LRBb1284/2
DAK/RLR/ARG:cjs&wlj:rs
March 2008 Special Session
2007 - 2008 LEGISLATURE
SENATE AMENDMENT 2,
TO SENATE AMENDMENT 1,
TO ASSEMBLY BILL 1
March 25, 2008 - Offered by Senators Miller and Decker.
AB1-SA1-SA2,1,7
7"
Section 9aim. 25.77 (11) of the statutes is created to read:
AB1-SA1-SA2,1,108
25.77
(11) In fiscal year 2007-08, $58,500,000, and in fiscal year 2008-09 and
9every fiscal year thereafter, $65,000,000, as adjusted, if necessary, to comply with s.
1050.375 (6), that is transferred from the hospital assessment fund.".
AB1-SA1-SA2,2,2
115. Page 4, line 6: after "hospitals." insert "From the hospital assessment fund
12there is transferred to the Medical Assistance trust fund $58,500,000 in fiscal year
12007-08 and $65,000,000 in fiscal year 2008-09 and every fiscal year thereafter, as
2adjusted, if necessary, to comply with s. 50.375 (6).".
AB1-SA1-SA2,2,5
5"
Section 9ajg. 46.27 (9) (a) of the statutes is amended to read:
AB1-SA1-SA2,2,146
46.27
(9) (a) The department may select up to 5 counties that volunteer to
7participate in a pilot project under which they will receive certain funds allocated for
8long-term care. The department shall allocate a level of funds to these counties
9equal to the amount that would otherwise be paid under s. 20.435 (4) (b)
, (gp), or (w),
10to nursing homes for providing care because of increased utilization of nursing home
11services, as estimated by the department. In estimating these levels, the department
12shall exclude any increased utilization of services provided by state centers for the
13developmentally disabled. The department shall calculate these amounts on a
14calendar year basis under sub. (10).
AB1-SA1-SA2,2,2116
46.27
(10) (a) 1. The department shall determine for each county participating
17in the pilot project under sub. (9) a funding level of state medical assistance
18expenditures to be received by the county. This level shall equal the amount that the
19department determines would otherwise be paid under s. 20.435 (4) (b)
, (gp), or (w),
20or because of increased utilization of nursing home services, as estimated by the
21department.
AB1-SA1-SA2,3,423
46.275
(5) (a) Medical Assistance reimbursement for services a county, or the
24department under sub. (3r), provides under this program is available from the
1appropriation accounts under s. 20.435 (4) (b),
(gp), (o), and (w). If 2 or more counties
2jointly contract to provide services under this program and the department approves
3the contract, Medical Assistance reimbursement is also available for services
4provided jointly by these counties.
AB1-SA1-SA2,3,126
46.275
(5) (c) The total allocation under s. 20.435 (4) (b),
(gp), (o), and (w) to
7counties and to the department under sub. (3r) for services provided under this
8section may not exceed the amount approved by the federal department of health and
9human services. A county may use funds received under this section only to provide
10services to persons who meet the requirements under sub. (4) and may not use
11unexpended funds received under this section to serve other developmentally
12disabled persons residing in the county.
AB1-SA1-SA2,3,1714
46.283
(5) Funding. From the appropriation accounts under s. 20.435 (4) (b),
15(bm),
(gp), (pa), and (w) and (7) (b), (bd), and (md), the department may contract with
16organizations that meet standards under sub. (3) for performance of the duties under
17sub. (4) and shall distribute funds for services provided by resource centers.
AB1-SA1-SA2,4,220
46.284
(5) (a) From the appropriation accounts under s. 20.435 (4) (b), (g),
(gp), 21(im), (o), and (w) and (7) (b), (bd), and (g), the department shall provide funding on
22a capitated payment basis for the provision of services under this section.
23Notwithstanding s. 46.036 (3) and (5m), a care management organization that is
24under contract with the department may expend the funds, consistent with this
1section, including providing payment, on a capitated basis, to providers of services
2under the family care benefit.
AB1-SA1-SA2,4,94
46.485
(2g) (intro.) From the appropriation
accounts account under s. 20.435
5(4) (b)
and (gp), the department may in each fiscal year transfer funds to the
6appropriation under s. 20.435 (7) (kb) for distribution under this section and from the
7appropriation
account under s. 20.435 (7) (mb) the department
may not shall 8distribute
more than $1,330,500 in each fiscal year to applying counties in this state
9that meet all of the following requirements, as determined by the department:".
AB1-SA1-SA2,4,11
11"
Section 9bfg. 49.45 (2) (a) 17. of the statutes is amended to read:
AB1-SA1-SA2,4,1612
49.45
(2) (a) 17. Notify the governor, the joint committee on legislative
13organization, the joint committee on finance and appropriate standing committees,
14as determined by the presiding officer of each house, if the appropriation
accounts 15account under s. 20.435 (4) (b)
and (gp) are is insufficient to provide the state share
16of medical assistance.
AB1-SA1-SA2,5,319
49.45
(5m) (am) Notwithstanding sub. (3) (e), from the appropriation accounts
20under s. 20.435 (4) (b),
(gp), (o), and (w), the department shall distribute not more
21than
$2,256,000 $5,256,000 in
each fiscal year
2007-08 and each fiscal year
22thereafter, to provide supplemental funds to rural hospitals that, as determined by
23the department, have high utilization of inpatient services by patients whose care
24is provided from governmental sources,
and to provide supplemental funds to critical
1access hospitals, except that the department may not distribute funds to a rural
2hospital
or to a critical access hospital to the extent that the distribution would
3exceed any limitation under
42 USC 1396b (i) (3).".
AB1-SA1-SA2,5,7
7"
Section 9bkg. 49.45 (6v) (b) of the statutes is amended to read:
AB1-SA1-SA2,5,138
49.45
(6v) (b) The department shall, each year, submit to the joint committee
9on finance a report for the previous fiscal year, except for the 1997-98 fiscal year, that
10provides information on the utilization of beds by recipients of medical assistance in
11facilities and a discussion and detailed projection of the likely balances,
12expenditures, encumbrances and carry over of currently appropriated amounts in
13the appropriation accounts under s. 20.435 (4) (b)
, (gp), and (o).
AB1-SA1-SA2,5,2015
49.45
(6x) (a) Notwithstanding sub. (3) (e), from the appropriation accounts
16under s. 20.435 (4) (b),
(gp), (o), and (w), the department shall distribute not more
17than $4,748,000 in each fiscal year, to provide funds to an essential access city
18hospital, except that the department may not allocate funds to an essential access
19city hospital to the extent that the allocation would exceed any limitation under
42
20USC 1396b (i) (3).
AB1-SA1-SA2,6,722
49.45
(6y) (a) Notwithstanding sub. (3) (e), from the appropriation accounts
23under s. 20.435 (4) (b),
(gp), (o), and (w), the department
shall may distribute funding
24in each fiscal year to provide supplemental payment to hospitals that enter into a
1contract under s. 49.02 (2) to provide health care services funded by a relief block
2grant, as determined by the department, for hospital services that are not in excess
3of the hospitals' customary charges for the services, as limited under
42 USC 1396b 4(i) (3). If no relief block grant is awarded under this chapter or if the allocation of
5funds to such hospitals would exceed any limitation under
42 USC 1396b (i) (3), the
6department may distribute funds to hospitals that have not entered into a contract
7under s. 49.02 (2).
AB1-SA1-SA2,6,159
49.45
(6y) (am) Notwithstanding sub. (3) (e), from the appropriation accounts
10under s. 20.435 (4) (b), (h),
(gp), (o), and (w), the department shall distribute funding
11in each fiscal year to provide supplemental payments to hospitals that enter into
12contracts under s. 49.02 (2) with a county having a population of 500,000 or more to
13provide health care services funded by a relief block grant, as determined by the
14department, for hospital services that are not in excess of the hospitals' customary
15charges for the services, as limited under
42 USC 1396b (i) (3).
AB1-SA1-SA2,7,418
49.45
(6z) (a) (intro.) Notwithstanding sub. (3) (e), from the appropriation
19accounts under s. 20.435 (4) (b),
(gp), (o), and (w), the department may distribute
20funding in each fiscal year to supplement payment for services to hospitals that enter
21into indigent care agreements, in accordance with the approved state plan for
22services under
42 USC 1396a, with relief agencies that administer the medical relief
23block grant under this chapter, if the department determines that the hospitals serve
24a disproportionate number of low-income patients with special needs. If no medical
25relief block grant under this chapter is awarded or if the allocation of funds to such
1hospitals would exceed any limitation under
42 USC 1396b (i) (3), the department
2may distribute funds to hospitals that have not entered into indigent care
3agreements. The department may not distribute funds under this subsection to the
4extent that the distribution would do any of the following:
AB1-SA1-SA2,7,106
49.45
(8) (b) Reimbursement under s. 20.435 (4) (b),
(gp), (o), and (w) for home
7health services provided by a certified home health agency or independent nurse
8shall be made at the home health agency's or nurse's usual and customary fee per
9patient care visit, subject to a maximum allowable fee per patient care visit that is
10established under par. (c).
AB1-SA1-SA2,7,1612
49.45
(24m) (intro.) From the appropriation accounts under s. 20.435 (4) (b),
13(gp), (o), and (w), in order to test the feasibility of instituting a system of
14reimbursement for providers of home health care and personal care services for
15medical assistance recipients that is based on competitive bidding, the department
16shall:
AB1-SA1-SA2,8,318
49.45
(52) Payment adjustments. Beginning on January 1, 2003, the
19department may, from the appropriation account under s. 20.435 (7) (b), make
20Medical Assistance payment adjustments to county departments under s. 46.215,
2146.22, 46.23, or 51.42, or 51.437 or to local health departments, as defined in s. 250.01
22(4), as appropriate, for covered services under s. 49.46 (2) (a) 2. and 4. d. and f. and
23(b) 6. b., c., f., fm., g., j., k., L., Lm., and m., 9., 12., 12m., 13., 15., and 16. Payment
24adjustments under this subsection shall include the state share of the payments.
25The total of any payment adjustments under this subsection and Medical Assistance
1payments made from appropriation accounts under s. 20.435 (4) (b),
(gp), (o), and (w)
, 2may not exceed applicable limitations on payments under
42 USC 1396a (a) (30)
3(A).".
AB1-SA1-SA2,8,6
6"
Section 9cbg. 49.472 (6) (a) of the statutes is amended to read:
AB1-SA1-SA2,8,127
49.472
(6) (a) Notwithstanding sub. (4) (a) 3., from the appropriation account
8under s. 20.435 (4) (b)
, (gp), or (w), the department shall, on the part of an individual
9who is eligible for medical assistance under sub. (3), pay premiums for or purchase
10individual coverage offered by the individual's employer if the department
11determines that paying the premiums for or purchasing the coverage will not be more
12costly than providing medical assistance.
AB1-SA1-SA2,8,1714
49.472
(6) (b) If federal financial participation is available, from the
15appropriation account under s. 20.435 (4) (b)
, (gp), or (w), the department may pay
16medicare Part A and Part B premiums for individuals who are eligible for medicare
17and for medical assistance under sub. (3).
AB1-SA1-SA2,8,2319
49.473
(5) The department shall audit and pay, from the appropriation
20accounts under s. 20.435 (4) (b)
, (gp), and (o), allowable charges to a provider who is
21certified under s. 49.45 (2) (a) 11. for medical assistance on behalf of a woman who
22meets the requirements under sub. (2) for all benefits and services specified under
23s. 49.46 (2).".
AB1-SA1-SA2,9,2
112. Page 15, line 10: delete "accounts under s. 20.435 (4) (xc) and (xd)" and
2substitute "account under s. 20.435 (4) (xc) and specified in s. 25.77 (11)".
AB1-SA1-SA2,9,9
4"
(6) If the department determines that any portion of the revenue that is
5collected under sub. (5) and appropriated under s. 20.435 (4) (xc) to provide Medical
6Assistance payment increases for inpatient and outpatient hospital services as fee
7for service or through health maintenance organizations is not eligible for federal
8financial participation, the department shall refund to hospitals, in proportion to
9each hospital's payment of the assessment under sub. (4), all of the following:
AB1-SA1-SA2,9,1110
(a) The amount appropriated under s. 20.435 (4) (xc) that is ineligible for
11federal financial participation.
AB1-SA1-SA2,9,1312
(b) After the amount under par. (a) is refunded, an amount that is 30.555
13percent of the amount under par. (a).".
AB1-SA1-SA2,9,20
17"(g) The governing bodies of the counties of Kenosha, Milwaukee, and Racine,
18and of the most populous city in each of these 3 counties, may submit to the electors
19in an advisory referendum the question of supporting an increase in the fees that
20may be imposed by the authority under subch. XIII of ch. 77.".
AB1-SA1-SA2,9,23
2117. Page 154, line 8: delete "
$2 $15" and substitute "$2
, or not to exceed $15
22if the governing body of the regional transit authority approves a fee under this
23section at such a rate,".