AB878,4,2322 2. Counsel individuals, or members of a family, who are under 60 years of age
23regarding consumer rights and grievance procedures relating to health care benefits.
AB878,4,2524 3. Refer individuals, or members of a family, who are under 60 years of age for
25legal assistance in obtaining and maintaining health care benefits.
AB878,5,3
14. Coordinate health care benefits available to an individual, or members of a
2family, who are under 60 years of age to maximize health care benefits for the
3individual or family members.
AB878,5,64 5. Assist individuals, or members of a family, who are under 60 years of age in
5obtaining coverage of expenses for drugs or medical equipment that has been
6prescribed for them.
AB878,5,97 6. Monitor and track whether individuals and family members to whom the
8entity provides services under this paragraph maintain health care benefits between
9encounters with the entity.
AB878,5,1210 7. Refer individuals to information regarding, or programs that promote,
11preventive health care, chronic disease management, responsible utilization of
12health care services, and healthy lifestyle.
AB878,5,1513 8. Assist individuals, or members of a family, who are under 60 years of age who
14require transportation, interpreter services, or other services to access health care
15benefits in obtaining those services.
AB878,5,2016 9. Coordinate provision of services under this paragraph with any aging unit
17that provides benefit specialist services for older individuals under s. 46.81, any
18resource center under s. 46.283, or any agency under contract with the department
19to administer the children with special health care needs program under s. 253.02
20that operates in the same geographic areas as the entity.
AB878,6,221 10. Bring together persons who work in the fields of public health, health care,
22elementary or secondary education, and other relevant fields for the purpose of
23educating them regarding activities under subds. 1. to 9. and for the purposes of
24sharing strategies for, and coordinating efforts to, assist individuals, and members

1of a family, who are under 60 years of age in obtaining and maintaining health care
2benefits.
AB878,6,63 (b) The oversight organization shall obtain approval of a request for proposals
4under par. (a) from the department and the office of the commissioner of insurance
5before issuing the request, and shall obtain approval for allocations of funding under
6par. (a) before finalizing the allocations.
AB878,6,107 (c) The oversight organization may allocate moneys under this subsection only
8to a governmental unit, an institution of higher education, or an organization
9described in section 501 (c) of the Internal Revenue Code that is exempt from federal
10income tax under section 501 (a) of the Internal Revenue Code.
AB878,6,1311 (d) As a condition of receiving funding under this subsection, an entity shall
12ensure that individuals who provide services under par. (a) have knowledge of all of
13the following:
AB878,6,1614 1. Health care benefits, and eligibility criteria and appeal procedures for health
15care benefits, under the federal Social Security Act for which an individual under 60
16years of age may be eligible.
AB878,6,2017 2. Health care benefits, eligibility criteria and appeal procedures for health
18care benefits, including procedures for appeals relating to disability determinations,
19under the Medical Assistance program subch. IV of ch. 49 and under Medical
20Assistance waiver programs under 42 USC 1396n.
AB878,6,2221 3. Health care benefits, eligibility criteria, and appeal procedures under the
22Health Insurance Risk-Sharing Plan under subch. II of ch. 149.
AB878,6,2423 4. Health care plans and group health plans, including appeal and grievance
24procedures under health care plans and group health plans.
AB878,6,2525 5. Federal law governing health care plans and group health plans.
AB878,7,2
16. Coordination between health care plans or group health plans and public
2health care benefits programs.
AB878,7,33 7. Provision of services in a family-centered and culturally competent manner.
AB878,7,64 (e) As a condition of receiving moneys under this subsection, an entity shall
5provide funding, from a source other than an allocation under this subsection, to
6support at least 25 percent of the cost of providing services under par. (a).
AB878,7,87 (f) An entity or an individual that the entity employs or contracts with to
8provide services under par. (a) may not do any of the following:
AB878,7,109 1. Be directly involved in licensing or accrediting a hospital, as defined in s.
1050.33 (2), or a nursing home, as defined in s. 50.01 (3).
AB878,7,1111 2. Be directly involved in granting a certificate of authority to a health insurer.
AB878,7,1312 3. Have a direct ownership or investment interest in a health insurer or an
13administrator of a group health plan.
AB878,7,1514 4. Be employed by or manage a health insurer or an administrator of a group
15health plan.
AB878,7,1716 5. Receive remuneration from a health insurer or an administrator of a group
17health plan.
AB878,7,22 18(4) As condition of receiving grant funding under sub. (2), the oversight
19organization shall in the 12 months beginning on the date that is 3 months after the
20effective date of this subsection .... [LRB inserts date], provide a total of $150,000,
21from sources other than the grant under sub. (2), to support the cost of performing
22the duties under sub. (2).
AB878,7,25 23(5) The department shall submit the report and plan received from the
24oversight organization under sub. (2) (e) to the chief clerk of each house of the
25legislature for distribution under s. 13.172 (2).
AB878,8,3
1(6) The department shall expend for the grant under sub. (2) any moneys
2received as federal financial participation under the federal Medicaid program for
3expenditures under s. 20.435 (4) (kr).
AB878, s. 5 4Section 5. Nonstatutory provisions.
AB878,8,75 (1) The department of health services shall apply for any federal moneys that
6are available to states for providing services described under section 46.79 (3) (a) of
7the statutes, as created by this act.
AB878, s. 6 8Section 6. Fiscal changes.
AB878,8,149 (1) In the schedule under section 20.005 (3) of the statutes for the appropriation
10to the office of the commissioner of insurance under section 20.145 (1) (g) of the
11statutes, as affected by the acts of 2009, the dollar amount is increased by $250,000
12for the second fiscal year of the fiscal biennium in which this subsection takes effect
13to provide funding for the program under section 46.79 of the statutes, as created by
14this act.
AB878, s. 7 15Section 7. Effective dates. This act takes effect on the day after publication,
16except as follows:
AB878,8,1817 (1) The treatment of sections 20.145 (1) (g) (intro.) and 20.435 (4) (kr) and (kv)
18of the statutes takes effect on July 1, 2010.
AB878,8,1919 (End)
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