Feed for /2003/related/proposals/ab995 PDF
LRB-4473/1
DAK/PJK/MDK:ALL:ch/jf
2003 - 2004 LEGISLATURE
March 11, 2004 - Introduced by Representatives Wasserman, Miller, Molepske,
Vruwink, Kreuser, Sherman, Shilling, Hebl, Taylor, Pope-Roberts, Cullen,
Schooff, Sinicki, Berceau, Staskunas, Huber
and Richards. Referred to
Committee on Health.
AB995,3,13 1An Act to repeal 49.46 (1) (L), S456.04 (4) and 628.36 (2m) (e) 4.; to renumber
246.277 (1m) (a), 49.45 (6v), 456.04 (1), 456.04 (2), 456.04 (3), 628.36 (2m) (a) 1.,
3628.36 (2m) (a) 2., 628.36 (2m) (a) 3. and 895.48 (1m); to renumber and amend
449.47 (4) (h), 51.30 (4) (b) 13., 100.31 (1) (a), 100.31 (1) (b), 146.89 (1), 456.04
5(intro.) (except 456.04 (title)), 456.08 and 628.36 (1); to consolidate,
6renumber and amend
628.36 (2m) (a) (intro.) and 2m.; to amend 20.435 (4)
7(b), 20.435 (7) (bd), 46.277 (1), 46.277 (2) (intro.), 46.277 (3) (a), 46.277 (3) (b)
81., 46.277 (3) (b) 2., 46.277 (4) (a), 46.277 (4) (b), 46.277 (5) (g), 46.277 (5g) (a),
949.46 (1) (a) 1., 49.46 (1) (a) 1g., 49.46 (1) (a) 1m., 49.46 (1) (a) 6., 49.46 (1) (a)
109., 49.46 (1) (a) 10., 49.46 (1) (a) 11., 49.46 (1) (a) 12., 49.46 (1) (e), 49.47 (4) (am)
111., 49.47 (4) (am) 2., 49.47 (4) (c) 1., 49.47 (4) (c) 3., 49.665 (4) (a) 1., 100.31 (title),
12100.31 (1) (c), 100.31 (2), 100.31 (4), 146.89 (2) (a), 146.89 (2) (c), 146.89 (2) (d),
13146.89 (3) (b) (intro.), 146.89 (3) (c), 146.89 (3) (d) (intro.), 441.07 (1) (d), 448.015
14(4), 448.04 (1) (a), 450.10 (1) (a) (intro.), 450.11 (1), 456.02 (intro.), 456.02 (1),

1456.02 (2), 456.02 (3), 456.02 (4), 456.02 (5), 456.02 (6), 456.02 (7), 456.09 (1) (c),
2609.22 (2), 609.32 (2) (a), 628.36 (2) (a) (intro.), 628.36 (2) (b) 3., 628.36 (2) (b)
34., 628.36 (2m) (e) 1., 628.36 (2m) (e) 2., 628.36 (2m) (e) 3., 628.36 (3), 632.89 (2)
4(b) 1., 632.89 (2) (c) 2. b., 632.89 (2) (d) 2. and 632.89 (2) (dm) 2.; to repeal and
5recreate
628.36 (2m) (title); and to create 46.03 (44), 46.277 (1m) (ag), 46.277
6(4) (c), 49.45 (6ur), 49.45 (53), 49.46 (1) (ar), 49.47 (4) (cg) 3., 49.665 (4) (d),
749.688 (4r), 100.31 (1) (ae), 100.31 (1) (as), 100.31 (2r), 146.385, 146.89 (1) (d),
8146.89 (1) (g), 146.89 (1) (h), 146.89 (3m), 441.16 (3m), 448.035, 450.11 (1g),
9456.04 (1m) (d), 456.04 (1m) (e), 456.04 (2m), 456.08 (1), (2), (3) and (4), 456.12,
10628.36 (1c) (intro.), 628.36 (2) (b) 4m., 632.89 (1) (am), 632.89 (1) (b), 632.89 (2)
11(f), 632.89 (6) and (7) and 895.48 (1m) (b) of the statutes; relating to: treating
12property taxes as a deduction to annual household income for purposes of
13determining eligibility and deductible amounts under the prescription drug
14assistance program for the elderly; exempting amounts claimed for
15depreciation for purposes of calculating farm and self-employment income
16under the Medical Assistance and Badger Care health care programs; requiring
17Medical Assistance incentive payments to hospitals that establish a physician
18order entry record system; prescriptions for antibiotic drugs for treatment of
19chlamydia, gonorrhea, or trichomonas; the requirements for examinations for
20nursing home administrator licenses and for reciprocal nursing home
21administrator licenses and creating an exemption from such requirements;
22provision of home and community-based services under a community
23integration program to persons relocated from facilities; discrimination in
24prescription drug prices; health care provider service rates and insurer health
25care services reimbursement rates; expanding the Volunteer Health Care

1Provider Program to include provision of services to students from 4-year-old
2kindergarten to grade 6 in public elementary schools, charter schools, and
3private schools that participate in the Milwaukee Parental Choice Program;
4allowing any provider to participate in a health care plan under the terms of the
5plan, requiring an annual period for providers to elect to participate in health
6care plans, and requiring notice to a provider of the reason for exclusion from
7a health care plan; treatment of prescription drug costs, diagnostic testing, and
8payments under mandated insurance coverage of treatment for nervous and
9mental disorders and alcoholism and other drug abuse problems; increasing the
10limits for insurance coverage of nervous or mental health disorders or
11alcoholism or other drug abuse problems; an exception to confidentiality
12requirements for treatment records; granting rule-making authority; and
13requiring the exercise of rule-making authority.
Analysis by the Legislative Reference Bureau
Under current law, elderly persons may purchase prescription drugs at reduced
amounts under a program commonly known as "Senior Care." A person is eligible
for Senior Care if he or she is a state resident, is at least 65 years of age, is not a
medical assistance (MA) recipient or does not receive prescription drug coverage as
an MA recipient, and his or her annual household income, as determined by the
Department of Health and Family Services (DHFS), does not exceed 240 percent of
the federal poverty line. A person must pay an annual $30 fee to enroll in Senior
Care. An enrollee pays the "program payment rate" for prescription drugs (105
percent of the MA prescription drug payment rate plus a dispensing fee) until the
enrollee has met an annual deductible, if applicable, and thereafter pays only a
copayment of $5 for generic prescription drugs and a copayment of $15 for nongeneric
prescription drugs. A person whose annual household income is 160 percent or less
of the federal poverty line pays no deductible; if the person's annual household
income is more than 160 percent but not more than 200 percent of the federal poverty
line, the deductible is $500; and if the person's annual household income exceeds 200
percent of the federal poverty line, the deductible is $850. Other persons who meet
all of the requirements except the income limitation are also eligible to purchase
prescription drugs for the $5 and $15 copayment amounts for the time remaining in
a 12-month period after spending the difference between their annual household

income and 240 percent of the federal poverty line by paying for prescription drugs
at the retail price and satisfying the $850 deductible by purchasing prescription
drugs at the program payment rate.
This bill requires that in determining a person's annual household income for
purposes of Senior Care eligibility, DHFS must deduct the amount that the person
paid in property taxes on his or her primary residence in the previous 12 months.
DHFS must also use the annual household income adjusted for property taxes to
determine the appropriate deductible amount for persons who are enrolled in Senior
Care.
Currently, DHFS administers the MA and Badger Care health care
(BadgerCare) programs.
Under part of the MA program, DHFS provides health care services and
benefits to individuals who meet the requirements under one of the following MA
eligibility categories:
1. AFDC-MA. Under this category, an individual who meets the nonfinancial
and financial requirements for the federal Aid to Families with Dependent Children
(AFDC) program that were in effect on July 16, 1996, without regard to the
individual's assets, is eligible to receive MA. The AFDC program was replaced with
the federal Temporary Assistance for Needy Families (TANF) program on July 16,
1996. Generally, individuals who qualify under the AFDC-MA category are certain
children under 19 years of age, their caretaker relatives, and pregnant women in the
eighth or ninth month of pregnancy.
2. AFDC-related MA. This category includes certain children under the age
of 19, their caretaker relatives, and pregnant women throughout the entire
pregnancy who meet the income requirements of the AFDC program that were in
effect on July, 16, 1996, without regard to assets, but who would not have received
an AFDC payment. Also eligible under this category are children under the age of
18 and pregnant women whose incomes do not exceed 133.33 percent of the
maximum payment under the AFDC program, and whose assets do not exceed
certain asset limits.
3. Healthy Start. This category includes children between the ages of six and
19 whose incomes do not exceed 100 percent of the federal poverty line, children
under the age of six and pregnant women whose incomes do not exceed 133.33
percent of the federal poverty line, and children under the age of six and pregnant
women whose incomes do not exceed 185 percent of the federal poverty line.
The BadgerCare program provides health care coverage to eligible low-income
children who do not reside with a parent and to eligible low-income families. A child
or family is generally considered low-income if the child's or family's income does not
exceed 185 percent of the poverty line.
Currently, in calculating an individual's income for the MA or BadgerCare
program, if the individual has farm or self-employment income, DHFS calculates
the amount of that income by adding the amount that the individual claimed for
depreciation to the amount of the individual's net taxable income.
This bill prohibits DHFS from adding any amounts claimed for depreciation to
an individual's net taxable farm or self-employment income for purposes of

determining whether an individual meets the income limits for the MA program
under the AFDC-MA, AFDC-related MA, or Healthy Start eligibility categories or
for the BadgerCare program.
Beginning on January 1, 2005, or the day after publication of this bill as an act,
whichever is later, this bill requires that, for each hospital that establishes and
maintains a physician order entry record system for medical services, DHFS
annually make an incentive MA payment that equals 1 percent of the MA
reimbursement to the hospital for the previous fiscal year. The hospital must
establish the physician order entry record system by January 1, 2007.
This bill allows a physician, physician assistant, or advanced practice nurse to
prescribe to a patient an antibiotic drug as a course of therapy for the treatment of
chlamydia, gonorrhea, or trichomonas for use by a person with whom the patient has
had sexual intercourse if the patient states that the person is not allergic to the drug.
Such a prescription may be made for no more than two people in one year with whom
the patient has had sexual intercourse. In addition, the prescription order must
state that the patient is responsible for paying for the antibiotic drug that is
prescribed for the person with whom the patient has had sexual intercourse. Also,
such a prescription may not be made for a controlled substance.
A physician, physician assistant, or advanced practice nurse who makes such
a prescription may provide the patient with written information specified in rules
promulgated by DHFS. The information must include information about sexually
transmitted diseases and their treatment and about the risk of drug allergies. In
addition, the physician, physician assistant, or advanced practice nurse may request
that the patient provide the written information to the person with whom he or she
has had sexual intercourse.
This bill makes changes to current law regarding the following: 1) the
requirements for a nursing home administrator license; 2) the requirements for a
reciprocal nursing home administrator license that apply to persons licensed in other
states; and 3) the requirement to be licensed as a nursing home administrator.
Under current law, a person must satisfy certain education requirements
before he or she is allowed to take the examination for a nursing home administrator
license. Specifically, he or she must complete a regular course of study, equivalent
specialized courses, or a program of study that is considered adequate academic
preparation for nursing home administration by the Nursing Home Administrator
Examining Board. In addition, the examining board is required to develop and
enforce standards regarding the supervised practical experience that is required for
a person to be licensed as a nursing home administrator. A person may satisfy the
supervised practical experience requirements before or after taking the
examination.
This bill changes the requirements that a person must satisfy before taking the
nursing home administrator examination. Under the bill, except as discussed below,
a person must satisfy certain education and supervised practical experience
requirements before he or she can take the examination. Regarding education, the
bill requires, except as discussed below, a person to have either: 1) a bachelor's,
master's, or doctoral degree with a health care administration or long-term care

major; or 2) a bachelor's degree and completion of a specialized course in nursing
home administration. The bill directs the Nursing Home Administrator Examining
Board to promulgate rules establishing the supervised practical experience
requirements. The rules must require a person to complete at least 2,000 hours in
an internship, administrator-in-training program, or other structured program
before he or she can take the examination. The 2,000 hours must be completed in
any consecutive three-year period within the five-year period immediately
preceding the date of application for the examination.
The bill creates an exception to the above requirements that apply to a person
who was enrolled, at any time within the two-year period before the bill's general
effective date, in a course of study that the Nursing Home Administrator Examining
Board had considered adequate preparation at that time. The bill allows such a
person to take the examination if he or she completes the course no later than two
years after the bill's general effective date and if the person satisfies, no later than
the same deadline, practical experience requirements specified in the bill.
Under current law, a person who has a nursing home administrator license in
another state is eligible for a reciprocal nursing home administrator license if he or
she satisfies certain requirements, including submitting satisfactory evidence of the
person's qualifications to the Nursing Home Administrator Examining Board. This
bill specifies the qualifications that a person must have to be eligible for a reciprocal
license. Under the bill, an applicant for such a license must have a bachelor's degree
or be certified as a nursing home administrator by the American College of Health
Care Administrators and must have practiced as a nursing home administrator in
good standing for at least 2,000 hours in any consecutive three-year period within
the five-year period immediately preceding the date of application for the reciprocal
license. Also, the applicant must not have an arrest or conviction record the
circumstances of which substantially relate to nursing home administration. In
addition, the person must pass an examination relating to state and federal laws
governing the practice of nursing home administration.
Finally, current law prohibits a person from practicing as a nursing home
administrator unless he or she is licensed by the Nursing Home Administrative
Examining Board. This bill creates an exception for a person who acts in the capacity
of an administrator of a nursing home operated by adherents of a church or religious
denomination which subscribes to the act of healing by prayer and the principles of
which do not include medical treatment. However, the exemption applies only if the
person does not use any title implying that he or she is a nursing home administrator.
Currently, the DHFS administers a Community Integration Program
(commonly known as "CIP II"), under which MA moneys are paid to counties to
provide home and community-based services, under a waiver of federal Medicaid
laws, to elderly and physically disabled persons who meet the level of care
requirements for MA-reimbursed nursing home care or are relocated from facilities.
DHFS must establish a uniform daily rate for CIP II and reimburse counties up to
that rate for each person enrolled in CIP II. Under 2003 Wisconsin Act 33 (the
biennial budget act), DHFS may provide enhanced reimbursement for CIP II
services for a person who is relocated to the community from a nursing home by a

county after July 16, 2003, if the nursing home bed used by the person is delicensed
upon the person's relocation.
This bill authorizes DHFS to provide CIP II funding for home and
community-based services to an MA-eligible person who relocates from a facility to
the community. Reimbursement is not conditioned on delicensure of a nursing home
bed upon the person's relocation. The funding begins on the date of the relocation
and ends on the date that the person discontinues program participation or no longer
meets the level of care requirements for MA reimbursement in a nursing home.
Funding in the aggregate for these relocated persons may not exceed the total MA
costs for the persons if served in nursing homes. DHFS may provide an enhanced
reimbursement rate for the services. The total number of persons who may
participate in this particular aspect of CIP II is not restricted by limitations on
numbers participating in the remainder of CIP II.
The bill changes a prohibition under current law against price discrimination
that applies to a seller who trades in prescription drugs for resale. Under current
law, the prohibition applies to a seller who sells prescription drugs directly to
consumers. Under the bill, the prohibition applies to a seller who sells to a
"dispenser," which the bill defines as a person who delivers a prescription drug to an
ultimate user for outpatient use, including an insurer that issues certain types of
managed health care plans. Also included under the definition of "dispenser" is a
hospital that directly or indirectly bills a patient for prescription drugs.
The prohibition on price discrimination under current law applies to
prescription drugs on a list of therapeutically equivalent drugs published by the
federal Food and Drug Administration (FDA). This bill provides that the prohibition
applies to drugs included in the most current version of either of the following: 1) the
FDA list; or 2) another publication specified in rules promulgated by the Department
of Agriculture, Trade and Consumer Protection that identifies drug products
approved on the basis of safety and effectiveness by the FDA under the federal Food,
Drug, and Cosmetic Act.
This bill requires DHFS annually by April 1 to make available, on the DHFS
website and, upon request, by mail, the current MA fee schedule for services of health
care providers (as defined in the bill). The bill requires health care providers,
annually by April 15, to provide to DHFS a statement of the providers' rates for
health care services for the following May 1 to April 30. Health care providers must
also inform DHFS, during this period, of any increase in any of their rates over the
amounts provided to DHFS. The rates must be stated in a form, as determined by
DHFS, that may include statement as a percentage of the MA fee schedule. In
addition, health care providers, annually beginning on May 1, must post their rates
on an Internet website, if the health care provider has such a website, and take
reasonable steps to ensure that their health care services consumers are aware that
rate information is available and are informed about how to obtain the information.
Any increase in a health care provider's rates is chargeable only after the health care
provider has notified DHFS and, if the health care provider has a website, has posted
information on the website about the rate increase.

The bill requires insurers, annually by April 15, to provide to DHFS and to the
insurers' insureds a statement of the insurers' rates of reimbursement for health
care provider services for the following May 1 to April 30, stated as a percentage of
the MA fee schedule. Insurers must also inform DHFS, during this period, of any
increase in any of their rates over the amounts provided to DHFS.
DHFS may make available, on the DHFS website and, upon request, by mail,
the health care provider rate and insurer reimbursement rate information, including
increases, provided to DHFS. DHFS is also authorized to contract for the receipt and
posting of this information and the current MA fee schedule for health care provider
services, in accordance with DHFS request-for-proposal procedures.
Under current law, if the Department of Administration (DOA) has approved
a joint application of a health care provider and a nonprofit agency, the health care
provider acting within the scope of his or her licensure or certification may provide,
without charge to low-income, uninsured persons at the agency, diagnostic tests,
health education, office visits, patient advocacy, prescriptions, information about
available health care resources, referrals to health care specialists, and, for dentists,
simple tooth extractions and necessary related suturing. The health care provider,
for the provision of these services, is a state agent of DHFS; as such, for a civil action
arising out of an act committed in the lawful course of the health care provider's
duties, certain time limitations for filing the action apply, legal counsel is provided
to the health care provider, judgments against the health care provider are paid by
the state, and amounts recoverable are capped at $250,000.
This bill expands the Volunteer Health Care Provider Program to authorize
provision of services, without charge, from four-year-old kindergarten to grade six
in a public elementary school, a charter school, or a private school participating in
the Milwaukee Parental Choice Program (MPCP), if DOA approves the joint
application of a health care provider and a school board or the governing body of a
charter school or a private school participating in MPCP. After providing to the
school board or relevant governing body proof of satisfactory completion of any
relevant competency requirements, the volunteer health care provider may provide
without charge to students from four-year-old kindergarten to grade six of the
school, regardless of income, diagnostic tests; health education; information about
available health care resources; office visits; patient advocacy; referrals to health
care specialists; first aid for illness or injury; in compliance with the written
instructions of a pupil's parent or guardian, the administration of any drug, other
than a contraceptive drug, that may lawfully be sold over the counter; health
screenings; any other health care services designated by the Department of Public
Instruction (DPI); and, for dentists, simple tooth extractions and necessary related
suturing. However, the volunteer health care provider may not provide emergency
medical services, hospitalization, or surgery, except as designated by DPI by rule,
and may not provide abortion referrals, contraceptives, or pregnancy tests.
Under current law, a health care plan must allow any provider to participate
in the plan under the terms of the plan. However, this requirement does not apply
to health maintenance organizations, limited service health organizations, or
preferred provider plans, each of which is a health care plan that requires, or

provides incentives for, its enrollees to obtain health care services from providers
participating in the plan. "Participating" is defined as being under contract to
provide health care services, items, or supplies to plan enrollees.
This bill requires any health care plan, including a health maintenance
organization, limited service health organization, or preferred provider plan, to
allow any provider to participate in the plan under the terms of the plan. The
requirement only applies to a health maintenance organization, limited service
health organization, or preferred provider plan, however, if the provider is located
in the geographic service area of the plan. The bill also requires a health care plan
that excludes a provider from participation in the plan to give the provider written
notice of the reason for the exclusion.
Also under current law, a health maintenance organization, limited service
health organization, or preferred provider plan that covers pharmaceutical services
provided by one or more pharmacists who are not full-time salaried employees or
partners of the organization or plan must provide an annual 30-day period during
which any pharmacist may elect to participate in the organization or plan under its
terms as a selected provider for at least one year. This bill expands that requirement.
Under the bill, a health maintenance organization, limited service health
organization, or preferred provider plan that covers health care services that are
provided by one or more health care professionals who are not full-time salaried
employees or partners of the organization or plan is required to provide an annual
30-day period during which any health care professional who provides those health
care services and who is located in the geographic service area of the organization
or plan may elect to participate in the organization or plan under its terms as a
selected provider for at least one year.
Under current law, a group health insurance policy that provides coverage of
any inpatient hospital services must cover those services for the treatment of
nervous and mental disorders and alcoholism and other drug abuse problems in the
minimum amount of the lesser of: 1) the expenses of 30 days of inpatient services;
or 2) $7,000 minus the applicable cost sharing under the policy or, if there is no cost
sharing under the policy, $6,300 in equivalent benefits measured in services
rendered. If a group health insurance policy provides coverage of any outpatient
hospital services, it must cover those services for the treatment of nervous and
mental disorders and alcoholism and other drug abuse problems in the minimum
amount of $2,000 minus the applicable cost sharing under the policy or, if there is no
cost sharing under the policy, $1,800 in equivalent benefits measured in services
rendered. If a group health insurance policy provides coverage of any inpatient or
outpatient hospital services, it must cover the cost of transitional treatment
arrangements (services, specified by rule by the commissioner of insurance, that are
provided in a less restrictive manner than inpatient services but in a more intensive
manner than outpatient services) for the treatment of nervous and mental disorders
and alcoholism and other drug abuse problems in the minimum amount of $3,000
minus the applicable cost sharing under the policy or, if there is no cost sharing under
the policy, $2,700 in equivalent benefits measured in services rendered. If a group
health insurance policy provides coverage for both inpatient and outpatient hospital

services, the total coverage for all types of treatment for nervous and mental
disorders and alcoholism and other drug abuse problems is not required to exceed
$7,000, or the equivalent benefits measured in services rendered, in a policy year.
This bill specifies that the minimum coverage limits required for the treatment
of nervous and mental disorders and alcoholism and other drug abuse problems do
not include costs incurred for prescription drugs and diagnostic testing. Diagnostic
testing is defined in the bill as procedures used to exclude the existence of conditions
other than nervous or mental disorders or alcoholism or other drug abuse problems.
DHFS is authorized to specify, by rule, the diagnostic testing procedures that are not
included under the coverage limits.
The bill provides that, if an insurer pays less than the amount that a provider
charges, the required minimum coverage limits apply to the amount actually paid
by the insurer rather than to the amount charged by the provider.
The bill changes the minimum amount of coverage that must be provided for
the treatment of nervous and mental disorders and alcoholism and other drug abuse
problems on the basis of the change in the consumer price index for medical services
since the coverage amounts in current law were enacted. Inpatient services must be
covered in the minimum amount of the lesser of: 1) the expenses of 30 days of
inpatient services; or 2) $16,800 minus the applicable cost sharing or, if there is no
cost sharing under the policy, $15,100 in equivalent benefits measured in services
rendered. Outpatient services must be covered in the minimum amount of $3,100
minus the applicable cost sharing or, if there is no cost sharing under the policy,
$2,800 in equivalent benefits measured in services rendered. Transitional treatment
arrangements must be covered in the minimum amount of $4,600 minus the
applicable cost sharing or, if there is no cost sharing under the policy, $4,100 in
equivalent benefits measured in services rendered. The total coverage for all types
of treatment for nervous and mental disorders and alcoholism and other drug abuse
problems is not required to exceed $16,800, or the equivalent benefits measured in
services rendered, in a policy year.
The table below provides information on treatment category, current minimum
coverage amount, year of enactment, and the proposed coverage amounts based on

the increase in the federal cost-of-living for medical coverage "indexed" since the
enactment of the current coverage amounts. - See PDF for table PDF - See PDF for table PDF
The bill also requires the DHFS to annually report to the governor and
legislature on the change in coverage limits necessary to conform with the change
in the federal consumer price index for medical costs.
Under current law, the treatment records of an individual who is treated for
mental illness, developmental disabilities, alcoholism, or drug dependence must
remain confidential, are privileged to the individual, and may be released only with
the individual's informed written consent. However, numerous exceptions apply
that permit the release of treatment records without informed written consent. One
of the exceptions permits the release of information contained in a treatment record
as to whether or not an individual is a patient at an inpatient facility; and the
information may be released to the individual's parents, children, or spouse, to a law
enforcement officer who is seeking to determine if the individual is on unauthorized
absence from the facility, and to mental health professionals who are providing
treatment to the individual.
This bill changes that exception to require that notice be provided as to whether
or not an individual is a patient at an inpatient facility and, if no longer a patient,
the facility to which the individual was transferred or other place, if known, at which
the individual is located. This information must be released to the individual's
siblings, as well as the individual's parents, children, or spouse, or to a law
enforcement officer or mental health professional. However, the bill prohibits the
release of the information to the individual's parents, children, siblings, or spouse if
the individual has specifically named the person and requested that the information
be withheld from him or her.

This bill also requires the DHFS fiscal intermediary for MA to maintain a
separate unit for the processing of MA claims for dental services provided under MA.
For further information see the state and local fiscal estimate, which will be
printed as an appendix to this bill.
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