Wisconsin Legislature: 59,9119

1. The advantages of high-deductible health plans and health savings accounts.

2. Examples of individuals or families that may benefit from high-deductible health plans and health savings accounts.

3. Any consumer-driven health plan design changes or initiatives approved by the group insurance board for implementation by the department of employee trust funds.

(b) No later than January 1, 2018, the department of employee trust funds shall submit the plan developed under paragraph (a), along with a request for any funding needed to conduct the educational campaign described under paragraph (a), to the joint committee on finance under section 13.10 of the statutes. The department of employee trust funds may not conduct the educational campaign unless the committee approves the plan.

(1t) Group insurance board plan for state program reserves.

(a) No later than March 1, 2018, the group insurance board shall submit to the joint committee on finance for review a plan that includes all of the following:

1. The amount of state program reserves as of December 31, 2017.

2. The amount of state program reserves that will be used during calendar year 2018 to reduce state program costs.

3. A projection of 2018 year-end state program reserves prepared by the group insurance board's consulting actuary.

4. The group insurance board's planned utilization of state program reserves in calendar year 2019.

(b) If, within 21 working days after the date on which the group insurance board submitted the plan described under paragraph (a), the cochairpersons of the joint committee on finance do not notify the group insurance board that the joint committee on finance has scheduled a meeting for the purpose of reviewing the plan, the group insurance board may implement the plan. If, within 21 working days after the date on which the group insurance board submitted the plan, the cochairpersons of the joint committee on finance notify the group insurance board that the joint committee on finance has scheduled a meeting for the purpose of reviewing the plan, the group insurance board may implement the plan only upon approval of the joint committee on finance.

(2p) Group insurance board; group health program reserves.

(a) During the 2017-19 fiscal biennium, the group insurance board shall use $68,800,000 of the state group health program reserves established under section 40.03 (6) of the statutes to reduce state group health program costs.

(b) During the 2017-19 fiscal biennium, the group insurance board shall review its policies related to maintaining reserves for fully insured health plans. In conducting this review, the group insurance board shall review at least all of the following:

1. The history of changes in the participation of fully insured health plans in the group health insurance program.

2. The number of members affected by the discontinuation of fully insured health plans from year to year.

3. The dollar amount of claims or premiums associated with members that are affected by the discontinuation of fully insured health plans from year to year.

(2w) State employee group health program savings. The group insurance board shall attempt to ensure that state employee group health program costs, paid from general purpose revenues, are reduced by $63,900,000 during the 2017-19 fiscal biennium. The reductions shall be achieved through a combination of the following:

(a) Savings resulting from negotiations with insurers who provide health care coverage to state employees.

(b) Utilization of state group health program reserves.

(d) Additional utilization of state group health program reserves during 2018 and 2019 if the group insurance board revises its reserve policy.

(e) Health care plan design changes, with a focus on consumer-driven health care, provided that the changes do not increase total employee premium costs under the lowest tier plans under section 40.51 (6) of the statutes by more than 10 percent during 2018 and 2019. The costs include health insurance premiums, co-pays, deductibles, coinsurance, and out-of-pocket expenditures.

(f) Any other state employee health program or health care plan changes, provided that they do not increase total employee health insurance premium costs under the lowest tier plans under section 40.51 (6) of the statutes by more than 10 percent during 2018 and 2019. The costs include health insurance premiums, co-pays, deductibles, coinsurance, and out-of-pocket expenditures.

59,9115 Section 9115. Nonstatutory provisions; Employment Relations Commission.

(1) Elimination of offices of commissioner. On the effective date of this subsection, the 3 offices of commissioner at the Employment Relations Commission are eliminated.

59,9116 Section 9116. Nonstatutory provisions; Ethics Commission.

59,9117 Section 9117. Nonstatutory provisions; Financial Institutions.

59,9118 Section 9118. Nonstatutory provisions; Governor.

59,9119 Section 9119. Nonstatutory provisions; Health and Educational Facilities Authority.

59,9120 Section 9120. Nonstatutory provisions; Health Services.

(1) Emergency rules on youth crisis stabilization facilities. The department of health services may promulgate emergency rules under section 227.24 of the statutes implementing certification of youth crisis stabilization facilities under section 51.042 of the statutes. Notwithstanding section 227.24 (1) (a) and (3) of the statutes, the department of health services is not required to provide evidence that promulgating a rule under this subsection as an emergency rule is necessary for the preservation of the public peace, health, safety, or welfare and is not required to provide a finding of emergency for a rule promulgated under this subsection. Notwithstanding section 227.24 (1) (c) and (2) of the statutes, emergency rules promulgated under this subsection remain in effect until July 1, 2019, or the date on which permanent rules take effect, whichever is sooner.

(1b) Supplement for youth crisis stabilization facilities. During the 2017-19 fiscal biennium, the department of health services may submit one or more requests to the joint committee on finance under section 13.10 of the statutes to supplement the appropriation under section 20.435 (5) (kd) of the statutes in a total of no more than $1,245,500 from the appropriation account under section 20.435 (2) (gk) of the statutes for the purpose of providing one or more grants to a youth crisis stabilization facility under section 51.042 of the statutes. In a submission under this subsection, the department of health services shall describe its plan for distributing grant moneys, including the conditions the department would specify for the expenditure of grant moneys and the criteria the department proposes to use for selecting grantees. The department of health services may not issue a request for proposals to award grants to a youth crisis stabilization facility until the joint committee on finance approves or modifies and approves the department's plan under this subsection.

(1c) Youth crisis stabilization facility funding proposal. The department of health services shall include in its 2019-21 biennial budget request a proposal for funding grants to youth crisis stabilization facilities under section 51.042 of the statutes with general fund moneys.

(1g) Peer-run respite center for veterans. The department of health services shall include in its 2019-21 biennial budget request a proposal to provide ongoing general purpose revenue funding for a peer-run respite center that provides services to veterans.

(1t) Grace period for county reports. Notwithstanding sections 51.61 (1) (z) and 980.08 (4) (dm) 4. of the statutes, beginning on the effective date of this subsection and ending on the first day of the 13th month beginning after the effective date of this subsection, the county shall submit a report required under section 980.08 (4) (dm) of the statutes to the department of health services within 180 days, rather than 120 days, following the court order or be subject to action as provided in sections 51.61 (1) (z) and 980.08 (4) (dm) 4. of the statutes.

(2) FoodShare employment and training program requirement pilot program.

(a) The department of health services may implement a requirement for able-bodied adults to participate in the food stamp program's employment and training program under section 49.79 (9) of the statutes in no more than 2 vendor regions of the food stamp program's employment and training program beginning in April 2019 . The department may not impose the pilot program requirement under this paragraph after June 30, 2020.

(b) The department of health services shall evaluate the pilot program under paragraph (a) and, depending on the department's findings, submit a proposal for statewide expansion of the requirement to participate in the food stamp program's employment and training program in its 2021-23 biennial budget.

(c) During the 2017-19 fiscal biennium, the department of health services shall submit a detailed implementation plan for the pilot program under paragraph (a) and may submit one or more requests to the joint committee on finance under section 13.10 of the statutes to supplement the appropriations under section 20.435 (4) (a), (bm), (bn), and (bp) of the statutes from the appropriation under section 20.865 (4) (a) of the statutes for the purpose of implementing the pilot program under paragraph (a). The department of health services may only use moneys for the pilot program under paragraph (a) of the statutes if the joint committee on finance approves the request under this paragraph. Notwithstanding section 13.101 (3) of the statutes, the joint committee on finance is not required to find that an emergency exists before making a supplementation under this paragraph.

(2p) Supplement for FoodShare child support and paternity compliance. During the 2017-19 fiscal biennium, the department of health services or the department of children and families may submit one or more requests to the joint committee on finance to supplement the appropriations under section 20.435 (4) (a), (bm), and (bn) or 20.437 (2) (a) of the statutes from the appropriation under section 20.865 (4) (a) of the statutes for the purpose of implementing child support and paternity compliance for the food stamp program under section 49.79 (6m), (6q), or (6t) of the statutes, subject to section 49.79 (6u) of the statutes. If, within 14 days after the date of a department's submittal, the cochairpersons of the committee do not notify the department that the committee has scheduled a meeting to review the request, the supplement is considered approved. If the cochairpersons notify the department that the committee has scheduled a meeting to review the request, the supplement may be made only upon the approval of the committee. Notwithstanding section 13.101 (3) of the statutes, the joint committee on finance is not required to find that an emergency exists before making a supplementation under this subsection.

(2s) FoodShare employment and training program outcomes report. By February 1, 2018, the department of health services shall provide to the joint committee on finance an outcome report on the food stamp program's employment and training program under section 49.79 (9) of the statutes. The report shall include any proposed program improvements and contract modifications necessary based on the reported outcomes.

(3t) Rate-based service contracts. If on the effective date of this subsection, the amount accumulated by a provider, as defined in section 46.036 (5m) (a) 1. of the statutes, from all contract periods ending before that date for all rate-based services, as defined in section 46.036 (5m) (a) 2. of the statutes, provided by the provider exceeds 10 percent of the provider's total contract amount for all rate-based services in the year before the effective date of this subsection, the provider shall provide written notice of that excess to all purchasers of that rate-based service and, upon the written request of such a purchaser received no later than 6 months after the date of the notice, shall return to the purchaser the purchaser's proportional share of that excess. If the department of health services under section 46.036 (5m) of the statutes determines based on an audit or fiscal review that the amount of the excess identified by the provider was incorrect, the department of health services may seek to recover funds after the 6-month period has expired. The department of health services shall commence any audit or fiscal review under this subsection within 6 years after the end of the contract period.

(4g) Physical medicine pilot program.

(a) Definitions. In this subsection:

1. “Department” means the department of health services.

2. “Medical Assistance program” means the program under subchapter IV of chapter 49 of the statutes.

3. “Physical medicine” means rehabilitation techniques that aim to enhance and restore functional ability and quality of life to persons with physical impairments, injuries, or disabilities.

(b) Study. The department shall study best practices for physical medicine and the impact the use of physical medicine has on the use and frequency of use of prescription and over-the-counter drugs and shall develop a proposal for a physical medicine pilot program to minimize prescription of addictive drugs for individuals who receive benefits under the Medical Assistance program by using chiropractic and physical and occupational therapy services that are reimbursed under the Medical Assistance program. In completing the study and developing the proposal under this paragraph, the department shall solicit input from persons that are interested in physical medicine, including those interested in chiropractic care and physical therapy.

(c) Report. No later than April 1, 2018, the department shall submit a report of the study and the proposal for the pilot program under paragraph (b) to the legislature under section 13.172 (2) of the statutes. The department may not implement the pilot program under paragraph (b) unless the legislature directs or explicitly authorizes the department to implement the pilot program.

(4j) Ambulatory surgical center reimbursement rates under Medical Assistance program. The department of health services shall consult with ambulatory surgical centers to develop a plan to increase reimbursement rates for ambulatory surgical centers for services provided to recipients of Medical Assistance under subchapter IV of chapter 49 of the statutes. During the 2017-19 fiscal biennium, the department of health services may submit one or more requests to the joint committee on finance to supplement the appropriation under section 20.435 (4) (b) of the statutes in a total of no more than $2,500,000 from the appropriation under section 20.865 (4) (a) of the statutes for the purpose of increasing reimbursement rates under the Medical Assistance program for ambulatory surgical centers in accordance with the plan established under this subsection. If, within 14 days after the date of the department's submittal, the cochairpersons of the committee do not notify the department of health services that the committee has scheduled a meeting to review the request, the supplement is considered approved. If the cochairpersons notify the department of health services that the committee has scheduled a meeting to review the request, the supplement may be made only upon the approval of the committee. Notwithstanding section 13.101 (3) of the statutes, the joint committee on finance is not required to find that an emergency exists before making a supplementation under this subsection.

(4k) Family Care Partnership program. By December 31, 2017, the department of health services shall submit a request for a waiver of federal Medicaid law to the federal department of health and human services to expand the Family Care Partnership program, as described in section 49.496 (1) (bk) 3. of the statutes, statewide. If the federal department of health and human services approves the request, the department of health services shall, within 60 days of receiving notice of the approval, submit a plan for expansion of the Family Care Partnership program following the guidelines in the waiver to the joint committee on finance for approval. The department of health services may expand the Family Care Partnership program only as approved by the joint committee on finance. If the federal department of health and human services disapproves the request, the department of health services shall submit a report to the joint committee on finance describing the reasons the request was disapproved.

(5b) Nursing home bed licenses.

(a) In this subsection, “nursing home" has the meaning given in section 50.01 (3) of the statutes.

(b) Notwithstanding sections 150.33, 150.35, and 150.39 of the statutes, from the nursing home beds that are available under section 150.31 of the statutes, the department of health services shall, following submission of the application under paragraph (c), redistribute 18 beds to a nursing home that satisfies all of the following:

1. On the effective date of this subdivision, it has a licensed bed capacity of no more than 30.

2. On the effective date of this subdivision, it is located in a county that has a population of at least 27,000, with the population of the county seat of no more than 9,200, and that is adjacent to a county with a population of at least 20,000.

3. It has requested the increase in the number of its licensed beds through a notice to the department of health services that includes its per diem operating and capital rates.

(c) The department of health services shall approve an application from a nursing home that meets the qualifications under paragraph (b) within 30 days after the department of health services receives the application.

(d) The department of health services shall develop a policy that specifies procedures for applying for, and receiving approval of, the transfer of available, licensed nursing home beds. The department of health services shall submit a report on the resulting policy to the joint committee on finance no later than July 1, 2018.

(5f) Emergency physician services and reimbursement workgroup.

(a) Under section 15.04 (1) (c) of the statutes, the department of health services shall establish a committee to examine medical services provided in hospital emergency departments to Medical Assistance recipients and make recommendations regarding potential savings in these services and increases to Medical Assistance reimbursement for emergency physician services. To the extent the committee determines appropriate, the committee may examine aspects of the healthcare system involving emergency care, including patient care practices, medication use and prescribing practices, billing and coding administration, organization of health care delivery systems, care coordination, patient financial incentives, and other aspects.

(b) The committee under paragraph (a) shall consist of all of the following members appointed by the secretary of health services:

1. Two physicians practicing in Wisconsin representing a statewide physician-member organization of emergency physicians.

2. Two representatives of the division of the department of health services that addresses Medical Assistance services, with experience in emergency physician services, codes, and payment.

3. One representative who is a hospital emergency department administrator employed by a Wisconsin hospital or hospital-based health system.

4. One coding and billing specialist from an organization with expertise on and in the business of emergency medicine that contracts emergency physicians practicing in Wisconsin.

(d) The committee under this subsection must first convene no later than 60 days after the effective date of this paragraph and meet at least every 45 days until arriving at a set of recommendations.

(e) The committee shall report its findings and recommendations to the joint committee on finance no later than September 1, 2018, and each recommendation must be made on the basis of a consensus of the committee.

(5h) Complex rehabilitation technology.

(a) The department of health services shall submit in proposed form the rules required under section 49.45 (9r) of the statutes, including the rules described under paragraph (b), to the legislative council staff under section 227.15 (1) of the statutes no later than the first day of the 13th month beginning after the effective date of this paragraph.

(b) The department of health services shall include in the proposed rules submitted under paragraph (a) rules that designate the healthcare common procedure coding system codes that are used in the federal Medicare program for complex rehabilitation technology for the Medical Assistance program and are in accordance with section 49.45 (9r) of the statutes.

(c) The department of health services shall in the proposed rules exempt the codes designated from any bidding or selective contracting requirements.

(6d) Critical access hospital grant. The department of health services shall award a grant of $250,000 in the 2017-19 fiscal biennium to a critical access hospital to support the cost of a behavioral health crisis management system. The department of health services shall award the grant under this subsection to a critical access hospital that meets all of the following criteria:

(a) The hospital presents a proposal that does all of the following:

1. Provides in-person triage, assessment, and brief intervention services to persons presenting in the hospital emergency department for reasons related to a behavioral health crisis.

2. Provides the services specified under subdivision 1. through video telemedicine consultation to persons presenting in hospital emergency departments, other than the hospital's emergency department, in the hospital's region.

3. Coordinates the transfer of persons who require care for a behavioral health condition to another facility, as appropriate.

(b) The hospital is located in the northwestern part of this state in a county that borders Minnesota and that has immediate access to the interstate highway known as I 94.

(6p) Medical Assistance audit of family planning providers.

(a) In this subsection, “covered entity” has the meaning given in 42 USC 256b (a) (4) (C) and (K).

(b) The office of the inspector general of the department of health services shall conduct an audit of all family planning service reimbursements paid to covered entities under the Medical Assistance program under subchapter IV of chapter 49 of the statutes for the period January 1, 2013, to December 31, 2016. The office of the inspector general shall conclude the audit under this subsection no later than June 30, 2019.

(6t) Community program grants. Notwithstanding the limitations on the amount of grants under section 46.48 of the statutes, in the 2019-21 fiscal biennium, from the appropriation account under section 20.435 (7) (bc) of the statutes, the department of health services may increase the amount of each grant or the number of grants awarded under section 46.48 of the statutes to expend the moneys described in Section 9220 (5r) of this act.

59,9121 Section 9121. Nonstatutory provisions; Higher Educational Aids Board.

(1f) Minority teacher loan program. Notwithstanding section 16.42 (1) (e) of the statutes, in submitting information under section 16.42 of the statutes for purposes of the 2019 biennial budget act, the higher educational aids board shall submit information concerning the appropriation under section 20.235 (1) (cr) of the statutes as though the total amount appropriated under section 20.235 (1) (cr) of the statutes for the 2018-19 fiscal year was $125,000 more than the total amount that was actually appropriated under section 20.235 (1) (cr) of the statutes for the 2018-19 fiscal year.

(2f) Teacher loan program. Notwithstanding section 16.42 (1) (e) of the statutes, in submitting information under section 16.42 of the statutes for purposes of the 2019 biennial budget act, the higher educational aids board shall submit information concerning the appropriation under section 20.235 (1) (ct) of the statutes as though the total amount appropriated under section 20.235 (1) (ct) of the statutes for the 2018-19 fiscal year was $125,000 more than the total amount that was actually appropriated under section 20.235 (1) (ct) of the statutes for the 2018-19 fiscal year.

59,9122 Section 9122. Nonstatutory provisions; Historical Society