AB995, s. 6 14Section 6. 46.277 (1m) (ag) of the statutes is created to read:
AB995,14,1615 46.277 (1m) (ag) "Delicensed" means deducted from the number of beds stated
16on a facility's license, as specified under s. 50.03 (4) (e).
AB995, s. 7 17Section 7. 46.277 (2) (intro.) of the statutes is amended to read:
AB995,15,518 46.277 (2) Departmental powers and duties. (intro.) The department may
19request a waiver from the secretary of the federal department of health and human
20services, under 42 USC 1396n (c), authorizing the department to serve medical
21assistance recipients, who meet the level of care requirements for medical assistance
22reimbursement in a skilled nursing facility or an intermediate care facility, in their
23communities by providing home or community-based services as part of medical
24assistance. The Except under sub. (4) (c), the number of persons for whom the waiver
25is requested may not exceed the number of nursing home beds that are delicensed

1as part of a plan submitted by the facility and approved by the department. If the
2department requests a waiver, it shall include all assurances required under 42 USC
31396n
(c) (2) in its request. If the department receives this waiver, it may request
4one or more 3-year extensions of the waiver under 42 USC 1396n (c) and shall
5perform the following duties:
AB995, s. 8 6Section 8. 46.277 (3) (a) of the statutes is amended to read:
AB995,15,167 46.277 (3) (a) Sections 46.27 (3) (b) and 46.275 (3) (a) and (c) to (e) apply to
8county participation in this program, except that services provided in the program
9shall substitute for care provided a person in a skilled nursing facility or
10intermediate care facility who meets the level of care requirements for medical
11assistance reimbursement to that facility rather than for care provided at a state
12center for the developmentally disabled. The Except in sub. (4) (c), the number of
13persons who receive services provided by the program under this paragraph may not
14exceed the number of nursing home beds, other than beds specified in sub. (5g) (b),
15that are delicensed as part of a plan submitted by the facility and approved by the
16department.
AB995, s. 9 17Section 9. 46.277 (3) (b) 1. of the statutes is amended to read:
AB995,15,2118 46.277 (3) (b) 1. If Except under sub. (4) (c), if the provision of services under
19this section results in a decrease in the statewide nursing home bed limit under s.
20150.31 (3), the facility affected by the decrease shall submit a plan for delicensing all
21or part of the facility that is approved by the department.
AB995, s. 10 22Section 10. 46.277 (3) (b) 2. of the statutes is amended to read:
AB995,16,323 46.277 (3) (b) 2. Each county department participating in the program shall
24provide home or community-based care to persons eligible under this section, except
25that the number of persons who receive home or community-based care under this

1section may not exceed, other than under sub. (4) (c), the number of nursing home
2beds, other than beds specified in sub. (5g) (b), that are delicensed as part of a plan
3submitted by the facility and approved by the department.
AB995, s. 11 4Section 11. 46.277 (4) (a) of the statutes is amended to read:
AB995,16,135 46.277 (4) (a) Any medical assistance recipient who meets the level of care
6requirements for medical assistance reimbursement in a skilled nursing facility or
7intermediate care facility is eligible to participate in the program, except that the
8number of participants may not exceed, other than under par. (c), the number of
9nursing home beds, other than beds specified in sub. (5g) (b), that are delicensed as
10part of a plan submitted by the facility and approved by the department. Such a
11recipient may apply, or any person may apply on behalf of such a recipient, for
12participation in the program. Section 46.275 (4) (b) applies to participation in the
13program.
AB995, s. 12 14Section 12. 46.277 (4) (b) of the statutes is amended to read:
AB995,16,2215 46.277 (4) (b) To the extent authorized under 42 USC 1396n and except under
16par. (c)
, if a person discontinues participation in the program, a medical assistance
17recipient may participate in the program in place of the participant who discontinues
18if that recipient meets the level of care requirements for medical assistance
19reimbursement in a skilled nursing facility or intermediate care facility, except that
20the number of participants may not exceed the number of nursing home beds, other
21than beds specified in sub. (5g) (b), that are delicensed as part of a plan submitted
22by the facility and approved by the department.
AB995, s. 13 23Section 13. 46.277 (4) (c) of the statutes is created to read:
AB995,17,924 46.277 (4) (c) The department may, under this paragraph, provide funding
25under this section for services for a medical assistance recipient who relocates from

1a facility to the community, beginning on the date of the relocation and ending on the
2date that the individual discontinues participation in the program or no longer meets
3the level of care requirements for medical assistance reimbursement in a skilled
4nursing facility or an intermediate care facility. Funding for medical assistance costs
5for individuals relocated under this paragraph may not exceed, in the aggregate,
6total medical assistance costs for the individuals if served in facilities. The total
7number of individuals who may participate in the program under this paragraph is
8not restricted by any otherwise applicable limitation on the number of individuals
9who may participate in the program under this section.
AB995, s. 14 10Section 14. 46.277 (5) (g) of the statutes, as created by 2003 Wisconsin Act 33,
11is amended to read:
AB995,17,1712 46.277 (5) (g) The department may provide enhanced reimbursement for
13services provided under this section to an individual who is relocated to the
14community from a nursing home by a county department on or after July 26, 2003,
15if the nursing home bed that was used by the individual is delicensed upon relocation
16of the individual or if the individual is relocated under sub. (4) (c). The department
17shall develop and utilize a formula to determine the enhanced reimbursement rate.
AB995, s. 15 18Section 15. 46.277 (5g) (a) of the statutes is amended to read:
AB995,17,2219 46.277 (5g) (a) The Except under sub. (4) (c), the number of persons served
20under this section may not exceed the number of nursing home beds that are
21delicensed as part of a plan submitted by the facility and approved by the
22department.
AB995, s. 16 23Section 16. 49.45 (6ur) of the statutes is created to read:
AB995,18,524 49.45 (6ur) Physician order entry record system; incentive payments. From
25the appropriation accounts under s. 20.435 (4) (b) and (o), the department shall

1annually make an incentive payment to each hospital that establishes, by January
21, 2007, and thereafter continues to maintain a physician order entry record system
3for provided medical services that, at a minimum, include pharmacy, laboratory,
4ultrasonography, and radiology services. The incentive payment shall equal 1% of
5the Medical Assistance reimbursement to the hospital for the previous fiscal year.
AB995, s. 17 6Section 17. 49.45 (6v) of the statutes is renumbered 49.45 (6L).
AB995, s. 18 7Section 18. 49.45 (53) of the statutes is created to read:
AB995,18,108 49.45 (53) Fiscal intermediary; dental forms. The department's fiscal
9intermediary shall maintain a separate unit for the processing of claims for dental
10services received under this section.
AB995, s. 19 11Section 19. 49.46 (1) (a) 1. of the statutes is amended to read:
AB995,18,1412 49.46 (1) (a) 1. Notwithstanding s. 49.19 (20), any individual who, without
13regard to the individual's resources and subject to par. (ar), would qualify for a grant
14of aid to families with dependent children under s. 49.19.
AB995, s. 20 15Section 20. 49.46 (1) (a) 1g. of the statutes is amended to read:
AB995,18,1916 49.46 (1) (a) 1g. Notwithstanding s. 49.19 (20), any individual who, without
17regard to the individual's resources and subject to par. (ar), would qualify for a grant
18of aid to families with dependent children but who would not receive the aid solely
19because of the application of s. 49.19 (11) (a) 7.
AB995, s. 21 20Section 21. 49.46 (1) (a) 1m. of the statutes is amended to read:
AB995,18,2421 49.46 (1) (a) 1m. Any pregnant woman whose income, determined in
22accordance with par. (ar),
does not exceed the standard of need under s. 49.19 (11)
23and whose pregnancy is medically verified. Eligibility continues to the last day of
24the month in which the 60th day after the last day of the pregnancy falls.
AB995, s. 22 25Section 22. 49.46 (1) (a) 6. of the statutes is amended to read:
AB995,19,4
149.46 (1) (a) 6. Any person not described in pars. (c) to (e) who, without regard
2to the individual's resources and subject to par. (ar), would be considered, under
3federal law, to be receiving aid to families with dependent children for the purpose
4of determining eligibility for medical assistance.
AB995, s. 23 5Section 23. 49.46 (1) (a) 9. of the statutes is amended to read:
AB995,19,86 49.46 (1) (a) 9. Any pregnant woman not described under subd. 1., 1g., or 1m.
7whose family income, determined in accordance with par. (ar), does not exceed 133%
8of the poverty line for a family the size of the woman's family.
AB995, s. 24 9Section 24. 49.46 (1) (a) 10. of the statutes is amended to read:
AB995,19,1210 49.46 (1) (a) 10. Any child not described under subd. 1. or 1g. who is under 6
11years of age and whose family income, determined in accordance with par. (ar), does
12not exceed 133% of the poverty line for a family the size of the child's family.
AB995, s. 25 13Section 25. 49.46 (1) (a) 11. of the statutes is amended to read:
AB995,19,2214 49.46 (1) (a) 11. If a waiver under s. 49.665 is granted and in effect, any child
15not described under subd. 1. or 1g. who has attained the age of 6 but has not attained
16the age of 19 and whose family income, determined in accordance with par. (ar), does
17not exceed 100% of the poverty line for a family the size of the child's family. If a
18waiver under s. 49.665 is not granted or in effect, any child not described in subd. 1.
19or 1g. who was born after September 30,1983, who has attained the age of 6 but has
20not attained the age of 19 and whose family income, determined in accordance with
21par. (ar),
does not exceed 100% of the poverty line for a family the size of the child's
22family.
AB995, s. 26 23Section 26. 49.46 (1) (a) 12. of the statutes is amended to read:
AB995,20,3
149.46 (1) (a) 12. Any child not described under subd. 1. or 1g. who is under 19
2years of age and whose income, determined in accordance with par. (ar), does not
3exceed the standard of need under s. 49.19 (11).
AB995, s. 27 4Section 27 . 49.46 (1) (ar) of the statutes is created to read:
AB995,20,145 49.46 (1) (ar) 1. Except as provided in subd. 2. and except to the extent that the
6determination is inconsistent with 42 USC 1396a (a) (17), for purposes of
7determining under par. (a) 1., 1g., or 6. whether an individual would qualify for a
8grant of aid to families with dependent children under s. 49.19 or would be
9considered, under federal law, to be receiving aid to families with dependent
10children, or of determining whether an individual meets the income limits under par.
11(a) 1m., 9., 10., 11., or 12., "income" includes income that would be included in
12determining eligibility for aid to families with dependent children under s. 49.19 and
13excludes income that would be excluded in determining eligibility for aid to families
14with dependent children under s. 49.19.
AB995,20,2115 2. Notwithstanding s. 49.19 (5), for purposes of determining under par. (a) 1.,
161g., or 6. whether an individual would qualify for a grant of aid to families with
17dependent children under s. 49.19 or would be considered, under federal law, to be
18receiving aid to families with dependent children, or of determining whether an
19individual meets the income limits under par. (a) 1m., 9., 10., 11., or 12., (am), or (e),
20the department shall exclude from the calculation of farm or self-employment
21income any amounts claimed for depreciation for income tax purposes.
AB995, s. 28 22Section 28. 49.46 (1) (e) of the statutes is amended to read:
AB995,21,423 49.46 (1) (e) If an application under s. 49.47 (3) shows that the individual
24individual's income, determined in accordance with par. (ar), meets the income limits
25under s. 49.19, or that the individual meets the income and resource requirements

1under federal Title XVI or s. 49.77, or that the individual is an essential person, an
2accommodated person, or a patient in a public medical institution, the individual
3shall be granted the benefits enumerated under sub. (2) whether or not the
4individual requests or receives a grant of any of such aids.
AB995, s. 29 5Section 29. 49.46 (1) (L) of the statutes is repealed.
AB995, s. 30 6Section 30. 49.47 (4) (am) 1. of the statutes is amended to read:
AB995,21,127 49.47 (4) (am) 1. A pregnant woman whose family income , determined in
8accordance with par. (cg),
does not exceed 155% of the poverty line for a family the
9size of the woman's family, except that, if a waiver under par. (j) or a change in the
10approved state plan under s. 49.46 (1) (am) 2. is in effect, the income limit is 185%
11of the poverty line for a family the size of the woman's family in each state fiscal year
12after the 1994-95 state fiscal year.
AB995, s. 31 13Section 31. 49.47 (4) (am) 2. of the statutes is amended to read:
AB995,21,1914 49.47 (4) (am) 2. A child who is under 6 years of age and whose family income,
15determined in accordance with par. (cg),
does not exceed 155% of the poverty line for
16a family the size of the child's family, except that, if a waiver under par. (j) or a change
17in the approved state plan under s. 49.46 (1) (am) 2. is in effect, the income limit is
18185% of the poverty line for a family the size of the child's family in each state fiscal
19year after the 1994-95 state fiscal year.
AB995, s. 32 20Section 32. 49.47 (4) (c) 1. of the statutes is amended to read:
AB995,22,221 49.47 (4) (c) 1. Except as provided in par. (am) and as limited by subd. 3.,
22eligibility exists if income, determined in accordance with par. (cg), does not exceed
23133 1/3% of the maximum aid to families with dependent children payment under
24s. 49.19 (11) for the applicant's family size or the combined benefit amount available

1under supplemental security income under 42 USC 1381 to 1383c and state
2supplemental aid under s. 49.77, whichever is higher. In this subdivision
AB995,22,10 3(cg) 1. Except as provided in subd. 3., for purposes of determining whether an
4individual's income meets the income requirements under par. (c),
"income" includes
5earned or unearned income that would be included in determining eligibility for the
6individual or family under s. 49.19 or 49.77, or for the aged, blind or disabled under
742 USC 1381 to 1385. "Income" does not include and excludes earned or unearned
8income which that would be excluded in determining eligibility for the individual or
9family under s. 49.19 or 49.77, or for the aged, blind or disabled individual under 42
10USC 1381
to 1385.
AB995, s. 33 11Section 33. 49.47 (4) (c) 3. of the statutes is amended to read:
AB995,22,1512 49.47 (4) (c) 3. Except as provided in par. (am), no person is eligible for medical
13assistance under this section if the person's income, determined in accordance with
14par. (cg),
exceeds the maximum income levels that the U.S. department of health and
15human services sets for federal financial participation under 42 USC 1396b (f).
AB995, s. 34 16Section 34 . 49.47 (4) (cg) 3. of the statutes is created to read:
AB995,22,2017 49.47 (4) (cg) 3. Notwithstanding s. 49.19 (5), for purposes of determining
18whether an individual under par. (ag) or (am) is eligible for medical assistance, the
19department shall exclude from the calculation of farm or self-employment income
20any amounts claimed for depreciation for income tax purposes.
AB995, s. 35 21Section 35. 49.47 (4) (h) of the statutes is renumbered 49.47 (4) (cg) 2. and
22amended to read:
AB995,23,323 49.47 (4) (cg) 2. For the Except as provided in subd. 3., for purposes of
24determining whether an individual meets the income limits under par. (am),
25"income" includes income that would be used included in determining eligibility for

1aid to families with dependent children under s. 49.19 and excludes income that
2would be excluded in determining eligibility for aid to families with dependent
3children under s. 49.19.
AB995, s. 36 4Section 36. 49.665 (4) (a) 1. of the statutes is amended to read:
AB995,23,95 49.665 (4) (a) 1. The family's income does not exceed 185% of the poverty line,
6except as provided in par. (at) and except that a family that is already receiving
7health care coverage under this section may have an income that does not exceed
8200% of the poverty line. The Subject to par. (d), the department shall establish by
9rule the criteria to be used to determine income.
AB995, s. 37 10Section 37. 49.665 (4) (d) of the statutes is created to read:
AB995,23,1411 49.665 (4) (d) For purposes of determining a family's or child's income under
12this section, the department shall exclude from the calculation of farm or
13self-employment income any amounts claimed for depreciation for income tax
14purposes.
AB995, s. 38 15Section 38. 49.688 (4r) of the statutes is created to read:
AB995,23,2216 49.688 (4r) In determining a person's annual household income under sub. (2)
17(a) 4. and (b) for purposes of determining eligibility for prescription drug assistance
18and under sub. (3) (b) 1. and 2. a. for purposes of establishing the required deductible
19amount, the department shall deduct the amount of property taxes that the person
20or any member of his or her household paid on the person's primary residence in the
2112-month period before the department makes an eligibility determination under
22sub. (4).
AB995, s. 39 23Section 39. 51.30 (4) (b) 13. of the statutes is renumbered 51.30 (4) (cm) and
24amended to read:
AB995,24,14
151.30 (4) (cm) Required access to records. To the parents, children
2Notwithstanding par. (a), treatment records of an individual shall be released
3without informed written consent, except as restricted under par. (c), to the parent,
4child, sibling,
or spouse of an individual who is or was a patient at an inpatient
5facility,; to a law enforcement officer who is seeking to determine whether an
6individual is on unauthorized absence from the facility, ; and to mental health
7professionals who are providing treatment to the individual at the time that the
8information is released to others. Information released under this subdivision
9paragraph is limited to notice as to whether or not an individual is a patient at the
10inpatient facility and, if the individual is no longer a patient at the inpatient facility,
11the facility or other place, if known, at which the individual is located. This
12paragraph does not apply to an individual's parent, child, sibling, or spouse from
13whom the individual has specifically requested that the information under this
14paragraph be withheld
.
AB995, s. 40 15Section 40. 100.31 (title) of the statutes is amended to read:
AB995,24,16 16100.31 (title) Unfair discrimination in Prescription drug pricing.
AB995, s. 41 17Section 41. 100.31 (1) (a) of the statutes is renumbered 100.31 (1) (bm) and
18amended to read:
AB995,24,2019 100.31 (1) (bm) "Drug" "Prescription drug" means any substance subject to 21
20USC 353
(b).
AB995, s. 42 21Section 42. 100.31 (1) (ae) of the statutes is created to read:
AB995,24,2322 100.31 (1) (ae) "Consumer" means a person for whom a prescription drug is
23prescribed.
AB995, s. 43 24Section 43. 100.31 (1) (as) of the statutes is created to read:
AB995,25,4
1100.31 (1) (as) "Federal drug list" means the "Approved Drug Products with
2Therapeutic Equivalence Evaluations" published by the federal food and drug
3administration, or other publication specified in rules promulgated by the
4department under sub. (2r).
AB995, s. 44 5Section 44. 100.31 (1) (b) of the statutes is renumbered 100.31 (1) (am) and
6amended to read:
AB995,25,127 100.31 (1) (am) "Purchaser" " Dispenser" means any person who engages
8primarily in selling dispensing, as defined in s. 450.01 (7), prescription drugs directly
9to consumers for outpatient use. "Dispenser" includes a hospital that directly or
10indirectly bills patients for prescription drugs, or an insurer that issues a defined
11network plan, as defined in s. 609.01 (1b), and that provides prescription drugs or
12prescription drug coverage to the enrollees of the plan
.
AB995, s. 45 13Section 45. 100.31 (1) (c) of the statutes is amended to read:
AB995,25,1514 100.31 (1) (c) "Seller" means any person who trades in prescription drugs for
15resale to purchasers dispensers in this state.
AB995, s. 46 16Section 46. 100.31 (2) of the statutes is amended to read:
AB995,25,2417 100.31 (2) Price discrimination prohibited. Every seller shall offer
18prescription drugs from the most current federal drug list of therapeutically
19equivalent drugs published by the federal food and drug administration
to every
20purchaser dispenser in this state, with all rights and privileges offered or accorded
21by the seller to the most favored purchaser dispenser, including purchase prices for
22similar volume purchases, rebates, free merchandise, samples, and similar trade
23concessions. Nothing in this subsection prohibits the giving of a discount for volume
24purchases.
AB995, s. 47 25Section 47. 100.31 (2r) of the statutes is created to read:
AB995,26,4
1100.31 (2r) Rules. The department may promulgate rules that, for purposes
2of sub. (1) (as), specify a publication that identifies drug products approved on the
3basis of safety and effectiveness by the federal food and drug administration under
4the federal Food, Drug, and Cosmetic Act.
AB995, s. 48 5Section 48. 100.31 (4) of the statutes is amended to read:
AB995,26,116 100.31 (4) Penalties. For any violation of this section, the department or a
7district attorney may commence an action on behalf of the state to recover a forfeiture
8of not less than $100 nor more than $10,000 for each offense. Each delivery of a
9prescription drug sold to a purchaser dispenser at a price in violation of this section
10and each separate day in violation of an injunction issued under this section is a
11separate offense.
AB995, s. 49 12Section 49. 146.385 of the statutes is created to read:
AB995,26,14 13146.385 Health care provider service rate charges; limitations. (1) In
14this section:
AB995,26,1615 (a) "Health care provider" means any of the following that receives income from
16the provision of health care or mental health services, items, or supplies in this state:
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