2019 - 2020 LEGISLATURE
January 8, 2020 - Introduced by Senators Jacque and Olsen, cosponsored by
Representatives Kurtz, Mursau, Doyle, Edming, Novak, Oldenburg, Stubbs,
Tranel, James, Wittke, Macco, Rohrkaste, Subeck, Plumer, Steffen and
Wichgers. Referred to Committee on Health and Human Services.
1An Act to amend
49.45 (24k) (a) 1. and 2. and 49.45 (24k) (c) (intro.) and 3. of 2
the statutes; relating to: expansion of the dental reimbursement pilot project
3under the Medical Assistance program.
Analysis by the Legislative Reference Bureau
This bill expands statewide the dental reimbursement pilot project that, under
current law, requires the Department of Health Services to distribute moneys to
increase Medical Assistance reimbursement rates for pediatric dental care and adult
emergency dental services provided in Brown, Marathon, Polk, and Racine Counties.
Under the bill, DHS is required, subject to any necessary approval from the federal
Department of Health and Human Services, to distribute moneys to increase
statewide Medical Assistance reimbursement rates for pediatric dental care and
adult emergency dental services.
For further information see the state fiscal estimate, which will be printed as
an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
49.45 (24k) (a) 1. and 2. of the statutes are amended to read:
(a) 1. Subject to approval of the federal department of health and 6
human services under par. (b), the department, as a pilot project, shall distribute
moneys allocated in each fiscal year for the purpose of increasing statewide
reimbursement rate under Medical Assistance for pediatric dental care and adult 3
emergency dental services, as defined by the department, that are provided in
4Brown, Marathon, Polk, and Racine counties. If, after increasing the reimbursement
5rate for counties specified in this subdivision, the moneys allocated for this purpose
6exceed $100,000, the department shall increase the reimbursement rate under
7Medical Assistance for pediatric dental care and adult emergency dental services in
8other counties, as determined by the department, where Medical Assistance
9recipients have the greatest need for pediatric dental care and adult emergency
2. For dental services provided on a fee-for-service basis as of July 1, 2015
the reimbursement rate increase specified in subd. 1. shall be distributed on a 13
fee-for-service basis. For dental services provided as of July 1, 2015
, by a health 14
maintenance organization that contracts with the department to provide Medical 15
Assistance services at a capitated rate, the department shall distribute the 16
reimbursement rate increase under subd. 1. to the health maintenance organization. 17
The department shall include in a contract with a health maintenance organization 18
that provides dental services described in subd. 1. in the counties specified in subd.
a requirement that the health maintenance organization reimburse providers of 20
services in accordance with the reimbursement rate increase pilot project under 21
subd. 1. The department may not distribute the reimbursement rate increase under 22
subd. 1. to federally qualified health centers that receive a grant under 42 USC 254b
49.45 (24k) (c) (intro.) and 3. of the statutes are amended to read:
(c) (intro.) No later than January 1,
, and biennially 25
thereafter, the department shall submit a report to the chief clerk of each house of
the legislature under s. 13.172 (2), each standing committee of the legislature with 2
jurisdiction over health or public benefits under s. 13.172 (3), and the joint committee 3
on finance that includes all of the following information on the pilot project under 4
3. The feasibility of continuing the pilot project and expanding the project in
6specific areas of the state or statewide
This act takes effect on July 1, 2020.