AB680: Bill Text

LRB-5051/1

SWB:skw

2019 - 2020 LEGISLATURE

2019 Assembly BILL 680

December 16, 2019 - Introduced by Representatives Kurtz, Mursau, Doyle, Edming, Novak, Oldenburg, Stubbs, Tranel, James, Wittke, Macco, Rohrkaste, Subeck, Plumer and Steffen, cosponsored by Senators Jacque and Olsen. Referred to Committee on Medicaid Reform and Oversight.

AB680,1,3 An Act to amend 49.45 (24k) (a) 1. and 2. and 49.45 (24k) (c) (intro.) and 3. of the statutes; relating to: expansion of the dental reimbursement pilot project under the Medical Assistance program.

Analysis by the Legislative Reference Bureau

This bill expands statewide the dental reimbursement pilot project that, under current law, requires the Department of Health Services to distribute moneys to increase Medical Assistance reimbursement rates for pediatric dental care and adult emergency dental services provided in Brown, Marathon, Polk, and Racine Counties. Under the bill, DHS is required, subject to any necessary approval from the federal Department of Health and Human Services, to distribute moneys to increase statewide Medical Assistance reimbursement rates for pediatric dental care and adult emergency dental services.

For further information see the state fiscal estimate, which will be printed as an appendix to this bill.

The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:

AB680,1 Section 1. 49.45 (24k) (a) 1. and 2. of the statutes are amended to read:

AB680,2,10 49.45 (24k) (a) 1. Subject to approval of the federal department of health and human services under par. (b), the department, as a pilot project, shall distribute moneys allocated in each fiscal year for the purpose of increasing statewide the reimbursement rate under Medical Assistance for pediatric dental care and adult emergency dental services, as defined by the department, that are provided in Brown, Marathon, Polk, and Racine counties. If, after increasing the reimbursement rate for counties specified in this subdivision, the moneys allocated for this purpose exceed $100,000, the department shall increase the reimbursement rate under Medical Assistance for pediatric dental care and adult emergency dental services in other counties, as determined by the department, where Medical Assistance recipients have the greatest need for pediatric dental care and adult emergency dental services.

AB680,2,22 2. For dental services provided on a fee-for-service basis as of July 1, 2015, the reimbursement rate increase specified in subd. 1. shall be distributed on a fee-for-service basis. For dental services provided as of July 1, 2015, by a health maintenance organization that contracts with the department to provide Medical Assistance services at a capitated rate, the department shall distribute the reimbursement rate increase under subd. 1. to the health maintenance organization. The department shall include in a contract with a health maintenance organization that provides dental services described in subd. 1. in the counties specified in subd. 1. a requirement that the health maintenance organization reimburse providers of services in accordance with the reimbursement rate increase pilot project under subd. 1. The department may not distribute the reimbursement rate increase under subd. 1. to federally qualified health centers that receive a grant under 42 USC 254b.

AB680,2 Section 2. 49.45 (24k) (c) (intro.) and 3. of the statutes are amended to read:

AB680,3,4 49.45 (24k) (c) (intro.) No later than January 1, 2020 2022, and biennially thereafter, the department shall submit a report to the chief clerk of each house of the legislature under s. 13.172 (2), each standing committee of the legislature with jurisdiction over health or public benefits under s. 13.172 (3), and the joint committee on finance that includes all of the following information on the pilot project under this subsection:

AB680,3,6 3. The feasibility of continuing the pilot project and expanding the project in specific areas of the state or statewide.

AB680,3 Section 3 . Effective date.

AB680,3,8 (1) This act takes effect on July 1, 2020.

AB680,3,9 (End)