LRBb0319LRBb0319/1
PJK:lmk:ch
2005 - 2006 LEGISLATURE
LFB:......Moore - Increase copayment for generic drugs under MA and BadgerCare to $3
For 2005-07 Budget -- Not Ready For Introduction
ASSEMBLY AMENDMENT ,
TO 2005 ASSEMBLY BILL 100
At the locations indicated, amend the bill as follows:
1.
Page 558, line 20: after that line insert:
"SECTION 1144p. 49.45 (18) (ag) 1. of the statutes is amended to read:
49.45 (18) (ag) 1. A copayment of $1 $3 for each prescription of a drug that bears only a generic name, as defined in s. 450.12 (1) (b).".
2.
Page 571, line 21: after that line insert:
"SECTION 1184c. 49.665 (5) (am) 1. of the statutes is amended to read:
49.665 (5) (am) 1. A copayment of $1 $3 for each prescription of a drug that bears only a generic name, as defined in s. 450.12 (1) (b).".
3.
Page 1113, line 18: after that line insert:
"(9w) GENERIC DRUG COPAYMENTS FOR MEDICAL ASSISTANCE AND BADGER CARE. The treatment of sections 49.45 (18) (ag) 1. and 49.665 (5) (am) 1. of the statutes first applies to drug prescriptions that are filled on the effective date of this subsection.".
4.
Page 1125, line 25: after that line insert:
"(11w) GENERIC DRUG COPAYMENTS FOR MEDICAL ASSISTANCE AND BADGER CARE. The treatment of sections 49.45 (18) (ag) 1. and 49.665 (5) (am) 1. of the statutes and SECTION 9321 (9w) of this act take effect on October 1, 2005.".
(End)
LRBb0320LRBb0320/2
PJK:cjs:rs
2005 - 2006 LEGISLATURE
LFB:......Moore - Coverage of bariatric (gastric bypass) surgery under MA and BadgerCare
For 2005-07 Budget -- Not Ready For Introduction
ASSEMBLY AMENDMENT ,
TO 2005 ASSEMBLY BILL 100
At the locations indicated, amend the bill as follows:
1.
Page 559, line 9: after that line insert:
"SECTION 1146j. 49.45 (27) of the statutes is amended to read:
49.45 (27) ELIGIBILITY OF ALIENS. A person who is not a U.S. citizen or an alien lawfully admitted for permanent residence or otherwise permanently residing in the United States under color of law may not receive medical assistance benefits except as provided under 8 USC 1255a (h) (3) or 42 USC 1396b (v), subject to s. 49.46 (2) (f).".
2.
Page 562, line 23: after that line insert:
"SECTION 1157j. 49.46 (2) (f) of the statutes is amended to read:
49.46 (2) (f) Benefits under this subsection or s. 49.45 (27) may not include payment for gastric bypass surgery or gastric stapling surgery unless it is performed because of a medical emergency the procedure is required to be covered under federal medicaid law, as interpreted by the federal centers for medicare and medicaid services.".
3.
Page 1113, line 18: after that line insert:
"(9q) COVERAGE OF BARIATRIC SURGERY UNDER MEDICAL ASSISTANCE. The treatment of sections 49.45 (27) and 49.46 (2) (f) of the statutes first applies to surgeries performed on the effective date of this subsection.".
(End)
LRBb0321LRBb0321/2
PJK:wlj:jf
2005 - 2006 LEGISLATURE
LFB:......Moore - Requiring DHFS to substantiate reductions in duration of occupational and physical therapy services for MA
For 2005-07 Budget -- Not Ready For Introduction
ASSEMBLY AMENDMENT ,
TO 2005 ASSEMBLY BILL 100
At the locations indicated, amend the bill as follows:
1.
Page 561, line 5: after that line insert:
"SECTION 1149f. 49.45 (42m) of the statutes is created to read:
49.45 (42m) PHYSICAL AND OCCUPATIONAL THERAPY. (a) If, in authorizing the provision of physical or occupational therapy services under s. 49.46 (2) (b) 6. b., the department authorizes a reduced duration of services from the duration that the provider specifies in the authorization request, the department shall substantiate the reduction that the department made in the duration of the services if the provider of the services requests any additional authorizations for the provision of physical or occupational therapy services to the same individual.
(b) The division of the department that is responsible for health care financing shall monitor compliance with the requirement under par. (a) in concert with representatives of the Wisconsin Physical Therapy Association and the Wisconsin Occupational Therapy Association.".
2.
Page 1113, line 18: after that line insert:
"(9k) AUTHORIZATION REQUESTS FOR PHYSICAL AND OCCUPATIONAL THERAPY SERVICES. The treatment of section 49.45 (42m) of the statutes first applies to durational reductions made with respect to authorization requests that are received by the department of health and family services on the effective date of this subsection.".
(End)
LRBb0322LRBb0322/2
DAK&RLR:lmk:pg
2005 - 2006 LEGISLATURE
LFB:......Moore - Nursing home rates and bed assessment
For 2005-07 Budget -- Not Ready For Introduction
ASSEMBLY AMENDMENT ,
TO 2005 ASSEMBLY BILL 100
At the locations indicated, amend the bill as follows:
1.
Page 394, line 14: delete "All In each fiscal year, all except $13,800,000 of the" and substitute "All".
2.
Page 592, line 11: delete lines 11 to 23 and substitute:
"SECTION 1222m. 50.14 (2) (intro.) of the statutes is amended to read:
50.14 (2) (intro.) For the privilege of doing business in this state, there is imposed on all licensed beds of a facility an assessment that may not exceed $445 per calendar month per licensed bed of an intermediate care facility for the mentally retarded may not exceed $435 in fiscal year 2003-04 and may not exceed $445 in fiscal year 2004-05 and an assessment that may not exceed $75 per calendar month per licensed bed of a nursing home. The assessment moneys collected shall be deposited in the general fund, except that in fiscal year 2003-04, amounts in excess of $14,300,000, in fiscal year 2004-05, amounts in excess of $13,800,000, and, beginning July 1, 2005, in each fiscal year, amounts in excess of 45% of the money received from the assessment shall be deposited in the Medical Assistance trust fund. In determining the number of licensed beds, all of the following apply:".
3.
Page 593, line 3: delete "the" and substitute "the".
4.
Page 593, line 4: delete that line and substitute "amount of any assessment collected under s. 77.59".
(End)
LRBb0323LRBb0323/1
DAK:cjs:rs
2005 - 2006 LEGISLATURE
LFB:......Moore - HMO assessment and rate increase; capitation rates
For 2005-07 Budget -- Not Ready For Introduction
ASSEMBLY AMENDMENT ,
TO 2005 ASSEMBLY BILL 100
At the locations indicated, amend the bill as follows:
1.
Page 394, line 18: delete lines 18 to 20.
2.
Page 550, line 17: delete the material beginning with that line and ending with page 552, line 13.
3.
Page 552, line 14: after that line insert:
"SECTION 1124g. 49.45 (3) (m) of the statutes is created to read:
49.45 (3) (m) Reimbursement for services provided by a health maintenance organization, as defined in s. 609.01 (2), with a contract under sub. (2) (b) 2. to provide health care to recipients of Medical Assistance or Badger Care, shall be made under capitation rates that are actuarially sound.".
4.
Page 1078, line 3: delete lines 3 to 19.
5.
Page 1113, line 10: delete lines 10 to 12.
(End)
LRBb0324LRBb0324/2
DAK:lmk&cs:jf
2005 - 2006 LEGISLATURE
LFB:......Moore - EACH supplement eligibility
For 2005-07 Budget -- Not Ready For Introduction
ASSEMBLY AMENDMENT ,
TO 2005 ASSEMBLY BILL 100
At the locations indicated, amend the bill as follows:
1.
Page 555, line 10: after that line insert:
"SECTION 1135c. 49.45 (6x) (title) of the statutes is amended to read:
49.45 (6x) (title) FUNDING FOR ESSENTIAL ACCESS CITY HOSPITAL HOSPITALS.".
2.
Page 555, line 11: delete lines 11 to 17 and substitute:
"SECTION 1135d. 49.45 (6x) (a) of the statutes is amended to read:
49.45 (6x) (a) Notwithstanding sub. (3) (e), from the appropriation accounts under s. 20.435 (4) (b), (gp), (o), and (w), the department shall distribute not more than $4,748,000 in each fiscal year, to provide funds to an essential access city hospital hospitals, except that the department may not allocate funds to an essential access city hospital to the extent that the allocation would exceed any limitation under 42 USC 1396b (i) (3).
SECTION 1135e. 49.45 (6x) (b) of the statutes is amended to read:
49.45 (6x) (b) The department shall develop procedures for solicitation and review of requests for funds and a method to distribute the funds under par. (a) to an individual hospital hospitals that shall include establishment of criteria for the designation as an essential access city hospital. Beginning on July 1, 2007, the criteria established by the department may not include reference to criteria that were required to have been met during July 1, 1995, to June 30, 1996, but shall include the requirement that more than 30 percent of a hospital's total inpatient days are reimbursable under Medical Assistance. No hospital that qualifies for a Medical Assistance pediatric inpatient supplement is eligible for funds under this subsection.".
(End)
LRBb0325LRBb0325/2
RLR:wlj:pg
2005 - 2006 LEGISLATURE
LFB:......Moore - MA, BadgerCare and Senior Care reimbursement for prescription drugs
For 2005-07 Budget -- Not Ready For Introduction
ASSEMBLY AMENDMENT ,
TO 2005 ASSEMBLY BILL 100
At the locations indicated, amend the bill as follows:
1.
Page 572, line 7: delete lines 7 to 11.
2.
Page 1082, line 16: after that line insert:
"(14k) PROHIBITION AGAINST LIMITATIONS ON MEDICAL ASSISTANCE REIMBURSEMENT FOR PSYCHOTROPIC MEDICATIONS. During the 2005-07 fiscal biennium, the department of health and family services may not impose new limitations on reimbursement under the Medical Assistance Program, Badger Care, or the program under section 49.688 of the statutes for psychotropic medications, other than stimulants and related agents or selective serotonin reuptake inhibitors, that are prescribed to treat a mental illness.
(14p) REPORT ON PHYSICIAN PRESCRIBING PRACTICES UNDER MEDICAL ASSISTANCE. By January 1, 2006, the department of health and family services shall submit to the joint committee on finance and, in the manner provided under section 13.172 (3) of the statutes, the appropriate standing committees of the legislature a report that includes the following information for each physician who is a certified provider of Medical Assistance, concerning prescriptions written by the physician in fiscal year 2004-05 for recipients of the Medical Assistance Program or Badger Care:
(a) The percentage of the prescriptions written for generic drugs and the percentage written for nongeneric drugs.
(b) The number and percentage of the prescriptions that required prior authorization.
(c) Of the prescriptions written for drugs for which a generic drug was available, the number and percentage that specified a nongeneric drug.".
3.
Page 1112, line 12: delete lines 12 to 14.
(End)
LRBb0326LRBb0326/4
DAK:lmk:pg
2005 - 2006 LEGISLATURE
LFB:......Carmichael - Inmate release MA mental health pilot program
For 2005-07 Budget -- Not Ready For Introduction
ASSEMBLY AMENDMENT ,
TO 2005 ASSEMBLY BILL 100
At the locations indicated, amend the bill as follows:
1.
Page 1082, line 16: after that line insert:
"(14x) INMATE MENTAL HEALTH SERVICES PILOT PROGRAM.(a) The department of health and family services shall in state fiscal year 2006-07 provide reimbursement for the provision of Medical Assistance-reimbursable services to up to 12 eligible inmates with severe and persistent mental illness following release from the Wisconsin Resource Center. Services provided to participants under the program under this subsection shall include all of the following:
1. Intensive case management, treatment, and support services.
2. Access to safe, secure residences.
3. Medication and medication monitoring.
