AB43,1083
1Section 1083. 49.45 (30) (a) of the statutes is repealed.
AB43,1084 2Section 1084. 49.45 (30) (b) of the statutes is renumbered 49.45 (30) and
3amended to read:
AB43,737,94 49.45 (30) Service provided by community support programs. The department
5shall reimburse a provider of county that provides services under s. 49.46 (2) (b) 6.
6L. only for the amount of the allowable charges for those services under the Medical
7Assistance program
that is provided by the federal government and for the amount
8of the allowable charges for those services under the Medical Assistance program
9that is not provided by the federal government
.
AB43,1085 10Section 1085. 49.45 (30e) (a) 2. of the statutes is repealed.
AB43,1086 11Section 1086. 49.45 (30e) (b) 3. of the statutes is amended to read:
AB43,737,1412 49.45 (30e) (b) 3. Requirements for certification of community-based
13psychosocial service programs. The department may certify county-based providers
14and providers that are not county-based providers.
AB43,1087 15Section 1087. 49.45 (30e) (c) of the statutes is renumbered 49.45 (30e) (c) 1.
16and amended to read:
AB43,737,2317 49.45 (30e) (c) 1. A For a county that elects to make provide the services under
18s. 49.46 (2) (b) 6. Lm. available shall reimburse a provider of the services for the
19amount of the allowable charges for those services under the medical assistance
20program that is not provided by the federal government. The
, the department shall
21reimburse the provider county only for the amount of the allowable charges for those
22services under the medical assistance Medical Assistance program that is provided
23by the federal government.
AB43,1088 24Section 1088. 49.45 (30e) (c) 2. of the statutes is created to read:
AB43,738,3
149.45 (30e) (c) 2. The department shall reimburse a provider that is not a
2county-based provider for services under s. 49.46 (2) (b) 6. Lm. for both the federal
3and nonfederal share of a fee schedule that is determined by the department.
AB43,1089 4Section 1089. 49.45 (30e) (d) of the statutes is amended to read:
AB43,738,125 49.45 (30e) (d) Provision of services on regional basis. Notwithstanding par.
6(c) 1. and subject to par. (e), in counties that elect to deliver provide the services under
7s. 49.46 (2) (b) 6. Lm. through the Medical Assistance program on a regional basis
8according to criteria established by the department, the department shall reimburse
9a provider of the services for the amount of the allowable charges for those services
10under the Medical Assistance program that is provided by the federal government
11and for the amount of the allowable charges that is not provided by the federal
12government.
AB43,1090 13Section 1090. 49.45 (30j) (title) of the statutes is amended to read:
AB43,738,1514 49.45 (30j) (title) Reimbursement for peer recovery coach and certified peer
15specialist
services.
AB43,1091 16Section 1091. 49.45 (30j) (a) 1. and 2. of the statutes are renumbered 49.45
17(30j) (a) 2m. and 3.
AB43,1092 18Section 1092. 49.45 (30j) (a) 1m. of the statutes is created to read:
AB43,738,2219 49.45 (30j) (a) 1m. “Certified peer specialist” means an individual who has
20experience in the mental health and substance use services system, who is trained
21to provide support to others, and who has received peer specialist or parent peer
22specialist certification under the rules established by the department.
AB43,1093 23Section 1093. 49.45 (30j) (bm) of the statutes is created to read:
AB43,739,3
149.45 (30j) (bm) The department shall reimburse under the Medical Assistance
2program under this subchapter any service provided by a certified peer specialist if
3the service satisfies all of the following conditions:
AB43,739,54 1. The recipient of the service provided by a certified peer specialist is in
5treatment for or recovery from a mental illness or a substance use disorder.
AB43,739,76 2. The certified peer specialist provides the service under the supervision of a
7competent mental health professional.
AB43,739,108 3. The certified peer specialist provides the service in coordination with the
9Medical Assistance recipient's individual treatment plan and in accordance with the
10recipient's individual treatment goals.
AB43,739,1311 4. The certified peer specialist providing the service has completed training
12requirements, as established by the department by rule, after consulting with
13members of the recovery community.
AB43,1094 14Section 1094. 49.45 (30j) (c) of the statutes is amended to read:
AB43,739,1715 49.45 (30j) (c) The department shall certify under Medical Assistance peer
16recovery coaches and certified peer specialists to provide services in accordance with
17this subsection.
AB43,1095 18Section 1095. 49.45 (30p) of the statutes is created to read:
AB43,739,1919 49.45 (30p) Detoxification and stabilization services. (a) In this subsection:
AB43,740,720 1. “Adult residential integrated behavioral health stabilization service” means
21a residential behavioral health treatment service, delivered under the oversight of
22a medical director, that provides withdrawal management and intoxication
23monitoring, as well as integrated behavioral health stabilization services, and
24includes nursing care on site for medical monitoring available on a 24-hour basis.
25“Adult residential integrated behavioral health stabilization service” may include

1the provision of services including screening, assessment, intake, evaluation and
2diagnosis, medical care, observation and monitoring, physical examination,
3determination of medical stability, medication management, nursing services, case
4management, drug testing, counseling, individual therapy, group therapy, family
5therapy, psychoeducation, peer support services, recovery coaching, recovery
6support services, and crisis intervention services, to ameliorate acute behavioral
7health symptoms and stabilize functioning.
AB43,740,108 2. “Community-based withdrawal management” means a medically managed
9withdrawal management service delivered on an outpatient basis by a physician or
10other service personnel acting under the supervision of a physician.
AB43,740,1311 3. “Detoxification and stabilization services” means adult residential
12integrated behavioral health stabilization service, residential withdrawal
13management service, or residential intoxication monitoring service.
AB43,740,2214 4. “Residential intoxication monitoring service” means a residential service
15that provides 24-hour observation to monitor the safe resolution of alcohol or
16sedative intoxication and to monitor for the development of alcohol withdrawal for
17intoxicated patients who are not in need of emergency medical or behavioral
18healthcare. “Residential intoxication monitoring service” may include the provision
19of services including screening, assessment, intake, evaluation and diagnosis,
20observation and monitoring, case management, drug testing, counseling, individual
21therapy, group therapy, family therapy, psychoeducation, peer support services,
22recovery coaching, and recovery support services.
AB43,741,1023 5. “Residential withdrawal management service” means a residential
24substance use treatment service that provides withdrawal management and
25intoxication monitoring, and includes medically managed 24-hour on-site nursing

1care, under the supervision of a physician. “Residential withdrawal management
2service” may include the provision of services, including screening, assessment,
3intake, evaluation and diagnosis, medical care, observation and monitoring,
4physical examination, medication management, nursing services, case
5management, drug testing, counseling, individual therapy, group therapy, family
6therapy, psychoeducation, peer support services, recovery coaching, and recovery
7support services, to ameliorate symptoms of acute intoxication and withdrawal and
8to stabilize functioning. “Residential withdrawal management service” may also
9include community-based withdrawal management and intoxication monitoring
10services.
AB43,741,1511 (b) Subject to par. (c), the department shall provide reimbursement for
12detoxification and stabilization services under the Medical Assistance program
13under s. 49.46 (2) (b) 14r. The department shall certify providers under the Medical
14Assistance program to provide detoxification and stabilization services in
15accordance with this subsection.
AB43,741,2316 (c) The department shall submit to the federal department of health and
17human services any request for a state plan amendment, waiver, or other federal
18approval necessary to provide reimbursement for detoxification and stabilization
19services as described in this subsection. If the federal department approves the
20request or if no federal approval is necessary, the department shall provide the
21reimbursement under par. 49.46 (2) (b) 14r. If the federal department disapproves
22the request, the department may not provide the reimbursement described in this
23subsection.
AB43,1096 24Section 1096 . 49.45 (30t) of the statutes is created to read:
AB43,741,2525 49.45 (30t) Doula services. (a) In this subsection:
AB43,742,2
11. “Certified doula” means an individual who has received certification from a
2doula certifying organization recognized by the department.
AB43,742,53 2. “Doula services” means childbirth education and support services, including
4emotional and physical support provided during pregnancy, labor, birth, and the
5postpartum period.
AB43,742,116 (b) The department shall request from the secretary of the federal department
7of health and human services any required waiver or any required amendment to the
8state plan for Medical Assistance to allow reimbursement for doula services provided
9by a certified doula. If the waiver or state plan amendment is granted, the
10department shall reimburse a certified doula under s. 49.46 (2) (b) 12p. for the
11allowable charges for doula services provided to Medical Assistance recipients.
AB43,1097 12Section 1097. 49.45 (39) (b) 1. of the statutes is amended to read:
AB43,743,2013 49.45 (39) (b) 1. `Payment for school medical services.' If a school district or a
14cooperative educational service agency elects to provide school medical services and
15meets all requirements under par. (c), the department shall reimburse the school
16district or the cooperative educational service agency for 60 100 percent of the federal
17share of allowable charges for the school medical services that it provides and, as
18specified in subd. 2., for allowable administrative costs. If the Wisconsin Center for
19the Blind and Visually Impaired or the Wisconsin Educational Services Program for
20the Deaf and Hard of Hearing elects to provide school medical services and meets all
21requirements under par. (c), the department shall reimburse the department of
22public instruction for 60 100 percent of the federal share of allowable charges for the
23school medical services that the Wisconsin Center for the Blind and Visually
24Impaired or the Wisconsin Educational Services Program for the Deaf and Hard of
25Hearing provides and, as specified in subd. 2., for allowable administrative costs. A

1school district, cooperative educational service agency, the Wisconsin Center for the
2Blind and Visually Impaired, or the Wisconsin Educational Services Program for the
3Deaf and Hard of Hearing may submit, and the department shall allow, claims for
4common carrier transportation costs as a school medical service unless the
5department receives notice from the federal health care financing administration
6that, under a change in federal policy, the claims are not allowed. If the department
7receives the notice, a school district, cooperative educational service agency, the
8Wisconsin Center for the Blind and Visually Impaired, or the Wisconsin Educational
9Services Program for the Deaf and Hard of Hearing may submit, and the department
10shall allow, unreimbursed claims for common carrier transportation costs incurred
11before the date of the change in federal policy. The department shall promulgate
12rules establishing a methodology for making reimbursements under this paragraph.
13All other expenses for the school medical services provided by a school district or a
14cooperative educational service agency shall be paid for by the school district or the
15cooperative educational service agency with funds received from state or local taxes.
16The school district, the Wisconsin Center for the Blind and Visually Impaired, the
17Wisconsin Educational Services Program for the Deaf and Hard of Hearing, or the
18cooperative educational service agency shall comply with all requirements of the
19federal department of health and human services for receiving federal financial
20participation.
AB43,1098 21Section 1098. 49.45 (39) (b) 2. of the statutes is amended to read:
AB43,744,622 49.45 (39) (b) 2. `Payment for school medical services administrative costs.' The
23department shall reimburse a school district or a cooperative educational service
24agency specified under subd. 1. and shall reimburse the department of public
25instruction on behalf of the Wisconsin Center for the Blind and Visually Impaired or

1the Wisconsin Educational Services Program for the Deaf and Hard of Hearing for
290 100 percent of the federal share of allowable administrative costs, using time
3studies, beginning in fiscal year 1999-2000. A school district or a cooperative
4educational service agency may submit, and the department of health services shall
5allow, claims for administrative costs incurred during the period that is up to 24
6months before the date of the claim, if allowable under federal law.
AB43,1099 7Section 1099. 49.45 (41) (a) of the statutes is renumbered 49.45 (41) (a) (intro.)
8and amended to read:
AB43,744,119 49.45 (41) (a) (intro.) In this subsection, “crisis intervention services" means
10crisis intervention services for the treatment of mental illness, intellectual disability,
11substance abuse, and dementia that are provided by a any of the following:
AB43,744,13 122. A crisis intervention program operated by, or under contract with, a county,
13if the county is certified as a medical assistance provider.
AB43,1100 14Section 1100. 49.45 (41) (a) 1. of the statutes is created to read:
AB43,744,1615 49.45 (41) (a) 1. A crisis urgent care and observation facility certified under s.
1651.036.
AB43,1101 17Section 1101. 49.45 (41) (b) of the statutes is amended to read:
AB43,745,218 49.45 (41) (b) If a county elects to become certified as a provider of crisis
19intervention services under par. (a) 2., the county may provide crisis intervention
20services under this subsection in the county to medical assistance recipients through
21the medical assistance program. A county that elects to provide the services shall
22pay the amount of the allowable charges for the services under the medical
23assistance program that is not provided by the federal government. The department
24shall reimburse the county under this subsection only for the amount of the allowable

1charges for those services under the medical assistance program that is provided by
2the federal government.
AB43,1102 3Section 1102. 49.45 (41) (c) (intro.) of the statutes is amended to read:
AB43,745,74 49.45 (41) (c) (intro.) Notwithstanding par. (b), if a county elects, pursuant to
5par. (a) 2.,
to deliver crisis intervention services under the Medical Assistance
6program on a regional basis according to criteria established by the department, all
7of the following apply:
AB43,1103 8Section 1103. 49.45 (41) (d) of the statutes is created to read:
AB43,745,159 49.45 (41) (d) The department shall request any necessary federal approval
10required to provide reimbursement to crisis urgent care and observation facilities
11certified under s. 51.036 for crisis intervention services under this subsection. If
12federal approval is granted or no federal approval is required, the department shall
13provide reimbursement under s. 49.46 (2) (b) 15. If federal approval is necessary but
14is not granted, the department may not provide reimbursement for crisis
15intervention services provided by crisis urgent care and observation facilities.
AB43,1104 16Section 1104. 49.45 (52) (a) 1. of the statutes is amended to read:
AB43,746,417 49.45 (52) (a) 1. If the department provides the notice under par. (c) selecting
18the payment procedure in this paragraph, the department may, from the
19appropriation account under s. 20.435 (7) (b), make Medical Assistance payment
20adjustments to county departments under s. 46.215, 46.22, 46.23, 51.42, or 51.437
21or to local health departments, as defined in s. 250.01 (4), as appropriate, for covered
22services under s. 49.46 (2) (a) 2. and 4. d. and f. and (b) 6. b., c., f., fm., g., j., k., L.,
23Lm., and m., 9., 12., 12m., 13., 15., and 16., except for services specified under s. 49.46
24(2) (b) 6. b. and c. provided to children participating in the early intervention program
25under s. 51.44. Payment adjustments under this paragraph shall include the state

1share of the payments. The total of any payment adjustments under this paragraph
2and Medical Assistance payments made from appropriation accounts under s. 20.435
3(4) (b), (gm), (o), and (w), may not exceed applicable limitations on payments under
442 USC 1396a (a) (30) (A).
AB43,1105 5Section 1105. 49.45 (52) (b) 1. of the statutes is amended to read:
AB43,746,116 49.45 (52) (b) 1. Annually, a county department under s. 46.215, 46.22, 46.23,
751.42, or 51.437 shall submit a certified cost report that meets the requirements of
8the federal department of health and human services for covered services under s.
949.46 (2) (a) 2. and 4. d. and f. and (b) 6. b., c., f., fm., g., j., k., L., Lm., and m., 9., 12.,
1012m., 13., 15., and 16., except for services specified under s. 49.46 (2) (b) 6. b. and c.
11provided to children participating in the early intervention program under s. 51.44.
AB43,1106 12Section 1106. 49.46 (1) (a) 1m. of the statutes is amended to read:
AB43,746,1713 49.46 (1) (a) 1m. Any pregnant woman whose income does not exceed the
14standard of need under s. 49.19 (11) and whose pregnancy is medically verified.
15Eligibility continues to the last day of the month in which the 60th day or, if approved
16by the federal government, the 90th 365th day after the last day of the pregnancy
17falls.
AB43,1107 18Section 1107. 49.46 (1) (j) of the statutes is amended to read:
AB43,746,2319 49.46 (1) (j) An individual determined to be eligible for benefits under par. (a)
209. remains eligible for benefits under par. (a) 9. for the balance of the pregnancy and
21to the last day of the month in which the 60th day or, if approved by the federal
22government, the 90th 365th day after the last day of the pregnancy falls without
23regard to any change in the individual's family income.
AB43,1108 24Section 1108 . 49.46 (2) (b) 8m. of the statutes is created to read:
AB43,747,2
149.46 (2) (b) 8m. Room and board for residential substance use disorder
2treatment.
AB43,1109 3Section 1109 . 49.46 (2) (b) 11m. of the statutes is created to read:
AB43,747,54 49.46 (2) (b) 11m. Subject to par. (bx), acupuncture provided by an
5acupuncturist who holds a certificate under ch. 451.
AB43,1110 6Section 1110 . 49.46 (2) (b) 12p. of the statutes is created to read:
AB43,747,87 49.46 (2) (b) 12p. Doula services provided by a certified doula, as specified
8under s. 49.45 (30t).
AB43,1111 9Section 1111. 49.46 (2) (b) 14c. of the statutes is created to read:
AB43,747,1110 49.46 (2) (b) 14c. Subject to par. (bv), services by a psychiatric residential
11treatment facility.
AB43,1112 12Section 1112. 49.46 (2) (b) 14p. of the statutes is amended to read:
AB43,747,1413 49.46 (2) (b) 14p. Subject to s. 49.45 (30j), services provided by a peer recovery
14coach or a certified peer specialist.
AB43,1113 15Section 1113. 49.46 (2) (b) 14r. of the statutes is created to read:
AB43,747,1716 49.46 (2) (b) 14r. Detoxification and stabilization services as specified under s.
1749.45 (30p).
AB43,1114 18Section 1114 . 49.46 (2) (b) 24. of the statutes is created to read:
AB43,747,2019 49.46 (2) (b) 24. Subject to par. (by), nonmedical services that contribute to the
20determinants of health.
AB43,1115 21Section 1115. 49.46 (2) (bv) of the statutes is created to read:
AB43,748,422 49.46 (2) (bv) The department shall submit to the federal department of health
23and human services any request for a state plan amendment, waiver, or other federal
24approval necessary to provide reimbursement for services by a psychiatric
25residential treatment facility. If the federal department of health and human

1services approves the request or if no federal approval is necessary, the department
2shall provide reimbursement under par. (b) 14c. If the federal department of health
3and human services disapproves the request, the department may not provide
4reimbursement for services under par. (b) 14c.
AB43,1116 5Section 1116 . 49.46 (2) (bx) of the statutes is created to read:
AB43,748,126 49.46 (2) (bx) The department shall submit to the federal department of health
7and human services any request for a state plan amendment, waiver, or other federal
8approval necessary to provide reimbursement for the benefit under par. (b) 11m. If
9the federal department approves the request or if no federal approval is necessary,
10the department shall provide the benefit and reimbursement under par. (b) 11m. If
11the federal department disapproves the request, the department may not provide the
12benefit or reimbursement for the benefit described under par. (b) 11m.
AB43,1117 13Section 1117 . 49.46 (2) (by) of the statutes is created to read:
AB43,748,2014 49.46 (2) (by) The department shall determine those services under par. (b) 24.
15that contribute to the determinants of health. The department shall seek any
16necessary state plan amendment or request any waiver of federal Medicaid law to
17implement this paragraph. The department is not required to provide the services
18under this paragraph as a benefit under the Medical Assistance program if the
19federal department of health and human services does not provide federal financial
20participation for the services under this paragraph.
AB43,1118 21Section 1118. 49.47 (4) (ag) 2. of the statutes is amended to read:
AB43,748,2522 49.47 (4) (ag) 2. Pregnant and the woman's pregnancy is medically verified.
23Eligibility continues to the last day of the month in which the 60th day or, if approved
24by the federal government, the 90th 365th day after the last day of the pregnancy
25falls.
AB43,1119
1Section 1119. 49.471 (1) (b) 2. of the statutes is amended to read:
AB43,749,22 49.471 (1) (b) 2. A stepfather, stepmother stepparent, stepbrother, or stepsister.
AB43,1120 3Section 1120 . 49.471 (1) (cr) of the statutes is created to read:
AB43,749,54 49.471 (1) (cr) “Enhanced federal medical assistance percentage" means a
5federal medical assistance percentage described under 42 USC 1396d (y) or (z).
AB43,1121 6Section 1121 . 49.471 (4) (a) 4. b. of the statutes is amended to read:
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