity, as applicable, including all 14of the following: AB50-ASA2-AA8,260,15151. Taxpayer identification number. AB50-ASA2-AA8,260,16162. National provider identifier. AB50-ASA2-AA8,260,17173. Employer identification number. AB50-ASA2-AA8,260,18184. Centers for Medicare and Medicaid Services certification number. AB50-ASA2-AA8,260,19195. National Association of Insurance Commissioners identification number. AB50-ASA2-AA8,260,21206. A personal identification number associated with a license issued by the 21commissioner of insurance. AB50-ASA2-AA8,260,23227. Pharmacy benefit manager identification number associated with a license 23or registration of the pharmacy benefit manager in this state. AB50-ASA2-AA8,260,2424(e) Name and contact information of a representative of the entity. AB50-ASA2-AA8,261,4
1(f) The name, business address, and business identification numbers listed in 2par. (d) for each person or entity that, with respect to the relevant health care 3entity, has an ownership or investment interest, has a controlling interest, is a 4management services organization, or is a significant equity investor. AB50-ASA2-AA8,261,65(g) A current organizational chart showing the business structure of the 6health care entity, including all of the following: AB50-ASA2-AA8,261,771. Any entity listed in par. (f). AB50-ASA2-AA8,261,982. Affiliates, including entities that control or are under common control as 9the health care entity. AB50-ASA2-AA8,261,1211(h) For a health care entity that is a provider organization or a health care 12facility, all of the following information: AB50-ASA2-AA8,261,15131. a. The affiliated health care providers identified by name, license type, 14specialty, national provider identifier, and other applicable identification number 15listed in par. (d). AB50-ASA2-AA8,261,1616b. The address of the principal practice location. AB50-ASA2-AA8,261,1717c. Whether the health care provider is employed or contracted by the entity. AB50-ASA2-AA8,261,19182. The name and address of affiliated health care facilities by license number, 19license type, and capacity in each major service area. AB50-ASA2-AA8,261,2120(i) The names, national provider identifier, if applicable, and compensation of 21all of the following: AB50-ASA2-AA8,261,2322a. The members of the governing board, board of directors, or similar 23governance body for the health care entity. AB50-ASA2-AA8,262,2
1b. Any entity that is owned or controlled by, affiliated with, or under common 2control as the health care entity. AB50-ASA2-AA8,262,33c. Any entity listed in par. (f). AB50-ASA2-AA8,262,74(j) Comprehensive financial reports of the health care entity and any 5ownership or control entities, including audited financial statements, cost reports, 6annual costs, annual receipts, realized capital gains and losses, accumulated 7surplus, and accumulated reserves. AB50-ASA2-AA8,262,98(2) Exceptions. All of the following health care entities are exempt from the 9reporting requirements under sub. (1): AB50-ASA2-AA8,262,1410(a) A health care entity that is an independent provider organization, without 11any ownership or control entities, consisting of 2 or fewer physicians, provided that 12if that health care entity experiences a material change transaction under s. 13150.992, the health care entity is subject to reporting under sub. (1) upon the 14consummation of the transaction. AB50-ASA2-AA8,262,2015(b) A health care provider or provider organization that is owned or controlled 16by another health care entity, if the health care provider or provider organization is 17shown in the organizational chart submitted under sub. (1) (g) and the owning or 18controlling health care entity reports all the information required under sub. (1) on 19behalf of the controlled or owned entity. Health care facilities are not subject to this 20exception. AB50-ASA2-AA8,263,221(3) Rules. (a) The department shall promulgate any rules necessary to 22implement this section, specify the format and content of reports, and impose 23penalties for noncompliance. The department may require additional reporting of 24data or information that it determines is necessary to better protect the public’s
1interest in monitoring the financial conditions, organizational structure, business 2practices, and market share of each registered health care entity. AB50-ASA2-AA8,263,43(b) The department may assess administrative fees on health care entities in 4an amount to help defray the costs in overseeing and implementing this section. AB50-ASA2-AA8,263,85(4) Ownership information. (a) Information provided under this section 6shall be public information and may not be considered confidential, proprietary, or 7a trade secret, except that any individual health care provider’s taxpayer 8identification that is also their social security number shall be confidential. AB50-ASA2-AA8,263,119(b) Not later than December 31, 2028, and annually thereafter, the 10department shall post on its publicly available website a report with respect to the 11previous one-year period, including all of the following information: AB50-ASA2-AA8,263,13121. The number of health care entities reporting for the year, disaggregated by 13the business structure of each specified entity. AB50-ASA2-AA8,263,15142. The names, addresses, and business structure of any entities with an 15ownership or controlling interest in each health care entity. AB50-ASA2-AA8,263,16163. Any change in ownership or control for each health care entity. AB50-ASA2-AA8,263,17174. Any change in the tax identification number of a health care entity. AB50-ASA2-AA8,263,21185. As applicable, the name, address, tax identification number, and business 19structure of other affiliates under common control, subsidiaries, and management 20services entities for the health care entity, including the business type and the tax 21identification number of each. AB50-ASA2-AA8,263,23226. An analysis of trends in horizontal and vertical consolidation, 23disaggregated by business structure and provider type. AB50-ASA2-AA8,264,724(c) The department may share information reported under this section with
1the attorney general, other state agencies, and other state officials to reduce or 2avoid duplication in reporting requirements or to facilitate oversight or enforcement 3under state law. Any tax identification numbers that are individual social security 4numbers may be shared with the attorney general, other state agencies, or other 5state officials that agree to maintain the confidentiality of such information. The 6department may, in consultation with the relevant state agencies, merge similar 7reporting requirements where appropriate. AB50-ASA2-AA8,264,128(5) Enforcement. (a) Audit and inspection authority. The department is 9authorized to audit and inspect the records of any health care entity that has failed 10to submit complete information pursuant to this section or if the department has 11reason to question the accuracy or completeness of the information submitted 12pursuant this section. AB50-ASA2-AA8,264,1513(b) Random audits. The department shall conduct annual audits of a random 14sample of health care entities to verify compliance with, accuracy, and completeness 15of the reported information pursuant to this section. AB50-ASA2-AA8,264,1816(c) Penalty for failure to report. If a health care entity fails to provide a 17complete report under sub. (1), or submits a report containing false information, the 18entity shall be subject to all of the following civil penalties, as appropriate: AB50-ASA2-AA8,264,22191. Health care entities consisting of independent health care providers or 20provider organizations without any 3rd-party ownership or control entities, with 10 21or fewer physicians or less than $10 million in annual revenue, a forfeiture of up to 22$50,000 for each report not provided or containing false information. AB50-ASA2-AA8,264,24232. For all other health care entities, a forfeiture of up to $500,000 for each 24report not provided or containing false information. AB50-ASA2-AA8,265,32(1) Healthcare ownership and transparency. The creation of subch. IX of 3ch. 150, ss. 150.99, 150.992, 150.994, and 150.996 takes effect on January 1, 2027.”. AB50-ASA2-AA8,265,11649.79 (7w) (a) 1. “Eligible retailer” includes any supermarket, grocery store, 7wholesaler, small-scale store, corner store, convenience store, neighborhood store, 8bodega, farmers’ market, direct-marketing farmer, nonprofit cooperative food-9purchasing venture, or community-supported agriculture program means a retailer 10authorized to participate in the food stamp program federal supplemental nutrition 11assistance program. AB50-ASA2-AA8,266,81349.79 (7w) (b) The department shall, through a competitive selection process, 14contract with one or more nonprofit 3rd-party organizations to administer a 15healthy food incentive program statewide. The healthy food incentive program 16shall provide to any food stamp program recipient assistance group that uses 17benefits at an eligible retailer participating in the healthy food incentive program 18under this subsection a monetary amount up to the amount of food stamp program 19benefits used at the eligible retailer for the purpose of purchasing fruits and 20vegetables from the eligible retailer. In administering the program, a nonprofit 3rd-21party organization shall prioritize including in the healthy food incentive program 22eligible retailers that source fruits and vegetables primarily from growers in this 23state and shall establish a timeline for expiration of matching monetary amounts 24provided for the purchase of fruits and vegetables under the healthy food incentive
1program such that a matching monetary amount expires no later than one year 2after it is provided. The department may establish a maximum amount of benefits 3that may be matched per day for a food stamp program recipient assistance group. 4Any nonprofit 3rd-party organization administering the healthy food incentive 5program shall ensure that matching amounts provided under the program that are 6unused and expire remain with the nonprofit 3rd-party organization and, upon 7expiration, are available for use to provide matching amounts to other food stamp 8recipients assistance groups under the program. AB50-ASA2-AA8,266,181049.79 (7w) (c) The department may allocate no more than 25 percent of the 11funding available for the healthy food incentive program under this subsection to 12program development, promotion of and outreach for the program, training, data 13collection, evaluation, administration, and reporting and shall allocate the 14remainder of the funding available to the eligible retailers participating in the 15healthy food incentive program under this subsection. The department shall seek, 16or require any 3rd-party organization chosen under par. (b) to seek, any available 17federal matching moneys from the Gus Schumacher Nutrition Incentive Program to 18fund the healthy food incentive program under this subsection. AB50-ASA2-AA8,266,222049.79 (7w) (cd) A 3rd-party organization chosen under par. (b) may retain for 21administrative purposes an amount not to exceed 33 percent of the total contracted 22amount or the applicable cap found in federal law or guidance, whichever is lower. AB50-ASA2-AA8,267,524(1) Healthy food incentive plan. In the schedule under s. 20.005 (3) for the
1appropriation to the department of health services under s. 20.435 (4) (bt), the 2dollar amount for fiscal year 2025-26 is increased by $488,600. In the schedule 3under s. 20.005 (3) for the appropriation to the department of health services under 4s. 20.435 (4) (bt), the dollar amount for fiscal year 2026-27 is increased by 5$488,600.”.
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