LRB-3887/1
TJD:cjs
2019 - 2020 LEGISLATURE
August 29, 2019 - Introduced by Senators Kooyenga, Bewley, Testin, Carpenter,
Bernier, Cowles, Darling, Erpenbach, Feyen, Hansen, Johnson, LeMahieu,
Petrowski, Schachtner, Stroebel and L. Taylor, cosponsored by
Representatives Loudenbeck, Kolste, Quinn, Riemer, Anderson, Ballweg,
Billings, Born, Bowen, Considine, Crowley, Dittrich, Doyle, Duchow,
Emerson, Felzkowski, Fields, Horlacher, Jagler, Kitchens, Kulp,
Kuglitsch, Kurtz, B. Meyers, Mursau, L. Myers, Nygren, Ohnstad,
Oldenburg, Petryk, Plumer, Pope, Rohrkaste, Snyder, Spreitzer, Steffen,
Subeck, Summerfield, Tauchen, C. Taylor, Thiesfeldt, Tittl, Tranel,
Tusler, VanderMeer and Zimmerman. Referred to Committee on Health and
Human Services.
SB380,1,6 1An Act to repeal 49.45 (29w) (b); to renumber 49.45 (29w) (a); to create 49.45
2(61), 49.46 (2) (b) 21., 49.46 (2) (b) 22. and 49.46 (2) (b) 23. of the statutes; and
3to affect 2019 Wisconsin Act 9, section 9119 (2); relating to: coverage of
4services under Medical Assistance provided through telehealth and other
5technologies, extending the time limit for emergency rule procedures, and
6granting rule-making authority.
Analysis by the Legislative Reference Bureau
This bill requires the Department of Health Services to provide reimbursement
under the Medical Assistance program for any benefit that is covered under the
Medical Assistance program, delivered by a certified Medical Assistance program,
and provided through interactive telehealth. DHS must pay for such a service
provided by a certified provider of Medical Assistance at a distant site an amount
equal to the amount the certified provider would receive under the Medical
Assistance program if the service were provided through a method other than
telehealth. The bill also requires DHS to provide as a benefit under the Medical
Assistance program and provide reimbursement under the Medical Assistance
program for all of the following: a consultation conducted through interactive
telehealth between a certified provider and a Medical Assistance recipient's
provider; remote patient monitoring of a Medical Assistance recipient; asynchronous
telehealth service, also known as store-and-forward; a service provided through

communication technology that is covered under the federal Medicare program; and
any other telehealth service specified by DHS by rule. DHS may exclude services by
rule from Medical Assistance reimbursement and may provide reimbursement by
rule for certain services that are not typically considered telehealth services.
The bill defines “telehealth” as a practice of health care delivery, diagnosis,
consultation, treatment, or transfer of medically relevant data by means of audio,
video, or data communications that are used either during a patient visit or a
consultation or are used to transfer medically relevant data about a patient.
“Telehealth” generally does not include communications delivered solely by
audio-only telephone, facsimile machine, or electronic mail unless the department
specifies otherwise by rule. Under the bill, “interactive telehealth” is telehealth
delivered using multimedia communication technology that permits 2-way,
real-time, interactive communications between a provider at a distant site and the
Medical Assistance recipient or the recipient's provider. “Remote patient
monitoring” is telehealth in which a patient's medical data is transmitted to a
provider for monitoring and response if necessary. “Asynchronous telehealth
service” is telehealth that is used to transmit medical data about a patient to a
provider when the transmission is not a 2-way, real-time, interactive
communication.
Under the bill, DHS is prohibited from requiring a certified provider of Medical
Assistance that provides a reimbursable service under the bill to obtain an additional
certification or meet additional requirements solely because the service was
delivered through telehealth, except that DHS may require, by rule, that the
transmission of information through telehealth be of sufficient quality to be
functionally equivalent to face-to-face contact. DHS may apply any requirement
that is applicable to a covered service that is not provided through telehealth to any
service provided through telehealth under the bill. The bill prohibits DHS from
limiting coverage or reimbursement of a service provided through telehealth under
the bill based on the location of the Medical Assistance recipient when the service is
provided.
Current law requires reimbursement under the Medical Assistance program of
certain mental health services provided through telehealth and defines telehealth
for that purpose. The bill eliminates the current provision that applies only to
mental health services. The benefit and reimbursement requirements under the bill
apply to any Medical Assistance services and are not limited to mental health
services.
For further information see the state fiscal estimate, which will be printed as
an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SB380,1 1Section 1. 49.45 (29w) (a) of the statutes is renumbered 49.45 (29w).
SB380,2
1Section 2. 49.45 (29w) (b) of the statutes, as affected by 2019 Wisconsin Act
29
, is repealed.
SB380,3 3Section 3. 49.45 (61) of the statutes is created to read:
SB380,3,54 49.45 (61) Services provided through telehealth and communications
5technology.
(a) In this subsection:
SB380,3,86 1. “Asynchronous telehealth service” is telehealth that is used to transmit
7medical data about a patient to a provider when the transmission is not a 2-way,
8real-time, interactive communication.
SB380,3,129 2. “Interactive telehealth” means telehealth delivered using multimedia
10communication technology that permits 2-way, real-time, interactive
11communications between a certified provider of Medical Assistance at a distant site
12and the Medical Assistance recipient or the recipient's provider.
SB380,3,1413 3. “Remote patient monitoring” is telehealth in which a patient's medical data
14is transmitted to a provider for monitoring and response if necessary.
SB380,3,2115 4. “Telehealth” means a practice of health care delivery, diagnosis,
16consultation, treatment, or transfer of medically relevant data by means of audio,
17video, or data communications that are used either during a patient visit or a
18consultation or are used to transfer medically relevant data about a patient.
19“Telehealth” does not include communications delivered solely by audio-only
20telephone, facsimile machine, or electronic mail unless the department specifies
21otherwise by rule.
SB380,3,2522 (b) Subject to par. (e), the department shall provide reimbursement under the
23Medical Assistance program for any benefit that is a covered benefit under s. 49.46
24(2), that is delivered by a certified provider for Medical Assistance through
25interactive telehealth.
SB380,4,2
1(c) Subject to par. (e), the department shall provide reimbursement under the
2Medical Assistance program for all of the following:
SB380,4,63 1. Except as provided by the department by rule, a consultation pertaining to
4a Medical Assistance recipient conducted through interactive telehealth between a
5certified provider of Medical Assistance and the Medical Assistance recipient's
6treating provider that is certified under Medical Assistance.
SB380,4,97 2. Except as provided by the department by rule, remote patient monitoring of
8a Medical Assistance recipient and asynchronous telehealth service in which the
9medical data pertains to a Medical Assistance recipient.
SB380,4,1210 3. Except as provided by the department by rule and subject to par. (e) 4.,
11services provided through communication technology that are covered under the
12Medicare program under 42 USC 1395 et seq.
SB380,4,1513 4. Any service that is not specified in subds. 1. to 3. or par. (b) that is provided
14through telehealth and that the department specifies by rule under par. (d) is a
15covered and reimbursable service under the Medical Assistance program.
SB380,4,2216 (d) The department shall promulgate rules specifying any services under par.
17(c) 4. that are reimbursable under Medical Assistance. The department may
18promulgate rules excluding services under par. (c) 1. to 3. from reimbursement under
19Medical Assistance. The department may promulgate rules specifying any
20telehealth service under par. (b) or (c) 1. or 2. that is provided solely by audio-only
21telephone, facsimile machine, or electronic mail as reimbursable under Medical
22Assistance.
SB380,5,223 (e) 1. The department shall pay for services provided under par. (b) by a
24certified provider of Medical Assistance at a distant site an amount equal to the

1amount the certified provider would receive under the Medical Assistance program
2if the service were provided through a method other than telehealth.
SB380,5,103 2. The department may not require a certified provider of Medical Assistance
4that provides a reimbursable service under par. (b) or (c) to obtain an additional
5certification or meet additional requirements solely because the service was
6delivered through telehealth, except that the department may require, by rule, that
7the transmission of information through telehealth be of sufficient quality to be
8functionally equivalent to face-to-face contact. The department may apply any
9requirement that is applicable to a covered service that is not provided through
10telehealth to any service provided under par. (b) or (c).
SB380,5,1311 3. The department may not limit coverage or reimbursement of a service
12provided under par. (b) or (c) based on the location of the Medical Assistance recipient
13when the service is provided.
SB380,5,1914 4. The department may not cover or provide reimbursement under Medical
15Assistance for a service described under par. (c) 3. that is first covered under the
16Medicare program under 42 USC 1395 et seq. after July 1, 2019, until the date that
17is one year after the date the service is covered under the Medicare program or the
18date the secretary explicitly approves the service as a Medical Assistance covered
19service, whichever is earlier.
SB380,4 20Section 4. 49.46 (2) (b) 21. of the statutes is created to read:
SB380,5,2221 49.46 (2) (b) 21. Subject to s. 49.45 (61), consultations between providers
22conducted through interactive telehealth described under s. 49.45 (61) (c) 1.
SB380,5 23Section 5. 49.46 (2) (b) 22. of the statutes is created to read:
SB380,5,2524 49.46 (2) (b) 22. Subject to s. 49.45 (61), asynchronous telehealth services and
25remote patient monitoring described under s. 49.45 (61) (c) 2.
SB380,6
1Section 6. 49.46 (2) (b) 23. of the statutes is created to read:
SB380,6,52 49.46 (2) (b) 23. Subject to s. 49.45 (61), services described under s. 49.45 (61)
3(c) 3. that are provided through communication technology and that are covered
4under the federal Medicare program and any telehealth services that the
5department specifies by rule under s. 49.45 (61) (d).
SB380,7 6Section 7. 2019 Wisconsin Act 9, section 9119 (2) is repealed.
SB380,8 7Section 8. Nonstatutory provisions.
SB380,6,108 (1) Telehealth services covered under Medical Assistance. The department
9of health services shall provide the coverage and reimbursement required under ss.
1049.45 (61) (c) and 49.46 (2) (b) 21., 22., and 23. on the earlier of the following:
SB380,6,1211 (a) The first day of the 13th month beginning after the effective date of this
12paragraph.
SB380,6,1513 (b) A date specified by the department of health services that is included in a
14notice submitted to the legislative reference bureau for publication in the Wisconsin
15Administrative Register.
SB380,9 16Section 9. Nonstatutory provisions.
SB380,7,417 (1) Rules regarding coverage of telehealth services. The department of
18health services may promulgate rules allowed under this act as emergency rules
19under s. 227.24. Notwithstanding s. 227.24 (1) (a) and (3), the department of health
20services is not required to provide evidence that promulgating a rule under this
21subsection as an emergency rule is necessary for the preservation of the public peace,
22health, safety, or welfare and is not required to provide a finding of emergency for a
23rule promulgated under this subsection. Notwithstanding s. 227.24 (1) (c) and (2),
24emergency rules promulgated under this subsection remain in effect until the sooner
25of July 1, 2022, or the date the permanent rules take effect, except that, if the

1department of health services has submitted in proposed form permanent rules to
2the legislative council staff under s. 227.15 (1) before July 1, 2022, emergency rules
3promulgated under this subsection remain in effect until the permanent rules take
4effect.
SB380,7,55 (End)
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