(4) All moneys transferred under 2007 Wisconsin Act (this act), section 9225 (1).
SECTION 13. 46.27 (9) (a) of the statutes is amended to read:
46.27 (9) (a) The department may select up to 5 counties that volunteer to participate in a pilot project under which they will receive certain funds allocated for long-term care. The department shall allocate a level of funds to these counties equal to the amount that would otherwise be paid under s. 20.435 (4) (b), (gp), or (w), or (xd) to nursing homes for providing care because of increased utilization of nursing home services, as estimated by the department. In estimating these levels, the department shall exclude any increased utilization of services provided by state centers for the developmentally disabled. The department shall calculate these amounts on a calendar year basis under sub. (10).
SECTION 14. 46.27 (10) (a) 1. of the statutes is amended to read:
46.27 (10) (a) 1. The department shall determine for each county participating in the pilot project under sub. (9) a funding level of state medical assistance expenditures to be received by the county. This level shall equal the amount that the department determines would otherwise be paid under s. 20.435 (4) (b), (gp), or (w), or (xd), or because of increased utilization of nursing home services, as estimated by the department.
SECTION 15. 46.275 (5) (a) of the statutes is amended to read:
46.275 (5) (a) Medical Assistance reimbursement for services a county, or the department under sub. (3r), provides under this program is available from the appropriation accounts under s. 20.435 (4) (b), (gp), (o), and (w), and (xd). If 2 or more counties jointly contract to provide services under this program and the department approves the contract, Medical Assistance reimbursement is also available for services provided jointly by these counties.
SECTION 16. 46.275 (5) (c) of the statutes is amended to read:
46.275 (5) (c) The total allocation under s. 20.435 (4) (b), (gp), (o), and (w), and (xd) to counties and to the department under sub. (3r) for services provided under this section may not exceed the amount approved by the federal department of health and human services. A county may use funds received under this section only to provide services to persons who meet the requirements under sub. (4) and may not use unexpended funds received under this section to serve other developmentally disabled persons residing in the county.
SECTION 17. 46.278 (6) (d) of the statutes is amended to read:
46.278 (6) (d) If a county makes available nonfederal funds equal to the state share of service costs under a waiver received under sub. (3), the department may, from the appropriation under s. 20.435 (4) (o), provide reimbursement for services that the county provides under this section to persons who are in addition to those who may be served under this section with funds from the appropriation account under s. 20.435 (4) (b) or, (w), or (xd).
SECTION 18. 46.2785 (5) (a) of the statutes is amended to read:
46.2785 (5) (a) Medical assistance reimbursement for services a county or private agency contracts for or provides under the waiver program shall be made from the appropriation accounts under s. 20.435 (4) (b) and, (o), and (xd).
SECTION 19. 46.283 (5) of the statutes is amended to read:
46.283 (5) FUNDING. From the appropriation accounts under s. 20.435 (4) (b), (bm), (gp), (pa), and (w), and (xd) and (7) (b), (bd), and (md), the department may contract with organizations that meet standards under sub. (3) for performance of the duties under sub. (4) and shall distribute funds for services provided by resource centers.
SECTION 20. 46.284 (5) (a) of the statutes is amended to read:
46.284 (5) (a) From the appropriation accounts under s. 20.435 (4) (b), (g), (gp), (im), (o), and (w), and (xd) and (7) (b) and (bd), the department shall provide funding on a capitated payment basis for the provision of services under this section. Notwithstanding s. 46.036 (3) and (5m), a care management organization that is under contract with the department may expend the funds, consistent with this section, including providing payment, on a capitated basis, to providers of services under the family care benefit.
SECTION 21. 46.485 (2g) (intro.) of the statutes is amended to read:
46.485 (2g) (intro.) From the appropriation accounts account under s. 20.435 (4) (b) and (gp), the department may in each fiscal year transfer funds to the appropriation under s. 20.435 (7) (kb) for distribution under this section and from the appropriation account under s. 20.435 (7) (mb) the department may not distribute more than $1,330,500 in each fiscal year to applying counties in this state that meet all of the following requirements, as determined by the department:
SECTION 22. 49.45 (2) (a) 17. of the statutes is amended to read:
49.45 (2) (a) 17. Notify the governor, the joint committee on legislative organization, the joint committee on finance and appropriate standing committees, as determined by the presiding officer of each house, if the appropriation accounts under s. 20.435 (4) (b) and (gp) (xd) are insufficient to provide the state share of medical assistance.
SECTION 23. 49.45 (5m) (am) of the statutes is amended to read:
49.45 (5m) (am) Notwithstanding sub. (3) (e), from the appropriation accounts under s. 20.435 (4) (b), (gp), (o), and (w), and (xd), the department shall distribute not more than $2,256,000 in each fiscal year, to provide supplemental funds to rural hospitals that, as determined by the department, have high utilization of inpatient services by patients whose care is provided from governmental sources, and to provide supplemental funds to critical access hospitals, except that the department may not distribute funds to a rural hospital or to a critical access hospital to the extent that the distribution would exceed any limitation under 42 USC 1396b (i) (3).
SECTION 24. 49.45 (6m) (ag) (intro.) of the statutes is amended to read:
49.45 (6m) (ag) (intro.) Payment for care provided in a facility under this subsection made under s. 20.435 (4) (b), (gp), (o), (pa), or (w), or (xd) shall, except as provided in pars. (bg), (bm), and (br), be determined according to a prospective payment system updated annually by the department. The payment system shall implement standards that are necessary and proper for providing patient care and that meet quality and safety standards established under subch. II of ch. 50 and ch. 150. The payment system shall reflect all of the following:
SECTION 25. 49.45 (6v) (b) of the statutes is amended to read:
49.45 (6v) (b) The department shall, each year, submit to the joint committee on finance a report for the previous fiscal year, except for the 1997-98 fiscal year, that provides information on the utilization of beds by recipients of medical assistance in facilities and a discussion and detailed projection of the likely balances, expenditures, encumbrances and carry over of currently appropriated amounts in the appropriation accounts under s. 20.435 (4) (b), (gp), and (o), and (xd).
SECTION 26. 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), and (xd), the department shall distribute not more than $4,748,000 in each fiscal year, to provide funds to an essential access city hospital, 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 27. 49.45 (6y) (a) of the statutes is amended to read:
49.45 (6y) (a) Notwithstanding sub. (3) (e), from the appropriation accounts under s. 20.435 (4) (b), (gp), (o), and (w), and (xd), the department shall may distribute funding in each fiscal year to provide supplemental payment to hospitals that enter into a contract under s. 49.02 (2) to provide health care services funded by a relief block grant, as determined by the department, for hospital services that are not in excess of the hospitals' customary charges for the services, as limited under 42 USC 1396b (i) (3). If no relief block grant is awarded under this chapter or if the allocation of funds to such hospitals would exceed any limitation under 42 USC 1396b (i) (3), the department may distribute funds to hospitals that have not entered into a contract under s. 49.02 (2).
****NOTE: This is reconciled s. 49.45 (6y) (a). This SECTION has been affected by drafts with the following LRB numbers: -0892/9 and -1521/5.
SECTION 28. 49.45 (6y) (am) of the statutes is amended to read:
49.45 (6y) (am) Notwithstanding sub. (3) (e), from the appropriation accounts under s. 20.435 (4) (b), (h), (gp), (o), and (w), and (xd), the department shall distribute funding in each fiscal year to provide supplemental payments to hospitals that enter into contracts under s. 49.02 (2) with a county having a population of 500,000 or more to provide health care services funded by a relief block grant, as determined by the department, for hospital services that are not in excess of the hospitals' customary charges for the services, as limited under 42 USC 1396b (i) (3).
SECTION 29. 49.45 (8) (b) of the statutes is amended to read:
49.45 (8) (b) Reimbursement under s. 20.435 (4) (b), (gp), (o), and (w), and (xd) for home health services provided by a certified home health agency or independent nurse shall be made at the home health agency's or nurse's usual and customary fee per patient care visit, subject to a maximum allowable fee per patient care visit that is established under par. (c).
SECTION 30. 49.45 (24m) (intro.) of the statutes is amended to read:
49.45 (24m) (intro.) From the appropriation accounts under s. 20.435 (4) (b), (gp), (o), and (w), and (xd), in order to test the feasibility of instituting a system of reimbursement for providers of home health care and personal care services for medical assistance recipients that is based on competitive bidding, the department shall:
SECTION 31. 49.45 (52) of the statutes is amended to read:
49.45 (52) PAYMENT ADJUSTMENTS. Beginning on January 1, 2003, the department may, from the appropriation account under s. 20.435 (7) (b), make Medical Assistance payment adjustments to county departments under s. 46.215, 46.22, 46.23, or 51.42, or 51.437 or to local health departments, as defined in s. 250.01 (4), as appropriate, for covered services under s. 49.46 (2) (a) 2. and 4. d. and f. and (b) 6. b., c., f., fm., g., j., k., L., Lm., and m., 9., 12., 12m., 13., 15., and 16. Payment adjustments under this subsection shall include the state share of the payments. The total of any payment adjustments under this subsection and Medical Assistance payments made from appropriation accounts under s. 20.435 (4) (b), (gp), (o), and (w), and (xd) may not exceed applicable limitations on payments under 42 USC 1396a (a) (30) (A).
SECTION 32. 49.472 (6) (a) of the statutes is amended to read:
49.472 (6) (a) Notwithstanding sub. (4) (a) 3., from the appropriation account under s. 20.435 (4) (b), (gp), or (w), or (xd), the department shall, on the part of an individual who is eligible for medical assistance under sub. (3), pay premiums for or purchase individual coverage offered by the individual's employer if the department determines that paying the premiums for or purchasing the coverage will not be more costly than providing medical assistance.
SECTION 33. 49.472 (6) (b) of the statutes is amended to read:
49.472 (6) (b) If federal financial participation is available, from the appropriation account under s. 20.435 (4) (b), (gp), or (w), or (xd), the department may pay medicare Part A and Part B premiums for individuals who are eligible for medicare and for medical assistance under sub. (3).
SECTION 34. 49.473 (5) of the statutes is amended to read:
49.473 (5) The department shall audit and pay, from the appropriation accounts under s. 20.435 (4) (b), (gp), and (o), and (xd), allowable charges to a provider who is certified under s. 49.45 (2) (a) 11. for medical assistance on behalf of a woman who meets the requirements under sub. (2) for all benefits and services specified under s. 49.46 (2).
SECTION 35. 49.665 (4) (at) 1. a. of the statutes is amended to read:
49.665 (4) (at) 1. a. Except as provided in subd. 1. b., the department shall establish a lower maximum income level for the initial eligibility determination if funding under s. 20.435 (4) (bc), (jz), (p), and (x), and (xd) is insufficient to accommodate the projected enrollment levels for the health care program under this section. The adjustment may not be greater than necessary to ensure sufficient funding.
****NOTE: This is reconciled s. 49.665 (4) (at) 1.a. This SECTION has been affected by drafts with the following LRB numbers: 0892, 1521, and 0905.
SECTION 36. 49.665 (4) (at) 1. cm. of the statutes is amended to read:
49.665 (4) (at) 1. cm. Notwithstanding s. 20.001 (3) (b), if, after reviewing the plan submitted under subd. 1. b., the joint committee on finance determines that the amounts appropriated under s. 20.435 (4) (bc), (jz), (p), and (x), and (xd) are insufficient to accommodate the projected enrollment levels, the committee may transfer appropriated moneys from the general purpose revenue appropriation account of any state agency, as defined in s. 20.001 (1), other than a sum sufficient appropriation account, to the appropriation account under s. 20.435 (4) (bc) to supplement the health care program under this section if the committee finds that the transfer will eliminate unnecessary duplication of functions, result in more efficient and effective methods for performing programs, or more effectively carry out legislative intent, and that legislative intent will not be changed by the transfer.
****NOTE: This is reconciled s. 49.665 (4) (at) 1. cm. This SECTION has been affected by drafts with the following LRB numbers: 0892, 1521, and 0905.
SECTION 37. 49.665 (4) (at) 2. of the statutes is amended to read:
49.665 (4) (at) 2. If, after the department has established a lower maximum income level under subd. 1., projections indicate that funding under s. 20.435 (4) (bc), (jz), (p), and (x), and (xd) is sufficient to raise the level, the department shall, by state plan amendment, raise the maximum income level for initial eligibility, but not to exceed 185% of the poverty line.
****NOTE: This is reconciled s. 49.665 (4) (at) 2.. This SECTION has been affected by drafts with the following LRB numbers: 0892, 1521, and 0905.
SECTION 38. 49.688 (7) (a) of the statutes is amended to read:
49.688 (7) (a) Except as provided in par. (b), from the appropriation accounts under s. 20.435 (4) (bv), (j), and (pg), and (xh), beginning on September 1, 2002, the department shall, under a schedule that is identical to that used by the department for payment of pharmacy provider claims under medical assistance, provide to pharmacies and pharmacists payments for prescription drugs sold by the pharmacies or pharmacists to persons eligible under sub. (2) who have paid the deductible specified under sub. (3) (b) 1. or 2. or who, under sub. (3) (b) 1., are not required to pay a deductible. The payment for each prescription drug under this paragraph shall be at the program payment rate, minus any copayment paid by the person under sub. (5) (a) 2. or 4., and plus, if applicable, incentive payments that are similar to those provided under s. 49.45 (8v). The department shall devise and distribute a claim form for use by pharmacies and pharmacists under this paragraph and may limit payment under this paragraph to those prescription drugs for which payment claims are submitted by pharmacists or pharmacies directly to the department. The department may apply to the program under this section the same utilization and cost control procedures that apply under rules promulgated by the department to medical assistance under subch. IV of ch. 49.
SECTION 39. 49.688 (7) (b) of the statutes is amended to read:
49.688 (7) (b) During any period in which funding under s. 20.435 (4) (bv) and, (pg), and (xh) is completely expended for the payments specified in par. (a), the requirements of par. (a) and subs. (3) (c), (5), and (6) (a) and (b) do not apply to drugs purchased during that period, but the department shall continue to accept applications and determine eligibility under sub. (4) and shall indicate to applicants that the eligibility of program participants to purchase prescription drugs as specified in sub. (3), under the requirements of sub. (5), is conditioned on the availability of funding under s. 20.435 (4) (bv) and, (pg), and (xh).
SECTION 40. 50.375 of the statutes is created to read:
50.375 Assessment. (1) Beginning in 2007, for the privilege of doing business in this state, there is imposed on each hospital an annual assessment, based on the hospital's gross revenue that each hospital shall pay before December 1. The assessments shall be deposited into the health care quality fund.
(2) The department shall verify the amount of each hospital's gross revenue and determine the amount of each hospital's assessment, based on claims information that shall be provided to the department under s. 153.46 (5).
(3) Although the department may consider the revenue received by a hospital for services or items provided as benefits under subch. IV of chapter 49, the department's determination under sub. (2) shall be based on a rate not to exceed 1 percent of the hospital's gross revenue, as adjusted by the department.
(4) Sections 77.59 (1) to (5), (6) (intro.), (a), and (c), and (7) to (10), 77.60 (1) to (7), (9), and (10), 77.61 (9) and (12) to (14), and 77.62, as they apply to the taxes under subch. III of ch. 77, apply to the assessment under this section, except that the amount of any assessment collected under sub. (1) shall be deposited in the health care quality fund.
(5) The department shall levy, enforce, and collect the assessment under this section and shall develop and distribute forms necessary for levying and collection.
(6) An affected hospital may contest an action by the department of health and family services under this section by submitting a written request for a hearing to the division of hearings and appeals in the department of administration within 30 days after the date of the department's action.
(7) Any order or determination made by the division of hearings and appeals in the department of administration under a hearing as specified in sub. (6) is subject to judicial review as prescribed under ch. 227.
SECTION 41. 139.31 (1) (a) of the statutes is amended to read:
139.31 (1) (a) On cigarettes weighing not more than 3 pounds per thousand, 38.5 101 mills on each cigarette.
SECTION 42. 139.31 (1) (b) of the statutes is amended to read:
139.31 (1) (b) On cigarettes weighing more than 3 pounds per thousand, 77 202 mills on each cigarette.
SECTION 43. 139.315 (1) of the statutes is amended to read:
139.315 (1) INVENTORY TAX IMPOSED. On the effective date of any increase in the sum of the rates under s. 139.31 (1) (a) and (c) or in the sum of the rates under s. 139.31 (1) (b) and (d), an inventory tax is imposed upon cigarettes held in inventory for sale or resale on which the cigarette tax has been paid at the prior rate and upon unaffixed stamps in the possession of distributors. Any person who is in possession of any such cigarettes or unaffixed stamps shall pay the tax imposed under this section. Any person liable for this tax shall determine the number of cigarettes and unaffixed stamps in the person's possession on the effective date of the increase, and by the 15th 30th day after the effective date of the increase the person shall file a return and shall by that date pay the tax due.
SECTION 44. 139.32 (5) of the statutes is amended to read:
139.32 (5) Manufacturers, bonded direct marketers, and distributors who are authorized by the department to purchase tax stamps shall receive a discount of 1.6% 0.7 percent of the tax paid on stamp purchases.
SECTION 45. 139.455 of the statutes is created to read:
139.455 Revenue distribution. From the taxes collected under this subchapter, in fiscal year 2007-08, the department shall deposit no more than $304,000,000 into the general fund and the remainder into the health care quality fund. From the taxes collected under this subchapter, in fiscal year 2008-09, and in each subsequent fiscal year thereafter, the department shall deposit no more than $305,000,000 into the general fund and the remainder into the health care quality fund.
SECTION 46. 139.76 (1) of the statutes is amended to read:
139.76 (1) An excise tax is imposed upon the sale, offering or exposing for sale, possession with intent to sell or removal for consumption or sale or other disposition for any purpose of tobacco products by any person engaged as a distributor of them at the rate of 25% 65.6 percent of the manufacturer's established list price to distributors without diminution by volume or other discounts on domestic products. On products imported from another country the rate of tax is 25% 65.6 percent of the amount obtained by adding the manufacturer's list price to the federal tax, duties and transportation costs to the United States. The tax attaches at the time the tobacco products are received by the distributor in this state. The tax shall be passed on to the ultimate consumer of the tobacco products. All tobacco products received in this state for sale or distribution within this state, except tobacco products actually sold as provided in sub. (2), shall be subject to such tax.
SECTION 47. 139.78 (1) of the statutes is amended to read:
139.78 (1) A tax is imposed upon the use or storage by consumers of tobacco products in this state at the rate of 25% 65.6 percent of the cost of the tobacco products. The tax does not apply if the tax imposed by s. 139.76 (1) on the tobacco products has been paid or if the tobacco products are exempt from the tobacco products tax under s. 139.76 (2).
SECTION 48. 139.865 of the statutes is created to read:
139.865 Revenue distribution. From the taxes collected under this subchapter, in fiscal year 2007-08, the department shall deposit no more than $18,400,000 into the general fund and the remainder into the health care quality fund. From the taxes collected under this subchapter, in fiscal year 2008-09, and in each subsequent fiscal year thereafter, the department shall deposit no more than $19,300,000 into the general fund and the remainder into the health care quality fund.
SECTION 49. 146.99 of the statutes is repealed.
SECTION 50. 255.15 (3) (b) (intro.) of the statutes is amended to read:
255.15 (3) (b) (intro.) From the appropriation accounts under s. 20.435 (5) (fm) and (r), the department may distribute grants for any of the following:
SECTION 9225. Fiscal changes; Insurance.
(1) HEALTH CARE QUALITY FUND. Notwithstanding section 655.27 (6) of the statutes, there is transferred from the injured patients and families compensation fund to the health care quality fund $175,000,000 in fiscal year 2007-08.
SECTION 9441. Effective dates; Revenue.
(1) CIGARETTE AND TOBACCO PRODUCTS TAX RATES. The treatment of sections 139.31 (1) (a) and (b), 139.315 (1), 139.32 (5), 139.455, 139.76 (1), 139.78 (1), and 139.865 of the statutes takes effect on September 1, 2007, or on the first day of the 3rd month beginning after publication, whichever is later.
(End)
LRB-0904LRB-0904/2
DAK:jld:rs
2007 - 2008 LEGISLATURE
DOA:......Johnston, BB0187 - Health Care Quality and Patient Safety Council
For 2007-09 Budget -- Not Ready For Introduction
