The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:
SECTION 1. 149.14 (5) (b) of the statutes is amended to read:
149.14 (5) (b) Except as provided in pars. (c) and (e), if the covered costs incurred in a calendar year by the an eligible person who is not eligible for Medicare exceed the deductible for major medical expense coverage in a calendar year, the plan shall pay at least 80% of any additional covered costs incurred by the person during the calendar year, and if the covered costs incurred in a calendar year by an eligible person who is eligible for Medicare exceed the deductible for major medical expense coverage or $2,000, whichever is less, the plan shall pay 100% of any additional covered costs incurred by the person during the calendar year.
SECTION 2. 149.14 (5) (c) of the statutes is amended to read:
149.14 (5) (c) Except as provided in par. (e), if the aggregate of the covered costs not paid by the plan under par. (b) and the deductible exceeds $500 for an eligible person receiving medicare, $2,000 for any other in a calendar year for an eligible person during a calendar year who is not eligible for Medicare, or $4,000 in a calendar year for all eligible persons in a family, the plan shall pay 100% of all covered costs incurred by the eligible person or the eligible persons in the family during the calendar year after the payment ceilings under this paragraph are exceeded.
SECTION 9421. Effective dates; health and family services.
(1) HEALTH INSURANCE RISK-SHARING PLAN DEDUCTIBLE. The treatment of section 149.14 (5) (b) and (c) of the statutes takes effect on January 1, 2006.
(End)
LRB-0270LRB-0270/1
PJK:jld:rs
2005 - 2006 LEGISLATURE
DOA:......Jablonsky, BB0040 - HIRSP eligibility
For 2005-07 Budget -- Not Ready For Introduction
2005 BILL
AN ACT ...; relating to: the budget.
Analysis by the Legislative Reference Bureau
Health and human services
Other health and human services
The Health Insurance Risk-Sharing Plan (HIRSP) under current law provides major medical health insurance coverage for persons who are covered under Medicare because they are disabled, persons who have tested positive for human immunodeficiency virus (HIV), persons who have been refused coverage, or coverage at an affordable price, in the private health insurance market because of their mental or physical health condition, as well as persons who do not currently have health insurance coverage, but who were covered under certain types of health insurance coverage for at least 18 months in the past. Specifically excluded from coverage under HIRSP are persons who are eligible for coverage under the Medical Assistance (MA) program, which is a program funded partially with state moneys and partially with federal moneys providing comprehensive, as well as various types of limited, health care services to persons who are eligible, which is generally based on a person's income.
This bill provides that persons who are eligible for only certain limited services provided under MA are not ineligible for HIRSP coverage because of their eligibility for those MA services, which include family planning services for low-income women between the ages of 15 and 44 years; payment of Medicare premiums, deductibles, and coinsurance for persons eligible for Medicare who meet the income and resource limitations; emergency medical services for persons who are not U.S. citizens; health care services for persons with tuberculosis who meet the income and resource requirements for the federal Supplemental Security Income program; and outpatient prenatal care for pregnant women who meet the income limitation.
The bill also specifically provides that persons who are eligible for the following programs or benefits are ineligible for HIRSP coverage: the Badger Care health care program (commonly known as BadgerCare), under which low-income families and children who do not reside with a parent receive comprehensive health care services; a program providing long-term care for children with disabilities and their families, including in-home habilitation services for children with autism spectrum disorders; the community integration programs commonly known as "CIP IA," "CIP IB," and "CIP II," under which persons who reside in state centers for the developmentally disabled or other institutions are relocated into their communities and provided home and community-based services; the waiver program under the Long-Term Support Community Options Program (commonly known as "COP-Waiver"), under which persons who are elderly, physically or developmentally disabled, chronically mentally ill, or chemically dependent receive long-term community support services; the Program for All-inclusive Care for the Elderly (known as PACE) or the Wisconsin Partnership Program (known as Partnership), both of which are managed care programs providing acute health and long-term care for elderly and disabled individuals who are eligible for nursing home care; and medical assistance provided under the Family Care Program, under which financial assistance is provided for long-term care and support items to persons who who have physical or developmental disabilities or infirmities of aging and who meet certain financial and functional criteria.
For further information see the state fiscal estimate, which will be printed as an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:
SECTION 1. 49.46 (1) (a) 15. of the statutes is amended to read:
49.46 (1) (a) 15. Any individual who is infected with tuberculosis and meets the income and resource eligibility requirements for the federal supplemental security Supplemental Security Income program under 42 USC 1381 to 1383d.
SECTION 2. 149.12 (2) (f) of the statutes is renumbered 149.12 (2) (f) 1. and amended to read:
149.12 (2) (f) 1. No Except as provided in subd. 2., no person who is eligible for medical assistance is eligible for coverage under the plan.
SECTION 3. 149.12 (2) (f) 2. of the statutes is created to read:
149.12 (2) (f) 2. Subdivision 1. does not apply to a person who is eligible for only any of the following types of medical assistance:
a. Family planning services under s. 49.45 (24r).
b. Care and services for the treatment of an emergency medical condition under 42 USC 1396b (v), as provided in s. 49.45 (27).
c. Medical assistance under s. 49.46 (1) (a) 15.
d. Ambulatory prenatal care under s. 49.465.
e. Medicare premium, coinsurance, and deductible payments under s. 49.46 (2) (c) 2. or 3., 49.468 (1) (b) or (c), or 49.47 (6) (a) 6. b. or c.
f. Medicare premium payments under s. 49.46 (2) (cm), 49.468 (1m) or (2), or 49.47 (6) (a) 6m.
SECTION 4. 149.12 (2) (g) of the statutes is created to read:
149.12 (2) (g) A person is not eligible for coverage under the plan if the person is eligible for any of the following:
1. Services under s. 46.27 (11), 46.275, 46.277, or 46.278.
2. Medical assistance provided as part of a family care benefit, as defined in s. 46.2805 (4).
3. Services provided under a waiver requested under 2001 Wisconsin Act 16, section 9123 (16rs), or 2003 Wisconsin Act 33, section 9124 (8c).
4. Services provided under the program of all-inclusive care for persons aged 55 or older authorized under 42 USC 1396u-4.
5. Services provided under the demonstration program under a federal waiver authorized under 42 USC 1315.
6. Health care coverage under the Badger Care health care program under s. 49.665.
(End)
LRB-0279LRB-0279/2
RAC:kjf:pg
2005 - 2006 LEGISLATURE
DOA:......Olsen-Hasek, BB0064 - Litigation costs funding
For 2005-07 Budget -- Not Ready For Introduction
2005 BILL
AN ACT ...; relating to: the budget.
Analysis by the Legislative Reference Bureau
REtirement and group insurance
Currently, the Employee Trust Funds Board may appoint outside legal counsel with the approval of the governor. This bill provides that the cost of such counsel is to be paid from moneys deposited in the public employee trust fund that are not otherwise appropriated for DETF operations.
For further information see the state fiscal estimate, which will be printed as an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:
SECTION 1. 20.515 (1) (r) of the statutes is amended to read:
20.515 (1) (r) Benefit and coverage payments. All moneys credited to the public employee trust fund for payment from the appropriate accounts and reserves of the fund of the benefits, contributions, insurance premiums, and refunds authorized by ch. 40 for the respective benefit plans and of the costs of legal counsel employed or selected under s. 40.03 (1) (c). Estimated disbursements under this paragraph shall not be included in the schedule under s. 20.005.
SECTION 2. 40.04 (2) (d) of the statutes is amended to read:
40.04 (2) (d) The costs of investing the assets of the benefit plans and retirement systems, including all costs due to s. 40.03 (1) (n), and the costs of legal counsel employed or selected under s. 40.03 (1) (c) shall be paid from the appropriation under s. 20.515 (1) (r) and charged directly against the appropriate investment income or reserve accounts of the benefit plan or retirement system receiving the services.
(End)
LRB-0280LRB-0280/1
RAC:jld:rs
2005 - 2006 LEGISLATURE
DOA:......Olsen-Hasek, BB0065 - DETF offices
For 2005-07 Budget -- Not Ready For Introduction
2005 BILL
AN ACT ...; relating to: the budget.
Analysis by the Legislative Reference Bureau
retirement and group health insurance
Current law requires DETF to maintain an office in Milwaukee. This bill eliminates this requirement.
For further information see the state fiscal estimate, which will be printed as an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:
SECTION 1. 15.16 (2) of the statutes is repealed.
SECTION 2. 40.03 (2) (b) of the statutes is amended to read:
40.03 (2) (b) Shall employ and select administrative, clerical or other employees as required for the administration of this chapter and establish the internal organization of the department, but the department shall always maintain an office in Milwaukee.
(End)
LRB-0281LRB-0281/2
RAC:kjf:pg
2005 - 2006 LEGISLATURE
DOA:......Olsen-Hasek, BB0066 - Gifts and grants
For 2005-07 Budget -- Not Ready For Introduction
2005 BILL
AN ACT ...; relating to: the budget.
Analysis by the Legislative Reference Bureau
retirement and group health insurance
This bill creates gifts and grants appropriations and an appropriation for the expenditure of federal moneys for DETF.
The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:
SECTION 1. 20.515 (1) (gm) of the statutes is created to read:
20.515 (1) (gm) Gifts and grants. All moneys received from gifts and grants to carry out the purposes for which made.
****NOTE: This SECTION involves a change in an appropriation that must be reflected in the revised schedule in s. 20.005, stats.
SECTION 2. 20.515 (1) (m) of the statutes is created to read:
20.515 (1) (m) Federal aid. All moneys received as federal aid, as authorized by the governor under s. 16.54, for operations and benefit programs under ch. 40.
****NOTE: This SECTION involves a change in an appropriation that must be reflected in the revised schedule in s. 20.005, stats.
SECTION 3. 20.515 (1) (sr) of the statutes is created to read:
20.515 (1) (sr) Gifts and grants; public employee trust fund. All moneys received from gifts and grants that are required to be deposited in the public employee trust fund to carry out the purposes for which made.
****NOTE: This SECTION involves a change in an appropriation that must be reflected in the revised schedule in s. 20.005, stats.
(End)
LRB-0282LRB-0282/1
RAC:wlj:rs
2005 - 2006 LEGISLATURE
DOA:......Olsen-Hasek, BB0067 - Reference to head of OSER
For 2005-07 Budget -- Not Ready For Introduction
