AB56-ASA1-AA2,19,1
170. Page 356, line 5: after that line insert:
AB56-ASA1-AA2,19,2 2 Section 691d. 49.46 (2) (b) 21. of the statutes is created to read:
AB56-ASA1-AA2,19,43 49.46 (2) (b) 21. Subject to par. (bv), nonmedical services that contribute to the
4determinants of health.
AB56-ASA1-AA2,691g 5Section 691g. 49.46 (2) (bv) of the statutes is created to read:
AB56-ASA1-AA2,19,126 49.46 (2) (bv) The department shall determine those services under par. (b) 21.
7that contribute to the determinants of health. The department shall seek any
8necessary state plan amendment or request any waiver of federal Medicaid law to
9implement this paragraph. The department is not required to provided the services
10under this paragraph as a benefit under the Medical Assistance program if the
11federal department of health and human services does not provide federal financial
12participation for the services under this paragraph.”.
AB56-ASA1-AA2,19,13 1371. Page 356, line 5: after that line insert:
AB56-ASA1-AA2,19,14 14 Section 695b. 49.47 (4) (ag) 2. of the statutes is amended to read:
AB56-ASA1-AA2,19,1715 49.47 (4) (ag) 2. Pregnant and the woman's pregnancy is medically verified
16Eligibility continues to the last day of the month in which the 60th day or, if approved
17by the federal government, the 365th day
after the last day of the pregnancy falls.”.
AB56-ASA1-AA2,19,18 1872. Page 356, line 23: after that line insert:
AB56-ASA1-AA2,19,19 19 Section 699c. 49.471 (1) (cr) of the statutes is created to read:
AB56-ASA1-AA2,19,2120 49.471 (1) (cr) “Enhanced federal medical assistance percentage" means a
21federal medical assistance percentage described under 42 USC 1396d (y) or (z).
AB56-ASA1-AA2,700c 22Section 700c. 49.471 (4) (a) 4. b. of the statutes is amended to read:
AB56-ASA1-AA2,20,3
149.471 (4) (a) 4. b. The individual's family income does not exceed 100 133
2percent of the poverty line before application of the 5 percent income disregard under
342 CFR 435.603 (d)
.
AB56-ASA1-AA2,701c 4Section 701c. 49.471 (4) (a) 8. of the statutes is created to read:
AB56-ASA1-AA2,20,55 49.471 (4) (a) 8. An individual who meets all of the following criteria:
AB56-ASA1-AA2,20,66 a. The individual is an adult under the age of 65.
AB56-ASA1-AA2,20,87 b. The adult has a family income that does not exceed 133 percent of the poverty
8line, except as provided in sub. (4g).
AB56-ASA1-AA2,20,109 c. The adult is not otherwise eligible for the Medical Assistance program under
10this subchapter or the Medicare program under 42 USC 1395 et seq.
AB56-ASA1-AA2,702c 11Section 702c. 49.471 (4g) of the statutes is created to read:
AB56-ASA1-AA2,20,1912 49.471 (4g) Medicaid expansion; federal medical assistance percentage. For
13services provided to individuals described under sub. (4) (a) 8., the department shall
14comply with all federal requirements to qualify for the highest available enhanced
15federal medical assistance percentage. The department shall submit any
16amendment to the state medical assistance plan, request for a waiver of federal
17Medicaid law, or other approval request required by the federal government to
18provide services to the individuals described under sub. (4) (a) 8. and qualify for the
19highest available enhanced federal medical assistance percentage.”.
AB56-ASA1-AA2,20,20 2073. Page 356, line 23: after that line insert:
AB56-ASA1-AA2,20,21 21 Section 703b. 49.471 (6) (b) of the statutes is amended to read:
AB56-ASA1-AA2,21,222 49.471 (6) (b) A pregnant woman who is determined to be eligible for benefits
23under sub. (4) remains eligible for benefits under sub. (4) for the balance of the
24pregnancy and to the last day of the month in which the 60th day or, if approved by

1the federal government, the 365th day
after the last day of the pregnancy falls
2without regard to any change in the woman's family income.
AB56-ASA1-AA2,704b 3Section 704b. 49.471 (6) (L) of the statutes is created to read:
AB56-ASA1-AA2,21,94 49.471 (6) (L) The department shall request from the federal department of
5health and human services approval of a state plan amendment, a waiver of federal
6Medicaid law, or approval of a demonstration project to maintain eligibility for
7post-partum women to the last day of the month in which the 365th day after the
8last day of the pregnancy falls under ss. 49.46 (1) (a) 1m. and 9. and (j), 49.47 (4) (ag)
92., and 49.471 (4) (a) 1g. and 1m., (6) (b), and (7) (b) 1.
AB56-ASA1-AA2,705b 10Section 705b. 49.471 (7) (b) 1. of the statutes is amended to read:
AB56-ASA1-AA2,21,2111 49.471 (7) (b) 1. A pregnant woman whose family income exceeds 300 percent
12of the poverty line may become eligible for coverage under this section if the
13difference between the pregnant woman's family income and the applicable income
14limit under sub. (4) (a) is obligated or expended for any member of the pregnant
15woman's family for medical care or any other type of remedial care recognized under
16state law or for personal health insurance premiums or for both. Eligibility obtained
17under this subdivision continues without regard to any change in family income for
18the balance of the pregnancy and to the last day of the month in which the 60th day
19or, if approved by the federal government, the 365th day after the last day of the
20woman's pregnancy falls. Eligibility obtained by a pregnant woman under this
21subdivision extends to all pregnant women in the pregnant woman's family.”.
AB56-ASA1-AA2,21,22 2274. Page 357, line 18: after that line insert:
AB56-ASA1-AA2,21,23 23 Section 711c. 49.686 (3) (d) of the statutes is amended to read:
AB56-ASA1-AA2,22,6
149.686 (3) (d) Has applied for coverage under and has been denied eligibility
2for medical assistance within 12 months prior to application for reimbursement
3under sub. (2). This paragraph does not apply to an individual who is eligible for
4benefits under the demonstration project for childless adults under s. 49.45 (23)
5BadgerCare Plus under s. 49.471 (4) (a) 8. or to an individual who is eligible for
6benefits under BadgerCare Plus under s. 49.471 (11).”.
AB56-ASA1-AA2,22,7 775. Page 363, line 8: after that line insert:
AB56-ASA1-AA2,22,8 8 Section 746t. 51.03 (7) of the statutes is created to read:
AB56-ASA1-AA2,22,129 51.03 (7) From the appropriation under s. 20.435 (5) (dg), the department shall
10award grants to regional crisis stabilization facilities for adults. The department
11shall establish criteria for a regional crisis stabilization facility to receive a grant
12under this subsection.”.
AB56-ASA1-AA2,22,14 1376. Page 364, line 14: delete the material beginning with that line and ending
14with page 365, line 8, and substitute:
AB56-ASA1-AA2,22,15 15 Section 750b. 51.422 (1) of the statutes is amended to read:
AB56-ASA1-AA2,22,2316 51.422 (1) Program creation. The department shall create 2 or 3 new, regional
17comprehensive opioid treatment programs, and in the 2017-19 fiscal biennium,
18shall create 2 or 3 additional regional comprehensive opioid and methamphetamine
19treatment programs, to provide treatment for opioid and opiate addiction and
20methamphetamine addiction in underserved, high-need areas. The department
21shall obtain and review proposals for opioid and methamphetamine treatment
22programs in accordance with its request-for-proposal procedures. A program under
23this section may not offer methadone treatment.
AB56-ASA1-AA2,751b 24Section 751b. 51.422 (2) of the statutes is amended to read:
AB56-ASA1-AA2,23,10
151.422 (2) Program components. An opioid or methamphetamine treatment
2program created under this section shall offer an assessment to individuals in need
3of service to determine what type of treatment is needed. The program shall
4transition individuals to a certified residential program, if that level of treatment is
5necessary. The program shall provide counseling, medication-assisted treatment,
6including both long-acting opioid antagonist and partial agonist medications that
7have been approved by the federal food and drug administration if for treating opioid
8addiction, and abstinence-based treatment. The program shall transition
9individuals who have completed treatment to county-based or private
10post-treatment care.”.
AB56-ASA1-AA2,23,11 1177. Page 365, line 9: delete lines 9 to 16 and substitute:
AB56-ASA1-AA2,23,12 12 Section 752b. 51.441 of the statutes is created to read:
AB56-ASA1-AA2,23,19 1351.441 Comprehensive mental health consultation program. The
14department shall convene a statewide group of interested persons, including at least
15one representative of the Medical College of Wisconsin, to develop a concept paper,
16business plan, and standards for a comprehensive mental health consultation
17program that incorporates general psychiatry, geriatric psychiatry, addiction
18medicine and psychiatry, a perinatal psychiatry consultation program, and the child
19psychiatry consultation program under s. 51.442.”.
AB56-ASA1-AA2,23,20 2078. Page 433, line 4: after that line insert:
AB56-ASA1-AA2,23,21 21 Section 1891b. 250.048 of the statutes is created to read:
AB56-ASA1-AA2,24,3 22250.048 Prescription drug importation program. (1) Importation
23program requirements.
The department, in consultation with persons interested in
24the sale and pricing of prescription drugs and appropriate officials and agencies of

1the federal government, shall design and implement a prescription drug importation
2program for the benefit of residents of this state, that generates savings for residents,
3and that satisfies all of the following:
AB56-ASA1-AA2,24,64 (a) The department shall designate a state agency to become a licensed
5wholesale distributor or to contract with a licensed wholesale distributor and shall
6seek federal certification and approval to import prescription drugs.
AB56-ASA1-AA2,24,97 (b) The prescription drug importation program under this section shall comply
8with relevant requirements of 21 USC 384, including safety and cost savings
9requirements.
AB56-ASA1-AA2,24,1210 (c) The prescription drug importation program under this section shall import
11prescription drugs from Canadian suppliers regulated under any appropriate
12Canadian or provincial laws.
AB56-ASA1-AA2,24,1513 (d) The prescription drug importation program under this section shall have
14a process to sample the purity, chemical composition, and potency of imported
15prescription drugs.
AB56-ASA1-AA2,24,1916 (e) The prescription drug importation program under this section shall import
17only those prescription drugs for which importation creates substantial savings for
18residents of the state and only those prescription drugs that are not brand-name
19drugs and that have fewer than 4 competitor prescription drugs in the United States.
AB56-ASA1-AA2,24,2220 (f) The department shall ensure that prescription drugs imported under the
21program under this section are not distributed, dispensed, or sold outside of the
22state.
AB56-ASA1-AA2,24,2423 (g) The prescription drug importation program under this section shall ensure
24all of the following:
AB56-ASA1-AA2,25,2
11. Participation by any pharmacy or health care provider in the program is
2voluntary.
AB56-ASA1-AA2,25,43 2. Any pharmacy or health care provider participating in the program has the
4appropriate license or other credential in this state.
AB56-ASA1-AA2,25,75 3. Any pharmacy or health care provider participating in the program charges
6a consumer or health plan the actual acquisition cost of the imported prescription
7drug that is dispensed.
AB56-ASA1-AA2,25,118 (h) The prescription drug importation program under this section shall ensure
9that a payment by a health plan or health insurance policy for a prescription drug
10imported under the program reimburses no more than the actual acquisition cost of
11the imported prescription drug that is dispensed.
AB56-ASA1-AA2,25,1412 (i) The prescription drug importation program under this section shall ensure
13that any health plan or health insurance policy participating in the program does all
14of the following:
AB56-ASA1-AA2,25,1615 1. Maintains a formulary and claims payment system with current information
16on prescription drugs imported under the program.
AB56-ASA1-AA2,25,1917 2. Bases cost-sharing amounts for participants or insureds under the plan or
18policy on no more than the actual acquisition cost of the prescription drug imported
19under the program that is dispensed to the participant or insured.
AB56-ASA1-AA2,25,2220 3. Demonstrates to the department or a state agency designated by the
21department how premiums under the policy or plan are affected by savings on
22prescription drugs imported under the program.
AB56-ASA1-AA2,25,2523 (j) Any wholesale distributor importing prescription drugs under the program
24under this section shall limit its profit margin to the amount established by the
25department or a state agency designated by the department.
AB56-ASA1-AA2,26,3
1(k) The prescription drug importation program under this section may not
2import any generic prescription drug that would violate federal patent laws on
3branded products in this country.
AB56-ASA1-AA2,26,84 (L) The prescription drug importation program under this section shall comply
5to the extent practical and feasible before the prescription drug to be imported comes
6into possession of the state's wholesale distributor and fully after the prescription
7drug to be imported is in possession of the state's wholesale distributor with tracking
8and tracing requirements of 21 USC 360eee to 360eee-1.
AB56-ASA1-AA2,26,119 (m) The prescription drug importation program under this section shall
10establish a fee or other approach to finance the program that does not jeopardize
11significant savings to residents of the state.
AB56-ASA1-AA2,26,1312 (n) The prescription drug importation program under this section shall have
13an audit function that ensures all of the following:
AB56-ASA1-AA2,26,1614 1. The department has a sound methodology to determine the most
15cost-effective prescription drugs to include in the importation program under this
16section.
AB56-ASA1-AA2,26,1817 2. The department has a process in place to select Canadian suppliers that are
18high quality, high performing, and in full compliance with Canadian laws.
AB56-ASA1-AA2,26,2019 3. Prescription drugs imported under the program are pure, unadulterated,
20potent, and safe.
AB56-ASA1-AA2,26,2221 4. The prescription drug importation program is complying with the
22requirements of this subsection.
AB56-ASA1-AA2,26,2523 5. The prescription drug importation program under this section is adequately
24financed to support administrative functions of the program while generating
25significant cost savings to residents of the state.
AB56-ASA1-AA2,27,2
16. The prescription drug importation program under this section does not put
2residents of the state at a higher risk than if the program did not exist.
AB56-ASA1-AA2,27,43 7. The prescription drug importation program under this section provides and
4is projected to continue to provide substantial cost savings to residents of the state.
AB56-ASA1-AA2,27,7 5(2) Anticompetitive behavior. The department, in consultation with the
6attorney general, shall identify the potential for and monitor anticompetitive
7behavior in industries affected by a prescription drug importation program.
AB56-ASA1-AA2,27,18 8(3) Approval of program design; certification. No later than the first day of
9the 7th month beginning after the effective date of this subsection .... [LRB inserts
10date], the department shall submit to the joint committee on finance a report that
11includes the design of the prescription drug importation program in accordance with
12this section. The department may not submit the proposed prescription drug
13importation program to the federal department of health and human services unless
14the joint committee on finance approves the proposed prescription drug
15implementation program. Within 14 days of the date of approval by the joint
16committee on finance of the proposed prescription drug importation program, the
17department shall submit to the federal department of health and human services a
18request for certification of the approved prescription drug importation program.
AB56-ASA1-AA2,28,2 19(4) Implementation of certified program. After the federal department of
20health and human services certifies the prescription drug importation program
21submitted under sub. (3), the department shall begin implementation of the program
22and the program shall be fully operational by 180 days after the date of certification
23by the federal department of health and human services. The department shall do
24all of the following to implement the prescription drug importation program to the

1extent the action is in accordance with other state laws and the certification by the
2federal department of health and human services:
AB56-ASA1-AA2,28,53 (a) Become a licensed wholesale distributor, designate another state agency to
4become a licensed wholesale distributor, or contract with a licensed wholesale
5distributor.
AB56-ASA1-AA2,28,76 (b) Contract with one or more Canadian suppliers that meet the criteria in sub.
7(1) (c).
AB56-ASA1-AA2,28,118 (c) Create an outreach and marketing plan to communicate with and provide
9information to health plans and health insurance policies, employers, pharmacies,
10health care providers, and residents of the state on participating in the prescription
11drug importation program.
AB56-ASA1-AA2,28,1412 (d) Develop and implement a registration process for health plans and health
13insurance policies, pharmacies, and health care providers interested in participating
14in the prescription drug importation program.
AB56-ASA1-AA2,28,1615 (e) Create a publicly accessible source for listing prices of prescription drugs
16imported under the program.
AB56-ASA1-AA2,28,1917 (f) Create, publicize, and implement a method of communication to promptly
18answer questions from and address the needs of persons affected by the
19implementation of the program before the program is fully operational.
AB56-ASA1-AA2,28,2120 (g) Establish the audit functions under sub. (1) (n) with a timeline to complete
21each audit function every 2 years.
AB56-ASA1-AA2,28,2422 (h) Conduct any other activities determined by the department to be important
23to successful implementation of the prescription drug importation program under
24this section.
AB56-ASA1-AA2,29,2
1(5) Report. By January 1 and July 1 of each year, the department shall submit
2to the joint committee on finance a report including all of the following:
AB56-ASA1-AA2,29,43 (a) A list of prescription drugs included in the importation program under this
4section.
AB56-ASA1-AA2,29,75 (b) The number of pharmacies, health care providers, and health plans and
6health insurance policies participating in the prescription drug importation program
7under this section.
AB56-ASA1-AA2,29,128 (c) The estimated amount of savings to residents of the state, health plans and
9health insurance policies, and employers resulting from the implementation of the
10prescription drug importation program under this section reported from the date of
11the previous report under this subsection and from the date the program was fully
12operational.
AB56-ASA1-AA2,29,1413 (d) Findings of any audit functions under sub. (1) (n) completed since the date
14of the previous report under this subsection.”.
AB56-ASA1-AA2,29,15 1579. Page 433, line 5: delete lines 5 to 11 and substitute:
AB56-ASA1-AA2,29,16 16 Section 1892b. 250.10 (1m) (b) of the statutes is amended to read:
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