AB1-SSA2,20,24 49.45 (23b) (c) 1. Persons who are eligible for the demonstration project under sub. (23) s. 49.471 (4) (a) 8. and who have monthly household income that exceeds 50 percent of the poverty line shall pay a monthly premium amount of $8 per household. A person who is eligible to receive an item or service furnished by an Indian health care provider is exempt from the premium requirement under this subdivision.

AB1-SSA2,21,6 2. The department may disenroll under par. (b) 5. a person for nonpayment of a required monthly premium only at annual eligibility redetermination after providing notice and reasonable opportunity for the person to pay. If a person who is disenrolled for nonpayment of premiums pays all owed premiums or becomes exempt from payment of premiums, he or she may reenroll in Medical Assistance under sub. (23) s. 49.471 (4) (a) 8.

AB1-SSA2,21,10 3. The department shall reduce the amount of the required household premium by up to half for a recipient of Medical Assistance under sub. (23) s. 49.471 (4) (a) 8. who does not engage in certain behaviors that increase health risks or who attests to actively managing certain unhealthy behaviors.

AB1-SSA2,25 Section 25 . 49.45 (23b) (e) of the statutes is amended to read:

AB1-SSA2,21,16 49.45 (23b) (e) Before December 31, 2023, the demonstration project requirements under this subsection may not be withdrawn and the department may not request from the federal government withdrawal, suspension, or termination of the demonstration project requirements under this subsection unless legislation has been enacted specifically allowing for the withdrawal, suspension, or termination.

AB1-SSA2,26 Section 26 . 49.471 (1) (cr) of the statutes is created to read:

AB1-SSA2,21,19 49.471 (1) (cr) “Enhanced federal medical assistance percentage" means a federal medical assistance percentage described under 42 USC 1396d (y) or (z).

AB1-SSA2,27 Section 27 . 49.471 (4) (a) 4. b. of the statutes is amended to read:

AB1-SSA2,21,23 49.471 (4) (a) 4. b. The individual's family income does not exceed 100 133 percent of the poverty line before application of the 5 percent income disregard under 42 CFR 435.603 (d).

AB1-SSA2,28 Section 28 . 49.471 (4) (a) 8. of the statutes is created to read:

AB1-SSA2,21,25 49.471 (4) (a) 8. An individual who meets all of the following criteria:

AB1-SSA2,22,1 a. The individual is an adult under the age of 65.

AB1-SSA2,22,3 b. The adult has a family income that does not exceed 133 percent of the poverty line, except as provided in sub. (4g).

AB1-SSA2,22,5 c. The adult is not otherwise eligible for the Medical Assistance program under this subchapter or the Medicare program under 42 USC 1395 et seq.

AB1-SSA2,29 Section 29 . 49.471 (4g) of the statutes is created to read:

AB1-SSA2,22,16 49.471 (4g) Medicaid expansion; federal medical assistance percentage. For services provided to individuals described under sub. (4) (a) 8., the department shall comply with all federal requirements to qualify for the highest available enhanced federal medical assistance percentage. The department shall submit any amendment to the state medical assistance plan, request for a waiver of federal Medicaid law, or other approval request required by the federal government to provide services to the individuals described under sub. (4) (a) 8. and qualify for the highest available enhanced federal medical assistance percentage. Sections 20.940 and 49.45 (2t) do not apply to a submission to the federal government under this subsection.

AB1-SSA2,30 Section 30 . 49.681 of the statutes is created to read:

AB1-SSA2,22,19 49.681 COVID-19 and other communicable disease aids for frontline health care workers. (1) In this section:

AB1-SSA2,22,20 (a) “COVID-19” means an infection caused by the SARS-CoV-2 coronavirus.

AB1-SSA2,22,21 (b) “Frontline health care worker” has the meaning given in s. 16.34 (1).

AB1-SSA2,23,3 (2) From the appropriation under s. 20.435 (4) (bu), subject to sub. (3), the department shall pay, at a rate determined by the department under sub. (4), for testing for and any treatment that is medically necessary and reasonably related to COVID-19 or any other communicable disease or complications from COVID-19 or other communicable disease for frontline health care workers who have been diagnosed with or are a patient under investigation of having COVID-19 or any other communicable disease.

AB1-SSA2,23,11 (3) No payment may be made under this section unless the recipient has no other form of coverage available from the federal Medicare program, from private health, accident, sickness, medical, and hospital insurance coverage, from any other available state, federal, or other health care coverage program, or under any grant, contract, or other contractual arrangement. If at any time federal or private insurance aid, other health care coverage, or a grant, contract, or other contractual arrangement becomes available during the treatment period, state aid under this section shall be terminated.

AB1-SSA2,23,21 (4) Payment for services provided under this section shall be at a rate determined by the department that does not exceed the allowable charges under the federal Medicare program. In no case shall state rates for individual service elements exceed the federally defined allowable costs. The rate of charges for services not covered by public and private insurance shall not exceed the reasonable charges as established by Medicare fee determination procedures. A person that provides to a patient a service for which payment is provided under this section shall accept the amount paid under this section for the service as payment in full and may not bill the patient for any amount by which the charge for the service exceeds the amount paid for the service under this section.

AB1-SSA2,23,23 (5) The department may promulgate rules to establish a process for individuals to establish eligibility and apply for and receive benefits under this section.

AB1-SSA2,31 Section 31 . 49.686 (3) (d) of the statutes is amended to read:

AB1-SSA2,24,6 49.686 (3) (d) Has applied for coverage under and has been denied eligibility for medical assistance within 12 months prior to application for reimbursement under sub. (2). This paragraph does not apply to an individual who is eligible for benefits under the demonstration project for childless adults under s. 49.45 (23) BadgerCare Plus under s. 49.471 (4) (a) 8. or to an individual who is eligible for benefits under BadgerCare Plus under s. 49.471 (11).

AB1-SSA2,32 Section 32 . 66.0137 (4) of the statutes is amended to read:

AB1-SSA2,24,14 66.0137 (4) Self-insured health plans. If a city, including a 1st class city, or a village provides health care benefits under its home rule power, or if a town provides health care benefits, to its officers and employees on a self-insured basis, the self-insured plan shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2), 632.729, 632.746 (10) (a) 2. and (b) 2., 632.747 (3), 632.798, 632.85, 632.853, 632.855, 632.867, 632.87 (4) to (6), 632.871, 632.885, 632.89, 632.895 (9) to (17), 632.896, and 767.513 (4).

AB1-SSA2,33 Section 33 . 73.03 (75) of the statutes is created to read: