AB68-ASA2-AA2,26,7 “ Section 229. 49.45 (5g) of the statutes is created to read:

AB68-ASA2-AA2,26,17 49.45 (5g) Payments to tribes. (a) Tribal care coordination agreements. A tribal health care provider's care coordination agreement with a nontribal health care provider shall meet federal requirements, including that a service provided by the nontribal health care provider be at the request of the tribal health care provider on behalf of a tribal member who remains in the tribal health care provider's care according to the care coordination agreement; that both the tribal health care provider and nontribal health care provider are providers, as defined in s. 49.43 (10); that an established relationship exists between the tribal health care provider and the tribal member; and that the care be provided pursuant to a written care coordination agreement.

AB68-ASA2-AA2,27,3 (b) Amount and distribution of payments. 1. From the appropriation account under s. 20.435 (4) (b), the department shall make payments to eligible governing bodies of federally recognized American Indian tribes or bands or tribal health care providers in an amount and manner determined by the department. The department shall determine payment amounts on the basis of the difference between the state share of medical assistance payments paid for services rendered to tribal members for whom a care coordination agreement with nontribal health care providers is in place and the state share of medical assistance payments that would have been paid for those services absent a care coordination agreement with nontribal partners.

AB68-ASA2-AA2,27,6 2. The department shall withhold from the payments under subd. 1. the state share of administrative costs associated with carrying out this subsection, not to exceed 10 percent of the amounts calculated in subd. 1.

AB68-ASA2-AA2,27,9 3. Federally recognized American Indian tribes or bands may use funds paid under this subsection for health-related purposes. The department shall consult biennially with tribes to determine the timing and distribution of payments.”.

AB68-ASA2-AA2,27,10 88. Page 292, line 12: after that line insert:

AB68-ASA2-AA2,27,11 “ Section 229c. 49.45 (6xm) of the statutes is created to read:

AB68-ASA2-AA2,27,15 49.45 (6xm) Pediatric inpatient supplement. (a) From the appropriations under s. 20.435 (4) (b), (o), and (w), the department shall, using a method determined by the department, distribute a total sum of $2,000,000 each state fiscal year to hospitals that meet all of the following criteria:

AB68-ASA2-AA2,27,16 1. The hospital is an acute care hospital located in this state.

AB68-ASA2-AA2,27,21 2. During the hospital's fiscal year, the inpatient days in the hospital's acute care pediatric units and intensive care pediatric units totaled more than 12,000 days, not including neonatal intensive care units. For purposes of this subsection, the hospital's fiscal year is the hospital's fiscal year that ended in the 2nd calendar year preceding the beginning of the state fiscal year.

AB68-ASA2-AA2,28,5 (b) Notwithstanding par. (a), from the appropriations under s. 20.435 (4) (b), (o), and (w), if the department has expanded eligibility under section 2001 (a) (1) (C) of the Patient Protection and Affordable Care Act, P.L. 111-148, for the Medical Assistance program under this subchapter, then the department may, using a method determined by the department, distribute an additional total sum of $7,500,000 in each state fiscal year to hospitals that are free-standing pediatric teaching hospitals located in Wisconsin that have a percentage calculated under s. 49.45 (3m) (b) 1. a. greater than 45 percent.

AB68-ASA2-AA2,229d Section 229d. 49.45 (23) of the statutes is repealed.

AB68-ASA2-AA2,229f Section 229f. 49.45 (23b) (title) of the statutes is amended to read:

AB68-ASA2-AA2,28,9 49.45 (23b) (title) Childless adults demonstration project reform waiver implementation required.

AB68-ASA2-AA2,229g Section 229g. 49.45 (23b) (b) of the statutes is amended to read:

AB68-ASA2-AA2,28,14 49.45 (23b) (b) Beginning as soon as practicable after October 31, 2018, and ending no sooner than December 31, 2023, the department shall do all of the following with regard to the childless adults demonstration project under sub. (23) s. 49.471 (4) (a) 8.:

AB68-ASA2-AA2,28,20 1. Require in each month persons, except exempt individuals, who are eligible to receive Medical Assistance under sub. (23) s. 49.471 (4) (a) 8. and who are at least 19 years of age but have not attained the age of 50 to participate in, document, and report 80 hours per calendar month of community engagement activities. The department, after finding good cause, may grant a temporary exemption from the requirement under this subdivision upon request of a Medical Assistance recipient.

AB68-ASA2-AA2,28,23 2. Require persons with incomes of at least 50 percent of the poverty line to pay premiums in accordance with par. (c) as a condition of eligibility for Medical Assistance under sub. (23) s. 49.471 (4) (a) 8.

AB68-ASA2-AA2,28,25 3. Require as a condition of eligibility for Medical Assistance under sub. (23) s. 49.471 (4) (a) 8. completion of a health risk assessment.

AB68-ASA2-AA2,29,3 4. Charge recipients of Medical Assistance under sub. (23) s. 49.471 (4) (a) 8. an $8 copayment for nonemergency use of the emergency department in accordance with 42 USC 1396o-1 (e) (1) and 42 CFR 447.54.

AB68-ASA2-AA2,29,8 5. Disenroll from Medical Assistance under sub. (23) s. 49.471 (4) (a) 8. for 6 months any individual who does not pay a required premium under subd. 2. and any individual who is required under subd. 1. to participate in a community engagement activity but who does not participate for 48 aggregate months in the community engagement activity.

AB68-ASA2-AA2,229h Section 229h. 49.45 (23b) (c) of the statutes is amended to read:

AB68-ASA2-AA2,29,15 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.

AB68-ASA2-AA2,29,21 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.

AB68-ASA2-AA2,29,25 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.

AB68-ASA2-AA2,229j Section 229j. 49.45 (23b) (e) of the statutes is amended to read:

AB68-ASA2-AA2,30,6 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.

AB68-ASA2-AA2,229m Section 229m. 49.45 (24L) of the statutes is created to read:

AB68-ASA2-AA2,30,11 49.45 (24L) Critical access reimbursement payments to dental providers. (a) Based on the criteria in pars. (b) and (c), the department shall increase reimbursements to dental providers that meet quality of care standards, as established by the department.