Amendment SSA1-SB308

SB308-SSA1,4,23 (6) Exclusions. (a) Medicare. No health care coverage plan, insurer or other organization subject to this section is required to duplicate coverage available under the federal medicare program.

SB308-SSA1,5,2 (b) Certain health care plans. This section does not apply to a health care coverage plan offered by a preferred provider plan, as defined in s. 609.01 (4), that is not a managed care plan, as defined in s. 609.01 (3c), or by a limited service health organization, as defined in s. 609.01 (3).

SB308-SSA1, s. 5 Section 5. 46.10 (8) (d) of the statutes is amended to read:

SB308-SSA1,5,8 46.10 (8) (d) After due regard to the case and to a spouse and minor children who are lawfully dependent on the property for support, compromise or waive any portion of any claim of the state or county for which a person specified under sub. (2) is liable, but not any claim payable by an insurer under s. 40.53 (2) or (5) or 632.89 (2) or (2m) or by any other 3rd party.

SB308-SSA1, s. 6 Section 6. 46.10 (14) (a) of the statutes is amended to read:

SB308-SSA1,5,24 46.10 (14) (a) Except as provided in pars. (b) and (c), liability of a person specified in sub. (2) or s. 46.03 (18) for inpatient care and maintenance of persons under 18 years of age at community mental health centers, a county mental health complex under s. 51.08, the centers for the developmentally disabled, Mendota mental health institute Mental Health Institute and Winnebago mental health institute Mental Health Institute or care and maintenance of persons under 18 years of age in residential, nonmedical facilities such as group homes, foster homes, treatment foster homes, child caring institutions and juvenile correctional institutions is determined in accordance with the cost-based fee established under s. 46.03 (18). The department shall bill the liable person up to any amount of liability not paid by an insurer under s. 40.53 (2) or (5) or 632.89 (2) or (2m) or by other 3rd party benefits, subject to rules which include formulas governing ability to pay promulgated by the department under s. 46.03 (18). Any liability of the patient not payable by any other person terminates when the patient reaches age 18, unless the liable person has prevented payment by any act or omission.

SB308-SSA1, s. 7 Section 7. 51.01 (3n) of the statutes is amended to read:

SB308-SSA1,6,5 51.01 (3n) "Community mental health program" means a program to provide community-based outpatient mental health services that is operated by or under contract with a county department of community programs or that requests payment for the services under the medical assistance program or under benefits required under s. 40.53 (2) or 632.89 (2).

SB308-SSA1, s. 8 Section 8. 51.038 of the statutes is amended to read:

SB308-SSA1,6,14 51.038 Outpatient mental health clinic certification. Except as provided in s. 51.032, if a facility that provides mental health services on an outpatient basis holds current accreditation from the council on accreditation of services for families and children, the department may accept evidence of this accreditation as equivalent to the standards established by the department, for the purpose of certifying the facility for the receipt of funds for services provided as a benefit to a medical assistance recipient under s. 49.46 (2) (b) 6. f., a community aids funding recipient under s. 51.423 (2) or as mandated coverage under s. 40.53 or 632.89.

SB308-SSA1, s. 9 Section 9. 51.04 of the statutes is amended to read:

SB308-SSA1,6,21 51.04 Treatment facility certification. Except as provided in s. 51.032, any treatment facility may apply to the department for certification of the facility for the receipt of funds for services provided as a benefit to a medical assistance recipient under s. 49.46 (2) (b) 6. f. or to a community aids funding recipient under s. 51.423 (2) or provided as mandated coverage under s. 40.53 or 632.89. The department shall annually charge a fee for each certification.

SB308-SSA1, s. 10 Section 10. 111.91 (2) (t) of the statutes is created to read:

SB308-SSA1,6,24 111.91 (2) (t) The requirements under s. 40.53 related to coverage of treatment for nervous and mental disorders and alcoholism and other drug abuse problems.

SB308-SSA1, s. 11 Section 11. 301.12 (8) (d) of the statutes is amended to read:

SB308-SSA1,7,5 301.12 (8) (d) After due regard to the case and to a spouse and minor children who are lawfully dependent on the property for support, compromise or waive any portion of any claim of the state or county for which a person specified under sub. (2) is liable, but not any claim payable by an insurer under s. 40.53 (2) or (5) or 632.89 (2) or (2m) or by any other 3rd party.

SB308-SSA1, s. 12 Section 12. 301.12 (14) (a) of the statutes is amended to read:

SB308-SSA1,7,17 301.12 (14) (a) Except as provided in pars. (b) and (c), liability of a person specified in sub. (2) or s. 301.03 (18) for care and maintenance of persons under 17 years of age in residential, nonmedical facilities such as group homes, foster homes, treatment foster homes, child caring institutions and juvenile correctional institutions is determined in accordance with the cost-based fee established under s. 301.03 (18). The department shall bill the liable person up to any amount of liability not paid by an insurer under s. 40.53 (2) or (5) or 632.89 (2) or (2m) or by other 3rd-party benefits, subject to rules which include formulas governing ability to pay promulgated by the department under s. 301.03 (18). Any liability of the resident not payable by any other person terminates when the resident reaches age 17, unless the liable person has prevented payment by any act or omission.

SB308-SSA1, s. 13 Section 13 . Nonstatutory provisions.

SB308-SSA1,7,19 (1) Actuarial study on cost.

SB308-SSA1,8,7 (a) Study requirements. The office of the commissioner of insurance shall enter into a contract for an actuarial study or evaluation to determine whether, and to what extent, the requirements under section 40.53 of the statutes, as created by this act, are likely to increase the cost of health insurance coverage. The study or evaluation shall make this determination separately for the health insurance coverage that is offered by the state under s. 40.51 (6) and by the group insurance board under s. 40.51 (7) and separately for health insurance coverage purchased directly in the private market by individuals and families and by private employers for their employes, as if the requirements under section 40.53 of the statutes, as created by this act, applied to such health insurance coverage. The office of the commissioner of insurance shall report the results of the study or evaluation to the appropriate standing committees of the legislature in the manner provided under section 13.172 (3) of the statutes no later than June 1, 2001.

SB308-SSA1,8,19 (b) Funding study. The office of the commissioner of insurance may not encumber or expend moneys from the appropriation under section 20.145 (1) (c) of the statutes, as created by this act, unless the office of the commissioner of insurance first notifies the joint committee on finance in writing of the proposed encumbrance or expenditure. If the cochairpersons of the joint committee on finance do not notify the office of the commissioner of insurance within 14 working days after the date of the office's notification that the committee has scheduled a meeting to review the proposed encumbrance or expenditure, the moneys may be encumbered or expended as proposed by the office. If, within 14 working days after the date of the office's notification, the cochairpersons of the committee notify the office that the committee has scheduled a meeting to review the proposed encumbrance or expenditure, the moneys may be encumbered or expended only upon approval of the committee.

SB308-SSA1, s. 14 Section 14. Initial applicability.

SB308-SSA1,8,21 (1) This act first applies to all of the following:

SB308-SSA1,8,23 (a) Except as provided in paragraph (b), health care coverage plans that are issued or renewed on the effective date of this paragraph.

SB308-SSA1,9,3 (b) Health care coverage plans covering employes who are affected by a collective bargaining agreement containing provisions inconsistent with this act that are issued or renewed on the earlier of the following:

SB308-SSA1,9,4 1. The day on which the collective bargaining agreement expires.

SB308-SSA1,9,6 2. The day on which the collective bargaining agreement is extended, modified or renewed.

SB308-SSA1, s. 15 Section 15. Effective dates. This act takes effect on the first day of the 6th month beginning after publication, except as follows:

SB308-SSA1,9,10 (1) Actuarial study on cost. Section 13 (1) of this act takes effect on the day after publication.

SB308-SSA1,9,12 (2) Funding for study. The repeal of section 20.145 (1) (c) of the statutes takes effect on July 1, 2001.

SB308-SSA1,9,13 (End)