Amendment JR1 AA1-AB11

AB11-AA1,7,14 19. Page 50, line 7: after that line insert:

AB11-AA1,7,16 " Section 119d. 49.45 (18) (ac) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

AB11-AA1,8,5 49.45 (18) (ac) Except as provided in pars. (am) to (d), and subject to par. (ag), any person eligible for medical assistance under s. 49.46, 49.468, or 49.47, or for the benefits under s. 49.46 (2) (a) and (b) under s. 49.471 shall pay up to the maximum amounts allowable under 42 CFR 447.53 to 447.58 for purchases of services provided under s. 49.46 (2). The service provider shall collect the specified or allowable copayment, coinsurance, or deductible, unless the service provider determines that the cost of collecting the copayment, coinsurance, or deductible exceeds the amount to be collected. The department shall reduce payments to each provider by the amount of the specified or allowable copayment, coinsurance, or deductible. Unless otherwise provided by the department by rule promulgated under sub. (2m) (c), no No provider may deny care or services because the recipient is unable to share costs, but an inability to share costs specified in this subsection does not relieve the recipient of liability for these costs.".

AB11-AA1,8,6 20. Page 50, line 11: after that line insert:

AB11-AA1,8,8 " Section 120d. 49.45 (18) (ag) (intro.) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

AB11-AA1,8,11 49.45 (18) (ag) (intro.) Except as provided in pars. (am), (b), and (c), and subject to par. (d), a recipient specified in par. (ac) shall pay all of the following, unless otherwise provided by the department by rule promulgated under sub. (2m) (c):".

AB11-AA1,8,12 21. Page 50, line 15: after that line insert:

AB11-AA1,8,14 " Section 121d. 49.45 (18) (b) (intro.) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

AB11-AA1,8,17 49.45 (18) (b) (intro.) Unless otherwise provided by the department by rule promulgated under sub. (2m) (c), the The following services are not subject to recipient cost sharing under this subsection:".

AB11-AA1,8,18 22. Page 50, line 21: after that line insert:

AB11-AA1,8,20 " Section 122d. 49.45 (18) (d) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

AB11-AA1,9,2 49.45 (18) (d) No person who designates a pharmacy or pharmacist as his or her sole provider of prescription drugs and who so uses that pharmacy or pharmacist is liable under this subsection for more than $12 per month for prescription drugs received, unless otherwise provided by the department by rule promulgated under sub. (2m) (c).".

AB11-AA1,9,3 23. Page 51, line 6: after that line insert:

AB11-AA1,9,5 " Section 123d. 49.45 (23) (a) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

AB11-AA1,9,14 49.45 (23) (a) The department shall request a waiver from the secretary of the federal department of health and human services to permit the department to conduct a demonstration project to provide health care coverage for basic primary and preventive care to adults who are under the age of 65, who have family incomes not to exceed 200 percent of the poverty line, and who are not otherwise eligible for medical assistance under this subchapter, the Badger Care health care program under s. 49.665, or Medicare under 42 USC 1395 et seq. If the department promulgates a rule under sub. (2m) (c) 10., this paragraph does not apply to the extent that it conflicts with the rule.".

AB11-AA1,9,15 24. Page 51, line 17: after that line insert:

AB11-AA1,9,17 " Section 124d. 49.45 (23) (b) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

AB11-AA1,9,24 49.45 (23) (b) If the waiver is granted and in effect, the department may promulgate rules defining the health care benefit plan, including more specific eligibility requirements and cost-sharing requirements. Unless otherwise provided by the department by rule promulgated under sub. (2m) (c), cost Cost sharing may include an annual enrollment fee, which may not exceed $75 per year. Notwithstanding s. 227.24 (3), the plan details under this subsection may be promulgated as an emergency rule under s. 227.24 without a finding of emergency. If the waiver is granted and in effect, the demonstration project under this subsection shall begin on January 1, 2009, or on the effective date of the waiver, whichever is later.".

AB11-AA1,10,4 25. Page 52, line 3: after that line insert:

AB11-AA1,10,6 " Section 125d. 49.45 (24g) (c) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

AB11-AA1,10,16 49.45 (24g) (c) The department's proposal under par. (a) shall specify increases in reimbursement rates for providers that satisfy the conditions under par. (a) 1. or 2., and shall provide for payment of a monthly per-patient care coordination fee to those providers. The department shall set the increases in reimbursement rates and the monthly per-patient care coordination fee so that together they provide sufficient incentive for providers to satisfy a condition under par. (a) 1. or 2. The proposal shall specify effective dates for the increases in reimbursement rates and the monthly per-patient care coordination fee that are no sooner than July 1, 2011. If the department promulgates a rule under sub. (2m) (c) 4., this paragraph does not apply to the extent that it conflicts with the rule.".

AB11-AA1,10,17 26. Page 52, line 11: after that line insert:

AB11-AA1,10,19 " Section 126d. 49.45 (24r) (a) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

AB11-AA1,11,2 49.45 (24r) (a) The department shall implement any waiver granted by the secretary of the federal department of health and human services to permit the department to conduct a demonstration project to provide family planning, as defined in s. 253.07 (1) (a), under medical assistance to any woman between the ages of 15 and 44 whose family income does not exceed 200% of the poverty line for a family the size of the woman's family. If the department promulgates a rule under sub. (2m) (c) 10., this paragraph does not apply to the extent it conflicts with the rule.".

AB11-AA1,11,3 27. Page 52, line 19: after that line insert:

AB11-AA1,11,5 " Section 127d. 49.45 (24r) (b) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

AB11-AA1,11,12 49.45 (24r) (b) The department may request an amended waiver from the secretary to permit the department to conduct a demonstration project to provide family planning to any man between the ages of 15 and 44 whose family income does not exceed 200 percent of the poverty line for a family the size of the man's family. If the amended waiver is granted, the department may implement the waiver. If the department promulgates a rule under sub. (2m) (c) 10., this paragraph does not apply to the extent it conflicts with the rule.".

AB11-AA1,11,13 28. Page 53, line 7: after that line insert:

AB11-AA1,11,15 " Section 128d. 49.45 (25g) (c) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

AB11-AA1,12,3 49.45 (25g) (c) The department's proposal under par. (b) shall specify increases in reimbursement rates for providers that satisfy the conditions under par. (b), and shall provide for payment of a monthly per-patient care coordination fee to those providers. The department shall set the increases in reimbursement rates and the monthly per-patient care coordination fee so that together they provide sufficient incentive for providers to satisfy a condition under par. (b) 1. or 2. The proposal shall specify effective dates for the increases in reimbursement rates and the monthly per-patient care coordination fee that are no sooner than January 1, 2011. The increases in reimbursement rates and monthly per-patient care coordination fees that are not provided by the federal government shall be paid from the appropriation under. s. 20.435 (1) (am). If the department promulgates a rule under sub. (2m) (c) 4., this paragraph does not apply to the extent it conflicts with the rule.".

AB11-AA1,12,4 29. Page 53, line 13: after that line insert:

AB11-AA1,12,6 " Section 129d. 49.45 (27) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

AB11-AA1,12,11 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), unless otherwise provided by the department by rule promulgated under sub. (2m) (c).".

AB11-AA1,12,12 30. Page 54, line 24: after that line insert:

AB11-AA1,12,14 " Section 130d. 49.45 (39) (b) 1. of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

AB11-AA1,13,25 49.45 (39) (b) 1. `Payment for school medical services.' If a school district or a cooperative educational service agency elects to provide school medical services and meets all requirements under par. (c), the department shall reimburse the school district or the cooperative educational service agency for 60% of the federal share of allowable charges for the school medical services that it provides , unless otherwise provided by the department by rule promulgated under sub. (2m) (c), and, as specified in subd. 2., for allowable administrative costs. If the Wisconsin Center for the Blind and Visually Impaired or the Wisconsin Educational Services Program for the Deaf and Hard of Hearing elects to provide school medical services and meets all requirements under par. (c), the department shall reimburse the department of public instruction for 60% of the federal share of allowable charges for the school medical services that the Wisconsin Center for the Blind and Visually Impaired or the Wisconsin Educational Services Program for the Deaf and Hard of Hearing provides, unless otherwise provided by the department by rule promulgated under sub. (2m) (c), and, as specified in subd. 2., for allowable administrative costs. A school district, cooperative educational service agency, the Wisconsin Center for the Blind and Visually Impaired or the Wisconsin Educational Services Program for the Deaf and Hard of Hearing may submit, and the department shall allow, claims for common carrier transportation costs as a school medical service unless the department receives notice from the federal health care financing administration that, under a change in federal policy, the claims are not allowed. If the department receives the notice, a school district, cooperative educational service agency, the Wisconsin Center for the Blind and Visually Impaired, or the Wisconsin Educational Services Program for the Deaf and Hard of Hearing may submit, and the department shall allow, unreimbursed claims for common carrier transportation costs incurred before the date of the change in federal policy. The department shall promulgate rules establishing a methodology for making reimbursements under this paragraph. All other expenses for the school medical services provided by a school district or a cooperative educational service agency shall be paid for by the school district or the cooperative educational service agency with funds received from state or local taxes. The school district, the Wisconsin Center for the Blind and Visually Impaired, the Wisconsin Educational Services Program for the Deaf and Hard of Hearing, or the cooperative educational service agency shall comply with all requirements of the federal department of health and human services for receiving federal financial participation.".

AB11-AA1,14,1 31. Page 55, line 2: after that line insert:

AB11-AA1,14,3 " Section 131d. 49.46 (1) (n) of the statutes, as created by 2011 Wisconsin Act .... (this act), is repealed.".

AB11-AA1,14,4 32. Page 55, line 7: after that line insert:

AB11-AA1,14,6 " Section 132d. 49.46 (2) (a) (intro.) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

AB11-AA1,14,10 49.46 (2) (a) (intro.) Except as provided in par. (be) and unless otherwise provided by the department by rule promulgated under s. 49.45 (2m) (c), the department shall audit and pay allowable charges to certified providers for medical assistance on behalf of recipients for the following federally mandated benefits:".

AB11-AA1,14,11 33. Page 55, line 12: after that line insert:

AB11-AA1,14,13 " Section 133d. 49.46 (2) (b) (intro.) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

AB11-AA1,14,17 49.46 (2) (b) (intro.) Except as provided in pars. (be) and (dc) and unless otherwise provided by the department by rule promulgated under s. 49.45 (2m) (c), the department shall audit and pay allowable charges to certified providers for medical assistance on behalf of recipients for the following services:".

AB11-AA1,14,18 34. Page 55, line 20: after that line insert:

AB11-AA1,14,20 " Section 134d. 49.465 (2) (intro.) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

AB11-AA1,15,3 49.465 (2) (intro.) Unless otherwise provided by the department by rule promulgated under s. 49.45 (2m) (c), a A pregnant woman is eligible for medical assistance benefits, as provided under sub. (3), during the period beginning on the day on which a qualified provider determines, on the basis of preliminary information, that the woman's family income does not exceed the highest level for eligibility for benefits under s. 49.46 (1) or 49.47 (4) (am) or (c) 1. and ending as follows:".

AB11-AA1,15,4 35. Page 55, line 25: after that line insert:

AB11-AA1,15,6 " Section 135d. 49.47 (4) (a) (intro.) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

AB11-AA1,15,10 49.47 (4) (a) (intro.) Unless otherwise provided by the department by rule under s. 49.45 (2m) (c), any Any individual who meets the limitations on income and resources under pars. (b) to (c) and who complies with pars. (cm) and (cr) shall be eligible for medical assistance under this section if such individual is:".

AB11-AA1,15,11 36. Page 56, line 13: after that line insert:

AB11-AA1,15,13 " Section 138d. 49.47 (5) (c) of the statutes, as created by 2011 Wisconsin Act .... (this act), is repealed.".

AB11-AA1,15,14 37. Page 56, line 17: after that line insert:

AB11-AA1,15,16 " Section 139d. 49.47 (6) (a) (intro.) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

AB11-AA1,15,19 49.47 (6) (a) (intro.) Unless otherwise provided by the department by rule promulgated under s. 49.45 (2m) (c), the The department shall audit and pay charges to certified providers for medical assistance on behalf of the following:".

AB11-AA1,15,20 38. Page 56, line 21: after that line insert:

AB11-AA1,15,22 " Section 140d. 49.471 (13) of the statutes, as created by 2011 Wisconsin Act .... (this act), is repealed.".

AB11-AA1,15,23 39. Page 57, line 2: after that line insert:

AB11-AA1,16,2 " Section 141d. 49.472 (3) (intro.) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

AB11-AA1,16,6 49.472 (3) Eligibility. (intro.) Except as provided in sub. (6) (a) and unless otherwise provided by the department by rule promulgated under s. 49.45 (2m) (c), an individual is eligible for and shall receive medical assistance under this section if all of the following conditions are met:".

AB11-AA1,16,7 40. Page 57, line 8: after that line insert:

AB11-AA1,16,9 " Section 142d. 49.472 (4) (b) (intro.) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

AB11-AA1,16,14 49.472 (4) (b) (intro.) The department may waive monthly premiums that are calculated to be below $10 per month. Unless otherwise provided by the department by rule promulgated under s. 49.45 (2m) (c), the The department may not assess a monthly premium for any individual whose income level, after adding the individual's earned income and unearned income, is below 150% of the poverty line.".

AB11-AA1,16,15 41. Page 57, line 14: after that line insert:

AB11-AA1,16,17 " Section 143d. 49.473 (2) (intro.) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

AB11-AA1,16,22 49.473 (2) (intro.) Unless otherwise provided by the department by rule promulgated under s. 49.45 (2m) (c), a A woman is eligible for medical assistance as provided under sub. (5) if, after applying to the department or a county department, the department or a county department determines that she meets all of the following requirements:".

AB11-AA1,16,23 42. Page 57, line 21: after that line insert:

AB11-AA1,17,2 " Section 144d. 49.473 (5) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

AB11-AA1,17,8 49.473 (5) The department shall audit and pay, from the appropriation accounts under s. 20.435 (4) (b) and (o), 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), unless otherwise provided by the department by rule promulgated under s. 49.45 (2m) (c).".

AB11-AA1,17,10 43. Page 58, line 15: delete "half of all actuarially required" and substitute "all employee required".

AB11-AA1,17,11 44. Page 58, line 17: delete "actuarially".

AB11-AA1,17,12 45. Page 60, line 5: after that line insert:

AB11-AA1,17,13 " Section 151d. 66.0509 (1m) of the statutes is created to read:

AB11-AA1,17,17 66.0509 (1m) (a) A local governmental unit, as defined in s. 66.0131 (1) (a), that does not have a civil service system on the effective date of this subsection .... [LRB inserts date], shall establish a grievance system not later than the first day of the 4th month beginning after the effective date of this subsection .... [LRB inserts date].

AB11-AA1,17,22 (b) To comply with the grievance system that is required under par. (a), a local governmental unit may establish either a civil service system under any provision authorized by law, to the greatest extent practicable, if no specific provision for the creation of a civil service system applies to that local governmental unit, or establish a grievance procedure as described under par. (d).

AB11-AA1,18,3 (c) Any civil service system that is established under any provision of law, and any grievance procedure that is created under this subsection, shall contain at least all of the following provisions:

AB11-AA1,18,4 1. A grievance procedure that addresses employee terminations.

AB11-AA1,18,5 2. Employee discipline.

AB11-AA1,18,6 3. Workplace safety.

AB11-AA1,18,8 (d) If a local governmental unit creates a grievance procedure under this subsection, the procedure shall contain at least all of the following elements:

AB11-AA1,18,10 1. A written document specifying the process that a grievant and an employer must follow.

AB11-AA1,18,11 2. A hearing before an impartial hearing officer.

AB11-AA1,18,13 3. An appeal process in which the highest level of appeal is the governing body of the local governmental unit.

AB11-AA1,18,18 (e) If an employee of a local governmental unit is covered by a civil service system on the effective date of this subsection .... [LRB inserts date], and if that system contains provisions that address the provisions specified in par. (c), the provisions that apply to the employee under his or her existing civil service system continue to apply to that employee.".

AB11-AA1,18,19 46. Page 60, line 16: after that line insert:

AB11-AA1,18,21 " Section 153g. 66.1105 (2) (k) of the statutes is renumbered 66.1105 (2) (k) 1. and amended to read:

AB11-AA1,19,8 66.1105 (2) (k) 1. "Tax incremental district" means a contiguous geographic area within a city defined and created by resolution of the local legislative body, consisting solely of whole units of property as are assessed for general property tax purposes, other than railroad rights-of-way, rivers or highways. Railroad rights-of-way, rivers or highways may be included in a tax incremental district only if they are continuously bounded on either side, or on both sides, by whole units of property as are assessed for general property tax purposes which are in the tax incremental district. "Tax incremental district" does not include any area identified as a wetland on a map under s. 23.32, except for an area identified on such a map that has been converted in compliance with state law so that it is no longer a wetland and except as provided in subd. 2.

AB11-AA1, s. 153m Section 153m. 66.1105 (2) (k) 2. of the statutes is created to read:

AB11-AA1,19,14 66.1105 (2) (k) 2. For an area that is identified as a wetland on a map under s. 23.32 and that is within the boundaries of a tax incremental district or is part of a tax incremental district parcel, the area shall be considered part of the tax incremental district for determining the applicability of exemptions from or compliance with water quality standards that are applicable to wetlands.".