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AB56,674 10Section 674 . 49.45 (23b) of the statutes is repealed.
AB56,675 11Section 675. 49.45 (24k) of the statutes is repealed.
AB56,676 12Section 676. 49.45 (24L) of the statutes is created to read:
AB56,539,1613 49.45 (24L) Critical access reimbursement payments to dental providers. (a)
14Based on the criteria in pars. (b) and (c), the department shall increase
15reimbursements to dental providers that meet quality of care standards, as
16established by the department.
AB56,539,1817 (b) In order to be eligible for enhanced reimbursement under this subsection,
18the provider must meet one of the following qualifications:
AB56,539,2119 1. For a nonprofit or public provider, 50 percent or more of the individuals
20served by the provider are individuals who are without dental insurance or are
21enrolled in the Medical Assistance program.
AB56,539,2322 2. For a for-profit provider, 5 percent or more of the individuals served by the
23provider are enrolled in the Medical Assistance program.
AB56,540,924 (c) For dental services rendered on or after January 1, 2020, by a qualified
25nonprofit critical access dental provider, the department shall increase

1reimbursement by 50 percent above the reimbursement rate that would otherwise
2be paid to that provider. For dental services rendered on or after January 1, 2020,
3by a qualified for-profit critical access dental provider, the department shall increase
4reimbursement by 30 percent above the reimbursement rate that would otherwise
5be paid to that provider. For dental providers rendering services to individuals in
6managed care under the Medical Assistance program, for services rendered on or
7after January 1, 2020, the department shall increase reimbursement to pay an
8additional amount on the basis of the rate that would have been paid to the dental
9provider had the individual not been enrolled in managed care.
AB56,540,1210 (d) If a provider has more than one service location, the thresholds described
11under par. (b) apply to each location, and payment for each service location would be
12determined separately.
AB56,677 13Section 677. 49.45 (29w) (b) 1. b. of the statutes is amended to read:
AB56,540,2314 49.45 (29w) (b) 1. b. “Telehealth" is means a service provided from a remote
15location using a combination of interactive video, audio, and externally acquired
16images through a networking environment between an individual or a provider at
17an originating site and a provider at a remote location with the service being of
18sufficient audio and visual fidelity and clarity as to be functionally equivalent to
19face-to-face contact; or, in circumstances determined by the department, an
20asynchronous transmission of digital clinical information through a secure
21electronic communications system from one provider to another provider
.
22“Telehealth" does not include telephone conversations or Internet-based
23communications between providers or between providers and individuals.
AB56,678 24Section 678. 49.45 (29y) (d) of the statutes is repealed.
AB56,679 25Section 679. 49.45 (30y) of the statutes is created to read:
AB56,541,3
149.45 (30y) Certified doula services; pilot project. (a) In this subsection,
2“certified doula" means an individual who has received certification from a doula
3certifying organization recognized by the department.
AB56,541,64 (b) For purposes of this subsection, services provided by certified doulas include
5continuous emotional and physical support during labor and birth of a child and
6intermittent services during the prenatal and postpartum periods.
AB56,541,117 (c) Subject to par. (d), the department shall reimburse under the Medical
8Assistance program benefits as provided under this subsection for pregnant women
9enrolled in the Medical Assistance program who reside in the counties of Brown,
10Dane, Milwaukee, Rock, or Sheboygan, or another county as determined by the
11department.
AB56,541,1712 (d) The department shall request from the secretary of the federal department
13of health and human services any approval necessary to allow reimbursement under
14the Medical Assistance program for services provided by a certified doula. The
15department may not pay reimbursement unless federal approval is not required or
16any required federal approval allowing reimbursement under s. 49.46 (2) (b) 12p. is
17approved and in effect.
AB56,680 18Section 680. 49.45 (41) of the statutes is amended to read:
AB56,541,2419 49.45 (41) Mental health crisis Crisis intervention services. (a) In this
20subsection, “mental health crisis intervention services" means crisis intervention
21services for the treatment of mental illness, intellectual disability, substance abuse,
22and dementia
that are provided by a mental health crisis intervention program
23operated by, or under contract with, a county, if the county is certified as a medical
24assistance provider.
AB56,542,9
1(b) If a county elects to become certified as a provider of mental health crisis
2intervention services, the county may provide mental health crisis intervention
3services under this subsection in the county to medical assistance recipients through
4the medical assistance program. A county that elects to provide the services shall
5pay the amount of the allowable charges for the services under the medical
6assistance program that is not provided by the federal government. The department
7shall reimburse the county under this subsection only for the amount of the allowable
8charges for those services under the medical assistance program that is provided by
9the federal government.
AB56,681 10Section 681. 49.45 (41) (c) of the statutes is created to read:
AB56,542,1311 49.45 (41) (c) Notwithstanding par. (b), if a county elects to deliver crisis
12intervention services under the Medical Assistance program on a regional basis
13according to criteria established by the department, all of the following apply:
AB56,542,1714 1. After January 1, 2020, the department shall require the county to annually
15contribute for the crisis intervention services an amount equal to 75 percent of the
16county's expenditures for crisis intervention services under this subsection in
17calendar year 2017, as determined by the department.
AB56,542,2118 2. The department shall reimburse the provider of crisis intervention services
19in the county the amount of allowable charges for those services under the Medical
20Assistance program, including both the federal share and nonfederal share of those
21charges, that exceeds the amount of the county contribution required under subd. 1.
AB56,542,2522 3. If a county submits a certified cost report under s. 49.45 (52) (b) to claim
23federal medical assistance funds, the claim based on certified costs made by a county
24for amounts under subd. 2. may not include any part of the nonfederal share of the
25amount under subd. 2.
AB56,682
1Section 682. 49.45 (47) (b) of the statutes is amended to read:
AB56,543,52 49.45 (47) (b) No person may receive reimbursement under s. 46.27 (11) for the
3provision of services to clients in an adult day care center unless the adult day care
4center is certified by the department under sub. (2) (a) 11. as a provider of medical
5assistance.
AB56,683 6Section 683 . 49.45 (47) (dm) of the statutes is created to read:
AB56,543,147 49.45 (47) (dm) Every 24 months, on a schedule determined by the department,
8an adult day care center shall submit through an online system prescribed by the
9department a report in the form and containing the information that the department
10requires, including payment of any fee due under par. (c). If a complete report is not
11timely filed, the department shall issue a warning to the operator of the adult day
12care center. The department may revoke an adult day care center's certification for
13failure to timely and completely report within 60 days after the report date
14established under the schedule determined by the department.
AB56,684 15Section 684. 49.45 (60) of the statutes is repealed.
AB56,685 16Section 685. 49.46 (1) (a) 1m. of the statutes is amended to read:
AB56,543,2017 49.46 (1) (a) 1m. Any pregnant woman whose income does not exceed the
18standard of need under s. 49.19 (11) and whose pregnancy is medically verified.
19Eligibility continues to the last day of the month in which the 60th day or, if approved
20by the federal government, the 365th day
after the last day of the pregnancy falls.
AB56,686 21Section 686. 49.46 (1) (a) 14. of the statutes is amended to read:
AB56,544,222 49.46 (1) (a) 14. Any person who would meet the financial and other eligibility
23requirements for home or community-based services under s. 46.27 (11), 46.277, or
2446.2785 but for the fact that the person engages in substantial gainful activity under
2542 USC 1382c (a) (3), if a waiver under s. 49.45 (38) is in effect or federal law permits

1federal financial participation for medical assistance coverage of the person and if
2funding is available for the person under s. 46.27 (11), 46.277, or 46.2785.
AB56,687 3Section 687. 49.46 (1) (em) of the statutes is amended to read:
AB56,544,104 49.46 (1) (em) To the extent approved by the federal government, for the
5purposes of determining financial eligibility and any cost-sharing requirements of
6an individual under par. (a) 6m., 14., or 14m., (d) 2., or (e), the department or its
7designee shall exclude any assets accumulated in a person's independence account,
8as defined in s. 49.472 (1) (c), and any income or assets from retirement benefits
9earned or accumulated from income or employer contributions while employed and
10receiving state-funded benefits under s. 46.27 or medical assistance under s. 49.472.
AB56,688 11Section 688. 49.46 (1) (j) of the statutes is amended to read:
AB56,544,1612 49.46 (1) (j) An individual determined to be eligible for benefits under par. (a)
139. remains eligible for benefits under par. (a) 9. for the balance of the pregnancy and
14to the last day of the month in which the 60th day or, if approved by the federal
15government, the 365th day
after the last day of the pregnancy falls without regard
16to any change in the individual's family income.
AB56,689 17Section 689. 49.46 (2) (b) 8. of the statutes is amended to read:
AB56,544,2118 49.46 (2) (b) 8. Home or community-based services, if provided under s. 46.27
19(11),
46.275, 46.277, 46.278, 46.2785, 46.99, or under the family care benefit if a
20waiver is in effect under s. 46.281 (1d), or under the disabled children's long-term
21support program, as defined in s. 46.011 (1g).
AB56,690 22Section 690 . 49.46 (2) (b) 12p. of the statutes is created to read:
AB56,544,2423 49.46 (2) (b) 12p. Subject to the limitations under s. 49.45 (30y), services
24provided by a certified doula.
AB56,691 25Section 691. 49.46 (2) (b) 15. of the statutes is amended to read:
AB56,545,2
149.46 (2) (b) 15. Mental health crisis Crisis intervention services under s. 49.45
2(41).
AB56,692 3Section 692. 49.46 (2) (b) 21. of the statutes is created to read:
AB56,545,54 49.46 (2) (b) 21. Subject to par. (bv), nonmedical services that contribute to the
5determinants of health.
AB56,693 6Section 693. 49.46 (2) (bv) of the statutes is created to read:
AB56,545,137 49.46 (2) (bv) The department shall determine those services under par. (b) 21.
8that contribute to the determinants of health. The department shall seek any
9necessary state plan amendment or request any waiver of federal Medicaid law to
10implement this paragraph. The department is not required to provided the services
11under this paragraph as a benefit under the Medical Assistance program if the
12federal department of health and human services does not provide federal financial
13participation for the services under this paragraph.
AB56,694 14Section 694. 49.463 of the statutes is repealed.
AB56,695 15Section 695. 49.47 (4) (ag) 2. of the statutes is amended to read:
AB56,545,1816 49.47 (4) (ag) 2. Pregnant and the woman's pregnancy is medically verified
17Eligibility continues to the last day of the month in which the 60th day or, if approved
18by the federal government, the 365th day
after the last day of the pregnancy falls.
AB56,696 19Section 696. 49.47 (4) (as) 1. of the statutes is amended to read:
AB56,545,2420 49.47 (4) (as) 1. The person would meet the financial and other eligibility
21requirements for home or community-based services under s. 46.27 (11), 46.277, or
2246.2785 or under the family care benefit if a waiver is in effect under s. 46.281 (1d)
23but for the fact that the person engages in substantial gainful activity under 42 USC
241382c
(a) (3).
AB56,697 25Section 697. 49.47 (4) (as) 3. of the statutes is amended to read:
AB56,546,2
149.47 (4) (as) 3. Funding is available for the person under s. 46.27 (11), 46.277,
2or 46.2785 or under the family care benefit if a waiver is in effect under s. 46.281 (1d).
AB56,698 3Section 698. 49.47 (4) (b) (intro.) of the statutes is amended to read:
AB56,546,114 49.47 (4) (b) (intro.) Eligibility exists if the applicant's property, subject to the
5exclusion of any amounts under the Long-Term Care Partnership Program
6established under s. 49.45 (31), any amounts in an independence account, as defined
7in s. 49.472 (1) (c), or any retirement assets that accrued from employment while the
8applicant was eligible for the community options program under s. 46.27 (11), 2017
9stats.,
or any other Medical Assistance program, including deferred compensation
10or the value of retirement accounts in the Wisconsin Retirement System or under the
11federal Social Security Act, does not exceed the following:
AB56,699 12Section 699 . 49.471 (1) (cr) of the statutes is created to read:
AB56,546,1413 49.471 (1) (cr) “Enhanced federal medical assistance percentage" means a
14federal medical assistance percentage described under 42 USC 1396d (y) or (z).
AB56,700 15Section 700 . 49.471 (4) (a) 4. b. of the statutes is amended to read:
AB56,546,1816 49.471 (4) (a) 4. b. The individual's family income does not exceed 100 133
17percent of the poverty line before application of the 5 percent income disregard under
1842 CFR 435.603 (d)
.
AB56,701 19Section 701 . 49.471 (4) (a) 8. of the statutes is created to read:
AB56,546,2020 49.471 (4) (a) 8. An individual who meets all of the following criteria:
AB56,546,2121 a. The individual is an adult under the age of 65.
AB56,546,2322 b. The adult has a family income that does not exceed 133 percent of the poverty
23line, except as provided in sub. (4g).
AB56,546,2524 c. The adult is not otherwise eligible for the Medical Assistance program under
25this subchapter or the Medicare program under 42 USC 1395 et seq.
AB56,702
1Section 702. 49.471 (4g) of the statutes is created to read:
AB56,547,92 49.471 (4g) Medicaid expansion; federal medical assistance percentage. For
3services provided to individuals described under sub. (4) (a) 8., the department shall
4comply with all federal requirements to qualify for the highest available enhanced
5federal medical assistance percentage. The department shall submit any
6amendment to the state medical assistance plan, request for a waiver of federal
7Medicaid law, or other approval request required by the federal government to
8provide services to the individuals described under sub. (4) (a) 8. and qualify for the
9highest available enhanced federal medical assistance percentage.
AB56,703 10Section 703. 49.471 (6) (b) of the statutes is amended to read:
AB56,547,1511 49.471 (6) (b) A pregnant woman who is determined to be eligible for benefits
12under sub. (4) remains eligible for benefits under sub. (4) for the balance of the
13pregnancy and to the last day of the month in which the 60th day or, if approved by
14the federal government, the 365th day
after the last day of the pregnancy falls
15without regard to any change in the woman's family income.
AB56,704 16Section 704. 49.471 (6) (L) of the statutes is created to read:
AB56,547,2217 49.471 (6) (L) The department shall request from the federal department of
18health and human services approval of a state plan amendment, a waiver of federal
19Medicaid law, or approval of a demonstration project to maintain eligibility for
20post-partum women to the last day of the month in which the 365th day after the
21last day of the pregnancy falls under ss. 49.46 (1) (a) 1m. and 9. and (j), 49.47 (4) (ag)
222., and 49.471 (4) (a) 1g. and 1m., (6) (b), and (7) (b) 1.
AB56,705 23Section 705. 49.471 (7) (b) 1. of the statutes is amended to read:
AB56,548,924 49.471 (7) (b) 1. A pregnant woman whose family income exceeds 300 percent
25of the poverty line may become eligible for coverage under this section if the

1difference between the pregnant woman's family income and the applicable income
2limit under sub. (4) (a) is obligated or expended for any member of the pregnant
3woman's family for medical care or any other type of remedial care recognized under
4state law or for personal health insurance premiums or for both. Eligibility obtained
5under this subdivision continues without regard to any change in family income for
6the balance of the pregnancy and to the last day of the month in which the 60th day
7or, if approved by the federal government, the 365th day after the last day of the
8woman's pregnancy falls. Eligibility obtained by a pregnant woman under this
9subdivision extends to all pregnant women in the pregnant woman's family.
AB56,706 10Section 706. 49.472 (3) (b) of the statutes is amended to read:
AB56,548,1811 49.472 (3) (b) The individual's assets do not exceed $15,000. In determining
12assets, the department may not include assets that are excluded from the resource
13calculation under 42 USC 1382b (a), assets accumulated in an independence
14account, and, to the extent approved by the federal government, assets from
15retirement benefits accumulated from income or employer contributions while
16employed and receiving medical assistance under this section or state-funded
17benefits under s. 46.27, 2017 stats. The department may exclude, in whole or in part,
18the value of a vehicle used by the individual for transportation to paid employment.
AB56,707 19Section 707. 49.472 (3) (f) of the statutes is amended to read:
AB56,548,2320 49.472 (3) (f) The individual maintains premium payments under sub. (4) (am)
21and, if applicable and to the extent approved by the federal government, premium
22payments calculated by the department in accordance with sub. (4) (bm), unless the
23individual is exempted from premium payments under sub. (4) (dm) or (5).
AB56,708 24Section 708. 49.472 (4) (am) of the statutes is amended to read:
AB56,549,3
149.472 (4) (am) To the extent approved by the federal government and except
2as provided in pars. (dm) and (em) and sub. (5), an individual who receives medical
3assistance under this section shall pay a monthly premium of $25 to the department.
AB56,709 4Section 709. 49.472 (5) of the statutes is repealed.
AB56,710 5Section 710 . 49.485 of the statutes is renumbered 20.9315 (19) and amended
6to read:
AB56,549,127 20.9315 (19) Whoever knowingly presents or causes to be presented to any
8officer, employee, or agent of this state a false claim for medical assistance shall
9forfeit not less than $5,000 nor more than $10,000, plus 3 times the amount of the
10damages that were sustained by the state or would have been sustained by the state,
11whichever is greater, as a result of the false claim.
The attorney general may bring
12an action on behalf of the state to recover any forfeiture incurred under this section.
AB56,711 13Section 711 . 49.686 (3) (d) of the statutes is amended to read:
AB56,549,1914 49.686 (3) (d) Has applied for coverage under and has been denied eligibility
15for medical assistance within 12 months prior to application for reimbursement
16under sub. (2). This paragraph does not apply to an individual who is eligible for
17benefits under the demonstration project for childless adults under s. 49.45 (23)
18BadgerCare Plus under s. 49.471 (4) (a) 8. or to an individual who is eligible for
19benefits under BadgerCare Plus under s. 49.471 (11).
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