Wisconsin Legislature: LRBs0382/1

(b) An insurer that issues or delivers a disability insurance policy that provides coverage to a resident of this state shall provide to the department, upon the department's request, information contained in the insurer's records regarding all of the following:

1. Information that the department needs to identify enrollees of family care who satisfy any of the following:

a. Are eligible for benefits under a disability insurance policy.

b. Would be eligible for benefits under a disability insurance policy if the enrollee were enrolled as a dependent of a person insured under the disability insurance policy.

2. Information required for submittal of claims under the insurer's disability insurance policy.

3. The types of benefits provided by the disability insurance policy.

(c) Upon requesting an insurer to provide the information under par. (b), the department shall enter into a written agreement with the insurer that satisfies all of the following:

1. Identifies in detail the information to be disclosed.

2. Includes provisions that adequately safeguard the confidentiality of the information to be disclosed.

(d) 1. An insurer shall provide the information requested under par. (b) within 180 days after receiving the department's request if it is the first time that the department has requested the insurer to disclose information under this subsection.

2. An insurer shall provide the information requested under par. (b) within 30 days after receiving the department's request if the department has previously requested the insurer to disclose information under this subsection.

3. If an insurer fails to comply with subd. 1. or 2., the department may notify the commissioner of insurance, and the commissioner of insurance may initiate enforcement proceedings against the insurer under s. 601.41 (4) (a).

SECTION 101. 47.03 (3) (d) of the statutes is amended to read:

47.03 (3) (d) Any person who violates this subsection shall be fined not more than $1,000 $10,000 or imprisoned for not more than 2 years 9 months or both.

SECTION 102. 48.355 (2d) (b) 3. of the statutes is amended to read:

48.355 (2d) (b) 3. That the parent has committed a violation of s. 940.19 (3), 1999 stats., a violation of s. 940.19 (2), (3), (4) or (5), 940.225 (1) or (2), 948.02 (1) or (2), 948.025 or 948.03 (2) (a) or (3) (a) or a violation of the law of any other state or federal law, if that violation would be a violation of s. 940.19 (2), (3), (4) or (5), 940.225 (1) or (2), 948.02 (1) or (2), 948.025 or 948.03 (2) (a) or (3) (a) if committed in this state, and that the violation resulted in great bodily harm, as defined in s. 939.22 (14), or in substantial bodily harm, as defined in s. 939.22 (38), to the child or another child of the parent.

SECTION 103. 48.415 (9m) (b) 2. of the statutes is amended to read:

48.415 (9m) (b) 2. The commission of a violation of s. 940.19 (3), 1999 stats., a violation of s. 940.19 (2), (3), (4) or (5), 940.225 (1) or (2), 948.02 (1) or (2), 948.025, 948.03 (2) (a) or (3) (a), 948.05, 948.06 or 948.08 or a violation of the law of any other state or federal law, if that violation would be a violation of s. 940.19 (2), (3), (4) or (5), 940.225 (1) or (2), 948.02 (1) or (2), 948.025, 948.03 (2) (a) or (3) (a), 948.05, 948.06 or 948.08 if committed in this state.

SECTION 104. 48.417 (1) (d) of the statutes is amended to read:

48.417 (1) (d) A court of competent jurisdiction has found that the parent has committed a violation of s. 940.19 (3), 1999 stats., a violation of s. 940.19 (2), (3), (4) or (5), 940.225 (1) or (2), 948.02 (1) or (2), 948.025 or 948.03 (2) (a) or (3) (a) or a violation of the law of any other state or federal law, if that violation would be a violation of s. 940.19 (2), (3), (4) or (5), 940.225 (1) or (2), 948.02 (1) or (2), 948.025 or 948.03 (2) (a) or (3) (a) if committed in this state, and that the violation resulted in great bodily harm, as defined in s. 939.22 (14), or in substantial bodily harm, as defined in s. 939.22 (38), to the child or another child of the parent.

SECTION 110. 48.57 (3p) (g) 2. of the statutes is amended to read:

48.57 (3p) (g) 2. The person has had imposed on him or her a penalty specified in s. 939.64, 1999 stats., or s. 939.641, 1999 stats., or s. 939.62, 939.621, 939.63, 939.64, 939.641 or 939.645 or has been convicted of a violation of the law of any other state or federal law under circumstances under which the person would be subject to a penalty specified in any of those sections if convicted in this state.

SECTION 111. 48.685 (1) (c) of the statutes is amended to read:

48.685 (1) (c) "Serious crime" means a violation of s. 940.19 (3), 1999 stats., a violation of s. 940.01, 940.02, 940.03, 940.05, 940.12, 940.19 (2), (3), (4), (5) or (6), 940.22 (2) or (3), 940.225 (1), (2) or (3), 940.285 (2), 940.29, 940.295, 948.02 (1) or (2), 948.025, 948.03 (2), 948.05, 948.055, 948.06, 948.07, 948.08, 948.11 (2) (a) or (am), 948.12, 948.13, 948.21 (1) or 948.30 or a violation of the law of any other state or United States jurisdiction that would be a violation of s. 940.19 (3), 1999 stats., or a violation of s. 940.01, 940.02, 940.03, 940.05, 940.12, 940.19 (2), (3), (4), (5) or (6), 940.22 (2) or (3), 940.225 (1), (2) or (3), 940.285 (2), 940.29, 940.295, 948.02 (1) or (2), 948.025, 948.03 (2), 948.05, 948.055, 948.06, 948.07, 948.08, 948.11 (2) (a) or (am), 948.12, 948.13, 948.21 (1) or 948.30 if committed in this state.

SECTION 112. 48.685 (5) (bm) 2. of the statutes is amended to read:

48.685 (5) (bm) 2. A violation of s. 940.19 (3), 1999 stats., or of s. 940.19 (2), (3), (4), (5) or (6) or 940.20 (1) or (1m), if the victim is the spouse of the person.

SECTION 113. 48.685 (5) (bm) 3. of the statutes is amended to read:

48.685 (5) (bm) 3. A violation of s. 943.23 (1m) or (1r), 1999 stats., or of s. 940.01, 940.02, 940.03, 940.05, 940.06, 940.21, 940.225 (1), (2) or (3), 940.23, 940.305, 940.31, 941.20 (2) or (3), 941.21, 943.10 (2), 943.23 (1g), (1m) or (1r) or 943.32 (2).

SECTION 114. 48.685 (5) (bm) 4. of the statutes is amended to read:

48.685 (5) (bm) 4. A violation of s. 940.19 (3), 1999 stats., or of s. 940.19 (2), (3), (4), (5) or (6), 940.20, 940.203, 940.205 or 940.207 or an offense under ch. 961 that is a felony, if committed not more than 5 years before the date of the investigation under sub. (2) (am).

SECTION 115. 49.141 (7) (a) of the statutes is amended to read:

49.141 (7) (a) A person who is convicted of violating sub. (6) in connection with the furnishing by that person of items or services for which payment is or may be made under Wisconsin works may be fined not more than $25,000 or imprisoned for not more than 7 years and 6 months or both is guilty of a Class H felony.

SECTION 116. 49.141 (7) (b) of the statutes is amended to read:

49.141 (7) (b) A person, other than a person under par. (a), who is convicted of violating sub. (6) may be fined not more than $10,000 or imprisoned for not more than 2 years 9 months or both.

SECTION 117. 49.141 (9) (a) of the statutes is amended to read:

49.141 (9) (a) Whoever solicits or receives any remuneration in cash or in-kind, in return for referring an individual to a person for the furnishing or arranging for the furnishing of any item or service for which payment may be made in whole or in part under Wisconsin works, or in return for purchasing, leasing, ordering, or arranging for or recommending purchasing, leasing, or ordering any good, facility, service, or item for which payment may be made in whole or in part under Wisconsin works, is guilty of a Class H felony, except that, notwithstanding the maximum fine specified in s. 939.50 (3) (h), the person may be fined not more than $25,000 or imprisoned for not more than 7 years and 6 months or both.

SECTION 118. 49.141 (9) (b) of the statutes is amended to read:

49.141 (9) (b) Whoever offers or pays any remuneration in cash or in-kind to any person to induce the person to refer an individual to a person for the furnishing or arranging for the furnishing of any item or service for which payment may be made in whole or in part under Wisconsin works, or to purchase, lease, order, or arrange for or recommend purchasing, leasing, or ordering any good, facility, service or item for which payment may be made in whole or in part under any provision of Wisconsin works, is guilty of a Class H felony, except that, notwithstanding the maximum fine specified in s. 939.50 (3) (h), the person may be fined not more than $25,000 or imprisoned for not more than 7 years and 6 months or both.

SECTION 119. 49.141 (10) (b) of the statutes is amended to read:

49.141 (10) (b) A person who violates this subsection is guilty of a Class H felony, except that, notwithstanding the maximum fine specified in s. 939.50 (3) (h), the person may be fined not more than $25,000 or imprisoned for not more than 7 years and 6 months or both.

SECTION 119m. 49.175 (1) (zh) 2. of the statutes, as affected by 2001 Wisconsin Act 16, is amended to read:

49.175 (1) (zh) 2. 'Taxable years 1999 and thereafter.' For the transfer of moneys from the appropriation account under s. 20.445 (3) (md) to the appropriation account under s. 20.835 (2) (kf) for the earned income tax credit, $51,244,500 in fiscal year 2001-02 and $52,200,000 $55,160,000 in fiscal year 2002-03.

SECTION 120. 49.195 (3n) (k) of the statutes is amended to read:

49.195 (3n) (k) Any person who removes, deposits or conceals or aids in removing, depositing or concealing any property upon which a levy is authorized under this subsection with intent to evade or defeat the assessment or collection of any debt may be fined not more than $5,000 or imprisoned for not more than 4 years and 6 months or both, is guilty of a Class H felony and shall be liable to the state for assessed the costs of prosecution.

SECTION 121. 49.195 (3n) (r) of the statutes is amended to read:

49.195 (3n) (r) No employer may discharge or otherwise discriminate with respect to the terms and conditions of employment against any employee by reason of the fact that his or her earnings have been subject to levy for any one levy or because of compliance with any provision of this subsection. Any person who violates this paragraph may be fined not more than $1,000 or imprisoned for not more than 2 years or both is guilty of a Class I felony.

SECTION 122. 49.45 (49) of the statutes is created to read:

49.45 (49) PRESCRIPTION DRUG PRIOR AUTHORIZATION. (a) The secretary shall exercise his or her authority under s. 15.04 (1) (c) to create a prescription drug prior authorization committee to advise the department on issues related to prior authorization decisions made concerning presciption drugs on behalf of medical assistance recipients. The secretary shall appoint as members at least all of the following:

1. Two physicians, as defined in s. 448.01 (5), who are currently in practice.

2. Two pharmacists, as defined in s. 450.01 (15).

3. One advocate for recipients of medical assistance who has sufficient medical background, as determined by the department, to evaluate a prescription drug's clinical effectiveness.

(b) The prescription drug prior authorization committee shall accept information or commentary from representatives of the pharmaceutical manufacturing industry in the committee's review of prior authorization policies.

SECTION 123. 49.49 (1) (b) 1. of the statutes is amended to read:

49.49 (1) (b) 1. In the case of such a statement, representation, concealment, failure, or conversion by any person in connection with the furnishing by that person of items or services for which medical assistance is or may be made, a person convicted of violating this subsection is guilty of a Class H felony, except that, notwithstanding the maximum fine specified in s. 939.50 (3) (h), the person may be fined not more than $25,000 or imprisoned for not more than 7 years and 6 months or both.

SECTION 124. 49.49 (2) (a) of the statutes is amended to read:

49.49 (2) (a) Solicitation or receipt of remuneration. Any person who solicits or receives any remuneration, including any kickback, bribe, or rebate, directly or indirectly, overtly or covertly, in cash or in kind, in return for referring an individual to a person for the furnishing or arranging for the furnishing of any item or service for which payment may be made in whole or in part under a medical assistance program, or in return for purchasing, leasing, ordering, or arranging for or recommending purchasing, leasing, or ordering any good, facility, service, or item for which payment may be made in whole or in part under a medical assistance program, is guilty of a Class H felony, except that, notwithstanding the maximum fine specified in s. 939.50 (3) (h), the person may be fined not more than $25,000 or imprisoned for not more than 7 years and 6 months or both.

SECTION 125. 49.49 (2) (b) of the statutes is amended to read:

49.49 (2) (b) Offer or payment of remuneration. Whoever offers or pays any remuneration including any kickback, bribe, or rebate directly or indirectly, overtly or covertly, in cash or in kind to any person to induce such person to refer an individual to a person for the furnishing or arranging for the furnishing of any item or service for which payment may be made in whole or in part under a medical assistance program, or to purchase, lease, order, or arrange for or recommend purchasing, leasing, or ordering any good, facility, service or item for which payment may be made in whole or in part under a medical assistance program, is guilty of a Class H felony, except that, notwithstanding the maximum fine specified in s. 939.50 (3) (h), the person may be fined not more than $25,000 or imprisoned for not more than 7 years and 6 months or both.

SECTION 126. 49.49 (3) of the statutes is amended to read:

49.49 (3) FRAUDULENT CERTIFICATION OF FACILITIES. No person may knowingly and wilfully make or cause to be made, or induce or seek to induce the making of, any false statement or representation of a material fact with respect to the conditions or operation of any institution or facility in order that such institution or facility may qualify either upon initial certification or upon recertification as a hospital, skilled nursing facility, intermediate care facility, or home health agency. Violators of A person who violates this subsection is guilty of a Class H felony, except that, notwithstanding the maximum fine specified in s. 939.50 (3) (h), the person may be fined not more than $25,000 or imprisoned for not more than 7 years and 6 months or both.

SECTION 127. 49.49 (3m) (b) of the statutes is amended to read:

49.49 (3m) (b) A person who violates this subsection is guilty of a Class H felony, except that, notwithstanding the maximum fine specified in s. 939.50 (3) (h), the person may be fined not more than $25,000 or imprisoned for not more than 7 years and 6 months or both.

SECTION 128. 49.49 (4) (b) of the statutes is amended to read:

49.49 (4) (b) A person who violates this subsection is guilty of a Class H felony, except that, notwithstanding the maximum fine specified in s. 939.50 (3) (h), the person may be fined not more than $25,000 or imprisoned for not more than 7 years and 6 months or both.

SECTION 128m. 49.665 (4) (at) 1. b. of the statutes is amended to read:

49.665 (4) (at) 1. b. The department may not lower the maximum income level for initial eligibility unless the department first submits to the joint committee on finance its plans a plan for lowering the maximum income level and the committee approves the plan. If, within 14 days after submitting the plan the date on which the plan is submitted to the joint committee on finance, the cochairpersons of the committee do not notify the secretary that the committee has scheduled a meeting for the purpose of reviewing the plan, the department shall implement the plan is considered approved by the committee as proposed. If, within 14 days after the date on which the plan is submitted to the committee, the cochairpersons of the committee notify the secretary that the committee has scheduled a meeting to review the plan, the department may implement the plan only as approved by the committee.

SECTION 128n. 49.665 (4) (at) 1. cm. of the statutes is created to read:

49.665 (4) (at) 1. cm. Notwithstanding s. 20.001 (3) (b), if, after reviewing the plan submitted under subd. 1. b., the joint committee on finance determines that the amounts appropriated under s. 20.435 (4) (bc), (jz), (p), and (x) are insufficient to accommodate the projected enrollment levels, the committee may transfer appropriated moneys from the general purpose revenue appropriation account of any state agency, as defined in s. 20.001 (1), other than a sum sufficient appropriation account, to the appropriation account under s. 20.435 (4) (bc) to supplement the health care program under this section if the committee finds that the transfer will eliminate unnecessary duplication of functions, result in more efficient and effective methods for performing programs, or more effectively carry out legislative intent, and that legislative intent will not be changed by the transfer.

SECTION 128p. 49.665 (5m) of the statutes is created to read:

49.665 (5m) INFORMATION ABOUT BADGER CARE RECIPIENTS. (a) In this subsection:

1. "Disability insurance policy" has the meaning given in s. 632.895 (1) (a).

2. "Insurer" has the meaning given in s. 600.03 (27).

1. Information that the department needs to identify recipients of badger care who satisfy any of the following:

a. Are eligible for benefits under a disability insurance policy.

b. Would be eligible for benefits under a disability insurance policy if the recipient were enrolled as a dependent of a person insured under the disability insurance policy.

2. Information required for submittal of claims under the insurer's disability insurance policy.

3. The types of benefits provided by the disability insurance policy.

(c) Upon requesting an insurer to provide the information under par. (b), the department shall enter into a written agreement with the insurer that satisfies all of the following:

1. Identifies in detail the information to be disclosed.

2. Includes provisions that adequately safeguard the confidentiality of the information to be disclosed.

SECTION 140p. 49.688 (2) (a) 3. of the statutes, as created by 2001 Wisconsin Act 16, is amended to read:

49.688 (2) (a) 3. The person is not a recipient of medical assistance or, as a recipient, does not receive prescription drug coverage.

SECTION 140q. 49.688 (3) (d) of the statutes, as created by 2001 Wisconsin Act 16, is amended to read:

49.688 (3) (d) Notwithstanding s. 49.002, if a person who is eligible under this section has other available coverage for payment of a prescription drug, this section applies only to costs for prescription drugs for the persons person that are not covered under the person's other available coverage.

SECTION 140r. 49.688 (8m) of the statutes is created to read: