SB70-AA3,211,2423 (b) A psychiatric residential treatment facility that has a certification from the
24department under this section is not subject to facility regulation under ch. 48.
SB70-AA3,211,25 25(3) Rules. The department may promulgate rules to implement this section.
SB70-AA3,9119
1Section 9119. Nonstatutory provisions; Health Services.
SB70-AA3,212,142 (1) Emergency rules on psychiatric residential treatment facilities. The
3department of health services may promulgate emergency rules under s. 227.24
4implementing certification of psychiatric residential treatment facilities under s.
551.044, including development of a new provider type and a reimbursement model
6for psychiatric residential treatment facilities under the Medical Assistance
7program under subch. IV of ch. 49. Notwithstanding s. 227.24 (1) (a) and (3), the
8department of health services is not required to provide evidence that promulgating
9a rule under this subsection as an emergency rule is necessary for the preservation
10of the public peace, health, safety, or welfare and is not required to provide a finding
11of emergency for a rule promulgated under this subsection. Notwithstanding s.
12227.24 (1) (c) and (2), emergency rules promulgated under this subsection remain in
13effect until July 1, 2025, or the date on which permanent rules take effect, whichever
14is sooner.”.
SB70-AA3,212,15 15246. Page 374, line 11: after that line insert:
SB70-AA3,212,16 16 Section 272. 46.48 (22) of the statutes is created to read:
SB70-AA3,212,2017 46.48 (22) Health care provider innovation grants. The department may
18distribute not more than $14,550,000 in each fiscal year as grants to health care
19providers and long-term care providers to implement best practices and innovative
20solutions to increase worker recruitment and retention.”.
SB70-AA3,212,21 21247. Page 374, line 11: after that line insert:
SB70-AA3,212,22 22 Section 9119. Nonstatutory provisions; Health Services.
SB70-AA3,212,2323 (4u) Complex patient pilot program.
SB70-AA3,212,2424 (a) In this subsection, “department” means the department of health services.
SB70-AA3,213,5
1(b) The department shall form an advisory group to assist with development
2and implementation of a complex patient pilot program. The secretary of health
3services, or his or her designee, shall be the chair of the advisory group. Members
4of the advisory group under this paragraph shall have clinical, financial, or
5administrative expertise in government programs, acute care, or post-acute care.
SB70-AA3,213,86 (c) The department shall use its request-for-proposal procedure to select
7partnership groups to be designated as participating sites for the complex patient
8pilot program under this subsection.
SB70-AA3,213,149 (d) The advisory group formed under this subsection shall develop a request
10for proposal for the complex patient pilot program that includes eligibility
11requirements. For purposes of the pilot program under this subsection, only
12partnerships of hospitals and post-acute facilities are eligible to submit proposals.
13An eligible partnership shall include at least one hospital and at least one post-acute
14facility, but may include more than one hospital or post-acute facility.
SB70-AA3,213,1715 (e) Each partnership group that applies to the department to be designated as
16a site for the complex patient pilot program shall specifically address all of the
17following issues:
SB70-AA3,213,1818 1. The number of beds that would be set aside in the post-acute facility.
SB70-AA3,213,2019 2. The goals of the partnership during the pilot program and after the pilot
20program.
SB70-AA3,213,2121 3. The types of complex patients for whom care would be provided.
SB70-AA3,213,2322 4. Expertise to successfully implement the proposal, including a discussion of
23at least all of the following issues:
SB70-AA3,213,2424 a. Experience of the partners working together.
SB70-AA3,213,2525 b. Plan for staffing the unit.
SB70-AA3,214,1
1c. Ability to electronically exchange health information.
SB70-AA3,214,22 d. Clinical expertise.
SB70-AA3,214,33 e. Hospital and post-acute facility survey history over the past 3 years.
SB70-AA3,214,44 f. Acute care partner readmissions history over the past 3 years.
SB70-AA3,214,55 g. Discharge planning and patient intake resources.
SB70-AA3,214,106 h. Stability of finances to support the proposal, including matching funds that
7could be dedicated to the pilot program under this subsection. No applicant is
8required to provide matching funds or a contribution, but the advisory group and the
9department of health services may take into consideration the availability of
10matching funds or a contribution in evaluating an application.
SB70-AA3,214,1211 5. The per diem rate requested to adequately compensate the hospital or
12hospitals and the post-acute facility or facilities.
SB70-AA3,214,1313 6. A post-acute bed reserve rate.
SB70-AA3,214,1514 7. Anticipated impediments to successful implementation and how the
15applicant partnership group intends to overcome the anticipated impediments.
SB70-AA3,214,1616 (f) The advisory group formed under this subsection shall do all of the following:
SB70-AA3,214,2017 1. Determine and recommend to the department an amount of the funding
18budgeted for the complex patient pilot program under s. 20.435 (7) (d) to be reserved
19for reconciliation to ensure that participants in the pilot program are held harmless
20from unanticipated financial loss.
SB70-AA3,215,221 2. Develop a methodology to evaluate the complex patient pilot program,
22including a recommendation on whether the department should contract with an
23independent organization to evaluate the complex patient pilot program. The
24department may contract with an independent organization to complete the
25evaluation described under this subdivision and, if the department does so, the

1department may pay the fee of the organization selected from the appropriation
2under s. 20.435 (7) (d).
SB70-AA3,215,53 3. Make recommendations to the secretary of health services regarding which
4partnership groups should receive designation as a participating site for the complex
5patient pilot program.
SB70-AA3,215,96 (g) 1. No later than 90 days after the effective date of this subdivision, the
7advisory group shall complete development of the request for proposal for
8partnership groups to be designated as participating sites in the complex patient
9pilot program and provide its recommendations to the secretary of health services.
SB70-AA3,215,1410 2. No later than 150 days after the effective date of this subdivision, the
11advisory group shall review all applications submitted in response to the request for
12proposal and select up to 4 partnership groups to recommend to the secretary of
13health services for designation as participating sites for the complex patient pilot
14program under this subsection.
SB70-AA3,215,2315 3. Between 6 months and 18 months after the effective date of this subdivision,
16the partnership groups designated by the department as participating sites in the
17complex patient pilot program shall implement the pilot program and meet quarterly
18with both the department and the advisory group or any independent organization
19hired by the department for the purpose of evaluating the pilot program to discuss
20experiences relating to the pilot program. From the appropriation under s. 20.435
21(7) (d), the department shall provide payments to partnership groups designated as
22participating sites for care provided during the course of the pilot program under this
23subsection.
SB70-AA3,216,324 4. No later than June 30, 2025, the advisory group or any independent
25organization hired by the department for the purpose of evaluating the complex

1patient pilot program shall complete and submit to the secretary of health services
2an evaluation of the complex patient pilot program under this subsection, including
3a written report and recommendations.
SB70-AA3,9419 4Section 9419. Effective dates; Health Services.
SB70-AA3,216,65 (1u) Complex patient pilot program. The repeal of s. 20.435 (7) (d) takes effect
6on July 1, 2025.”.
SB70-AA3,216,7 7248. Page 374, line 11: after that line insert:
SB70-AA3,216,8 8 Section 273. 20.455 (1) (hn) of the statutes is created to read:
SB70-AA3,216,109 20.455 (1) (hn) Payments to relators. All moneys received by the department
10that are owed to a relator, to provide payments owed to a relator.
SB70-AA3,274 11Section 274. 20.9315 of the statutes is created to read:
SB70-AA3,216,12 1220.9315 False claims; actions by or on behalf of state. (1) In this section:
SB70-AA3,216,1513 (a) 1. “Claim” means any request or demand, whether under a contract or
14otherwise, for money or property, whether the state has title to the money or property,
15that is any of the following:
SB70-AA3,216,1616 a. Presented to an officer, employee, agent, or other representative of the state.
SB70-AA3,216,2117 b. Made to a contractor, grantee, or other person if the money or property is to
18be spent or used on the state's behalf or to advance a state program or interest and
19if the state provides any portion of the money or property that is requested or
20demanded or will reimburse directly or indirectly the contractor, grantee, or other
21person for any portion of the money or property that is requested or demanded.
SB70-AA3,216,2322 2. “Claim” includes a request or demand for services from a state agency or as
23part of a state program.
SB70-AA3,217,3
13. “Claim” does not include requests or demands for money or property that the
2state has paid to an individual as compensation for state employment or as an income
3subsidy with no restriction on that individual's use of the money or property.
SB70-AA3,217,74 (b) “Knowingly" means, with respect to information, having actual knowledge
5of the information, acting in deliberate ignorance of the truth or falsity of the
6information, or acting in reckless disregard of the truth or falsity of the information.
7“Knowingly" does not mean specifically intending to defraud.
SB70-AA3,217,98 (c) “Material” means having a natural tendency to influence, or be capable of
9influencing, the payment or receipt of money or property or the receipt of services.
SB70-AA3,217,1010 (d) “Medical assistance" has the meaning given under s. 49.43 (8).
SB70-AA3,217,1111 (e) “Obligation” has the meaning given in 31 USC 3729 (b) (3).
SB70-AA3,217,1212 (f) “Original source” has the meaning given in 31 USC 3730 (e) (4) (B).
SB70-AA3,217,1513 (g) “Proceeds" includes damages, civil penalties, surcharges, payments for
14costs of compliance, and any other economic benefit realized by this state as a result
15of an action or settlement of a claim.
SB70-AA3,217,20 16(2) Except as provided in sub. (3), any person who does any of the following is
17liable to this state for 3 times the amount of the damages that were sustained by the
18state or would have been sustained by the state,whichever is greater, because of the
19actions of the person and shall forfeit, for each violation, an amount within the range
20specified under 31 USC 3729 (a):
SB70-AA3,217,2221 (a) Knowingly presents or causes to be presented a false or fraudulent claim
22to a state agency, including a false or fraudulent claim for medical assistance.
SB70-AA3,217,2523 (b) Knowingly makes, uses, or causes to be made or used a false record or
24statement material to a false or fraudulent claim to a state agency, including a false
25or fraudulent claim for medical assistance.
SB70-AA3,218,5
1(c) Knowingly makes, uses, or causes to be made or used a false record or
2statement material to an obligation to pay or transmit money or property to the
3Medical Assistance program, or knowingly conceals or knowingly and improperly
4avoids or decreases an obligation to pay or transmit money or property to the Medical
5Assistance program.
SB70-AA3,218,96 (d) Knowingly makes, uses, or causes to be made or used a false record or
7statement material to an obligation to pay or transmit money or property to a state
8agency or knowingly conceals or knowingly and improperly avoids or decreases an
9obligation to pay or transmit money or property to a state agency.
SB70-AA3,218,1010 (e) Conspires to commit a violation under par. (a), (b), (c), or (d).
SB70-AA3,218,14 11(3) The court may assess against a person who violates sub. (2) not less than
122 nor more than 3 times the amount of the damages sustained by the state because
13of the acts of the person, and shall not assess any forfeiture, if the court finds all of
14the following:
SB70-AA3,218,1715 (a) The person who commits the acts furnished the attorney general with all
16information known to the person about the acts within 30 days after the date on
17which the person obtained the information.
SB70-AA3,218,1818 (b) The person fully cooperated with any investigation by this state of the acts.
SB70-AA3,218,2219 (c) At the time that the person furnished the attorney general with information
20concerning the acts, no criminal prosecution or civil or administrative enforcement
21action had been commenced with respect to any such act, and the person did not have
22actual knowledge of the existence of any investigation into any such act.
SB70-AA3,218,25 23(5) (a) Except as provided in subs. (10) and (12), any person may bring a civil
24action as a qui tam plaintiff against a person who commits an act in violation of sub.
25(2) for the person and the state in the name of the state.
SB70-AA3,219,8
1(b) The plaintiff under par. (a) shall serve upon the attorney general a copy of
2the complaint and documents disclosing substantially all material evidence and
3information that the plaintiff possesses. The plaintiff shall file a copy of the
4complaint with the court for inspection in camera. Except as provided in par. (c), the
5complaint shall remain under seal for a period of 60 days from the date of filing and
6shall not be served upon the defendant until the court so orders. Within 60 days from
7the date of service upon the attorney general of the complaint, evidence, and
8information under this paragraph, the attorney general may intervene in the action.
SB70-AA3,219,139 (bm) Any complaint filed by the state in intervention, whether filed separately
10or as an amendment to the qui tam plaintiff's complaint, shall relate back to the filing
11date of the qui tam plaintiff's complaint to the extent that the state's claim arises out
12of the conduct, transactions, or occurrences set forth, or attempted to be set forth, in
13the qui tam plaintiff's complaint.
SB70-AA3,219,1614 (c) The attorney general may, for good cause shown, move the court for one or
15more extensions of the period during which a complaint in an action under this
16subsection remains under seal.
SB70-AA3,219,1817 (d) Before the expiration of the period during which the complaint remains
18under seal, the attorney general shall do one of the following:
SB70-AA3,219,2019 1. Proceed with the action or an alternate remedy under sub. (10), in which case
20the action or proceeding under sub. (10) shall be prosecuted by the state.
SB70-AA3,219,2221 2. Notify the court that he or she declines to proceed with the action, in which
22case the person bringing the action may proceed with the action.
SB70-AA3,219,2523 (e) If a person brings a valid action under this subsection, no person other than
24the state may intervene or bring a related action based upon the same facts
25underlying the original action while the original action is pending.
SB70-AA3,220,3
1(f) In any action brought under this subsection or other proceeding under sub.
2(10), the plaintiff is required to prove all essential elements of the cause of action or
3complaint, including damages, by a preponderance of the evidence.
SB70-AA3,220,7 4(6) If the state proceeds with an action under sub. (5) or an alternate remedy
5under sub. (10), the state has primary responsibility for prosecuting the action under
6sub. (5) or proceeding under sub. (10). The state is not bound by any act of the person
7bringing the action, but that person has the right to continue as a party to the action.
SB70-AA3,220,15 8(7) (b) With the approval of the governor, the attorney general may compromise
9and settle an action under sub. (5) or an administrative proceeding under sub. (10)
10to which the state is a party, notwithstanding objection of the person bringing the
11action, if the court determines, after affording to the person bringing the action the
12right to a hearing at which the person is afforded the opportunity to present evidence
13in opposition to the proposed settlement, that the proposed settlement is fair,
14adequate, and reasonable considering the relevant circumstances pertaining to the
15violation.
SB70-AA3,220,2216 (c) Upon a showing by the state that unrestricted participation in the
17prosecution of an action under sub. (5) or an alternate proceeding under sub. (10) to
18which the state is a party by the person bringing the action would interfere with or
19unduly delay the prosecution of the action or proceeding, or would result in
20consideration of repetitious or irrelevant evidence or evidence presented for
21purposes of harassment, the court may limit the person's participation in the
22prosecution, such as:
SB70-AA3,220,2323 1. Limiting the number of witnesses that the person may call.
SB70-AA3,220,2424 2. Limiting the length of the testimony of the witnesses.
SB70-AA3,220,2525 3. Limiting the cross-examination of witnesses by the person.
SB70-AA3,221,2
14. Otherwise limiting the participation by the person in the prosecution of the
2action or proceeding.
SB70-AA3,221,73 (d) Upon a showing by a defendant that unrestricted participation in the
4prosecution of an action under sub. (5) or alternate proceeding under sub. (10) to
5which the state is a party by the person bringing the action would result in
6harassment or would cause the defendant undue burden or unnecessary expense, the
7court may limit the person's participation in the prosecution.
SB70-AA3,221,14 8(8) Except as provided in sub. (7), if the state elects not to participate in an
9action filed under sub. (5), the person bringing the action may prosecute the action.
10If the attorney general so requests, the attorney general shall, at the state's expense,
11be served with copies of all pleadings and deposition transcripts in the action. If the
12person bringing the action initiates prosecution of the action, the court, without
13limiting the status and rights of that person, may permit the state to intervene at a
14later date upon a showing by the state of good cause for the proposed intervention.
SB70-AA3,221,24 15(9) Whether or not the state participates in an action under sub. (5), upon a
16showing in camera by the attorney general that discovery by the person bringing the
17action would interfere with the state's ongoing investigation or prosecution of a
18criminal or civil matter arising out of the same facts as the facts upon which the
19action is based, the court may stay such discovery in whole or in part for a period of
20not more than 60 days. The court may extend the period of any such stay upon a
21further showing in camera by the attorney general that the state has pursued the
22criminal or civil investigation of the matter with reasonable diligence and the
23proposed discovery in the action brought under sub. (5) will interfere with the
24ongoing criminal or civil investigation or prosecution.
SB70-AA3,222,12
1(10) The attorney general may pursue a claim relating to an alleged violation
2of sub. (2) through an alternate remedy available to the state or any state agency,
3including an administrative proceeding to assess a civil forfeiture. If the attorney
4general elects any such alternate remedy, the attorney general shall serve timely
5notice of his or her election upon the person bringing the action under sub. (5), and
6that person has the same rights in the alternate venue as the person would have had
7if the action had continued under sub. (5). Any finding of fact or conclusion of law
8made by a court or by a state agency in the alternate venue that has become final is
9conclusive upon all parties named in an action under sub. (5). For purposes of this
10subsection, a finding or conclusion is final if it has been finally determined on appeal,
11if all time for filing an appeal or petition for review with respect to the finding or
12conclusion has expired, or if the finding or conclusion is not subject to judicial review.
SB70-AA3,222,18 13(11) (a) Except as provided in pars. (b) and (e), if the state proceeds with an
14action brought by a person under sub. (5) or the state pursues an alternate remedy
15relating to the same acts under sub. (10), the person who brings the action shall
16receive at least 15 percent but not more than 25 percent of the proceeds of the action
17or settlement of the claim, depending upon the extent to which the person
18contributed to the prosecution of the action or claim.
SB70-AA3,223,319 (b) Except as provided in par. (e), if an action or claim is one that the court or
20other adjudicator finds to be based primarily upon disclosures of specific information
21not provided by the person who brings the action or claim under sub. (5) relating to
22allegations or transactions specifically disclosed in a criminal, civil, or
23administrative hearing; legislative or administrative report, hearing, audit, or
24investigation; or report made by the news media, the court or other adjudicator may
25award an amount to the person as it considers appropriate, but not more than 10

1percent of the proceeds of the action or settlement of the claim, depending upon the
2significance of the information and the role of the person bringing the action in
3advancing the prosecution of the action or claim.
SB70-AA3,223,84 (c) Except as provided in par. (e), in addition to any amount received under par.
5(a) or (b), a person bringing an action under sub. (5) shall be awarded his or her
6reasonable expenses necessarily incurred in bringing the action together with the
7person's costs and reasonable actual attorney fees. The court or other adjudicator
8shall assess any award under this paragraph against the defendant.
Loading...
Loading...