AB11-CSA1,32,98 1. Increasing the cost effectiveness and efficiency of care and the care delivery
9system for Medical Assistance programs.
AB11-CSA1,32,1110 2. Limiting switching from private health insurance to Medical Assistance
11programs.
AB11-CSA1,32,1312 3. Ensuring the long-term viability and sustainability of Medical Assistance
13programs.
AB11-CSA1,32,1514 4. Advancing the accuracy and reliability of eligibility for Medical Assistance
15programs and claims determinations and payments.
AB11-CSA1,32,1716 5. Improving the health status of individuals who receive benefits under a
17Medical Assistance program.
AB11-CSA1,32,1918 6. Aligning Medical Assistance program benefit recipient and service provider
19incentives with health care outcomes.
AB11-CSA1,32,2020 7. Supporting responsibility and choice of medical assistance recipients.
AB11-CSA1,32,2421 (c) If the department determines, as a result of the study under par. (b), that
22revision of existing statutes or rules would be necessary to advance a purpose
23described in par. (b) 1. to 7., the department may promulgate rules that do any of the
24following related to Medical Assistance programs:
AB11-CSA1,33,2
11. Require cost sharing from program benefit recipients up to the maximum
2allowed by federal law or a waiver of federal law.
AB11-CSA1,33,43 2. Authorize providers to deny care or services if a program benefit recipient
4is unable to share costs, to the extent allowed by federal law or waiver.
AB11-CSA1,33,65 3. Modify existing benefits or establish various benefit packages and offer
6different packages to different groups of recipients.
AB11-CSA1,33,77 4. Revise provider reimbursement models for particular services.
AB11-CSA1,33,88 5. Mandate that program benefit recipients enroll in managed care.
AB11-CSA1,33,99 6. Restrict or eliminate presumptive eligibility.
AB11-CSA1,33,1110 7. To the extent permitted by federal law, impose restrictions on providing
11benefits to individuals who are not citizens of the United States.
AB11-CSA1,33,1212 8. Set standards for establishing and verifying eligibility requirements.
AB11-CSA1,33,1413 9. Develop standards and methodologies to assure accurate eligibility
14determinations and redetermine continuing eligibility.
AB11-CSA1,33,1615 10. Reduce income levels for purposes of determining eligibility to the extent
16allowed by federal law or waiver and subject to the limitations under par. (e) 2.
AB11-CSA1,33,2217 (e) 1. The department shall submit an amendment to the state Medical
18Assistance plan or request a waiver of federal laws related to medical assistance, if
19necessary, to the extent necessary to implement any rule promulgated under par. (c).
20If the federal department of health and human services does not allow the
21amendment or does not grant the waiver, the department may not put the rule into
22effect or implement the action described in the rule.
AB11-CSA1,34,723 2. The department shall request a waiver from the secretary of the federal
24department of health and human services to permit the department to have in effect
25eligibility standards, methodologies, and procedures under the state Medical

1Assistance plan or waivers of federal laws related to medical assistance that are more
2restrictive than those in place on March 23, 2010. If the waiver request does not
3receive federal approval before December 31, 2011, the department shall reduce
4income levels on July 1, 2012, for the purposes of determining eligibility to 133
5percent of the federal poverty line for adults who are not pregnant and not disabled,
6to the extent permitted under 42 USC 1396a (gg), if the department follows the
7procedures under 42 USC 1396a (gg) (3).
AB11-CSA1, s. 100 8Section 100. 49.45 (2m) of the statutes, as created by 2011 Wisconsin Act ....
9(this act), is repealed.
AB11-CSA1, s. 101 10Section 101. 49.45 (3) (n) of the statutes is created to read:
AB11-CSA1,34,1211 49.45 (3) (n) This subsection does not apply if the department promulgates a
12rule under sub. (2m) (c) 4., to the extent that the rule conflicts with this subsection.
AB11-CSA1, s. 102 13Section 102. 49.45 (3) (n) of the statutes, as created by 2011 Wisconsin Act ....
14(this act), is repealed.
AB11-CSA1, s. 103 15Section 103. 49.45 (6m) (n) of the statutes is created to read:
AB11-CSA1,34,1716 49.45 (6m) (n) This subsection does not apply if the department promulgates
17a rule under sub. (2m) (c) 4., to the extent that the rule conflicts with this subsection.
AB11-CSA1, s. 104 18Section 104. 49.45 (6m) (n) of the statutes, as created by 2011 Wisconsin Act
19.... (this act), is repealed.
AB11-CSA1, s. 105 20Section 105. 49.45 (8) (b) of the statutes is amended to read:
AB11-CSA1,35,221 49.45 (8) (b) Reimbursement Unless otherwise provided by the department by
22rule promulgated under sub. (2m) (c), reimbursement
under s. 20.435 (4) (b), (o), and
23(w) for home health services provided by a certified home health agency or
24independent nurse shall be made at the home health agency's or nurse's usual and

1customary fee per patient care visit, subject to a maximum allowable fee per patient
2care visit that is established under par. (c).
AB11-CSA1, s. 106 3Section 106. 49.45 (8) (b) of the statutes, as affected by 2011 Wisconsin Act ....
4(this act), is amended to read:
AB11-CSA1,35,105 49.45 (8) (b) Unless otherwise provided by the department by rule promulgated
6under sub. (2m) (c), reimbursement
Reimbursement under s. 20.435 (4) (b), (o), and
7(w) for home health services provided by a certified home health agency or
8independent nurse shall be made at the home health agency's or nurse's usual and
9customary fee per patient care visit, subject to a maximum allowable fee per patient
10care visit that is established under par. (c).
AB11-CSA1, s. 107 11Section 107. 49.45 (8) (c) of the statutes is amended to read:
AB11-CSA1,35,1712 49.45 (8) (c) The department shall establish a maximum statewide allowable
13fee per patient care visit, for each type of visit with respect to provider, that may be
14no greater than the cost per patient care visit, as determined by the department from
15cost reports of home health agencies, adjusted for costs related to case management,
16care coordination, travel, record keeping and supervision, unless otherwise provided
17by the department by rule promulgated under sub. (2m) (c)
.
AB11-CSA1, s. 108 18Section 108. 49.45 (8) (c) of the statutes, as affected by 2011 Wisconsin Act ....
19(this act), is amended to read:
AB11-CSA1,35,2520 49.45 (8) (c) The department shall establish a maximum statewide allowable
21fee per patient care visit, for each type of visit with respect to provider, that may be
22no greater than the cost per patient care visit, as determined by the department from
23cost reports of home health agencies, adjusted for costs related to case management,
24care coordination, travel, record keeping and supervision, unless otherwise provided
25by the department by rule promulgated under sub. (2m) (c)
.
AB11-CSA1, s. 109
1Section 109. 49.45 (8r) of the statutes is amended to read:
AB11-CSA1,36,92 49.45 (8r) Payment for certain obstetric and gynecological care. The Unless
3otherwise provided by the department by rule promulgated under sub. (2m) (c), the

4rate of payment for obstetric and gynecological care provided in primary care
5shortage areas, as defined in s. 36.60 (1) (cm), or provided to recipients of medical
6assistance who reside in primary care shortage areas, that is equal to 125% of the
7rates paid under this section to primary care physicians in primary care shortage
8areas, shall be paid to all certified primary care providers who provide obstetric or
9gynecological care to those recipients.
AB11-CSA1, s. 110 10Section 110. 49.45 (8r) of the statutes, as affected by 2011 Wisconsin Act ....
11(this act), is amended to read:
AB11-CSA1,36,1912 49.45 (8r) Payment for certain obstetric and gynecological care. Unless
13otherwise provided by the department by rule promulgated under sub. (2m) (c), the

14The rate of payment for obstetric and gynecological care provided in primary care
15shortage areas, as defined in s. 36.60 (1) (cm), or provided to recipients of medical
16assistance who reside in primary care shortage areas, that is equal to 125% of the
17rates paid under this section to primary care physicians in primary care shortage
18areas, shall be paid to all certified primary care providers who provide obstetric or
19gynecological care to those recipients.
AB11-CSA1, s. 111 20Section 111. 49.45 (8v) of the statutes is amended to read:
AB11-CSA1,37,621 49.45 (8v) Incentive-based pharmacy payment system. The department shall
22establish a system of payment to pharmacies for legend and over-the-counter drugs
23provided to recipients of medical assistance that has financial incentives for
24pharmacists who perform services that result in savings to the medical assistance
25program. Under this system, the department shall establish a schedule of fees that

1is designed to ensure that any incentive payments made are equal to or less than the
2documented savings unless otherwise provided by the department by rule
3promulgated under sub. (2m) (c)
. The department may discontinue the system
4established under this subsection if the department determines, after performance
5of a study, that payments to pharmacists under the system exceed the documented
6savings under the system.
AB11-CSA1, s. 112 7Section 112. 49.45 (8v) of the statutes, as affected by 2011 Wisconsin Act ....
8(this act), is amended to read:
AB11-CSA1,37,199 49.45 (8v) Incentive-based pharmacy payment system. The department shall
10establish a system of payment to pharmacies for legend and over-the-counter drugs
11provided to recipients of medical assistance that has financial incentives for
12pharmacists who perform services that result in savings to the medical assistance
13program. Under this system, the department shall establish a schedule of fees that
14is designed to ensure that any incentive payments made are equal to or less than the
15documented savings unless otherwise provided by the department by rule
16promulgated under sub. (2m) (c)
. The department may discontinue the system
17established under this subsection if the department determines, after performance
18of a study, that payments to pharmacists under the system exceed the documented
19savings under the system.
AB11-CSA1, s. 113 20Section 113. 49.45 (18) (ac) of the statutes is amended to read:
AB11-CSA1,38,821 49.45 (18) (ac) Except as provided in pars. (am) to (d), and subject to par. (ag),
22any person eligible for medical assistance under s. 49.46, 49.468, or 49.47, or for the
23benefits under s. 49.46 (2) (a) and (b) under s. 49.471 shall pay up to the maximum
24amounts allowable under 42 CFR 447.53 to 447.58 for purchases of services provided
25under s. 49.46 (2). The service provider shall collect the specified or allowable

1copayment, coinsurance, or deductible, unless the service provider determines that
2the cost of collecting the copayment, coinsurance, or deductible exceeds the amount
3to be collected. The department shall reduce payments to each provider by the
4amount of the specified or allowable copayment, coinsurance, or deductible. No
5Unless otherwise provided by the department by rule promulgated under sub. (2m)
6(c), no
provider may deny care or services because the recipient is unable to share
7costs, but an inability to share costs specified in this subsection does not relieve the
8recipient of liability for these costs.
AB11-CSA1, s. 114 9Section 114. 49.45 (18) (ac) of the statutes, as affected by 2011 Wisconsin Act
10.... (this act), is amended to read:
AB11-CSA1,38,2311 49.45 (18) (ac) Except as provided in pars. (am) to (d), and subject to par. (ag),
12any person eligible for medical assistance under s. 49.46, 49.468, or 49.47, or for the
13benefits under s. 49.46 (2) (a) and (b) under s. 49.471 shall pay up to the maximum
14amounts allowable under 42 CFR 447.53 to 447.58 for purchases of services provided
15under s. 49.46 (2). The service provider shall collect the specified or allowable
16copayment, coinsurance, or deductible, unless the service provider determines that
17the cost of collecting the copayment, coinsurance, or deductible exceeds the amount
18to be collected. The department shall reduce payments to each provider by the
19amount of the specified or allowable copayment, coinsurance, or deductible. Unless
20otherwise provided by the department by rule promulgated under sub. (2m) (c), no

21No provider may deny care or services because the recipient is unable to share costs,
22but an inability to share costs specified in this subsection does not relieve the
23recipient of liability for these costs.
AB11-CSA1, s. 115 24Section 115. 49.45 (18) (ag) (intro.) of the statutes is amended to read:
AB11-CSA1,39,3
149.45 (18) (ag) (intro.) Except as provided in pars. (am), (b), and (c), and subject
2to par. (d), a recipient specified in par. (ac) shall pay all of the following, unless
3otherwise provided by the department by rule promulgated under sub. (2m) (c)
:
AB11-CSA1, s. 116 4Section 116. 49.45 (18) (ag) (intro.) of the statutes, as affected by 2011
5Wisconsin Act .... (this act), is amended to read:
AB11-CSA1,39,86 49.45 (18) (ag) (intro.) Except as provided in pars. (am), (b), and (c), and subject
7to par. (d), a recipient specified in par. (ac) shall pay all of the following, unless
8otherwise provided by the department by rule promulgated under sub. (2m) (c)
:
AB11-CSA1, s. 117 9Section 117. 49.45 (18) (b) (intro.) of the statutes is amended to read:
AB11-CSA1,39,1210 49.45 (18) (b) (intro.) The Unless otherwise provided by the department by rule
11promulgated under sub. (2m) (c), the
following services are not subject to recipient
12cost sharing under this subsection:
AB11-CSA1, s. 118 13Section 118. 49.45 (18) (b) (intro.) of the statutes, as affected by 2011
14Wisconsin Act .... (this act), is amended to read:
AB11-CSA1,39,1715 49.45 (18) (b) (intro.) Unless otherwise provided by the department by rule
16promulgated under sub. (2m) (c), the
The following services are not subject to
17recipient cost sharing under this subsection:
AB11-CSA1, s. 119 18Section 119. 49.45 (18) (d) of the statutes is amended to read:
AB11-CSA1,39,2319 49.45 (18) (d) No person who designates a pharmacy or pharmacist as his or
20her sole provider of prescription drugs and who so uses that pharmacy or pharmacist
21is liable under this subsection for more than $12 per month for prescription drugs
22received, unless otherwise provided by the department by rule promulgated under
23sub. (2m) (c)
.
AB11-CSA1, s. 120 24Section 120. 49.45 (18) (d) of the statutes, as affected by 2011 Wisconsin Act
25.... (this act), is amended to read:
AB11-CSA1,40,5
149.45 (18) (d) No person who designates a pharmacy or pharmacist as his or
2her sole provider of prescription drugs and who so uses that pharmacy or pharmacist
3is liable under this subsection for more than $12 per month for prescription drugs
4received, unless otherwise provided by the department by rule promulgated under
5sub. (2m) (c)
.
AB11-CSA1, s. 121 6Section 121. 49.45 (23) (a) of the statutes is amended to read:
AB11-CSA1,40,157 49.45 (23) (a) The department shall request a waiver from the secretary of the
8federal department of health and human services to permit the department to
9conduct a demonstration project to provide health care coverage for basic primary
10and preventive care to adults who are under the age of 65, who have family incomes
11not to exceed 200 percent of the poverty line, and who are not otherwise eligible for
12medical assistance under this subchapter, the Badger Care health care program
13under s. 49.665, or Medicare under 42 USC 1395 et seq. If the department
14promulgates a rule under sub. (2m) (c) 10., this paragraph does not apply to the
15extent that it conflicts with the rule.
AB11-CSA1, s. 122 16Section 122. 49.45 (23) (a) of the statutes, as affected by 2011 Wisconsin Act
17.... (this act), is amended to read:
AB11-CSA1,41,218 49.45 (23) (a) The department shall request a waiver from the secretary of the
19federal department of health and human services to permit the department to
20conduct a demonstration project to provide health care coverage for basic primary
21and preventive care to adults who are under the age of 65, who have family incomes
22not to exceed 200 percent of the poverty line, and who are not otherwise eligible for
23medical assistance under this subchapter, the Badger Care health care program
24under s. 49.665, or Medicare under 42 USC 1395 et seq. If the department

1promulgates a rule under sub. (2m) (c) 10., this paragraph does not apply to the
2extent that it conflicts with the rule.
AB11-CSA1, s. 123 3Section 123. 49.45 (23) (b) of the statutes is amended to read:
AB11-CSA1,41,134 49.45 (23) (b) If the waiver is granted and in effect, the department may
5promulgate rules defining the health care benefit plan, including more specific
6eligibility requirements and cost-sharing requirements. Cost Unless otherwise
7provided by the department by rule promulgated under sub. (2m) (c), cost
sharing
8may include an annual enrollment fee, which may not exceed $75 per year.
9Notwithstanding s. 227.24 (3), the plan details under this subsection may be
10promulgated as an emergency rule under s. 227.24 without a finding of emergency.
11If the waiver is granted and in effect, the demonstration project under this subsection
12shall begin on January 1, 2009, or on the effective date of the waiver, whichever is
13later.
AB11-CSA1, s. 124 14Section 124. 49.45 (23) (b) of the statutes, as affected by 2011 Wisconsin Act
15.... (this act), is amended to read:
AB11-CSA1,41,2516 49.45 (23) (b) If the waiver is granted and in effect, the department may
17promulgate rules defining the health care benefit plan, including more specific
18eligibility requirements and cost-sharing requirements. Unless otherwise provided
19by the department by rule promulgated under sub. (2m) (c), cost
Cost sharing may
20include an annual enrollment fee, which may not exceed $75 per year.
21Notwithstanding s. 227.24 (3), the plan details under this subsection may be
22promulgated as an emergency rule under s. 227.24 without a finding of emergency.
23If the waiver is granted and in effect, the demonstration project under this subsection
24shall begin on January 1, 2009, or on the effective date of the waiver, whichever is
25later.
AB11-CSA1, s. 125
1Section 125. 49.45 (24g) (c) of the statutes is amended to read:
AB11-CSA1,42,112 49.45 (24g) (c) The department's proposal under par. (a) shall specify increases
3in reimbursement rates for providers that satisfy the conditions under par. (a) 1. or
42., and shall provide for payment of a monthly per-patient care coordination fee to
5those providers. The department shall set the increases in reimbursement rates and
6the monthly per-patient care coordination fee so that together they provide
7sufficient incentive for providers to satisfy a condition under par. (a) 1. or 2. The
8proposal shall specify effective dates for the increases in reimbursement rates and
9the monthly per-patient care coordination fee that are no sooner than July 1, 2011.
10If the department promulgates a rule under sub. (2m) (c) 4., this paragraph does not
11apply to the extent that it conflicts with the rule.
AB11-CSA1, s. 126 12Section 126. 49.45 (24g) (c) of the statutes, as affected by 2011 Wisconsin Act
13.... (this act), is amended to read:
AB11-CSA1,42,2314 49.45 (24g) (c) The department's proposal under par. (a) shall specify increases
15in reimbursement rates for providers that satisfy the conditions under par. (a) 1. or
162., and shall provide for payment of a monthly per-patient care coordination fee to
17those providers. The department shall set the increases in reimbursement rates and
18the monthly per-patient care coordination fee so that together they provide
19sufficient incentive for providers to satisfy a condition under par. (a) 1. or 2. The
20proposal shall specify effective dates for the increases in reimbursement rates and
21the monthly per-patient care coordination fee that are no sooner than July 1, 2011.
22If the department promulgates a rule under sub. (2m) (c) 4., this paragraph does not
23apply to the extent that it conflicts with the rule.
AB11-CSA1, s. 127 24Section 127. 49.45 (24r) (a) of the statutes is amended to read:
AB11-CSA1,43,7
149.45 (24r) (a) The department shall implement any waiver granted by the
2secretary of the federal department of health and human services to permit the
3department to conduct a demonstration project to provide family planning, as
4defined in s. 253.07 (1) (a), under medical assistance to any woman between the ages
5of 15 and 44 whose family income does not exceed 200% of the poverty line for a family
6the size of the woman's family. If the department promulgates a rule under sub. (2m)
7(c) 10., this paragraph does not apply to the extent it conflicts with the rule.
AB11-CSA1, s. 128 8Section 128. 49.45 (24r) (a) of the statutes, as affected by 2011 Wisconsin Act
9.... (this act), is amended to read:
AB11-CSA1,43,1610 49.45 (24r) (a) The department shall implement any waiver granted by the
11secretary of the federal department of health and human services to permit the
12department to conduct a demonstration project to provide family planning, as
13defined in s. 253.07 (1) (a), under medical assistance to any woman between the ages
14of 15 and 44 whose family income does not exceed 200% of the poverty line for a family
15the size of the woman's family. If the department promulgates a rule under sub. (2m)
16(c) 10., this paragraph does not apply to the extent it conflicts with the rule.
AB11-CSA1, s. 129 17Section 129. 49.45 (24r) (b) of the statutes is amended to read:
AB11-CSA1,43,2418 49.45 (24r) (b) The department may request an amended waiver from the
19secretary to permit the department to conduct a demonstration project to provide
20family planning to any man between the ages of 15 and 44 whose family income does
21not exceed 200 percent of the poverty line for a family the size of the man's family.
22If the amended waiver is granted, the department may implement the waiver. If the
23department promulgates a rule under sub. (2m) (c) 10., this paragraph does not apply
24to the extent it conflicts with the rule.
AB11-CSA1, s. 130
1Section 130. 49.45 (24r) (b) of the statutes, as affected by 2011 Wisconsin Act
2.... (this act), is amended to read:
AB11-CSA1,44,93 49.45 (24r) (b) The department may request an amended waiver from the
4secretary to permit the department to conduct a demonstration project to provide
5family planning to any man between the ages of 15 and 44 whose family income does
6not exceed 200 percent of the poverty line for a family the size of the man's family.
7If the amended waiver is granted, the department may implement the waiver. If the
8department promulgates a rule under sub. (2m) (c) 10., this paragraph does not apply
9to the extent it conflicts with the rule.
AB11-CSA1, s. 131 10Section 131. 49.45 (25g) (c) of the statutes is amended to read:
AB11-CSA1,44,2211 49.45 (25g) (c) The department's proposal under par. (b) shall specify increases
12in reimbursement rates for providers that satisfy the conditions under par. (b), and
13shall provide for payment of a monthly per-patient care coordination fee to those
14providers. The department shall set the increases in reimbursement rates and the
15monthly per-patient care coordination fee so that together they provide sufficient
16incentive for providers to satisfy a condition under par. (b) 1. or 2. The proposal shall
17specify effective dates for the increases in reimbursement rates and the monthly
18per-patient care coordination fee that are no sooner than January 1, 2011. The
19increases in reimbursement rates and monthly per-patient care coordination fees
20that are not provided by the federal government shall be paid from the appropriation
21under. s. 20.435 (1) (am). If the department promulgates a rule under sub. (2m) (c)
224., this paragraph does not apply to the extent it conflicts with the rule.
AB11-CSA1, s. 132 23Section 132. 49.45 (25g) (c) of the statutes, as affected by 2011 Wisconsin Act
24.... (this act), is amended to read:
AB11-CSA1,45,12
149.45 (25g) (c) The department's proposal under par. (b) shall specify increases
2in reimbursement rates for providers that satisfy the conditions under par. (b), and
3shall provide for payment of a monthly per-patient care coordination fee to those
4providers. The department shall set the increases in reimbursement rates and the
5monthly per-patient care coordination fee so that together they provide sufficient
6incentive for providers to satisfy a condition under par. (b) 1. or 2. The proposal shall
7specify effective dates for the increases in reimbursement rates and the monthly
8per-patient care coordination fee that are no sooner than January 1, 2011. The
9increases in reimbursement rates and monthly per-patient care coordination fees
10that are not provided by the federal government shall be paid from the appropriation
11under. s. 20.435 (1) (am). If the department promulgates a rule under sub. (2m) (c)
124., this paragraph does not apply to the extent it conflicts with the rule.
AB11-CSA1, s. 133 13Section 133. 49.45 (27) of the statutes is amended to read:
AB11-CSA1,45,1814 49.45 (27) Eligibility of aliens. A person who is not a U.S. citizen or an alien
15lawfully admitted for permanent residence or otherwise permanently residing in the
16United States under color of law may not receive medical assistance benefits except
17as provided under 8 USC 1255a (h) (3) or 42 USC 1396b (v), unless otherwise
18provided by the department by rule promulgated under sub. (2m) (c)
.
AB11-CSA1, s. 134 19Section 134. 49.45 (27) of the statutes, as affected by 2011 Wisconsin Act ....
20(this act), is amended to read:
AB11-CSA1,45,2521 49.45 (27) Eligibility of aliens. A person who is not a U.S. citizen or an alien
22lawfully admitted for permanent residence or otherwise permanently residing in the
23United States under color of law may not receive medical assistance benefits except
24as provided under 8 USC 1255a (h) (3) or 42 USC 1396b (v), unless otherwise
25provided by the department by rule promulgated under sub. (2m) (c)
.
AB11-CSA1, s. 135
1Section 135. 49.45 (39) (b) 1. of the statutes is amended to read:
AB11-CSA1,47,112 49.45 (39) (b) 1. `Payment for school medical services.' If a school district or a
3cooperative educational service agency elects to provide school medical services and
4meets all requirements under par. (c), the department shall reimburse the school
5district or the cooperative educational service agency for 60% of the federal share of
6allowable charges for the school medical services that it provides , unless otherwise
7provided by the department by rule promulgated under sub. (2m) (c),
and, as
8specified in subd. 2., for allowable administrative costs. If the Wisconsin Center for
9the Blind and Visually Impaired or the Wisconsin Educational Services Program for
10the Deaf and Hard of Hearing elects to provide school medical services and meets all
11requirements under par. (c), the department shall reimburse the department of
12public instruction for 60% of the federal share of allowable charges for the school
13medical services that the Wisconsin Center for the Blind and Visually Impaired or
14the Wisconsin Educational Services Program for the Deaf and Hard of Hearing
15provides, unless otherwise provided by the department by rule promulgated under
16sub. (2m) (c),
and, as specified in subd. 2., for allowable administrative costs. A school
17district, cooperative educational service agency, the Wisconsin Center for the Blind
18and Visually Impaired or the Wisconsin Educational Services Program for the Deaf
19and Hard of Hearing may submit, and the department shall allow, claims for common
20carrier transportation costs as a school medical service unless the department
21receives notice from the federal health care financing administration that, under a
22change in federal policy, the claims are not allowed. If the department receives the
23notice, a school district, cooperative educational service agency, the Wisconsin
24Center for the Blind and Visually Impaired, or the Wisconsin Educational Services
25Program for the Deaf and Hard of Hearing may submit, and the department shall

1allow, unreimbursed claims for common carrier transportation costs incurred before
2the date of the change in federal policy. The department shall promulgate rules
3establishing a methodology for making reimbursements under this paragraph. All
4other expenses for the school medical services provided by a school district or a
5cooperative educational service agency shall be paid for by the school district or the
6cooperative educational service agency with funds received from state or local taxes.
7The school district, the Wisconsin Center for the Blind and Visually Impaired, the
8Wisconsin Educational Services Program for the Deaf and Hard of Hearing, or the
9cooperative educational service agency shall comply with all requirements of the
10federal department of health and human services for receiving federal financial
11participation.
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