SB40: Bill Text

SB40,1335,4 (a) Identifying strategies and actions necessary to do all of the following:

SB40,1335,7 1. Attempt to achieve goals established by the Institute of Medicine of the National Academy of Sciences for health care that is safe, effective, patient-centered, timely, efficient, and equitable.

SB40,1335,10 2. Extend health care information systems statewide so as to optimize the improvement of health care quality, safety, and efficiency within a reasonable period of time and with reasonable financial investment.

SB40,1335,13 (b) Considering the most cost-effective means of implementing a statewide integrated or interoperable health care information system, including all of the following:

SB40,1335,15 1. Assessing the benefits of an integrated or interoperable system for supporting rapid deployment of health care providers.

SB40,1335,17 2. Promoting accurate and appropriate shared information about individual patients among health care providers.

SB40,1335,19 3. Creating points of reference for performance indicators among health care provider organizations for organizational performance improvement.

SB40,1335,21 4. Reporting to the public on health care quality, safety, and efficiency data for consumer and purchaser decision making.

SB40,1335,22 (3) The council shall advise the secretary on all of the following:

SB40,1335,23 (a) A communication and marketing plan.

SB40,1335,25 (b) Annually, on recommendations to improve the committee organizational structure of the council.

SB40,1336,2 (c) The distribution of funding to entities to promote the health information technology agenda of the governor.

SB40,1336,6 (d) Whether a health facility, as defined in s. 231.01 (5), or a participating health institution, as defined in s. 231.01 (6), that seeks financial assistance from the Wisconsin Health and Educational Facilities Authority under s. 231.03 demonstrates progress in improving medical information systems technology.

SB40,1336,9 (4) By January 1, 2008, and at least annually thereafter, the council shall report to the legislature under s. 13.172 (3) and to the governor on the council's plans, activities, accomplishments, and recommendations.

SB40,1336,11 (5) Any subcommittee of the council shall align its work with recommendations of the American Health Information Community.

SB40, s. 2872 Section 2872. 146.76 of the statutes is created to read:

SB40,1336,21 146.76 Approval of certain financial assistance. The secretary shall determine whether a health facility, as defined in s. 231.01 (5), or a participating health institution, as defined in s. 231.01 (6), that seeks financial assistance from the Wisconsin Health and Educational Facilities Authority under s. 231.03 demonstrates progress in improving medical information systems technology and shall inform the Wisconsin Health and Educational Facilities Authority of his or her determination. In making a determination under this section, the secretary shall consider as a factor the advice of the health care quality and patient safety council, as provided under s. 146.75 (3) (d).

SB40, s. 2873 Section 2873. 146.91 (2) (c) of the statutes is repealed.

SB40, s. 2874 Section 2874. 146.91 (5) of the statutes is repealed.

SB40, s. 2875 Section 2875. 146.99 of the statutes is repealed.

SB40, s. 2876 Section 2876. 149.11 (2) (a) 1. of the statutes is amended to read:

SB40,1337,2 149.11 (2) (a) 1. Insurer assessments under s. 149.13, paid to the authority under s. 20.145 (5) (g).

SB40, s. 2877 Section 2877. 149.11 (2) (a) 3. of the statutes is repealed and recreated to read:

SB40,1337,5 149.11 (2) (a) 3. Moneys received from the federal government in high risk pool grants.

SB40, s. 2878 Section 2878. 149.11 (2) (b) of the statutes is amended to read:

SB40,1337,10 149.11 (2) (b) The authority controls the assets of the fund and shall select regulated financial institutions in this state that receive deposits in which to establish and maintain accounts for assets needed on a current basis. If practicable, the accounts shall earn interest.

SB40, s. 2879 Section 2879. 149.12 (2) (e) of the statutes is renumbered 149.12 (2) (e) 1. and amended to read:

SB40,1337,16 149.12 (2) (e) 1. No Subject to subd. 2., no person who is eligible for creditable coverage, other than those benefits specified in s. 632.745 (11) (b) 1. to 12., that is provided by an employer on a self-insured basis or through health insurance is eligible for coverage under the plan.

SB40, s. 2880 Section 2880. 149.12 (2) (e) 2. of the statutes is created to read:

SB40,1337,19 149.12 (2) (e) 2. The board may specify other types of coverage provided by an employer that do not render a person ineligible for coverage under the plan.

SB40, s. 2881 Section 2881. 149.12 (2) (f) 2. g. of the statutes is created to read:

SB40,1337,22 149.12 (2) (f) 2. g. Benefits under the demonstration project for childless adults under s. 49.45 (23).

SB40, s. 2882 Section 2882. 149.12 (2) (g) 3. of the statutes is amended to read:

SB40,1338,3 149.12 (2) (g) 3. Services provided under a waiver requested under 2001 Wisconsin Act 16, section 9123 (16rs), or 2003 Wisconsin Act 33, section 9124 (8c) the disabled children's long-term support program, as defined in s. 46.011 (1g).

SB40, s. 2883 Section 2883. 149.12 (3) (a) of the statutes is amended to read:

SB40,1338,10 149.12 (3) (a) Except as provided in pars. (b) and (bm) to (c), no person is eligible for coverage under the plan for whom a premium, deductible, or coinsurance amount is paid or reimbursed by a federal, state, county, or municipal government or agency as of the first day of any term for which a premium amount is paid or reimbursed and as of the day after the last day of any term during which a deductible or coinsurance amount is paid or reimbursed.

SB40, s. 2884 Section 2884. 149.12 (3) (c) of the statutes is created to read:

SB40,1338,15 149.12 (3) (c) Persons for whom premium costs for health insurance coverage and copayments for certain prescription drugs are paid under the pilot program under s. 49.686 (6) are not ineligible for coverage under the plan by reason of such payments.

SB40, s. 2885 Section 2885. 149.13 (3) (a) of the statutes is amended to read:

SB40,1338,22 149.13 (3) (a) Each insurer's proportion of participation under sub. (2) shall be determined annually by the commissioner based on annual statements and other reports filed by the insurer with the commissioner. The commissioner shall assess an insurer for the insurer's proportion of participation based on the total assessments estimated by the authority. An insurer shall pay the amount of the assessment directly to the authority.

SB40, s. 2886 Section 2886. 149.14 (2) (c) 1. of the statutes is renumbered 149.14 (2) (c).

SB40, s. 2887 Section 2887. 149.14 (2) (c) 2. of the statutes is repealed.

SB40, s. 2888 Section 2888. 149.14 (3) (intro.) of the statutes is amended to read:

SB40,1339,8 149.14 (3) Covered expenses. (intro.) Covered expenses for coverage under the plan shall be the payment rates established by the authority for services provided by persons licensed under ch. 446 and certified under s. 49.45 (2) (a) 11. Covered expenses for coverage under the plan shall also be the payment rates established by the authority for, at a minimum, the following services and articles if the service or article is prescribed by a physician who is licensed under ch. 448 or in another state and who is certified under s. 49.45 (2) (a) 11. and, except as provided in sub. (3m), if the service or article is provided by a provider certified under s. 49.45 (2) (a) 11.:

SB40, s. 2889 Section 2889. 149.14 (3m) of the statutes is created to read:

SB40,1339,17 149.14 (3m) Pharmacy network. Covered expenses for prescription drugs shall be the payment rates established by the authority for prescription drugs that are provided to eligible persons by a network of pharmacists and pharmacies approved by the board, regardless of whether the provider of the drug is certified under s. 49.45 (2) (a) 11. The network of pharmacists and pharmacies approved by the board shall include, at a minimum, all pharmacists licensed under s. 450.03 who are certified under s. 49.45 (2) (a) 11. and all pharmacies licensed under s. 450.06 that are certified under s. 49.45 (2) (a) 11.

SB40, s. 2890 Section 2890. 149.14 (5) (a) of the statutes is amended to read:

SB40,1339,21 149.14 (5) (a) The authority shall establish and provide subsidies for deductibles paid by eligible persons with coverage under s. 149.14 (2) (a) and household incomes specified in s. 149.165 (2) (a) 1. to 5.

SB40, s. 2891 Section 2891. 149.142 (1) of the statutes is amended to read:

SB40,1340,8 149.142 (1) Establishment of rates. The authority shall establish provider payment rates for covered expenses that consist of the allowable charges paid under s. 49.46 (2) usual and customary payment rates, as determined by the authority, for the services and articles provided plus an enhancement adjustment determined by the authority. The rates shall be based on the allowable charges paid under s. 49.46 (2), projected plan costs, and trend factors. Using the same methodology that applies to medical assistance under subch. IV of ch. 49, the authority shall establish hospital outpatient per visit reimbursement rates and hospital inpatient reimbursement rates that are specific to diagnostically related groups of eligible persons. The adjustments to the usual and customary rates shall be sufficient to cover the portion of plan costs specified in s. 149.143 (1) (c) and (2) (b).

SB40, s. 2892 Section 2892. 149.143 (1) (intro.) of the statutes is amended to read:

SB40,1340,15 149.143 (1) Costs excluding subsidies. (intro.) The authority shall pay plan costs, excluding any premium, deductible, and copayment subsidies, first from any federal funds, if any, that are transferred to the fund under s. 20.145 (5) (m) and under s. 149.11 (2) (a) 3. that exceed premium, deductible, and copayment subsidy costs in a policy year. The remainder of the plan costs, excluding premium, deductible, and copayment subsidy costs, shall be paid as follows:

SB40, s. 2893 Section 2893. 149.143 (2) (intro.) of the statutes is amended to read:

SB40,1340,20 149.143 (2) Subsidy costs. (intro.) The authority shall pay for premium, deductible, and copayment subsidies in a policy year first from any federal funds, if any, that are transferred to the fund under s. 20.145 (5) (m) under s. 149.11 (2) (a) 3. received in that year. The remainder of the subsidy costs shall be paid as follows:

SB40, s. 2894 Section 2894. 149.165 (2) (bc) of the statutes is amended to read:

SB40,1341,5 149.165 (2) (bc) Subject to sub. (3m), if the household income, as defined in s. 71.52 (5) and as determined under sub. (3), of an eligible person with coverage under s. 149.14 (2) (b) or (c) is equal to or greater than the first amount and less than the 2nd amount listed in par. (a) 1., 2., 3., 4., or 5., the authority shall reduce the premium established for the eligible person by the same percentage as the authority reduces, under par. (a), the premium established for an eligible person with coverage under s. 149.14 (2) (a) who has a household income specified in the same subdivision under par. (a) as the household income of the eligible person with coverage under s. 149.14 (2) (b) or (c).

SB40, s. 2895 Section 2895. 149.65 (1) of the statutes is amended to read:

SB40,1341,14 149.65 (1) Subject to sub. (2), the authority shall design and administer a program of health care coverage, called the Health Care Tax Credit Program, under which a covered eligible individual may receive an income tax credit under 26 USC 35 for a portion of premiums paid for the coverage. The Health Care Tax Credit Program shall be designed to satisfy the requirements of qualified health insurance under 26 USC 35 (e) (1) (E), (2), and (3). Any person with which the authority contracts under s. 149.43 (4) (a) shall also be the administrator for the program under this subchapter.

SB40, s. 2896 Section 2896. 150.31 (1) (intro.) of the statutes is amended to read:

SB40,1341,22 150.31 (1) (intro.) In order to enable the state to budget accurately for medical assistance and to allocate fiscal resources most appropriately, the maximum number of licensed nursing home beds statewide is 51,795 42,000 and the maximum number of beds statewide in facilities primarily serving the developmentally disabled is 3,704. The department may adjust these limits on licensed beds as provided in subs. (2) to (6). The department shall also biennially recommend changes to this limit based on the following criteria:

SB40, s. 2897 Section 2897. 150.31 (5t) of the statutes is repealed.

SB40, s. 2898 Section 2898. 150.345 (1) (a) of the statutes is amended to read:

SB40,1342,3 150.345 (1) (a) The receiving nursing home is within the same area for allocation of nursing home beds, as determined by the department, as is the transferring nursing home, or is in a county an adjoining that area.

SB40, s. 2899 Section 2899. 165.07 of the statutes is created to read:

SB40,1342,11 165.07 Assistant attorney general — public intervenor. (1) The attorney general shall designate an assistant attorney general on the attorney general's staff as public intervenor. The head of each agency responsible for proceedings under chs. 30, 31, 281 to 285, and 289 to 299, shall give notice of those proceedings to the public intervenor, to the administrators of divisions primarily assigned the departmental functions under chs. 29, 281, 285, and 289 to 299, and to the natural areas preservation council.

SB40,1342,19 (2) The public intervenor shall formally intervene in proceedings described in sub. (1) when requested to do so by an administrator of a division primarily assigned the departmental functions under chs. 29, 281, 285, or 289 to 299. The public intervenor may, on the public intervenor's own initiative or upon request of any committee of the legislature, formally intervene in proceedings described in sub. (1) whenever that intervention is needed for the protection of public rights in water and other natural resources, as provided in chs. 30 and 31 and defined by the supreme court.

SB40,1343,6 (3) Personnel of the department of natural resources shall, upon the request of the public intervenor, make such investigations, studies, and reports as the public intervenor may request in connection with proceedings described in sub. (1), either before or after formal intervention. Personnel of state agencies shall, at the public intervenor's request, provide information, serve as witnesses in proceedings described in sub. (1), and otherwise cooperate in the carrying out of the public intervenor's intervention functions. The public intervenor shall formally intervene by filing a statement to that effect with the examiner or other person immediately in charge of the proceeding. Upon that filing, the public intervenor shall be considered a party in interest with full power to present evidence, subpoena and cross-examine witnesses, submit proof, file briefs, or do any other acts appropriate for a party to the proceedings.

SB40,1343,12 (4) The public intervenor may appeal from administrative rulings to the courts. In all administrative proceedings and judicial review proceedings, the public intervenor shall be identified as "public intervenor." This section does not preclude or prevent any division of the department of natural resources, or any other department or independent agency, from appearing by its staff as a party in any proceedings.

SB40, s. 2900 Section 2900. 165.075 of the statutes is created to read:

SB40,1343,18 165.075 Assistant attorney general; public intervenor; authority. In carrying out his or her duty to protect public rights in water and other natural resources, the public intervenor has the authority to initiate actions and proceedings before any agency or court in order to raise issues, including issues concerning constitutionality, present evidence and testimony, and make arguments.

SB40, s. 2901 Section 2901. 165.076 of the statutes is created to read:

SB40,1344,7 165.076 Assistant attorney general; public intervenor; advisory committee. The attorney general shall appoint a public intervenor advisory committee under s. 15.04 (1) (c). The public intervenor advisory committee shall consist of not less than 7 nor more than 9 members. The attorney general may only appoint members who have backgrounds in or demonstrated experience or records relating to environmental protection or natural resource conservation. The attorney general shall appoint at least one member who has working knowledge of business and at least one member who has working knowledge of agriculture. The public intervenor advisory committee shall advise the public intervenor consistent with his or her duty to protect public rights in water and other natural resources. The public intervenor advisory committee shall conduct meetings consistent with subch. V of ch. 19 and shall permit public participation and public comment on public intervenor activities.

SB40, s. 2902 Section 2902. 165.08 of the statutes is amended to read:

SB40,1344,16 165.08 Power to compromise. Any civil action prosecuted by the department by direction of any officer, department, board or commission, shall be compromised or discontinued when so directed by such officer, department, board or commission. Any Except as provided in s. 20.931 (7) (b), any civil action prosecuted by the department on the initiative of the attorney general, or at the request of any individual may be compromised or discontinued with the approval of the governor. In any criminal action prosecuted by the attorney general, the department shall have the same powers with reference to such action as are vested in district attorneys.

SB40, s. 2903 Section 2903. 165.10 of the statutes is created to read:

SB40,1344,23 165.10 Civil rights enforcement. If any person, whether or not acting under color of law, interferes with the exercise or enjoyment by any individual of a right secured by the constitution or laws of the United States, or of a right secured by the constitution or laws of this state, the attorney general may bring an action for injunction or other appropriate equitable relief to protect the peaceable exercise or enjoyment of the right secured.

SB40, s. 2904 Section 2904. 165.25 (11) of the statutes is created to read:

SB40,1345,3 165.25 (11) False claims. Diligently investigate possible violations of s. 20.931, and, if the department determines that a person has committed an act that is punishable under s. 20.931, may bring a civil action against that person.

SB40, s. 2905 Section 2905. 165.72 (3) of the statutes is amended to read:

SB40,1345,8 165.72 (3) Reward payment program. The department shall administer a reward payment program. Under the program, the department may offer and pay rewards from the appropriation under s. 20.455 (2) (e) (m) for information under sub. (2) (a) leading to the arrest and conviction of a person for a violation of ch. 961.

SB40, s. 2906 Section 2906. 165.85 (3) (cm) of the statutes is amended to read:

SB40,1345,25 165.85 (3) (cm) Decertify law enforcement, tribal law enforcement, jail or secure detention officers who terminate employment or are terminated, who violate or fail to comply with a rule or order of the board relating to curriculum or training, who fail to pay court-ordered payments of child or family support, maintenance, birth expenses, medical expenses or other expenses related to the support of a child or former spouse or who fail to comply, after appropriate notice, with a subpoena or warrant issued by the department of workforce development children and families or a county child support agency under s. 59.53 (5) and related to paternity or child support proceedings. The board shall establish procedures for decertification in compliance with ch. 227, except that decertification for failure to pay court-ordered payments of child or family support, maintenance, birth expenses, medical expenses or other expenses related to the support of a child or former spouse or for failure to comply, after appropriate notice, with a subpoena or warrant issued by the department of workforce development children and families or a county child support agency under s. 59.53 (5) and related to paternity or child support proceedings shall be done as provided under sub. (3m) (a).

SB40, s. 2907 Section 2907. 165.85 (3m) (a) of the statutes is amended to read:

SB40,1346,12 165.85 (3m) (a) As provided in a memorandum of understanding entered into with the department of workforce development children and families under s. 49.857, refuse certification to an individual who applies for certification under this section, refuse recertification to an individual certified under this section or decertify an individual certified under this section if the individual fails to pay court-ordered payments of child or family support, maintenance, birth expenses, medical expenses or other expenses related to the support of a child or former spouse or if the individual fails to comply, after appropriate notice, with a subpoena or warrant issued by the department of workforce development children and families or a county child support agency under s. 59.53 (5) and related to paternity or child support proceedings.

SB40, s. 2908 Section 2908. 165.85 (3m) (b) 1. of the statutes is amended to read:

SB40,1346,23 165.85 (3m) (b) 1. Request that an individual provide the board with his or her social security number when he or she applies for certification or recertification under this section. Except as provided in subd. 2., if an individual who is requested by the board to provide his or her social security number under this paragraph does not comply with the board's request, the board shall deny the individual's application for certification or recertification. The board may disclose a social security number provided by an individual under this paragraph only to the department of workforce development children and families as provided in a memorandum of understanding entered into with the department of workforce development children and families under s. 49.857.

SB40, s. 2909 Section 2909. 165.85 (3m) (b) 2. of the statutes is amended to read:

SB40,1347,7 165.85 (3m) (b) 2. As a condition of applying for certification or recertification, an individual who does not have a social security number shall submit a statement made or subscribed under oath or affirmation to the board that he or she does not have a social security number. The form of the statement shall be prescribed by the department of workforce development children and families. A certification or recertification issued in reliance on a false statement submitted under this subdivision is invalid.

SB40, s. 2910 Section 2910. 166.03 (2) (a) 5. of the statutes is amended to read: