AB955: Bill Text

AB955,9,20 (6) The scope of health care services and other benefits, if any, that shall be required to be provided under the universal health plan, including all of the following:

AB955,9,23 (a) Services of all persons licensed, certified, registered or permitted to treat the sick under chs. 441, 446, 447, 448, 449, 450, 451, 455 and 459 and services of professional counselors and marriage and family therapists under ch. 457.

AB955,9,25 (b) Health care and mental health treatment services provided by facilities or services governed under ss. 45.365, 46.03 (1), 49.70, 49.72 (1), 50.02, 50.03, 50.033, 50.034, 50.32 to 50.39, 50.49, 50.50, 50.91, 51.038, 51.08, 51.09, 58.05, 58.06, 251.05, 252.073, 252.076, 252.10 and 301.02 and the offices and clinics of persons licensed, certified, registered or permitted to treat the sick under chs. 441, 446, 447, 448, 449, 450, 451, 455 and 459.

AB955,10,5 (c) Services provided by social workers certified under ch. 457.

AB955,10,6 (d) Preventive health care services and health promotional programs.

AB955,10,9 (e) Long-term care and services provided in institutional and community-based settings as convalescent or custodial care or care for a chronic condition or terminal illness.

AB955,10,10 (f) Eyeglasses and contact lenses.

AB955,10,11 (g) Hearing aids, as defined in s. 459.01 (2).

AB955,10,12 (h) Prescription drugs, as defined in s. 450.01 (20).

AB955,10,13 (i) Prostheses, including dental prostheses.

AB955,10,14 (j) Medical supplies and equipment.

AB955,10,16 (7) The definition of the terms "health care provider", "health care facility" and "cosmetic surgery" for purposes of reimbursement under the universal health plan.

AB955,10,22 (8) The formulation of criteria for determining payment and the formulation of procedures for determining payment and negotiating applicable rates to be used for payment for health care providers, including health care facilities, under the universal health plan. The criteria and procedures for determining payment shall include the concept of periodic budgeting, including separately budgeting for operational costs, for health care facilities.

AB955,11,2 (9) The formulation of criteria and procedures to review and to provide funding for capital expenditures, from an account separate from that from which health care services are paid, for the establishment, maintenance or expansion of health care facilities.

AB955,11,4 (10) The formulation of prohibitions on issuance of disability insurance policies that duplicate the coverage provided under the universal health plan.

AB955,11,6 (11) The formulation of criteria and procedures for recovery of overpayments made to health care providers under the universal health plan.

AB955,11,8 (12) The creation of a timetable for the phasing in, no later than July 1, 2004, of services under the universal health plan for each of the following groups:

AB955,11,10 (a) Individuals, other than those specified in par. (b), who have no coverage under disability insurance policies.

AB955,11,14 (b) Individuals who have no coverage under disability insurance policies and who receive federally funded, state-funded or locally funded health care, treatment for nervous or mental disorders or treatment or prevention services for alcohol and other drug abuse.

AB955,11,18 (c) Individuals who are employes of state, county, city, village or town government and who, as a benefit of the employment, have coverage for themselves and family members under provisions of group disability insurance policies or under self-insured health plans.

AB955,11,21 (d) Individuals, other than those specified in par. (c) or (h), who, by reason of their employment or as family members of individuals who are employed, have coverage under group disability insurance policies.

AB955,11,23 (e) Individuals who have coverage under individual disability insurance policies.

AB955,11,25 (f) Individuals who have coverage under the mandatory health insurance risk-sharing plan under ch. 149.

AB955,12,3 (g) Individuals who are eligible for benefits or services under s. 49.46, 49.47 or 49.665, medicare or federal block grants that provide health care services or mental health services.

AB955,12,6 (h) Individuals who are employes of self-insured employers, other than those specified in par. (c), and who receive health care benefits for themselves and family members under self-insured health plans.

AB955,12,7 (i) Individuals who receive medical benefits under worker's compensation.

AB955,12,9 (13) The determination of factors requisite to establishing an annual state health budget for the provision of services under the universal health plan.

AB955,12,13 (14) The scope of functions of the department and the attendant reduction of scope of the functions of the department of health and family services, the office of the commissioner of insurance, the board on aging and long-term care and any other applicable state agency powers or responsibilities.

AB955,12,15 (15) The solicitation and use of information provided by the health policy councils.

AB955,12,18 (16) The likelihood of and procedures necessary to obtain waivers or statutory change to 29 USC 1144 (a), or, alternatively, the means by which operation of the universal health plan may avoid conflict with 29 USC 1144 (a).

AB955,12,20 (17) The necessity of exempting operation of the universal health plan from ch. 133.

AB955,12,23 (18) Investigation of the feasibility of providing the state with subrogation rights to payments for injury or disease to residents that are provided under motor vehicle or other liability insurance policies or plans.

AB955,13,2 (19) Development of a system for determination and periodic review of areas in this state, and specific populations within those areas, that are medically underserved; and development of plans for providing health care services to those areas and populations that include establishment of community health centers.

AB955,13,5 (20) Development of a system for periodic reviews and evaluations of all aspects of the operation of the universal health plan, including the adequacy, effectiveness and quality of health care services provided.

AB955,13,8 (21) Development of a notice and hearing procedure for review of complaints of residents under the universal health plan, in accordance with the requirements of ch. 227.

AB955,13,10 (22) Means of containing costs for services provided under the universal health plan.

AB955,13,12 (23) Formulation of criteria and procedures for payment under the universal health plan of out-of-state health care costs incurred by residents.

AB955,13,14 (24) Other issues that the board determines are relevant to the universal health plan.

AB955,13,15 (25) State statutory changes that may be necessary to effect subs. (1) to (24).

AB955,13,17 52.30 Regional health councils; powers and duties. (1) Each regional health council shall do all of the following:

AB955,13,22 (a) Appoint one member of the regional health council to serve as a member of the board under s. 15.20 (1) (a). If the term of the member who is so appointed expires with respect to the regional health council or with respect to the board under s. 15.20 (1) (a), the regional health council shall appoint a current member of the council to serve as a member of the board in his or her stead.

AB955,14,2 (b) Study and continuously monitor the delivery and quality of and access to health care services in the region of the regional health council and recommend to the board ways to improve the quality of and help ensure access to health care services.

AB955,14,5 (c) Study and continuously monitor the unmet health care service needs in the region of the regional health council and recommend to the board ways by which the needs may be met.

AB955,14,8 (d) Report at least annually to the board with respect to the health care needs, problems and concerns of the region and provide to the board recommendations to alleviate these needs, problems and concerns.

AB955,14,9 (e) Perform other duties as required by the board.

AB955,14,12 (2) Each regional health council may, for cause, recall the member appointed under sub. (1) (a) and may appoint another member to fulfill that term on the board if all of the following are done:

AB955,14,14 (a) The appointed member of the board for whom recall is sought receives notice of the recall prior to the meeting at which recall is voted upon.

AB955,14,17 (b) Notice of the recall of the appointed member is made on the agenda of the meeting of the regional health council that is immediately prior to the meeting at which recall is voted upon.

AB955, s. 11 Section 11. 59.17 (2) (c) of the statutes is amended to read:

AB955,14,23 59.17 (2) (c) Appoint the members of all boards and, commissions and councils where appointments are required and where the statutes provide that the appointments are made by the county board or by the chairperson of the county board. All appointments to boards and, commissions and councils by the county executive are subject to confirmation by the county board.

AB955, s. 12 Section 12. 59.53 (24) of the statutes is created to read:

AB955,15,2 59.53 (24) Regional health council. Each board shall appoint members of a regional health council, as specified in s. 15.207 (1) (b).

AB955, s. 13 Section 13. 62.09 (8) (cm) of the statutes is created to read:

AB955,15,6 62.09 (8) (cm) The mayor of a 1st class city may, with the advice and consent of the common council of that city, appoint 6 members of a regional health council, as specified under s. 15.207 (1) (b) 6.

AB955, s. 14 Section 14. Nonstatutory provisions; health planning and financed.

AB955,15,12 (1) Health policy board; appointment of members. Notwithstanding the length of terms specified for the voting members of the health policy board under section 15.20 (1) (intro.) of the statutes, as created by this act, the initial members of the health policy board shall be appointed by the first day of the 3rd month beginning after the effective date of this subsection for the following terms:

AB955,15,17 (a) Two members specified under section 15.20 (1) (b) of the statutes, as created by this act, and 2 members specified under section 15.20 (1) (a) of the statutes, as created by this act, one of whom is appointed from the northern regional council and one of whom is appointed from the southeastern regional council, for terms expiring on May 1, 2002.

AB955,15,22 (b) Two members specified under section 15.20 (1) (b) of the statutes, as created by this act, and 2 members specified under section 15.20 (1) (a) of the statutes, as created by this act, one of whom is appointed from the northeastern regional council and one of whom is appointed from the regional council within the area of Milwaukee County, for terms expiring on May 1, 2004.

AB955,16,2 (c) One member specified under section 15.20 (1) (b) of the statutes, as created by this act, and 2 members specified under section 15.20 (1) (a) of the statutes, as created by this act, one of whom is appointed from the southern regional council and one of whom is appointed from the western regional council, for terms expiring on May 1, 2006.

AB955,16,10 (2) Health policy board; proposed legislation. The health policy board shall, beginning on January 1, 1999, and ending on September 1, 1999, meet at least semimonthly to formulate decisions on issues concerning the Wisconsin universal health plan, as specified in section 52.20 (1) to (24) of the statutes, as created by this act. The health policy board shall convey these decisions to and cooperate with the legislative reference bureau in the drafting of proposed legislation that is necessary to meet those issues, for introduction in the legislature on or before January 11, 2000, by the appropriate committee of the legislature.

AB955, s. 15 Section 15. Nonstatutory provisions; legislative reference bureau.

AB955,16,17 (1) Drafting proposed legislation on the Wisconsin universal health plan. The legislative reference bureau shall, after meeting with and receiving the decisions of the health policy board with respect to the Wisconsin universal health plan, prepare in proper form proposed legislation that shall relate to those decisions, for introduction on or before January 11, 2000, by the appropriate committee of the legislature.

AB955, s. 16 Section 16. Effective dates. This act takes effect on the day after publication, except as follows:

AB955,16,20 (1) The creation of section 52.10 of the statutes takes effect on July 1, 2001.

AB955,16,21 (End)