AB68,750,98
(b) In order to be eligible for enhanced reimbursement under this subsection,
9the provider must meet one of the following qualifications:
AB68,750,1210
1. For a nonprofit or public provider, 50 percent or more of the individuals
11served by the provider are individuals who are without dental insurance or are
12enrolled in the Medical Assistance program.
AB68,750,1413
2. For a for-profit provider, 5 percent or more of the individuals served by the
14provider are enrolled in the Medical Assistance program.
AB68,750,2515
(c) For dental services rendered on or after January 1, 2022, by a qualified
16nonprofit or public dental provider, the department shall increase reimbursement by
1750 percent above the reimbursement rate that would otherwise be paid to that
18provider. For dental services rendered on or after January 1, 2022, by a qualified
19for-profit dental provider, the department shall increase reimbursement by 30
20percent above the reimbursement rate that would otherwise be paid to that provider.
21For dental providers rendering services to individuals in managed care under the
22Medical Assistance program, for services rendered on or after January 1, 2022, the
23department shall increase reimbursement to pay an additional amount on the basis
24of the rate that would have been paid to the dental provider had the individual not
25been enrolled in managed care.
AB68,751,3
1(d) If a provider has more than one service location, the thresholds described
2under par. (b) apply to each location, and the department will determine the payment
3for each separate service location.
AB68,751,54
(e) Any provider that receives reimbursement through the pilot project under
5sub. (24k) is not eligible for reimbursement under this subsection.
AB68,1024
6Section 1024
. 49.45 (25) (bj) of the statutes is amended to read:
AB68,751,147
49.45
(25) (bj) The department of corrections may elect to provide case
8management services under this subsection to persons who are under the
9supervision of that department under s. 938.183, 938.34
(4h), (4m), or (4n), or
10938.357 (3) or (4), who are Medical Assistance beneficiaries, and who meet one or
11more of the conditions specified in par. (am). The amount of the allowable charges
12for those services under the Medical Assistance program that is not provided by the
13federal government shall be paid from the appropriation account under s. 20.410 (3)
14(hm), (ho), or (hr).
AB68,1025
15Section 1025
. 49.45 (25) (bj) of the statutes, as affected by
2019 Wisconsin Act
168 and 2021 Wisconsin Act .... (this act), is repealed and recreated to read:
AB68,751,2317
49.45
(25) (bj) The department of corrections may elect to provide case
18management services under this subsection to persons who are under the
19supervision of that department under s. 938.183, 938.34 (4m), or 938.357 (3) or (4),
20who are Medical Assistance beneficiaries, and who meet one or more of the conditions
21specified in par. (am). The amount of the allowable charges for those services under
22the Medical Assistance program that is not provided by the federal government shall
23be paid from the appropriation account under s. 20.410 (3) (hm), (ho), or (hr).
AB68,1026
24Section
1026. 49.45 (25r) of the statutes is created to read:
AB68,751,2525
49.45
(25r) Community health worker services. (a) In this subsection:
AB68,752,2
11. “Community health services” means services provided by a community
2health worker.
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2. “Community health worker” means a frontline public health worker who is
4a trusted member of or has a close understanding of the community served, enabling
5the worker to serve as a liaison, link, or intermediary between health and social
6services and the community to facilitate access to services and improve the quality
7and cultural competence of service delivery, and who builds individual and
8community capacity by increasing health knowledge and self-sufficiency through a
9range of activities such as outreach, community education, informal counseling,
10social support, and advocacy.
AB68,752,1811
(b) The department shall request any necessary waiver from, or submit any
12necessary amendments to the state Medical Assistance plan to, the secretary of the
13federal department of health and human services to provide community health
14services to eligible Medical Assistance recipients. If the waiver or state plan
15amendment is granted, the department shall reimburse certified providers for those
16community health services approved by the federal department of health and human
17services for Medical Assistance coverage and as provided to Medical Assistance
18recipients under s. 49.46 (2) (b) 9m.
AB68,1027
19Section
1027. 49.45 (30e) (a) 2. of the statutes is repealed.
AB68,1028
20Section
1028. 49.45 (30e) (b) 3. of the statutes is amended to read:
AB68,752,2321
49.45
(30e) (b) 3. Requirements for certification of community-based
22psychosocial service programs.
The department may certify county-based providers
23and providers that are not county-based providers.
AB68,1029
24Section
1029. 49.45 (30e) (c) of the statutes is renumbered 49.45 (30e) (c) 1.
25and amended to read:
AB68,753,7
149.45
(30e) (c) 1.
A
The department shall reimburse a county that elects to
2make the provide services under s. 49.46 (2) (b) 6. Lm.
available shall reimburse a
3provider of the services for the amount of the allowable charges for those services
4under the
medical assistance Medical Assistance program that is not provided by the
5federal government
. The department shall reimburse the provider only for and the
6amount of the allowable charges for those services under the
medical assistance 7Medical Assistance program that is provided by the federal government.
AB68,1030
8Section
1030. 49.45 (30e) (c) 2. of the statutes is created to read:
AB68,753,119
49.45
(30e) (c) 2. The department shall reimburse to a provider that is not a
10county-based provider for services under s. 49.46 (2) (b) 6. Lm. for both the federal
11and nonfederal share of a fee schedule that is determined by the department.
AB68,1031
12Section
1031. 49.45 (30e) (d) of the statutes is amended to read:
AB68,753,2013
49.45
(30e) (d)
Provision of services on regional basis. Notwithstanding par.
14(c)
1. and subject to par. (e), in counties that elect to
deliver provide the services under
15s. 49.46 (2) (b) 6. Lm. through the Medical Assistance program on a regional basis
16according to criteria established by the department, the department shall reimburse
17a provider of the services for the amount of the allowable charges for those services
18under the Medical Assistance program that is provided by the federal government
19and for the amount of the allowable charges that is not provided by the federal
20government.
AB68,1032
21Section
1032. 49.45 (30t) of the statutes is created to read:
AB68,753,2222
49.45
(30t) Doula services. (a) In this subsection:
AB68,753,2423
1. “Certified doula” means an individual who has received certification from a
24doula certifying organization recognized by the department.
AB68,754,3
12. “Doula services” means childbirth education and support services, including
2emotional and physical support provided during pregnancy, labor, birth, and the
3postpartum period.