SB44: Bill Text

SB44,625,21 1. A copayment of $1 for each prescription of a drug that bears only a generic name, as defined in s. 450.12 (1) (b).

SB44,625,23 2. A copayment of $3 for each prescription of a drug that bears a brand name, as defined in s. 450.12 (1) (a).

SB44, s. 1423 Section 1423. 49.68 (3) (a) of the statutes is amended to read:

SB44,626,4 49.68 (3) (a) Any Subject to s. 49.687 (1m), any permanent resident of this state who suffers from chronic renal disease may be accepted into the dialysis treatment phase of the renal disease control program if the resident meets standards set by rule under sub. (2) and s. 49.687.

SB44, s. 1424 Section 1424. 49.68 (3) (d) 1. of the statutes is amended to read:

SB44,626,19 49.68 (3) (d) 1. No aid may be granted under this subsection unless the recipient has no other form of aid available from the federal medicare program or, from private health, accident, sickness, medical, and hospital insurance coverage, or from other health care coverage specified by rule under s. 49.687 (1m) (b). If insufficient aid is available from other sources and if the recipient has paid an amount equal to the annual medicare deductible amount specified in subd. 2., the state shall pay the difference in cost to a qualified recipient. If at any time sufficient federal or private insurance aid or other health care coverage becomes available during the treatment period, state aid under this subsection shall be terminated or appropriately reduced. Any patient who is eligible for the federal medicare program shall register and pay the premium for medicare medical insurance coverage where permitted, and shall pay an amount equal to the annual medicare deductible amounts required under 42 USC 1395e and 1395L (b), prior to becoming eligible for state aid under this subsection.

SB44, s. 1425 Section 1425. 49.68 (3) (d) 3. of the statutes is created to read:

SB44,626,25 49.68 (3) (d) 3. No payment shall be made under this subsection for any portion of medical treatment costs or other expenses that are payable under any state, federal, or other health care coverage program, including a health care coverage program specified by rule under s. 49.687 (1m) (b), or under any grant, contract, or other contractual arrangement.

SB44, s. 1426 Section 1426. 49.68 (3) (e) of the statutes is amended to read:

SB44,627,13 49.68 (3) (e) State aids for services provided under this section shall be equal to may not exceed the allowable charges under the federal medicare program. In no case shall state rates for individual service elements exceed the federally defined allowable costs. The rate of charges for services not covered by public and private insurance shall not exceed the reasonable charges as established by medicare fee determination procedures. A person that provides to a patient a service for which aid is provided under this section shall accept the amount paid under this section for the service as payment in full and may not bill the patient for any amount by which the charge for the service exceeds the amount paid for the service under this section. The state may not pay for the cost of travel, lodging, or meals for persons who must travel to receive inpatient and outpatient dialysis treatment for kidney disease. This paragraph shall not apply to donor related costs as defined in par. (b).

SB44, s. 1427 Section 1427. 49.682 (6) of the statutes is amended to read:

SB44,627,16 49.682 (6) The department may contract with or employ retain an attorney to probate estates to recover under this section the costs of care.

SB44, s. 1428 Section 1428. 49.683 (1) of the statutes is amended to read:

SB44,627,21 49.683 (1) The Subject to s. 49.687 (1m), the department may provide financial assistance for costs of medical care of persons over the age of 18 years with the diagnosis of cystic fibrosis who meet financial requirements established by the department by rule under s. 49.687 (1).

SB44, s. 1429 Section 1429. 49.683 (3) of the statutes is created to read:

SB44,628,2 49.683 (3) No payment shall be made under this section for any portion of medical care costs that are payable under any state, federal, or other health care coverage program, including a health care coverage program specified by rule under s. 49.687 (1m) (b), or under any grant, contract, or other contractual arrangement.

SB44, s. 1430 Section 1430. 49.685 (6) (b) of the statutes is amended to read:

SB44,628,11 49.685 (6) (b) Reimbursement shall not be made under this section for any blood products or supplies which that are not purchased from or provided by a comprehensive hemophilia treatment center, or a source approved by the treatment center. Reimbursement shall not be made under this section for any portion of the costs of blood products or supplies which that are payable under any other state or, federal program, or other health care coverage program, including a health care coverage program specified by rule under s. 49.687 (1m) (b), or under any grant, contract and any, or other contractual arrangement.

SB44, s. 1431 Section 1431. 49.687 (title) of the statutes is amended to read:

SB44,628,14 49.687 (title) Disease aids; patient requirements; rebate agreements; cost containment.

SB44, s. 1432 Section 1432. 49.687 (1) of the statutes is amended to read:

SB44,629,3 49.687 (1) The department shall promulgate rules that require a person who is eligible for benefits under s. 49.68, 49.683, or 49.685 and whose current estimated total family income exceeds specified limits for the current year is at or above 200% of the poverty line to obligate or expend specified portions of the income for medical care for treatment of kidney disease, cystic fibrosis, or hemophilia before receiving benefits under s. 49.68, 49.683, or 49.685. The rules shall require a person to pay 1% of his or her total family income for the cost of medical treatment covered under s. 49.68, 49.683, or 49.685 if that income is from 300% to 325% of the federal poverty line, 1.75% if that income is more than 325% but not more than 350% of the federal poverty line, 2.5% if that income is more than 350% but not more than 375% of the federal poverty line, 3.25% if that income is more than 375% but not more than 400% of the federal poverty line, and 4.25% if that income is more than 400% of the federal poverty line.

SB44, s. 1433 Section 1433. 49.687 (1m) of the statutes is created to read:

SB44,629,9 49.687 (1m) (a) A person is not eligible to receive benefits under s. 49.68, 49.683, or 49.685 unless, before the person applies for benefits under s. 49.68, 49.683, or 49.685, the person first applies for benefits under all other health care coverage programs specified by the department by rule under par. (b) for which the person reasonably may be eligible.

SB44,629,15 (b) The department shall promulgate rules that specify other health care coverage programs for which a person must apply before applying for benefits under s. 49.68, 49.683, or 49.685. The programs specified by rule must include the Medical Assistance program under subch. IV, the Badger Care health care program under s. 49.665, and the prescription drug assistance for elderly persons program under s. 49.688.

SB44,629,23 (c) Using the procedure under s. 227.24, the department may promulgate rules under par. (b) for the period before the effective date of any permanent rules promulgated under par. (b), but not to exceed the period authorized under s. 227.24 (1) (c) and (2). Notwithstanding s. 227.24 (1) (a), (2) (b), and (3), the department is not required to provide evidence that promulgating a rule under par. (b) as an emergency rule is necessary for the preservation of the public peace, health, safety, or welfare and is not required to make a finding of emergency for promulgating a rule under par. (b) as an emergency rule.

SB44, s. 1434 Section 1434. 49.687 (2) of the statutes is amended to read:

SB44,630,10 49.687 (2) The department shall develop and implement a sliding scale of patient liability for kidney disease aid under s. 49.68, cystic fibrosis aid under s. 49.683, and hemophilia treatment under s. 49.685, based on the patient's ability to pay for treatment. To The department shall continuously review the sliding scale for patient liability and revise it as needed to ensure that the needs for treatment of patients with lower incomes receive priority within the availability of funds amounts budgeted under s. 20.435 (4) (e) and (je), the department shall revise the sliding scale for patient liability by January 1, 1994, and shall, every 3 years thereafter by January 1, review and, if necessary, revise the sliding scale are sufficient to cover treatment costs.

SB44, s. 1435 Section 1435. 49.687 (2m) of the statutes is created to read:

SB44,630,16 49.687 (2m) If a pharmacy directly bills the department or an entity with which the department contracts for a drug supplied to a person receiving benefits under s. 49.68, 49.683, or 49.685 and prescribed for treatment covered under s. 49.68, 49.683, or 49.685, the person shall pay a $5 copayment amount for each such generic drug and a $15 copayment amount for each such brand name drug.

SB44, s. 1436 Section 1436. 49.687 (3) (a) of the statutes is amended to read:

SB44,630,24 49.687 (3) (a) That, as a condition of coverage for prescription drugs of a manufacturer under s. 49.68, 49.683, or 49.685, the manufacturer shall make rebate payments for each prescription drug of the manufacturer that is prescribed for and purchased by persons who meet eligibility criteria under s. 49.68, 49.683, or 49.685, to the state treasurer secretary of administration to be credited to the appropriation under s. 20.435 (4) (je), each calendar quarter or according to a schedule established by the department.

SB44, s. 1437 Section 1437. 49.687 (4) of the statutes is created to read:

SB44,631,2 49.687 (4) The department may adopt managed care methods of cost containment for the programs under ss. 49.68, 49.683, and 49.685.

SB44, s. 1438 Section 1438. 49.688 (1) (e) of the statutes is amended to read:

SB44,631,7 49.688 (1) (e) "Program payment rate" means the rate of payment made for the identical drug specified under s. 49.46 (2) (b) 6. h., plus 5%, plus a dispensing fee that is equal to the dispensing fee permitted to be charged for prescription drugs for which coverage is provided under s. 49.46 (2) (b) 6. h.

SB44, s. 1439 Section 1439. 49.688 (3) (a) of the statutes is renumbered 49.688 (3) (a) (intro.) and amended to read:

SB44,631,13 49.688 (3) (a) (intro.) For each 12-month benefit period, a program enrollment fee of $20. that is based on the percentage that a person's annual household income, as determined by the department, is of the federal poverty line for a family the size of the person's eligible family, as follows:

SB44, s. 1440 Section 1440. 49.688 (3) (a) 1. of the statutes is created to read:

SB44,631,15 49.688 (3) (a) 1. Two hundred percent or less, $25.

SB44, s. 1441 Section 1441. 49.688 (3) (a) 2. of the statutes is created to read:

SB44,631,17 49.688 (3) (a) 2. More than 200%, $30.

SB44, s. 1442 Section 1442. 49.688 (3) (b) 1. of the statutes is renumbered 49.688 (3) (b) 1. (intro.) and amended to read:

SB44,631,24 49.688 (3) (b) 1. (intro.) For each 12-month benefit period, for a person specified in sub. (2) (a), a deductible for prescription drugs of $500, except that a person whose that is based on the percentage that a person's annual household income, as determined by the department, is 160% or less of the federal poverty line for a family the size of the person's eligible family pays no deductible., as follows:

SB44, s. 1443 Section 1443. 49.688 (3) (b) 1. a. of the statutes is created to read:

SB44,632,1 49.688 (3) (b) 1. a. One hundred sixty percent or less, no deductible.

SB44, s. 1444 Section 1444. 49.688 (3) (b) 1. b. of the statutes is created to read:

SB44,632,3 49.688 (3) (b) 1. b. More than 160%, but not more than 200%, $500.

SB44, s. 1445 Section 1445. 49.688 (3) (b) 1. c. of the statutes is created to read:

SB44,632,5 49.688 (3) (b) 1. c. More than 200%, but not more than 240%, $750.

SB44, s. 1446 Section 1446. 49.688 (3) (b) 2. b. of the statutes is amended to read:

SB44,632,7 49.688 (3) (b) 2. b. Five Eight hundred fifty dollars.

SB44, s. 1447 Section 1447. 49.688 (6) (a) of the statutes is amended to read:

SB44,632,15 49.688 (6) (a) That, except as provided in sub. (7) (b), the manufacturer shall make rebate payments for each prescription drug of the manufacturer that is prescribed for and purchased by persons who meet criteria under sub. (2) (a) and persons who meet criteria under sub. (2) (b) and have paid the deductible under sub. (3) (b) 2. a., to the state treasurer secretary of administration to be credited to the appropriation account under s. 20.435 (4) (j), each calendar quarter or according to a schedule established by the department.

SB44, s. 1448 Section 1448 . 49.78 (5) of the statutes, as affected by 2003 Wisconsin Act .... (this act), is amended to read:

SB44,632,25 49.78 (5) Personnel examinations. Statewide examinations to ascertain qualifications of applicants in any county department administering aid to families with dependent children shall be given by the administrator of the division of merit recruitment and selection in the department of employment relations administration. The department of employment relations administration shall be reimbursed for actual expenditures incurred in the performance of its functions under this section from the appropriations available to the department of health and family services for administrative expenditures.

SB44, s. 1449 Section 1449. 49.785 (1) (intro.) of the statutes, as affected by 2003 Wisconsin Act .... (this act), is amended to read:

SB44,633,11 49.785 (1) (intro.) Except as provided in sub. (1m), if any recipient of a stipend under s. 49.147 (3m) (g) or of benefits or wages under s. 49.148, 49.46, or 49.77, or under 42 USC 1381 to 1385 in effect on May 8, 1980, dies and the estate of the deceased recipient is insufficient to pay the funeral, burial, and cemetery expenses of the deceased recipient, the county or applicable tribal governing body or organization responsible for burial of the recipient shall pay, to the person designated by the county department under s. 46.215, 46.22, or 46.23 or applicable tribal governing body or organization responsible for the burial of the recipient, all of the following:

SB44, s. 1450 Section 1450. 49.79 (4) of the statutes is amended to read:

SB44,633,17 49.79 (4) Deductions from county income maintenance payments. The department shall withhold the value of food stamp losses for which a county or federally recognized American Indian tribe is liable under sub. (3) from the payment to the county or tribe under income maintenance contracts under s. 49.33 49.78 and reimburse the federal government from the funds withheld.

SB44, s. 1451 Section 1451. 49.85 (title) of the statutes is amended to read:

SB44,633,20 49.85 (title) Certification of certain public assistance overpayments and delinquent loan repayments.

SB44, s. 1452 Section 1452. 49.85 (1) of the statutes is amended to read:

SB44,634,7 49.85 (1) Department notification requirement. If a county department under s. 46.215, 46.22, or 46.23 or a governing body of a federally recognized American Indian tribe or band determines that the department of health and family services may recover an amount under s. 49.497 or that the department of workforce development may recover an amount under s. 49.161, 49.195 (3), or 49.793, or collect an amount under s. 49.147 (6) (cm), the county department or governing body shall notify the affected department of the determination. If a Wisconsin works agency determines that the department of workforce development may recover an amount under s. 49.161 or 49.195 (3), or collect an amount under s. 49.147 (6) (cm), the Wisconsin works agency shall notify the department of workforce development of the determination.

SB44, s. 1453 Section 1453 . 49.85 (1) of the statutes, as affected by 2003 Wisconsin Act .... (this act), is amended to read:

SB44,634,20 49.85 (1) Department notification requirement. If a county department under s. 46.215, 46.22, or 46.23 or a governing body of a federally recognized American Indian tribe or band determines that the department of health and family services may recover an amount under s. 49.497 or that the department of workforce development may recover an amount under s. 49.161, 49.195 (3), or 49.793, or collect an amount under s. 49.147 (6) (cm) 49.1471 (3m), the county department or governing body shall notify the affected department of the determination. If a Wisconsin works agency determines that the department of workforce development may recover an amount under s. 49.161 or 49.195 (3), or collect an amount under s. 49.147 (6) (cm) 49.1471 (3m), the Wisconsin works agency shall notify the department of workforce development of the determination.

SB44, s. 1454 Section 1454. 49.85 (2) (b) of the statutes is amended to read:

SB44,635,5 49.85 (2) (b) At least annually, the department of workforce development shall certify to the department of revenue the amounts that, based on the notifications received under sub. (1) and on other information received by the department of workforce development, the department of workforce development has determined that it may recover under ss. 49.161, 49.195 (3), and 49.793, and collect under s. 49.147 (6) (cm), except that the department of workforce development may not certify an amount under this subsection unless it has met the notice requirements under sub. (3) and unless its determination has either not been appealed or is no longer under appeal.

SB44, s. 1455 Section 1455 . 49.85 (2) (b) of the statutes, as affected by 2003 Wisconsin Act .... (this act), is amended to read:

SB44,635,16 49.85 (2) (b) At least annually, the department of workforce development shall certify to the department of revenue the amounts that, based on the notifications received under sub. (1) and on other information received by the department of workforce development, the department of workforce development has determined that it may recover under ss. 49.161, 49.195 (3), and 49.793, and collect under s. 49.147 (6) (cm) 49.1471 (3m), except that the department of workforce development may not certify an amount under this subsection unless it has met the notice requirements under sub. (3) and unless its determination has either not been appealed or is no longer under appeal.

SB44, s. 1456 Section 1456. 49.85 (3) (b) (intro.) of the statutes is amended to read:

SB44,635,21 49.85 (3) (b) (intro.) At least 30 days before certification of an amount, the department of workforce development shall send a notice to the last-known address of the person from whom that department intends to recover or collect the amount. The notice shall do all of the following:

SB44, s. 1457 Section 1457. 49.85 (3) (b) 1. of the statutes is amended to read:

SB44,636,2 49.85 (3) (b) 1. Inform the person that the department of workforce development intends to certify to the department of revenue an amount that the department of workforce development has determined to be due under s. 49.161, 49.195 (3), or 49.793, or to be delinquent under a repayment agreement for a loan under s. 49.147 (6), for setoff from any state tax refund that may be due the person.

SB44, s. 1458 Section 1458 . 49.85 (3) (b) 1. of the statutes, as affected by 2003 Wisconsin Act .... (this act), is amended to read:

SB44,636,10 49.85 (3) (b) 1. Inform the person that the department of workforce development intends to certify to the department of revenue an amount that the department of workforce development has determined to be due under s. 49.161, 49.195 (3), or 49.793, or to be delinquent under a repayment agreement for a loan under s. 49.147 (6) 49.1471, for setoff from any state tax refund that may be due the person.

SB44, s. 1459 Section 1459. 49.85 (5) of the statutes is amended to read:

SB44,636,20 49.85 (5) Effect of certification. Receipt of a certification by the department of revenue shall constitute a lien, equal to the amount certified, on any state tax refunds or credits owed to the obligor. The lien shall be foreclosed by the department of revenue as a setoff under s. 71.93. Certification of an amount under this section does not prohibit the department of health and family services or the department of workforce development from attempting to recover or collect the amount through other legal means. The department of health and family services or the department of workforce development shall promptly notify the department of revenue upon recovery or collection of any amount previously certified under this section.

SB44, s. 1460 Section 1460. 49.854 (11) (b) of the statutes is amended to read:

SB44,637,2 49.854 (11) (b) The department. The department may assess a collection fee to recover the department's costs incurred in levying against property under this section. The department shall determine its costs to be paid in all cases of levy. The obligor is liable to the department for the amount of the collection fee authorized under this paragraph. Fees collected under this paragraph shall be credited to the appropriation account under s. 20.445 (1) (L) (3) (ja).

SB44, s. 1461 Section 1461. 49.95 (4m) (a) of the statutes is amended to read:

SB44,637,9 49.95 (4m) (a) Without legal authority, sends or brings a person to a county, tribal governing body, or municipality or advises a person to go to a county, tribal governing body, or municipality for the purpose of obtaining relief funded by a relief block grant, wages, a stipend, or benefits under the Wisconsin works Works program under ss. 49.141 to 49.161, aid to families with dependent children under s. 49.19, medical assistance under subch. IV, or food stamps under 7 USC 2011 to 2029.

SB44, s. 1462 Section 1462. 49.95 (11) of the statutes is amended to read:

SB44,637,12 49.95 (11) "Public assistance" as used in this section includes relief funded by a relief block grant and wages, a stipend, or benefits under ss. 49.141 to 49.161.