AB995: Bill Text

AB995, s. 36 Section 36. 49.665 (4) (a) 1. of the statutes is amended to read:

AB995,23,9 49.665 (4) (a) 1. The family's income does not exceed 185% of the poverty line, except as provided in par. (at) and except that a family that is already receiving health care coverage under this section may have an income that does not exceed 200% of the poverty line. The Subject to par. (d), the department shall establish by rule the criteria to be used to determine income.

AB995, s. 37 Section 37. 49.665 (4) (d) of the statutes is created to read:

AB995,23,14 49.665 (4) (d) For purposes of determining a family's or child's income under this section, the department shall exclude from the calculation of farm or self-employment income any amounts claimed for depreciation for income tax purposes.

AB995, s. 38 Section 38. 49.688 (4r) of the statutes is created to read:

AB995,23,22 49.688 (4r) In determining a person's annual household income under sub. (2) (a) 4. and (b) for purposes of determining eligibility for prescription drug assistance and under sub. (3) (b) 1. and 2. a. for purposes of establishing the required deductible amount, the department shall deduct the amount of property taxes that the person or any member of his or her household paid on the person's primary residence in the 12-month period before the department makes an eligibility determination under sub. (4).

AB995, s. 39 Section 39. 51.30 (4) (b) 13. of the statutes is renumbered 51.30 (4) (cm) and amended to read:

AB995,24,14 51.30 (4) (cm) Required access to records. To the parents, children Notwithstanding par. (a), treatment records of an individual shall be released without informed written consent, except as restricted under par. (c), to the parent, child, sibling, or spouse of an individual who is or was a patient at an inpatient facility,; to a law enforcement officer who is seeking to determine whether an individual is on unauthorized absence from the facility, ; and to mental health professionals who are providing treatment to the individual at the time that the information is released to others. Information released under this subdivision paragraph is limited to notice as to whether or not an individual is a patient at the inpatient facility and, if the individual is no longer a patient at the inpatient facility, the facility or other place, if known, at which the individual is located. This paragraph does not apply to an individual's parent, child, sibling, or spouse from whom the individual has specifically requested that the information under this paragraph be withheld.

AB995, s. 40 Section 40. 100.31 (title) of the statutes is amended to read:

AB995,24,16 100.31 (title) Unfair discrimination in Prescription drug pricing.

AB995, s. 41 Section 41. 100.31 (1) (a) of the statutes is renumbered 100.31 (1) (bm) and amended to read:

AB995,24,20 100.31 (1) (bm) "Drug" "Prescription drug" means any substance subject to 21 USC 353 (b).

AB995, s. 42 Section 42. 100.31 (1) (ae) of the statutes is created to read:

AB995,24,23 100.31 (1) (ae) "Consumer" means a person for whom a prescription drug is prescribed.

AB995, s. 43 Section 43. 100.31 (1) (as) of the statutes is created to read:

AB995,25,4 100.31 (1) (as) "Federal drug list" means the "Approved Drug Products with Therapeutic Equivalence Evaluations" published by the federal food and drug administration, or other publication specified in rules promulgated by the department under sub. (2r).

AB995, s. 44 Section 44. 100.31 (1) (b) of the statutes is renumbered 100.31 (1) (am) and amended to read:

AB995,25,12 100.31 (1) (am) "Purchaser" " Dispenser" means any person who engages primarily in selling dispensing, as defined in s. 450.01 (7), prescription drugs directly to consumers for outpatient use. "Dispenser" includes a hospital that directly or indirectly bills patients for prescription drugs, or an insurer that issues a defined network plan, as defined in s. 609.01 (1b), and that provides prescription drugs or prescription drug coverage to the enrollees of the plan.

AB995, s. 45 Section 45. 100.31 (1) (c) of the statutes is amended to read:

AB995,25,15 100.31 (1) (c) "Seller" means any person who trades in prescription drugs for resale to purchasers dispensers in this state.

AB995, s. 46 Section 46. 100.31 (2) of the statutes is amended to read:

AB995,25,24 100.31 (2) Price discrimination prohibited. Every seller shall offer prescription drugs from the most current federal drug list of therapeutically equivalent drugs published by the federal food and drug administration to every purchaser dispenser in this state, with all rights and privileges offered or accorded by the seller to the most favored purchaser dispenser, including purchase prices for similar volume purchases, rebates, free merchandise, samples, and similar trade concessions. Nothing in this subsection prohibits the giving of a discount for volume purchases.

AB995, s. 47 Section 47. 100.31 (2r) of the statutes is created to read:

AB995,26,4 100.31 (2r) Rules. The department may promulgate rules that, for purposes of sub. (1) (as), specify a publication that identifies drug products approved on the basis of safety and effectiveness by the federal food and drug administration under the federal Food, Drug, and Cosmetic Act.

AB995, s. 48 Section 48. 100.31 (4) of the statutes is amended to read:

AB995,26,11 100.31 (4) Penalties. For any violation of this section, the department or a district attorney may commence an action on behalf of the state to recover a forfeiture of not less than $100 nor more than $10,000 for each offense. Each delivery of a prescription drug sold to a purchaser dispenser at a price in violation of this section and each separate day in violation of an injunction issued under this section is a separate offense.

AB995, s. 49 Section 49. 146.385 of the statutes is created to read:

AB995,26,14 146.385 Health care provider service rate charges; limitations. (1) In this section:

AB995,26,16 (a) "Health care provider" means any of the following that receives income from the provision of health care or mental health services, items, or supplies in this state:

AB995,26,19 1. An individual who is licensed, registered, permitted, or certified by the department of health and family services or by the department of regulation and licensing to provide health care or mental health services, items, or supplies.

AB995,26,21 2. A partnership, corporation, or limited liability company of individuals specified in subd. 1.

AB995,26,23 3. A facility or agency that provides health care or mental health services, items, or supplies.

AB995,27,3 (b) "Insurer" means an insurer that is authorized to do business in this state, in one or more lines of insurance that includes health insurance, and that offers health care plans, as defined in s. 628.36 (2) (a) 1., covering individuals in this state.

AB995,27,7 (2) (a) By April 1 annually, the department shall make available on the department's website, in a form that is downloadable, and, upon request, by mail, the current Medical Assistance fee schedule for health care services of health care providers.

AB995,27,9 (b) The department may make available on the department's website, in a form that is downloadable, and, upon request, by mail, all of the following:

AB995,27,12 1. The current insurer rates of health care providers provided to the department under sub. (3) (a), including any rate increases about which the department is informed under sub. (3 (a).

AB995,27,15 2. The current rates of reimbursement for health care services of health care providers provided to the department under sub. (5), including any rate increases about which the department is informed under sub. (5).

AB995,27,18 (c) The department may contract for the receipt of information under sub. (3) (a) or (5) and for the posting of the information under par. (a) or (b), in accordance with the department's request-for-proposal procedures.

AB995,28,2 (3) (a) By April 15 annually, a health care provider shall provide to the department, on a form provided by the department, a statement of the provider's rates for health care services for the period from the following May 1 to April 30. If during this period the health care provider increases any of the rates from the amount stated, the health care provider shall so inform the department, on a form provided by the department. The rates shall be stated in a form determined by the department that may include statement as a percentage of the Medical Assistance fee schedule for services of providers, as specified by the department under sub. (2) (a).

AB995,28,5 (b) Beginning on May 1 annually, a health care provider shall, with respect to the provider's rates for the period from that date to April 30 of the following year, do all of the following:

AB995,28,7 1. If the health care provider has an Internet website, post the rates, including any rate increases, on the website, in a form that is downloadable.

AB995,28,11 2. Take reasonable steps to ensure that health care consumers of services of the health care provider are aware that information on the provider's rates for health care services is available and are informed about the means by which the rate information may be obtained.

AB995,28,15 (4) Any increase in a rate for the health care service of a health care provider is chargeable only after the health care provider has, under sub. (3) (a), informed the department of the increase and has, if applicable, posted the rate increase under sub. (3) (b) 1.

AB995,28,24 (5) By April 15 annually, an insurer shall provide to the department, on a form provided by the department, and to the insurer's insureds a statement of the insurer's rates of reimbursement for health care services of health care providers for the period from the following May 1 to April 30. If during this period the insurer increases any of the rates of reimbursement from the amount stated, the insurer shall so inform the department, on a form provided by the department. The rates of reimbursement shall be stated as a percentage of the Medical Assistance fee schedule for health care services of health care providers, as specified by the department under sub. (2) (a).

AB995, s. 50 Section 50. 146.89 (1) of the statutes is renumbered 146.89 (1) (intro.) and amended to read:

AB995,29,3 146.89 (1) (intro.) In this section, "volunteer:

AB995,29,10 (r) "Volunteer health care provider" means an individual who is licensed as a physician under ch. 448, dentist under ch. 447, registered nurse, practical nurse, or nurse-midwife under ch. 441, optometrist under ch. 449, or physician assistant under ch. 448 or certified as a dietitian under subch. V of ch. 448 and who receives no income from the practice of that health care profession or who receives no income from the practice of that health care profession when providing services at the nonprofit agency or school specified under sub. (3).

AB995, s. 51 Section 51. 146.89 (1) (d) of the statutes is created to read:

AB995,29,13 146.89 (1) (d) "Governing body" means the governing body of any of the following:

AB995,29,14 1. A charter school, as defined in s. 115.001 (1).

AB995,29,16 2. A private school, as defined in s. 115.001 (3r), that participates in the Milwaukee Parental Choice Program under s. 119.23.

AB995, s. 52 Section 52. 146.89 (1) (g) of the statutes is created to read:

AB995,29,18 146.89 (1) (g) "School" means any of the following:

AB995,29,19 1. A public elementary school.

AB995,29,20 2. A charter school, as defined in s. 115.001 (1).

AB995,29,22 3. A private school, as defined in s. 115.001 (3r), that participates in the Milwaukee Parental Choice Program under s. 119.23

AB995, s. 53 Section 53. 146.89 (1) (h) of the statutes is created to read:

AB995,29,24 146.89 (1) (h) "School board" has the meaning given in s. 115.001 (7).

AB995, s. 54 Section 54. 146.89 (2) (a) of the statutes is amended to read:

AB995,30,10 146.89 (2) (a) A volunteer health care provider may participate under this section only if he or she submits a joint application with a nonprofit agency, school board, or governing body to the department of administration and that department approves the application. If the volunteer health care provider submits a joint application with a school board or governing body, the application shall include a statement by the school board or governing body that certifies that the volunteer health care provider has received materials that specify school board or governing body policies concerning the provision of health care services to students and has agreed to comply with the policies. The department of administration shall provide application forms for use under this paragraph.

AB995, s. 55 Section 55. 146.89 (2) (c) of the statutes is amended to read:

AB995,30,14 146.89 (2) (c) The department of administration shall notify the volunteer health care provider and the nonprofit agency, school board, or governing body of the department's decision to approve or disapprove the application.

AB995, s. 56 Section 56. 146.89 (2) (d) of the statutes is amended to read:

AB995,30,23 146.89 (2) (d) Approval of an application of a volunteer health care provider is valid for one year. If a volunteer health care provider wishes to renew approval, he or she shall submit a joint renewal application with a nonprofit agency , school board, or governing body to the department of administration. The department of administration shall provide renewal application forms that are developed by the department of health and family services and that include questions about the activities that the individual has undertaken as a volunteer health care provider in the previous 12 months.

AB995, s. 57 Section 57. 146.89 (3) (b) (intro.) of the statutes is amended to read:

AB995,31,2 146.89 (3) (b) (intro.) The Under this section, the nonprofit agency may provide the following health care services:

AB995, s. 58 Section 58. 146.89 (3) (c) of the statutes is amended to read:

AB995,31,6 146.89 (3) (c) The Under this section, the nonprofit agency may not provide emergency medical services, hospitalization, or surgery, except as provided in par. (b) 8.

AB995, s. 59 Section 59. 146.89 (3) (d) (intro.) of the statutes is amended to read:

AB995,31,10 146.89 (3) (d) (intro.) The Under this section, the nonprofit agency shall provide health care services primarily to low-income persons who are uninsured and who are not recipients of any of the following:

AB995, s. 60 Section 60. 146.89 (3m) of the statutes is created to read:

AB995,31,14 146.89 (3m) All of the following apply to a volunteer health care provider whose joint application with a school board or relevant governing body is approved under sub. (2):

AB995,31,19 (a) Before providing health care services in a school, the volunteer health care provider shall provide to the school board or relevant governing body proof of satisfactory completion of any competency requirements that are relevant to the volunteer health care provider, as specified by the department of public instruction by rule.

AB995,31,21 (b) Under this section, the volunteer health care provider may provide only to students from 4-year-old kindergarten to grade 6 the following health care services:

AB995,31,23 1. Except as specified in par. (c), the health care services specified in sub. (3) (b) 1. to 5., 7., and 8.

AB995,31,24 2. First aid for illness or injury.

AB995,32,2 3. Except as specified in par. (c), the administration of drugs, as specified in s. 118.29 (2) (a) 1. to 3.

AB995,32,3 4. Health screenings.

AB995,32,5 5. Any other health care services designated by the department of public instruction by rule.

AB995,32,7 (c) Under this section, the volunteer health care provider may not provide any of the following:

AB995,32,8 1. Emergency medical services.

AB995,32,9 2. Hospitalization.

AB995,32,10 3. Surgery, except as provided in par. (b) 2. and 5.

AB995,32,11 4. A referral for abortion, as defined in s. 48.375.

AB995,32,12 5. A contraceptive article, as defined in s. 450.155 (1) (a).

AB995,32,13 6. A pregnancy test.

AB995,32,16 (d) Any health care services provided under par. (b) shall be provided without charge at the school and shall be available to all students from 4-year-old kindergarten to grade 6 regardless of income.

AB995, s. 61 Section 61. 441.07 (1) (d) of the statutes is amended to read:

AB995,32,20 441.07 (1) (d) Misconduct or unprofessional conduct. In this paragraph, "misconduct" and "unprofessional conduct" do not include the prescribing of an antibiotic drug as described in s. 448.035.