Amendment JR1 SA1-SB11

LRBb0051/2

RAC/TJD/MES/JTK:all:md

January 2011 Special Session

2011 - 2012 LEGISLATURE

SENATE AMENDMENT 1, TO SENATE BILL 11

February 17, 2011 - Offered by Joint Committee on Finance.

SB11-SA1,1,1 At the locations indicated, amend the bill as follows:

SB11-SA1,1,2 1. Page 1, line 4: delete "an appropriation" and substitute "appropriations".

SB11-SA1,1,3 2. Page 9, line 21: after that line insert:

SB11-SA1,1,4 " Section 5m. 13.488 (1) (m) of the statutes is amended to read:

SB11-SA1,2,3 13.488 (1) (m) The duty to compute determine and make payments to the United States required under 26 USC 148 (f) so that public debt, revenue obligations and operating notes issued pursuant to ch. 18 will not be treated as arbitrage bonds for the purpose of exclusion from gross income under 26 USC 103 (b) (2) so as to avoid an adverse effect on any exclusion of interest from gross income for federal income tax purposes on public debt, revenue obligations, and operating notes issued pursuant to ch. 18, master lease obligations issued pursuant to s. 16.76, and appropriation obligations issued pursuant to s. 16.527 and to make any payments to advisors that assist in making the determination. If the proceeds of an obligation are utilized for an activity that is financed from program revenue, the building commission shall make the payment payments required under this paragraph from that revenue, to the extent it is available.".

SB11-SA1,2,5 3. Page 11, line 23: delete the material beginning with that line and ending with page 12, line 10.

SB11-SA1,2,7 4. Page 24, line 2: delete "Notwithstanding" and substitute "Except as provided in sub. (3m) and notwithstanding".

SB11-SA1,2,8 5. Page 24, line 11: delete lines 11 to 22 and substitute:

SB11-SA1,2,16 "(2) If there is any outstanding public debt, a portion of which was used to finance the acquisition, construction, or improvement of any plant that is sold, or is the subject of a contract for operation, under sub. (1), the department shall determine any actions that may be necessary or appropriate so as not to adversely affect any exclusion of interest on such public debt from gross income for federal income tax purposes, including payments to advisors or the federal internal revenue service. The department shall apply the net proceeds from any sale of a plant to do all of the following:

SB11-SA1,2,18 (a) To make any payments to advisors or the federal internal revenue service determined by the department to be necessary or appropriate.

SB11-SA1,2,20 (b) If the plant was acquired, constructed, or improved with federal financial assistance, to repay the federal government, as required by federal law.

SB11-SA1,2,24 (c) To deposit a sufficient amount of the net proceeds from any sale of the plant in the bond security and redemption fund under s. 18.09 to repay the principal and pay the interest on such portion of the public debt, and any premium due upon repayment of such portion of the public debt.

SB11-SA1,3,3 (3) Except as provided in s. 51.06, the department shall deposit in the budget stabilization fund any net proceeds in excess of the amount required to be deposited or paid under sub. (2).".

SB11-SA1,3,4 6. Page 24, line 22: after that line insert:

SB11-SA1,3,15 "(3m) If the department proposes to sell, lease, or contract for the operation of any plant identified in sub. (1), the department shall first notify the joint committee on finance in writing of its proposed action. If the cochairpersons of the committee do not notify the department that the committee has scheduled a meeting for the purpose of reviewing the proposed sale within 14 working days after the date of the department's notification, the plant may be sold by the department. If, within 14 working days after the date of the department's notification, the cochairpersons of the committee notify the department that the committee has scheduled a meeting for the purpose of reviewing the proposed sale, the plant may be sold under sub. (1) only upon approval of the committee. Together with any notification, the department shall also provide all of the following:

SB11-SA1,3,17 (a) The estimated value of the plant as determined by the department and by at least one qualified privately owned assessor.

SB11-SA1,3,19 (b) The full cost of retiring any remaining public debt incurred to finance the acquisition, construction, or improvement of the plant.

SB11-SA1,3,22 (c) A cost-benefit analysis that considers the short-term and long-term costs and benefits to the state from selling, leasing, or contracting for the operation of the plant.

SB11-SA1,3,24 (d) The length and conditions of any proposed sale, lease, or service agreement between this state and a proposed purchaser, lessee, or contractor.

SB11-SA1,4,3 (e) The estimated budgetary impact of the proposed sale, lease, or contractual operation upon affected state agencies for at least the current and following fiscal biennium.

SB11-SA1,4,4 (f) Any other information requested by the committee.".

SB11-SA1,4,6 7. Page 28, line 9: delete the material beginning with "No moneys" and ending with "administration." on line 10.

SB11-SA1,4,7 8. Page 31, line 3: after that line insert:

SB11-SA1,4,8 " Section 63m. 20.867 (3) (h) of the statutes is amended to read:

SB11-SA1,5,5 20.867 (3) (h) Principal repayment, interest, and rebates, and tax-related payments. A sum sufficient to guarantee full payment of principal and interest costs for self-amortizing or partially self-amortizing facilities enumerated under ss. 20.190 (1) (j), 20.245 (1) (j), 20.285 (1) (im), (je), (jq), (kd), (km), and (ko), 20.370 (7) (eq), 20.485 (1) (go), and 20.867 (3) (kd) if moneys available in those appropriations are insufficient to make full payment, to make full payment of the amounts determined by the building commission under s. 13.488 (1) (m) if the appropriation under s. 20.190 (1) (j), 20.245 (1) (j), 20.285 (1) (im), (je), (jq), (kd), (km), or (ko), 20.485 (1) (g), or 20.867 (3) (kd) is insufficient to make full payment of those amounts, and to make payments under an agreement or ancillary arrangement entered into under s. 18.06 (8) (a), and to make payments to the federal internal revenue service or to advisors determined under s. 16.896 (2) if the net proceeds from a sale under s. 16.896 are insufficient to make such payments or if there are no net proceeds. All amounts advanced under the authority of this paragraph shall be repaid to the general fund whenever the balance of the appropriation for which the advance was made is sufficient to meet any portion of the amount advanced. The department of administration may take whatever action is deemed necessary including the making of transfers from program revenue appropriations and corresponding appropriations from program receipts in segregated funds and including actions to enforce contractual obligations that will result in additional program revenue for the state, to ensure recovery of the amounts advanced.".

SB11-SA1,5,7 9. Page 34, line 22: delete the material beginning with ", other" and ending with "230.26" on line 23.

SB11-SA1,5,8 10. Page 37, line 10: delete lines 10 to 24.

SB11-SA1,5,9 11. Page 41, line 16: delete lines 16 to 18.

SB11-SA1,5,10 12. Page 48, line 2: after that line insert:

SB11-SA1,5,12 " Section 112d. 49.45 (2m) of the statutes, as created by 2011 Wisconsin Act .... (this act), is repealed.".

SB11-SA1,5,13 13. Page 48, line 5: after that line insert:

SB11-SA1,5,15 " Section 113d. 49.45 (3) (n) of the statutes, as created by 2011 Wisconsin Act .... (this act), is repealed.".

SB11-SA1,5,16 14. Page 48, line 8: after that line insert:

SB11-SA1,5,18 " Section 114d. 49.45 (6m) (n) of the statutes, as created by 2011 Wisconsin Act .... (this act), is repealed.".

SB11-SA1,5,19 15. Page 48, line 15: after that line insert:

SB11-SA1,5,21 " Section 115d. 49.45 (8) (b) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

SB11-SA1,6,3 49.45 (8) (b) Unless otherwise provided by the department by rule promulgated under sub. (2m) (c), reimbursement Reimbursement under s. 20.435 (4) (b), (o), and (w) 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).".

SB11-SA1,6,4 16. Page 48, line 22: after that line insert:

SB11-SA1,6,6 " Section 116d. 49.45 (8) (c) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

SB11-SA1,6,12 49.45 (8) (c) The department shall establish a maximum statewide allowable fee per patient care visit, for each type of visit with respect to provider, that may be no greater than the cost per patient care visit, as determined by the department from cost reports of home health agencies, adjusted for costs related to case management, care coordination, travel, record keeping and supervision, unless otherwise provided by the department by rule promulgated under sub. (2m) (c).".

SB11-SA1,6,13 17. Page 49, line 6: after that line insert:

SB11-SA1,6,15 " Section 117d. 49.45 (8r) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

SB11-SA1,6,23 49.45 (8r) Payment for certain obstetric and gynecological care. Unless otherwise provided by the department by rule promulgated under sub. (2m) (c), the The rate of payment for obstetric and gynecological care provided in primary care shortage areas, as defined in s. 36.60 (1) (cm), or provided to recipients of medical assistance who reside in primary care shortage areas, that is equal to 125% of the rates paid under this section to primary care physicians in primary care shortage areas, shall be paid to all certified primary care providers who provide obstetric or gynecological care to those recipients.".

SB11-SA1,6,24 18. Page 49, line 18: after that line insert:

SB11-SA1,7,2 " Section 118d. 49.45 (8v) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

SB11-SA1,7,13 49.45 (8v) Incentive-based pharmacy payment system. The department shall establish a system of payment to pharmacies for legend and over-the-counter drugs provided to recipients of medical assistance that has financial incentives for pharmacists who perform services that result in savings to the medical assistance program. Under this system, the department shall establish a schedule of fees that is designed to ensure that any incentive payments made are equal to or less than the documented savings unless otherwise provided by the department by rule promulgated under sub. (2m) (c). The department may discontinue the system established under this subsection if the department determines, after performance of a study, that payments to pharmacists under the system exceed the documented savings under the system.".

SB11-SA1,7,14 19. Page 50, line 7: after that line insert:

SB11-SA1,7,16 " Section 119d. 49.45 (18) (ac) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

SB11-SA1,8,5 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.".

SB11-SA1,8,6 20. Page 50, line 11: after that line insert:

SB11-SA1,8,8 " Section 120d. 49.45 (18) (ag) (intro.) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

SB11-SA1,8,11 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):".

SB11-SA1,8,12 21. Page 50, line 15: after that line insert:

SB11-SA1,8,14 " Section 121d. 49.45 (18) (b) (intro.) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

SB11-SA1,8,17 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:".

SB11-SA1,8,18 22. Page 50, line 21: after that line insert:

SB11-SA1,8,20 " Section 122d. 49.45 (18) (d) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

SB11-SA1,9,2 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).".

SB11-SA1,9,3 23. Page 51, line 6: after that line insert:

SB11-SA1,9,5 " Section 123d. 49.45 (23) (a) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

SB11-SA1,9,14 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.".

SB11-SA1,9,15 24. Page 51, line 17: after that line insert:

SB11-SA1,9,17 " Section 124d. 49.45 (23) (b) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

SB11-SA1,9,24 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.".

SB11-SA1,10,4 25. Page 52, line 3: after that line insert:

SB11-SA1,10,6 " Section 125d. 49.45 (24g) (c) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

SB11-SA1,10,16 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.".

SB11-SA1,10,17 26. Page 52, line 11: after that line insert:

SB11-SA1,10,19 " Section 126d. 49.45 (24r) (a) of the statutes, as affected by 2011 Wisconsin Act .... (this act), is amended to read:

SB11-SA1,11,2 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.".