Amendment AA8-ASA1-AB64

AB64-ASA1-AA8,30,6 (c) Subject to par. (d), no disability insurance policy and no self-insured health plan may subject the coverage of any of the preventive services under par. (b) to any deductibles, copayments, or coinsurance under the policy or plan.

AB64-ASA1-AA8,30,10 (d) 1. If an office visit and a preventive service specified under par. (b) are billed separately by the health care provider, the disability insurance policy or self-insured health plan may apply deductibles to and impose copayments or coinsurance on the office visit but not on the preventive service.

AB64-ASA1-AA8,30,13 2. If the primary reason for an office visit is not to obtain a preventive service, the disability insurance policy or self-insured health plan may apply deductibles to and impose copayments or coinsurance on the office visit.

AB64-ASA1-AA8,30,22 3. If a preventive service specified under par. (b) is provided by a health care provider that is outside the disability insurance policy's or self-insured health plan's network of providers, the policy or plan may apply deductibles to and impose copayments or coinsurance on the office visit and the preventive service. If a preventive service specified under par. (b) is provided by a health care provider that is outside the disability insurance policy's or self-insured health plan's network of providers because there is no available health care provider in the policy's or plan's network of providers that provides the preventive service, the policy or plan may not apply deductibles to or impose copayments or coinsurance on preventive service.

AB64-ASA1-AA8,31,2 4. If multiple well-woman visits described under par. (b) 47. are required to fulfill all necessary preventive services and are in accordance with clinical recommendations, the disability insurance policy or self-insured health plan may not apply a deductible or impose a copayment or coinsurance to any of those well-woman visits.

AB64-ASA1-AA8,2219d Section 2219d. 632.895 (14) (a) 1. i. and j. of the statutes are amended to read:

AB64-ASA1-AA8,31,4 632.895 (14) (a) 1. i. Hepatitis A and B.

AB64-ASA1-AA8,31,5 j. Varicella and herpes zoster.

AB64-ASA1-AA8,2219f Section 2219f. 632.895 (14) (a) 1. k. to o. of the statutes are created to read:

AB64-ASA1-AA8,31,7 632.895 (14) (a) 1. k. Human papillomavirus.

AB64-ASA1-AA8,31,8 L. Meningococcal meningitis.

AB64-ASA1-AA8,31,9 m. Pneumococcal pneumonia.

AB64-ASA1-AA8,31,10 n. Influenza.

AB64-ASA1-AA8,31,11 o. Rotavirus.

AB64-ASA1-AA8,2219h Section 2219h. 632.895 (14) (b) of the statutes is amended to read:

AB64-ASA1-AA8,31,18 632.895 (14) (b) Except as provided in par. (d), every disability insurance policy, and every self-insured health plan of the state or a county, city, town, village, or school district, that provides coverage for a dependent of the insured shall provide coverage of appropriate and necessary immunizations, from birth to the age of 6 years, for an insured or plan participant, including a dependent who is a child of the insured or plan participant.

AB64-ASA1-AA8,2219j Section 2219j. 632.895 (14) (c) of the statutes is amended to read:

AB64-ASA1-AA8,31,24 632.895 (14) (c) The coverage required under par. (b) may not be subject to any deductibles, copayments, or coinsurance under the policy or plan. This paragraph applies to a defined network plan, as defined in s. 609.01 (1b), only with respect to appropriate and necessary immunizations provided by providers participating, as defined in s. 609.01 (3m), in the plan.

AB64-ASA1-AA8,2219m Section 2219m. 632.895 (14) (d) 3. of the statutes is amended to read:

AB64-ASA1-AA8,32,3 632.895 (14) (d) 3. A health care plan offered by a limited service health organization, as defined in s. 609.01 (3), or by a preferred provider plan, as defined in s. 609.01 (4), that is not a defined network plan, as defined in s. 609.01 (1b).

AB64-ASA1-AA8,2219p Section 2219p. 632.895 (16m) (b) of the statutes is amended to read:

AB64-ASA1-AA8,32,9 632.895 (16m) (b) The coverage required under this subsection may be subject to any limitations, or exclusions , or cost-sharing provisions that apply generally under the disability insurance policy or self-insured health plan. The coverage required under this subsection may not be subject to any deductibles, copayments, or coinsurance.

AB64-ASA1-AA8,2219r Section 2219r. 632.895 (17) (b) 2. of the statutes is amended to read:

AB64-ASA1-AA8,32,15 632.895 (17) (b) 2. Outpatient consultations, examinations, procedures, and medical services that are necessary to prescribe, administer, maintain, or remove a contraceptive, if covered for any other drug benefits under the policy or plan sterilization procedures, and patient education and counseling for all females with reproductive capacity.

AB64-ASA1-AA8,2219t Section 2219t. 632.895 (17) (c) of the statutes is amended to read:

AB64-ASA1-AA8,33,6 632.895 (17) (c) Coverage under par. (b) may be subject only to the exclusions, and limitations, or cost-sharing provisions that apply generally to the coverage of outpatient health care services, preventive treatments and services, or prescription drugs and devices that is provided under the policy or self-insured health plan. A disability insurance policy or self-insured health plan may not apply a deductible or impose a copayment or coinsurance to at least one of each type of contraceptive method approved by the federal food and drug administration for which coverage is required under this subsection. The disability insurance policy or self-insured health plan may apply reasonable medical management to a method of contraception to limit coverage under this subsection that is provided without being subject to a deductible, copayment, or coinsurance to prescription drugs without a brand name. The disability insurance policy or self-insured health plan may apply a deductible or impose a copayment or coinsurance for coverage of a contraceptive that is prescribed for a medical need if the services for the medical need would otherwise be subject to a deductible, copayment, or coinsurance.”.

AB64-ASA1-AA8,33,7 27. Page 925, line 14: after that line insert:

AB64-ASA1-AA8,33,8 “ Section 2218s. 609.845 of the statutes is created to read:

AB64-ASA1-AA8,33,10 609.845 Lifetime and annual limits. Limited service health organizations, preferred provider plans, and defined network plans are subject to s. 632.883.

AB64-ASA1-AA8,2218x Section 2218x. 632.883 of the statutes is created to read:

AB64-ASA1-AA8,33,15 632.883 Lifetime and annual limits. (1) No group or individual disability insurance policy, as defined in s. 632.895 (1) (a), and no self-insured health plan, as defined in s. 632.745 (24), may impose a lifetime limit on the dollar value of benefits provided under the policy or plan.

AB64-ASA1-AA8,33,18 (2) No group or individual disability insurance policy, as defined in s. 632.895 (1) (a), and no self-insured health plan, as defined in s. 632.745 (24), may impose an annual limit on the dollar value of benefits under the policy or plan.”.

AB64-ASA1-AA8,33,19 28. Page 1015, line 10: after that line insert:

AB64-ASA1-AA8,34,2 “(5r) Extension of prescription drug assistance for elderly. The department of health services shall request from the federal secretary of health and human services any waiver of federal medicaid laws necessary to permit the department of health services to continue administering the program under section 49.688 of the statutes for 4 years from the date the waiver under this subsection is granted. The department shall implement any waiver received under this subsection.”.

AB64-ASA1-AA8,34,3 29. Page 1015, line 10: after that line insert:

AB64-ASA1-AA8,34,4 “(5p) Medical Assistance nonemergency medical transportation.

AB64-ASA1-AA8,34,12 (b) The department of health services shall, to the extent permitted by the contract, modify the contract that is in effect on the effective date of this paragraph for the arrangement and reimbursement of nonemergency medical transportation services to recipients of Medical Assistance under subchapter IV of chapter 49 of the statutes to exclude recipients of Medical Assistance residing in Buffalo, Eau Claire, Jefferson, Kenosha, Milwaukee, Ozaukee, Pepin, Racine, Rock, Trempealeau, Walworth, Washington, and Waukesha counties from that contract unless the county chooses to remain under the original contract.

AB64-ASA1-AA8,35,4 (c) If the department of health services modifies the contract under paragraph (b), the department of health services shall make alternative arrangements with counties, health maintenance organizations, or transportation providers to provide nonemergency medical transportation services to Medical Assistance recipients who reside in the counties specified in paragraph (b ), except any county that chooses to remain under the original contract, no later than January 1, 2019. The department of health services shall include in any contract for alternative arrangements under this paragraph a requirement that the nonemergency medical transportation provider submit to the department of health services information substantially similar to the information required under the original contract including trip log data, summary information on all calls for services and contacts with Medical Assistance recipients, encounter data based on Centers for Medicare and Medicaid Services 1500 claim form data, network provider information, accident and moving violation reports, vehicle reports, complaint summary reports, telecommunications system reports, annual fiscal audit reports, and daily reports including numbers of trips, canceled trips, denied trips, and complaints.”.

AB64-ASA1-AA8,35,5 30. Page 1015, line 10: after that line insert:

AB64-ASA1-AA8,35,11 “(5t) Increasing Medical Assistance reimbursement rates for personal care services. The department of health services shall increase the reimbursement rates 15 percent under the Medical Assistance program for the 2017-18 biennium for personal care services providers and shall increase the reimbursement rates 15 percent under the Medical Assistance program for the 2018-19 biennium for personal care services providers.

AB64-ASA1-AA8,35,16 (5v) Increasing Medical Assistance reimbursement rates for nursing homes. The department of health services shall increase the reimbursement rates 5 percent under the Medical Assistance program for the 2017-18 biennium for nursing homes and shall increase the reimbursement rates 5 percent under the Medical Assistance program for the 2018-19 biennium for nursing homes.”.

AB64-ASA1-AA8,35,17 31. Page 1016, line 20: after that line insert:

AB64-ASA1-AA8,35,23 “(7g) Increasing Medical Assistance reimbursement rates. The department of health services shall increase the reimbursement rates 12 percent under the Medical Assistance program for dates of service on and after January 1, 2017, for noninstitutional providers who are not personal care services providers, hospitals, nursing homes, or providers of services for which reimbursement is made on a basis other than a maximum fee schedule.”.

AB64-ASA1-AA8,35,24 32. Page 1065, line 18: after that line insert:

AB64-ASA1-AA8,36,1 “(1e) Preexisting conditions.

AB64-ASA1-AA8,36,8 (d) For policies and plans containing inconsistent provisions, the treatment of sections 40.51 (8), 40.51 (8m), 66.0137 (4), 120.13 (2) (g), 185.983 (1) (intro.), 609.847, 625.12 (1) (a) and (e) and (2), 625.15 (1), 628.34 (3) (a), 632.728, 632.746 (1) (a) and (b), (2) (a), (c), (d), and (e), (3) (a) and (d) 1., 2. and 3., (5), and (8) (a) (intro.), 632.76 (2) (a) and (ac) 1., 2., and 3., 632.795 (4) (a), and 632.897 (11) (a) of the statutes first applies to policy or plan years beginning on January 1 of the year following the year in which this paragraph takes effect, except as provided in paragraph (e).

AB64-ASA1-AA8,36,17 (e) For policies or plans that are affected by a collective bargaining agreement containing inconsistent provisions, the treatment of sections 40.51 (8), 40.51 (8m), 66.0137 (4), 120.13 (2) (g), 185.983 (1) (intro.), 609.847, 625.12 (1) (a) and (e) and (2), 625.15 (1), 628.34 (3) (a), 632.728, 632.746 (1) (a) and (b), (2) (a), (c), (d), and (e), (3) (a) and (d) 1., 2. and 3., (5), and (8) (a) (intro.), 632.76 (2) (a) and (ac) 1., 2., and 3., 632.795 (4) (a), and 632.897 (11) (a) of the statutes first applies to policy or plan years beginning on the effective date of this paragraph or on the day on which the collective bargaining agreement is newly established, extended, modified, or renewed, whichever is later.”.

AB64-ASA1-AA8,36,18 33. Page 1065, line 18: after that line insert:

AB64-ASA1-AA8,36,19 “(1d) Preventive services.

AB64-ASA1-AA8,36,24 (f) For policies and plans containing inconsistent provisions, the treatment of sections 40.51 (8m), 66.0137 (4), 120.13 (2) (g), 609.896, 632.895 (8) (d), (13m), (14) (a) 1. i., j., and k. to o., (b), (c), and (d) 3., (16m) (b), and (17) (b) 2. and (c) of the statutes first applies to policy or plan years beginning on January 1 of the year following the year in which this paragraph takes effect, except as provided in paragraph (g).

AB64-ASA1-AA8,37,7 (g) For policies and plans that are affected by a collective bargaining agreement containing inconsistent provisions, the treatment of sections 40.51 (8m), 66.0137 (4), 120.13 (2) (g), 609.896, 632.895 (8) (d), (13m), (14) (a) 1. i., j., and k. to o., (b), (c), and (d) 3., (16m) (b), and (17) (b) 2. and (c) of the statutes first applies to policy or plan years beginning on the effective date of this paragraph or on the day on which the collective bargaining agreement is newly established, extended, modified, or renewed, whichever is later.”.

AB64-ASA1-AA8,37,8 34. Page 1065, line 18: after that line insert:

AB64-ASA1-AA8,37,9 “(1f) Lifetime and annual limits.

AB64-ASA1-AA8,37,14 (h) For policies and plans containing provisions inconsistent with this act, the treatment of sections 40.51 (8) and (8m), 66.0137 (4), 120.13 (2) (g), 185.983 (1) (intro.), 609.845, and 632.883 of the statutes first applies to policy or plan years beginning on January 1 of the year following the year in which this paragraph takes effect, except as provided in paragraph (i ).

AB64-ASA1-AA8,37,20 (i) For policies or plans that are affected by a collective bargaining agreement containing provisions inconsistent with this act, the treatment of sections 40.51 (8) and (8m), 66.0137 (4), 120.13 (2) (g), 185.983 (1) (intro.), 609.845, and 632.883 of the statutes first applies to policy or plan years beginning on the effective date of this paragraph or on the day on which the collective bargaining agreement is newly established, extended, modified, or renewed, whichever is later.”.

AB64-ASA1-AA8,37,21 35. Page 1080, line 17: after that line insert:

AB64-ASA1-AA8,37,24 “(7g) Medicaid expansion. The treatment of sections 49.45 (23) (a) and 49.471 (1) (cr), (4) (a) 4. b., and (4g) of the statutes take effect on January 1, 2018, or on the day after publication, whichever is later.”.

AB64-ASA1-AA8,38,1 36. Page 1080, line 24: after that line insert:

AB64-ASA1-AA8,38,7 “(2e) Preexisting conditions. This act 40.51 (8), 40.51 (8m), 66.0137 (4), 120.13 (2) (g), 185.983 (1) (intro.), 609.847, 625.12 (1) (a) and (e) and (2), 625.15 (1), 628.34 (3) (a), 632.728, 632.746 (1) (a) and (b), (2) (a), (c), (d), and (e), (3) (a) and (d) 1., 2. and 3., (5), and (8) (a) (intro.), 632.76 (2) (a) and (ac) 1., 2., and 3., 632.795 (4) (a), and 632.897 (11) (a) of the statutes and Section 9324 (1e) take effect on the first day of the 4th month beginning after publication.”.

AB64-ASA1-AA8,38,8 37. Page 1080, line 24: after that line insert:

AB64-ASA1-AA8,38,12 “(2d) Preventive services. The treatment of sections 40.51 (8m), 66.0137 (4), 120.13 (2) (g), 609.896, 632.895 (8) (d), (13m), (14) (a) 1. i., j., and k. to o., (b), (c), and (d) 3., (16m) (b), and (17) (b) 2. and (c) of the statutes and Section 9324 (1d) of this act takes effect on the first day of the 4th month beginning after publication.”.

AB64-ASA1-AA8,38,13 38. Page 1080, line 24: after that line insert:

AB64-ASA1-AA8,38,17 “(2f) Lifetime and annual limits. The treatment of sections 40.51 (8) and (8m), 66.0137 (4), 120.13 (2) (g), 185.983 (1) (intro.), 609.845, and 632.883 of the statutes and Section 9324 (1f) of this act take effect on the first day of the 4th month beginning after publication.”.

AB64-ASA1-AA8,38,18 39. At the appropriate places, insert all of the following:

AB64-ASA1-AA8,38,19 “ Section 1ab. 1.12 (1) (b) of the statutes is amended to read:

AB64-ASA1-AA8,39,2 1.12 (1) (b) “State agency" means an office, department, agency, institution of higher education, the legislature, a legislative service agency, the courts, a judicial branch agency, an association, society, or other body in state government that is created or authorized to be created by the constitution or by law, for which appropriations are made by law, excluding the Badger Health Benefit Authority and the Wisconsin Economic Development Corporation.

AB64-ASA1-AA8,1ac Section 1ac. 13.172 (1) of the statutes is amended to read:

AB64-ASA1-AA8,39,9 13.172 (1) In this section, “agency" means an office, department, agency, institution of higher education, association, society, or other body in state government created or authorized to be created by the constitution or any law, that is entitled to expend moneys appropriated by law, including the legislature and the courts, and any authority created in subch. II of ch. 114 or subch. III of ch. 636 or in ch. 231, 233, 234, 238, or 279.

AB64-ASA1-AA8,1ad Section 1ad. 13.62 (2) of the statutes is amended to read:

AB64-ASA1-AA8,39,15 13.62 (2) “Agency" means any board, commission, department, office, society, institution of higher education, council, or committee in the state government, or any authority created in subch. II of ch. 114 or subch. III of ch. 636 or in ch. 231, 232, 233, 234, 237, 238, or 279, except that the term does not include a council or committee of the legislature.

AB64-ASA1-AA8,1ae Section 1ae. 13.94 (1) (dj) of the statutes is created to read:

AB64-ASA1-AA8,39,21 13.94 (1) (dj) At least once every 2 years, perform a financial audit and performance evaluation audit of any health benefit plan exchange under subch. II of ch. 636 and an audit of the Badger Health Benefit Authority's policies and management practices and file copies of each audit report under this paragraph with the distributees specified in par. (b).

AB64-ASA1-AA8,1af Section 1af. 13.94 (1s) (c) 9. of the statutes is created to read:

AB64-ASA1-AA8,39,24 13.94 (1s) (c) 9. The Badger Health Benefit Authority for the cost of the audit under sub. (1) (dj).

AB64-ASA1-AA8,1ag Section 1ag. 13.95 (intro.) of the statutes is amended to read:

AB64-ASA1-AA8,40,13 13.95 Legislative fiscal bureau. (intro.) There is created a bureau to be known as the “Legislative Fiscal Bureau" headed by a director. The fiscal bureau shall be strictly nonpartisan and shall at all times observe the confidential nature of the research requests received by it; however, with the prior approval of the requester in each instance, the bureau may duplicate the results of its research for distribution. Subject to s. 230.35 (4) (a) and (f), the director or the director's designated employees shall at all times, with or without notice, have access to all state agencies, the University of Wisconsin Hospitals and Clinics Authority, the Wisconsin Aerospace Authority, the Badger Health Benefit Authority, the Lower Fox River Remediation Authority, the Wisconsin Economic Development Corporation, and the Fox River Navigational System Authority, and to any books, records, or other documents maintained by such agencies or authorities and relating to their expenditures, revenues, operations, and structure.

AB64-ASA1-AA8,1ah Section 1ah. 16.002 (2) of the statutes is amended to read:

AB64-ASA1-AA8,40,19 16.002 (2) “Departments" means constitutional offices, departments, and independent agencies and includes all societies, associations, and other agencies of state government for which appropriations are made by law, but not including authorities created in subch. II of ch. 114 or subch. III of ch. 636 or in ch. 231, 232, 233, 234, 237, 238, or 279.

AB64-ASA1-AA8,1aj Section 1aj. 16.004 (4) of the statutes is amended to read:

AB64-ASA1-AA8,41,2 16.004 (4) Freedom of access. The secretary and such employees of the department as the secretary designates may enter into the offices of state agencies and authorities created under subch. II of ch. 114 and subch. III of ch. 636 and under chs. 231, 233, 234, 237, 238, and 279, and may examine their books and accounts and any other matter that in the secretary's judgment should be examined and may interrogate the agency's employees publicly or privately relative thereto.

AB64-ASA1-AA8,1ak Section 1ak. 16.004 (5) of the statutes is amended to read:

AB64-ASA1-AA8,41,8 16.004 (5) Agencies and employees to cooperate. All state agencies and authorities created under subch. II of ch. 114 and subch. III of ch. 636 and under chs. 231, 233, 234, 237, 238, and 279, and their officers and employees, shall cooperate with the secretary and shall comply with every request of the secretary relating to his or her functions.

AB64-ASA1-AA8,1am Section 1am. 16.004 (12) (a) of the statutes is amended to read:

AB64-ASA1-AA8,41,17 16.004 (12) (a) In this subsection, “state agency" means an association, authority, board, department, commission, independent agency, institution, office, society, or other body in state government created or authorized to be created by the constitution or any law, including the legislature, the office of the governor, and the courts, but excluding the University of Wisconsin Hospitals and Clinics Authority, the Wisconsin Aerospace Authority, the Lower Fox River Remediation Authority, the Wisconsin Economic Development Corporation, the Badger Health Benefit Authority, and the Fox River Navigational System Authority.

AB64-ASA1-AA8,1an Section 1an. 16.045 (1) (a) of the statutes is amended to read:

AB64-ASA1-AA8,41,24 16.045 (1) (a) “Agency" means an office, department, independent agency, institution of higher education, association, society, or other body in state government created or authorized to be created by the constitution or any law, that is entitled to expend moneys appropriated by law, including the legislature and the courts, but not including an authority created in subch. II of ch. 114 or subch. III of ch. 636 or in ch. 231, 232, 233, 234, 237, 238, or 279.

AB64-ASA1-AA8,1ap Section 1ap. 16.15 (1) (ab) of the statutes is amended to read:

AB64-ASA1-AA8,42,4 16.15 (1) (ab) “Authority" has the meaning given under s. 16.70 (2), but excludes the University of Wisconsin Hospitals and Clinics Authority, the Lower Fox River Remediation Authority, and the Wisconsin Economic Development Corporation, and the Badger Health Benefit Authority.

AB64-ASA1-AA8,1aq Section 1aq. 16.41 (4) of the statutes is amended to read: