Amendment JR2 AA1-ASA1-AB1

AB1-ASA1-AA1, s. 100ig Section 100ig. 40.05 (4) (bm) of the statutes is amended to read:

AB1-ASA1-AA1,79,3 40.05 (4) (bm) Except as provided under par. pars. (bg) and (bp), accumulated unused sick leave under ss. 36.30 and 230.35 (2) or 233.10 of any eligible employee shall, upon request of the employee at the time the employee is subject to layoff under s. 40.02 (40), be converted at the employee's current basic pay rate to credits for payment of health insurance premiums on behalf of the employee. Any supplemental compensation that is paid to a state employee who is classified under the state classified civil service as a teacher, teacher supervisor or education director for the employee's completion of educational courses that have been approved by the employee's employer is considered as part of the employee's basic pay for purposes of this paragraph. The full amount of the required employee contribution for any eligible employee who is insured at the time of the layoff shall be deducted from the credits until the credits are exhausted, the employee is reemployed, or 5 years have elapsed from the date of layoff, whichever occurs first.

AB1-ASA1-AA1, s. 100ih Section 100ih. 40.05 (4) (bp) 1. of the statutes is amended to read:

AB1-ASA1-AA1,79,15 40.05 (4) (bp) 1. Except as provided in subds. 2. and 3., for sick leave which accumulates beginning on August 1, 1987 January 1, 2003, conversion under par. (b) or (bm) of accumulated unused sick leave under s. 36.30 to credits for payment of health insurance premiums shall be limited to the annual amounts of sick leave specified in this subdivision. For faculty and academic staff personnel who are appointed to work 52 weeks per year, conversion is limited to 8.5 6.375 days of sick leave per year. For faculty and academic staff personnel who are appointed to work 39 weeks per year, conversion is limited to 6.4 4.8 days of sick leave per year. For faculty and academic staff personnel not otherwise specified, conversion is limited to a number of days of sick leave per year to be determined by the secretary by rule, in proportion to the number of weeks per year appointed to work.".

AB1-ASA1-AA1,79,16 96. Page 32, line 23: after that line insert:

AB1-ASA1-AA1,79,17 " Section 100ij. 40.05 (5) of the statutes is repealed and recreated to read:

AB1-ASA1-AA1,79,23 40.05 (5) Income continuation insurance premiums. For any income continuation insurance provided under subch. V, the entire premium shall be paid as a deduction under s. 40.06 (1) (a) from an employee's earnings. For employees who are included in a collective bargaining unit for which a representative is recognized or certified under subch. V of ch. 111, this subsection shall apply unless otherwise provided in a collective bargaining agreement.

AB1-ASA1-AA1, s. 100ik Section 100ik. 40.61 (2) of the statutes is amended to read:

AB1-ASA1-AA1,80,18 40.61 (2) Except as provided in sub. (4), any eligible employee may become covered by income continuation insurance by electing coverage within 30 days of initial eligibility, to be effective as of the first day of the month which begins on or after the date the application is received by the employer, or by electing coverage within 30 days of initially becoming eligible for a higher level of employer contribution towards the premium cost to be effective as of the first day of the month following the date the application is received by the employer for teachers employed by the university and effective as of the following April 1 for all other employees. Any employee who does not so elect at one of these times, or who subsequently cancels the insurance, may not thereafter become insured unless the employee furnishes evidence of insurability under the terms of the contract, or as otherwise provided by rule for employees under sub. (3), at the employee's own expense or obtains coverage subject to contractual waiting periods if contractual waiting periods are provided for by the contract or by rule for employees under sub. (3). An employee who furnishes satisfactory evidence of insurability under the terms of the contract shall become insured as of the first day of the month following the date of approval of evidence. The method to be used shall be determined by the group insurance board under sub. (1).".

AB1-ASA1-AA1,80,19 97. Page 32, line 23: after that line insert:

AB1-ASA1-AA1,80,21 " Section 100j. 41.19 of the statutes, as affected by 2001 Wisconsin Act 16, is repealed.".

AB1-ASA1-AA1,80,22 98. Page 32, line 23: after that line insert:

AB1-ASA1-AA1,80,24 " Section 100hp. 40.51 (6) of the statutes is renumbered 40.51 (6) (a) and amended to read:

AB1-ASA1-AA1,81,6 40.51 (6) (a) This Except as provided in par. (b), the state shall offer to all of its employees at least 2 insured or uninsured health care coverage plans providing substantially equivalent hospital and medical benefits, including a health maintenance organization or a preferred provider plan, if those health care plans are determined by the group insurance board to be available in the area of the place of employment and are approved by the group insurance board.

AB1-ASA1-AA1, s. 100hr Section 100hr. 40.51 (6) (b) of the statutes is created to read:

AB1-ASA1-AA1,81,14 40.51 (6) (b) Notwithstanding s. 40.03 (6) (c), in addition to the health care coverage plans offered under par. (a), the state shall also offer to all of its employees a defined contribution plan that permits employees to choose the level of premiums, deductibles, and co-payments and to select the hospital and medical benefits offered under the plan, but only if the group insurance board determines that such a defined contribution plan is available in the area of the place of employment and approves the plan.

AB1-ASA1-AA1, s. 100ic Section 100ic. 40.98 (2) (h) of the statutes is created to read:

AB1-ASA1-AA1,81,21 40.98 (2) (h) The department may seek funding from any person for the payment of costs of designing, marketing, and contracting for or providing administrative services under the health care coverage program and for lapsing to the general fund any amount required under sub. (6m). Any moneys received by the department under this paragraph shall be credited to the appropriation account under s. 20.515 (2) (g).

AB1-ASA1-AA1, s. 100ix Section 100ix. 40.98 (6m) of the statutes is created to read:

AB1-ASA1-AA1,82,6 40.98 (6m) The secretary of administration shall lapse from the appropriation under s. 20.515 (2) (g) to the general fund the amounts necessary to repay the loan under s. 601.34 when the secretary of administration, after consulting with the board, determines that funds in the appropriation under s. 20.515 (2) (g) are sufficient to make the lapse. The amounts that are required to be lapsed under s. 20.515 (2) (g) shall equal the amount necessary to pay all principal and interest costs on the loan, less any amount that is lapsed to the general fund under s. 20.515 (2) (a) at the end of the 2001-03 fiscal biennium. The secretary of administration may lapse the amounts under s. 20.515 (2) (g) in installments.".

AB1-ASA1-AA1,82,7 99. Page 32, line 23: after that line insert:

AB1-ASA1-AA1,82,8 " Section 100iL. 43.52 (2) of the statutes is repealed.

AB1-ASA1-AA1, s. 100kL Section 100kL. 43.57 (5) (e) of the statutes is repealed.".

AB1-ASA1-AA1,82,10 100. Page 32, line 23: after that line insert:

AB1-ASA1-AA1,82,11 " Section 100hm. 40.05 (4) (a) 1. of the statutes is amended to read:

AB1-ASA1-AA1,82,17 40.05 (4) (a) 1. For Beginning on January 1, 2003, for health insurance, each insured employee shall contribute $10 per month for single coverage or $20 per month for family coverage, whichever is applicable, and shall contribute the balance of the required premium amounts after applying required employer contributions, if any, and each insured retired employee shall contribute the balance of the required premium amounts after applying required employer contributions, if any.".

AB1-ASA1-AA1,82,18 101. Page 33, line 2: after that line insert:

AB1-ASA1-AA1,82,19 " Section 100n. 46.03 (18) (am) of the statutes is amended to read:

AB1-ASA1-AA1,82,24 46.03 (18) (am) Paragraph (a) does not prevent the department from charging and collecting the cost of adoptive placement investigations and child care as authorized under s. 48.837 (7). Paragraph (a) also does not prevent a county department under s. 51.42 or 51.437 from charging and collecting the cost of an examination ordered under s. 938.295 (2) (a) as authorized under s. 938.295 (2) (c).".

AB1-ASA1-AA1,83,1 102. Page 38, line 20: after that line insert:

AB1-ASA1-AA1,83,2 " Section 121t. 49.45 (6m) (ar) 1. a. of the statutes is amended to read:

AB1-ASA1-AA1,83,12 49.45 (6m) (ar) 1. a. The department shall establish standards for payment of allowable direct care costs, for facilities that do not primarily serve the developmentally disabled, that take into account direct care costs for a sample of all of those facilities in this state and separate standards for payment of allowable direct care costs, for facilities that primarily serve the developmentally disabled, that take into account direct care costs for a sample of all of those facilities in this state. The standards shall be adjusted by the department for regional labor cost variations. For facilities in Pierce and St. Croix counties, the department shall perform the adjustment by use of the wage index that is used by the federal department of health and human services for hospital reimbursement under 42 USC 1395 to 1395ggg.".

AB1-ASA1-AA1,83,13 103. Page 38, line 20: after that line insert:

AB1-ASA1-AA1,83,14 " Section 121m. 49.45 (18) (d) of the statutes is amended to read:

AB1-ASA1-AA1,83,18 49.45 (18) (d) No person who designates a pharmacy or pharmacist as his or her sole provider of prescription drugs and who so uses that pharmacy or pharmacist is liable under this subsection for more than $5 $10 per month for prescription drugs received.".

AB1-ASA1-AA1,83,19 104. Page 38, line 21: delete lines 21 and 22 and substitute:

AB1-ASA1-AA1,83,20 " Section 122b. 49.45 (49) of the statutes is created to read:

AB1-ASA1-AA1,83,24 49.45 (49) Prescription drug prior authorization. (a) In this subsection, "prescription drug" means a prescription drug, as defined in s. 450.01 (20), that is included in the legend drugs under s. 49.46 (2) (b) 6. h. and that may be prescribed for a medical assistance recipient.

AB1-ASA1-AA1,84,2 (b) The department may not establish prior authorization policies for a prescription drug that is used to treat respiratory illness, mental illness, or diabetes.

AB1-ASA1-AA1,84,5 (c) Before the department establishes a requirement for prior authorization for a prescription drug, the department shall hold a public meeting concerning the prior authorization, for which the department shall do all of the following:

AB1-ASA1-AA1,84,6 1. Send written notice of the public meeting to all of the following:

AB1-ASA1-AA1,84,8 a. The revisor of statutes, for publication in the Wisconsin Administrative Register under s. 35.93.

AB1-ASA1-AA1,84,9 b. The secretary of administration.

AB1-ASA1-AA1,84,11 c. Appropriate standing committees of the legislature, in the manner provided under s. 13.172 (3).

AB1-ASA1-AA1,84,13 2. Take any action that the department considers necessary to provide notice of the public meeting to other interested persons.

AB1-ASA1-AA1,84,17 3. At the beginning of the public meeting, present a summary of the medical, pharmacological, or economic rationale on which the prior authorization requirement is based, including any information obtained from the prescription drug prior authorization committee under par. (e).

AB1-ASA1-AA1,84,19 4. Afford each interested person or a representative the opportunity to present oral or written facts, opinion, or argument.

AB1-ASA1-AA1,84,21 5. Keep a record of the meeting in a manner that the department considers desirable and feasible.

AB1-ASA1-AA1,84,23 6. Limit oral presentations if the meeting would be unduly lengthened by repetitious testimony.

AB1-ASA1-AA1,84,24 7. If appropriate, question the persons presenting facts, opinion, or argument.

AB1-ASA1-AA1,85,5 (d) By October 1, 2002, and every 6 months thereafter, the department shall review and reconsider prior authorization policies for each prescription drug that is subject to prior authorization requirements. The department shall hold a public meeting concerning the review and reconsideration, for which the department shall do all of the following:

AB1-ASA1-AA1,85,6 1. Send written notice of the public meeting to all of the following:

AB1-ASA1-AA1,85,8 a. The revisor of statutes, for publication in the Wisconsin Administrative Register under s. 35.93.

AB1-ASA1-AA1,85,9 b. The secretary of administration.

AB1-ASA1-AA1,85,11 c. Appropriate standing committees of the legislature, in the manner provided under s. 13.172 (3).

AB1-ASA1-AA1,85,13 2. Take any action that the department considers necessary to provide notice of the public meeting to other interested persons.

AB1-ASA1-AA1,85,17 3. At the beginning of the public meeting, present a summary of the medical, pharmacological, or economic rationale on which the prior authorization requirement is based, including any information obtained from the prescription drug prior authorization committee under par. (e).

AB1-ASA1-AA1,85,19 4. Afford each interested person or a representative the opportunity to present oral or written facts, opinion, or argument.

AB1-ASA1-AA1,85,21 5. Keep a record of the meeting in a manner that the department considers desirable and feasible.

AB1-ASA1-AA1,85,23 6. Limit oral presentations if the meeting would be unduly lengthened by repetitious testimony.

AB1-ASA1-AA1,85,24 7. If appropriate, question the persons presenting facts, opinion, or argument.

AB1-ASA1-AA1,85,25 (e) The secretary shall".

AB1-ASA1-AA1,86,1 105. Page 39, line 8: delete "(b)" and substitute "(f)".

AB1-ASA1-AA1,86,2 106. Page 39, line 10: after that line insert:

AB1-ASA1-AA1,86,3 " Section 122c. 49.45 (50) of the statutes is created to read:

AB1-ASA1-AA1,86,7 49.45 (50) Disease management. (a) In this subsection, "disease management" means an integrated and systematic approach for managing the health care needs of patients who are at risk of or are diagnosed with a specific disease, using all of the following:

AB1-ASA1-AA1,86,8 1. Best practices.

AB1-ASA1-AA1,86,9 2. Prevention strategies.

AB1-ASA1-AA1,86,10 3. Clinical practice improvement.

AB1-ASA1-AA1,86,11 4. Clinical interventions and protocols.

AB1-ASA1-AA1,86,12 5. Outcomes research, information, and technology.

AB1-ASA1-AA1,86,14 6. Other tools and resources to reduce overall costs and improve measurable outcomes.

AB1-ASA1-AA1,86,17 (b) The department may contract with an entity, under the department's request-for-proposal procedures, to engage in disease management activities on behalf of recipients of medical assistance.".

AB1-ASA1-AA1,86,18 107. Page 41, line 13: after that line insert:

AB1-ASA1-AA1,86,19 " Section 128g. 49.49 (6) of the statutes is amended to read:

AB1-ASA1-AA1,87,5 49.49 (6) Recovery. In addition to other remedies available under this section, the court may award the department of justice the reasonable and necessary costs of investigation, an amount reasonably necessary to remedy the harmful effects of the violation and the reasonable and necessary expenses of prosecution, including attorney fees, from any person who violates this section. The department of justice shall deposit in the state treasury for deposit in the general fund all moneys that the court awards to the department or the state under this subsection. Ten percent of the money deposited in the general fund that was awarded under this subsection for the costs of investigation and the expenses of prosecution, including attorney fees, shall be credited to the appropriation account under s. 20.455 (1) (gh).".

AB1-ASA1-AA1,87,6 108. Page 41, line 13: after that line insert:

AB1-ASA1-AA1,87,7 " Section 128k. 49.665 (2m) of the statutes is created to read:

AB1-ASA1-AA1,87,12 49.665 (2m) Unborn children. (a) If the secretary determines that federal law under 42 USC 1397aa to 1397jj authorizes the department to allow a woman and her unborn child, as defined in s. 48.02 (19), to be considered a family for the purpose of determining eligibility for the program under this section, the department shall do so.

AB1-ASA1-AA1,87,20 (b) If the secretary of health and family services determines that federal law under 42 USC 1397aa to 1397jj does not authorize the expansion of eligibility described under par. (a), the department shall request a waiver from the federal secretary of health and human services that would permit the department to allow a woman and her unborn child, as defined in s. 48.02 (19), to be considered a family for the purpose of determining eligibility for the program under this section. If the waiver is granted and in effect, the department shall administer the program as permitted in the waiver.".

AB1-ASA1-AA1,87,21 109. Page 47, line 25: after that line insert:

AB1-ASA1-AA1,87,22 " Section 148n. 50.36 (3d) of the statutes is created to read:

AB1-ASA1-AA1,88,3 50.36 (3d) (a) A hospital shall develop and maintain a system under which the hospital may grant emergency staff privileges to a health care provider, as defined in s. 146.81 (1), to whom all of the following apply:

AB1-ASA1-AA1,88,6 1. The health care provider seeks to provide care at the hospital during a period of a state of emergency related to public health declared by the governor under s. 166.03 (1) (b) 1.

AB1-ASA1-AA1,88,9 2. The health care provider does not have staff privileges at the hospital at the time that the state of emergency related to public health is declared by the governor under s. 166.03 (1) (b) 1.

AB1-ASA1-AA1,88,10 3. The health care provider has staff privileges at another hospital.

AB1-ASA1-AA1,88,13 (b) A hospital that grants emergency staff privileges under par. (a) has immunity from civil liability for acts or omissions by a health care provider who is granted emergency staff privileges under par. (a).".

AB1-ASA1-AA1,88,14 110. Page 48, line 5: after that line insert:

AB1-ASA1-AA1,88,15 " Section 149m. 51.20 (13) (ct) 1m. of the statutes is amended to read: