LRBs0216/1
PJK/TJD/JK:all:rs
December 2013 Special Session
2013 - 2014 LEGISLATURE
SENATE SUBSTITUTE AMENDMENT 1,
TO 2013 ASSEMBLY BILL 1
December 19, 2013 - Offered by Senators C. Larson, Carpenter, Erpenbach,
Hansen, Harris, Jauch, Lassa, Lehman, Miller, Shilling, L. Taylor and
Wirch.
AB1-SSA1,2,2 1An Act to repeal 49.471 (4m) and 49.67 (9m); to amend 20.145 (5) (k), 71.07 (5g)
2(b), 71.07 (5g) (c) 1., 71.07 (5g) (d) 2., 71.28 (5g) (b), 71.28 (5g) (c) 1., 71.28 (5g)
3(d) 2., 71.47 (5g) (b), 71.47 (5g) (c) 1., 71.47 (5g) (d) 2., 76.655 (2), 76.655 (3) (a),
476.655 (5), 177.075 (3), 895.514 (2), 895.514 (3) (a) and 895.514 (3) (b); to repeal
5and recreate
49.45 (23) (a), 49.45 (23) (a) and 49.471 (4) (a) 4. b.; to create
649.471 (1) (cr) and 49.471 (4g) of the statutes; and to affect 2013 Wisconsin Act
720
, section 9122 (1L) (b) 1. b., 2013 Wisconsin Act 20, section 9122 (1L) (b) 1. c.,
82013 Wisconsin Act 20, section 9122 (1L) (b) 2. and 3. a. and c., 2013 Wisconsin
9Act 20
, section 9122 (1L) (b) 4., 2013 Wisconsin Act 20, section 9122 (1L) (b) 8.
10(intro.) and 2013 Wisconsin Act 20, section 9122 (1L) (b) 8. a., 9. a., 10. a. and
11b. and 11. b.; relating to: eligibility changes to BadgerCare Plus and
12BadgerCare Plus Core, including Medical Assistance expansion; and extending

1coverage under, and the deadline for the dissolution of, the Health Insurance
2Risk-Sharing Plan.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB1-SSA1,1 3Section 1. 20.145 (5) (k) of the statutes, as created by 2013 Wisconsin Act 20,
4is amended to read:
AB1-SSA1,2,85 20.145 (5) (k) Operational expenses. All moneys transferred from the
6appropriation account under par. (g) for operational expenses related to winding up
7the affairs of the Health Insurance Risk-Sharing Plan, including hiring consultants,
8limited-term employees, and experts.
AB1-SSA1,2 9Section 2 . 49.45 (23) (a) of the statutes, as affected by 2013 Wisconsin Act 20,
10section 1046, is repealed and recreated to read:
AB1-SSA1,2,1911 49.45 (23) (a) The department shall request a waiver from the secretary of the
12federal department of health and human services to permit the department to
13conduct a demonstration project to provide health care coverage to adults who are
14under the age of 65, who have family incomes not to exceed 133 percent of the poverty
15line, except as provided in s. 49.471 (4g), and who are not otherwise eligible for
16medical assistance under this subchapter, the Badger Care health care program
17under s. 49.665, or Medicare under 42 USC 1395 et seq. If the department creates
18a policy under sub. (2m) (c) 10., this paragraph does not apply to the extent that it
19conflicts with the policy.
AB1-SSA1,3 20Section 3 . 49.45 (23) (a) of the statutes, as affected by 2013 Wisconsin Act 20,
21section 1047, and 2013 Wisconsin Act .... (this act), is repealed and recreated to read:
AB1-SSA1,3,522 49.45 (23) (a) The department shall request a waiver from the secretary of the
23federal department of health and human services to permit the department to

1conduct a demonstration project to provide health care coverage to adults who are
2under the age of 65, who have family incomes not to exceed 133 percent of the poverty
3line, except as provided in s. 49.471 (4g), and who are not otherwise eligible for
4medical assistance under this subchapter, the Badger Care health care program
5under s. 49.665, or Medicare under 42 USC 1395 et seq.
AB1-SSA1,3p 6Section 3p. 49.471 (1) (cr) of the statutes is created to read:
AB1-SSA1,3,87 49.471 (1) (cr) "Enhanced federal medical assistance percentage" means a
8federal medical assistance percentage described under 42 USC 1396d (y) or (z).
AB1-SSA1,4 9Section 4. 49.471 (4) (a) 4. b. of the statutes, as affected by 2013 Wisconsin Act
1020
, is repealed and recreated to read:
AB1-SSA1,3,1211 49.471 (4) (a) 4. b. Except as provided in sub. (4g), the individual's family
12income does not exceed 133 percent of the poverty line.
AB1-SSA1,4d 13Section 4d. 49.471 (4g) of the statutes is created to read:
AB1-SSA1,3,2214 49.471 (4g) Medicaid expansion; federal medical assistance percentage. For
15services provided to individuals described under sub. (4) (a) 4. and s. 49.45 (23), the
16department shall comply with all federal requirements to qualify for the highest
17available enhanced federal medical assistance percentage. The department shall
18submit any amendment to the state medical assistance plan, any request for a waiver
19of the federal Medicaid law, or any other approval required by the federal
20government to provide services to the individuals described under sub. (4) (a) 4. and
21s. 49.45 (23) and to qualify for the highest available enhanced federal medical
22assistance percentage.
AB1-SSA1,5 23Section 5. 49.471 (4m) of the statutes, as created by 2013 Wisconsin Act 20,
24is repealed.
AB1-SSA1,6 25Section 6. 49.67 (9m) of the statutes is repealed.
AB1-SSA1,7
1Section 7. 71.07 (5g) (b) of the statutes, as affected by 2013 Wisconsin Act 20,
2is amended to read:
AB1-SSA1,4,83 71.07 (5g) (b) Filing claims. Subject to the limitations provided under this
4subsection, for taxable years beginning after December 31, 2005, and before January
51, 2014 2015, a claimant may claim as a credit against the taxes imposed under s.
671.02 an amount that is equal to the amount of the assessment under s. 149.13, 2011
7stats., that the claimant paid in the claimant's taxable year, multiplied by the
8percentage determined under par. (c) 1.
AB1-SSA1,8 9Section 8. 71.07 (5g) (c) 1. of the statutes, as affected by 2013 Wisconsin Act
1020
, is amended to read:
AB1-SSA1,4,2311 71.07 (5g) (c) 1. The department of revenue, in consultation with the office of
12the commissioner of insurance, shall determine the percentage under par. (b) for
13each claimant for each taxable year. The percentage shall be equal to $5,000,000
14divided by the aggregate assessment under s. 149.13, 2011 stats., except that for
15taxable years beginning after December 31, 2013, and before January 1, 2015, the
16percentage shall be equal to $1,250,000 divided by the aggregate assessment under
17s. 149.13, 2011 stats., and shall not exceed 100 percent.
The office of the
18commissioner of insurance shall provide to each claimant that participates in the
19cost of administering the plan the aggregate assessment at the time that it notifies
20the claimant of the claimant's assessment. The aggregate amount of the credit under
21this subsection and ss. 71.28 (5g), 71.47 (5g), and 76.655 for all claimants
22participating in the cost of administering the plan under ch. 149, 2011 stats., shall
23not exceed $5,000,000 in each fiscal year.
AB1-SSA1,9 24Section 9. 71.07 (5g) (d) 2. of the statutes, as created by 2013 Wisconsin Act
2520
, is amended to read:
AB1-SSA1,5,4
171.07 (5g) (d) 2. No credit may be claimed under this subsection for taxable
2years beginning after December 31, 2013 2014. Credits under this subsection for
3taxable years that begin before January 1, 2014 2015, may be carried forward to
4taxable years that begin after December 31, 2013 2014.
AB1-SSA1,10 5Section 10. 71.28 (5g) (b) of the statutes, as affected by 2013 Wisconsin Act 20,
6is amended to read:
AB1-SSA1,5,127 71.28 (5g) (b) Filing claims. Subject to the limitations provided under this
8subsection, for taxable years beginning after December 31, 2005, and before January
91, 2014 2015, a claimant may claim as a credit against the taxes imposed under s.
1071.23 an amount that is equal to the amount of assessment under s. 149.13, 2011
11stats., that the claimant paid in the claimant's taxable year, multiplied by the
12percentage determined under par. (c) 1.
AB1-SSA1,11 13Section 11. 71.28 (5g) (c) 1. of the statutes, as affected by 2013 Wisconsin Act
1420
, is amended to read:
AB1-SSA1,6,215 71.28 (5g) (c) 1. The department of revenue, in consultation with the office of
16the commissioner of insurance, shall determine the percentage under par. (b) for
17each claimant for each taxable year. The percentage shall be equal to $5,000,000
18divided by the aggregate assessment under s. 149.13, 2011 stats., except that for
19taxable years beginning after December 31, 2013, and before January 1, 2015, the
20percentage shall be equal to $1,250,000 divided by the aggregate assessment under
21s. 149.13, 2011 stats., and shall not exceed 100 percent.
The office of the
22commissioner of insurance shall provide to each claimant that participates in the
23cost of administering the plan the aggregate assessment at the time that it notifies
24the claimant of the claimant's assessment. The aggregate amount of the credit under
25this subsection and ss. 71.07 (5g), 71.47 (5g), and 76.655 for all claimants

1participating in the cost of administering the plan under ch. 149, 2011 stats., shall
2not exceed $5,000,000 in each fiscal year.
AB1-SSA1,12 3Section 12. 71.28 (5g) (d) 2. of the statutes, as created by 2013 Wisconsin Act
420
, is amended to read:
AB1-SSA1,6,85 71.28 (5g) (d) 2. No credit may be claimed under this subsection for taxable
6years beginning after December 31, 2013 2014. Credits under this subsection for
7taxable years that begin before January 1, 2014 2015, may be carried forward to
8taxable years that begin after December 31, 2013 2014.
AB1-SSA1,13 9Section 13. 71.47 (5g) (b) of the statutes, as affected by 2013 Wisconsin Act 20,
10is amended to read:
AB1-SSA1,6,1611 71.47 (5g) (b) Filing claims. Subject to the limitations provided under this
12subsection, for taxable years beginning after December 31, 2005, and before January
131, 2014 2015, a claimant may claim as a credit against the taxes imposed under s.
1471.43 an amount that is equal to the amount of assessment under s. 149.13, 2011
15stats., that the claimant paid in the claimant's taxable year, multiplied by the
16percentage determined under par. (c) 1.
AB1-SSA1,14 17Section 14. 71.47 (5g) (c) 1. of the statutes, as affected by 2013 Wisconsin Act
1820
, is amended to read:
AB1-SSA1,7,619 71.47 (5g) (c) 1. The department of revenue, in consultation with the office of
20the commissioner of insurance, shall determine the percentage under par. (b) for
21each claimant for each taxable year. The percentage shall be equal to $5,000,000
22divided by the aggregate assessment under s. 149.13, 2011 stats., except that for
23taxable years beginning after December 31, 2013, and before January 1, 2015, the
24percentage shall be equal to $1,250,000 divided by the aggregate assessment under
25s. 149.13, 2011 stats., and shall not exceed 100 percent.
The office of the

1commissioner of insurance shall provide to each claimant that participates in the
2cost of administering the plan the aggregate assessment at the time that it notifies
3the claimant of the claimant's assessment. The aggregate amount of the credit under
4this subsection and ss. 71.07 (5g), 71.28 (5g), and 76.655 for all claimants
5participating in the cost of administering the plan under ch. 149, 2011 stats., shall
6not exceed $5,000,000 in each fiscal year.
AB1-SSA1,15 7Section 15. 71.47 (5g) (d) 2. of the statutes, as created by 2013 Wisconsin Act
820
, is amended to read:
AB1-SSA1,7,129 71.47 (5g) (d) 2. No credit may be claimed under this subsection for taxable
10years beginning after December 31, 2013 2014. Credits under this subsection for
11taxable years that begin before January 1, 2014 2015, may be carried forward to
12taxable years that begin after December 31, 2013 2014.
AB1-SSA1,16 13Section 16. 76.655 (2) of the statutes, as affected by 2013 Wisconsin Act 20,
14is amended to read:
AB1-SSA1,7,2015 76.655 (2) Filing claims. Subject to the limitations provided under this section,
16for taxable years beginning after December 31, 2005, and before January 1, 2014
172015, a claimant may claim as a credit against the fees imposed under ss. 76.60,
1876.63, 76.65, 76.66 or 76.67 an amount that is equal to the amount of assessment
19under s. 149.13, 2011 stats., that the claimant paid in the claimant's taxable year,
20multiplied by the percentage determined under sub. (3).
AB1-SSA1,17 21Section 17. 76.655 (3) (a) of the statutes, as affected by 2013 Wisconsin Act 20,
22is amended to read:
AB1-SSA1,8,1023 76.655 (3) (a) The department of revenue, in consultation with the office of the
24commissioner of insurance, shall determine the percentage under sub. (2) for each
25claimant for each taxable year. The percentage shall be equal to $5,000,000 divided

1by the aggregate assessment under s. 149.13, 2011 stats., except that for taxable
2years beginning after December 31, 2013, and before January 1, 2015, the
3percentage shall be equal to $1,250,000 divided by the aggregate assessment under
4s. 149.13, 2011 stats., and shall not exceed 100 percent.
The office of the
5commissioner of insurance shall provide to each claimant that participates in the
6cost of administering the plan the aggregate assessment at the time that it notifies
7the claimant of the claimant's assessment. The aggregate amount of the credit under
8this subsection and ss. 71.07 (5g), 71.28 (5g), and 71.47 (5g) for all claimants
9participating in the cost of administering the plan under ch. 149, 2011 stats., shall
10not exceed $5,000,000 in each fiscal year.
AB1-SSA1,18 11Section 18. 76.655 (5) of the statutes, as created by 2013 Wisconsin Act 20, is
12amended to read:
AB1-SSA1,8,1613 76.655 (5) Sunset. No credit may be claimed under this section for taxable
14years beginning after December 31, 2013 2014. Credits under this section for taxable
15years that begin before January 1, 2014 2015, may be carried forward to taxable
16years that begin after December 31, 2013 2014.
AB1-SSA1,19 17Section 19. 177.075 (3) of the statutes, as created by 2013 Wisconsin Act 20,
18is amended to read:
AB1-SSA1,8,2319 177.075 (3) Any intangible property distributable in the course of the
20dissolution of the Health Insurance Risk-Sharing Plan under 2013 Wisconsin Act
2120
, section 9122 (1L), and 2013 Wisconsin Act .... (this act), section 32 (1) (b ), is
22presumed abandoned as otherwise provided under this chapter if sub. (1) (a), (b), or
23(c) does not apply with respect to the distribution.
AB1-SSA1,20 24Section 20. 895.514 (2) of the statutes, as created by 2013 Wisconsin Act 20,
25is amended to read:
AB1-SSA1,9,8
1895.514 (2) No cause of action of any nature may arise against, and no liability
2may be imposed upon, the authority, plan, or board; or any agent, employee, or
3director of any of them; or insurers participating in the plan; or the commissioner;
4or any agent, employee, or representative of the commissioner, for any act or
5omission by any of them in the performance of their powers and duties under ch. 149,
62011 stats., or under 2013 Wisconsin Act 20, section 9122 (1L), or under 2013
7Wisconsin Act .... (this act), section 32 (1) (b ),
unless the person asserting liability
8proves that the act or omission constitutes willful misconduct.
AB1-SSA1,21 9Section 21. 895.514 (3) (a) of the statutes, as created by 2013 Wisconsin Act
1020
, is amended to read:
AB1-SSA1,9,1511 895.514 (3) (a) Except as provided in 2013 Wisconsin Act 20, section 9122 (1L),
12and 2013 Wisconsin Act .... (this act), section 32 (1 ) (b), neither the state nor any
13political subdivision of the state nor any officer, employee, or agent of the state or a
14political subdivision acting within the scope of employment or agency is liable for any
15debt, obligation, act, or omission of the authority.
AB1-SSA1,22 16Section 22. 895.514 (3) (b) of the statutes, as created by 2013 Wisconsin Act
1720
, is amended to read:
AB1-SSA1,9,2318 895.514 (3) (b) All of the expenses incurred by the authority, or the
19commissioner, or any agent, employee, or representative of the commissioner, in
20exercising its duties and powers under ch. 149, 2011 stats., or under 2013 Wisconsin
21Act 20
, section 9122 (1L), or under 2013 Wisconsin Act .... (this act), section 32 (1) (b ),
22shall be payable only from funds of the authority or from the appropriation under s.
2320.145 (5) (g) or (k), or from any combination of those payment sources.
AB1-SSA1,23 24Section 23. 2013 Wisconsin Act 20, section 9122 (1L) (b) 1. b. is repealed and
25recreated to read:
AB1-SSA1,10,8
1[2013 Wisconsin Act 20] Section 9122 (1L) (b) 1. b. Coverage under the policies
2issued under the plan, including to persons whose coverage under the plan is funded
3under a contract with the federal department of health and human services,
4terminates at 11:59 p.m. on December 31, 2013. At least 60 days before coverage
5terminates, the authority shall provide notice of the date on which coverage
6terminates to all covered persons, all insurers and providers that are affected by the
7termination of the coverage, the office, the legislative audit bureau, and the insurers
8described in subsection (1m) (b) 1.
AB1-SSA1,24 9Section 24. 2013 Wisconsin Act 20, section 9122 (1L) (b) 1. c. is repealed.
AB1-SSA1,25 10Section 25. 2013 Wisconsin Act 20, section 9122 (1L) (b) 2. and 3. a. and c. are
11repealed and recreated to read:
AB1-SSA1,10,2012[2013 Wisconsin Act 20] Section 9122 (1L) (b) 2. `Provider claims.' Providers
13of medical services and devices and prescription drugs to covered persons must file
14claims for payment no later than June 1, 2014. Any claim filed after that date is not
15payable and may not be charged to the covered person who received the service,
16device, or drug. Except for copayments, coinsurance, or deductibles required under
17the plan, consistent with sections 149.14 (3) and 149.142 (2m) of the statutes, a
18provider may not bill a covered person who receives a covered service or article and
19shall accept as payment in full the payment rate determined under section 149.142
20(1) of the statutes.
AB1-SSA1,10,2321 3. a. Except for a grievance related to a prior authorization, any grievance by
22a covered person must be in writing and received no later than July 1, 2014, or be
23barred.
AB1-SSA1,11,224 c. A covered person who submits a grievance after March 31, 2014, must
25request an independent review, if any, with respect to the grievance no later than

1August 1, 2014, or be barred from requesting an independent review with respect to
2the grievance.
AB1-SSA1,26 3Section 26. 2013 Wisconsin Act 20, section 9122 (1L) (b) 4. is amended to read:
AB1-SSA1,11,104[2013 Wisconsin Act 20] Section 9122 (1L) (b) 4. `Payment of plan costs.' The
5To the extent possible, the authority shall pay plan costs incurred in 2013 and all
6other costs associated with dissolving the plan that are incurred before
7administrative responsibility for the dissolution of the plan is transferred to the
8office under subdivision 8. The authority and the office shall make every effort to pay
9plan costs in accordance with, or as closely as possible to, the manner provided in
10section 149.143 of the statutes.
AB1-SSA1,27 11Section 27. 2013 Wisconsin Act 20, section 9122 (1L) (b) 8. (intro.) is repealed
12and recreated to read:
AB1-SSA1,11,1413[2013 Wisconsin Act 20] Section 9122 (1L) (b) 8. `Transfer to the office.' (intro.)
14On February 28, 2014, all of the following shall occur:
AB1-SSA1,28 15Section 28. 2013 Wisconsin Act 20, section 9122 (1L) (b) 8. a., 9. a., 10. a. and
16b. and 11. b. are amended to read:
AB1-SSA1,11,2517[2013 Wisconsin Act 20] Section 9122 (1L) (b) 8. a. Administrative
18responsibility for the operations and dissolution of the plan is transferred to the
19office. The commissioner shall take any action necessary or advisable to manage and
20wind up the affairs of the plan and shall notify the legislative audit bureau when the
21windup is completed and provide to the legislative audit bureau the final financial
22statements of the plan. For purposes of chapter 177 of the statutes, as affected by
23this act, the dissolution, and winding up of the affairs, of the plan shall be considered
24a dissolution of an insurer in accordance with section 645.44 of the statutes, except
25that a court order of dissolution is not required to effect the dissolution of the plan.
AB1-SSA1,12,5
19. a. There is created, 60 days after the date coverage under the plan terminates
2under subdivision 1. b.
on March 1, 2014, a Health Insurance Risk-Sharing Plan
3advisory committee consisting of the commissioner, or his or her designee, and the
4other 13 members of the board holding office on the date the advisory committee is
5created.
AB1-SSA1,12,166 10. a. On behalf of the commissioner, the authority shall provide notice of the
7plan's dissolution to all persons known, or reasonably expected from the plan's
8records, to have claims against the plan, including all covered persons. The notice
9shall be sent by first class mail to the last-known addresses at least 60 days before
10the date on which coverage terminates under subdivision 1. b. Notice to potential
11claimants of the plan shall require the claimants to file their claims, together with
12proofs of claims, within 90 days after the date on which coverage terminates under
13subdivision 1. b.
by June 1, 2014. The notice shall be consistent with any relevant
14terms of the policies under the plan and contracts and with section 645.47 (1) (a) of
15the statutes. The notice shall serve as final notice consistent with section 645.47 (3)
16of the statutes.
AB1-SSA1,13,317 b. Proofs of all claims must be filed with the office in the form provided by the
18office consistent with the proof of claim, as applicable, under section 645.62 of the
19statutes, on or before the last day for filing specified in the notice. For good cause
20shown, the office shall permit a claimant to make a late filing if the existence of the
21claim was not known to the claimant and the claimant files the claim within 30 days
22after learning of the claim, but not more than 210 days after the date on which
23coverage terminates under subdivision 1. b.
later than September 1, 2014. Any such
24late claim that would have been payable under the policy under the plan if it had been
25filed timely and that was not covered by a succeeding insurer shall be permitted

1unless the claimant had actual notice of the termination of the plan or the notice was
2mailed to the claimant by first class mail at least 10 days before the insured event
3occurred.
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