SB55-ASA1, s. 2850Ld 18Section 2850Ld. 149.142 (2) of the statutes is amended to read:
SB55-ASA1,949,2019 149.142 (2) The Except as provided in sub. (1) (b), the rates established under
20this section are subject to adjustment under ss. 149.143 and 149.144.
SB55-ASA1, s. 2850Le 21Section 2850Le. 149.143 (1) (b) 1. d. of the statutes is amended to read:
SB55-ASA1,950,222 149.143 (1) (b) 1. d. Fourth, notwithstanding subd. 2., by increasing insurer
23assessments, excluding assessments under s. 149.144, and adjusting provider
24payment rates, subject to s. 149.142 (1) (b) and excluding adjustments to those rates

1under s. 149.144, in equal proportions and to the extent that the amounts under
2subd. 1. a. to c. are insufficient to pay 60% of plan costs.
SB55-ASA1, s. 2850Lf 3Section 2850Lf. 149.143 (1) (b) 2. b. of the statutes is amended to read:
SB55-ASA1,950,64 149.143 (1) (b) 2. b. Fifty percent from adjustments to provider payment rates,
5subject to s. 149.142 (1) (b) and excluding adjustments to those rates under s.
6149.144.
SB55-ASA1, s. 2850Lg 7Section 2850Lg. 149.143 (2) (a) 4. of the statutes is amended to read:
SB55-ASA1,950,118 149.143 (2) (a) 4. By the same rule as under subd. 3. adjust the provider
9payment rate for the new plan year, subject to s. 149.142 (1) (b), by estimating and
10setting the rate at the level necessary to equal the amounts specified in sub. (1) (b)
111. d. and 2. b. and as provided in s. 149.145.
SB55-ASA1, s. 2850Lj 12Section 2850Lj. 149.143 (2m) (b) 3. of the statutes is created to read:
SB55-ASA1,950,1713 149.143 (2m) (b) 3. For distribution to eligible persons, notwithstanding any
14requirements in this chapter related to setting premium amounts. The department,
15with the approval of the board and the concurrence of the plan actuary, shall
16determine the policies, eligibility criteria, methodology, and other factors to be used
17in making any distribution under this subdivision.
SB55-ASA1, s. 2850Lh 18Section 2850Lh. 149.143 (3) (a) of the statutes is amended to read:
SB55-ASA1,951,319 149.143 (3) (a) If, during a plan year, the department determines that the
20amounts estimated to be received as a result of the rates and amount set under sub.
21(2) (a) 2. to 4. and any adjustments in insurer assessments and the provider payment
22rate under s. 149.144 will not be sufficient to cover plan costs, the department may
23by rule increase the premium rates set under sub. (2) (a) 2. for the remainder of the
24plan year, subject to s. 149.146 (2) (b) and the maximum specified in sub. (2) (a) 2.,
25by rule increase the assessments set under sub. (2) (a) 3. for the remainder of the plan

1year, subject to sub. (1) (b) 2. a., and by the same rule under which assessments are
2increased adjust the provider payment rate set under sub. (2) (a) 4. for the remainder
3of the plan year, subject to sub. (1) (b) 2. b. and s. 149.142 (1) (b).
SB55-ASA1, s. 2850Li 4Section 2850Li. 149.143 (3) (b) of the statutes is amended to read:
SB55-ASA1,951,115 149.143 (3) (b) If the department increases premium rates and insurer
6assessments and adjusts the provider payment rate under par. (a) and determines
7that there will still be a deficit and that premium rates have been increased to the
8maximum extent allowable under par. (a), the department may further adjust, in
9equal proportions, assessments set under sub. (2) (a) 3. and the provider payment
10rate set under sub. (2) (a) 4., without regard to sub. (1) (b) 2. but subject to s. 149.142
11(1) (b).
SB55-ASA1, s. 2850Lj 12Section 2850Lj. 149.143 (5) (a) of the statutes is amended to read:
SB55-ASA1,951,1913 149.143 (5) (a) Annually, no later than April 30, the department shall perform
14a reconciliation with respect to plan costs, premiums, insurer assessments, and
15provider payment rate adjustments based on data from the previous calendar year.
16On the basis of the reconciliation, the department shall make any necessary
17adjustments in premiums, insurer assessments, or provider payment rates, subject
18to s. 149.142 (1) (b),
for the fiscal year beginning on the first July 1 after the
19reconciliation, as provided in sub. (2) (b).
SB55-ASA1, s. 2850Lk 20Section 2850Lk. 149.143 (5) (b) of the statutes is amended to read:
SB55-ASA1,952,221 149.143 (5) (b) Except as provided in sub. (3) and s. 149.144, the department
22shall adjust the provider payment rates to meet the providers' specified portion of the
23plan costs no more than once annually, subject to s. 149.142 (1) (b). The department
24may not determine the adjustment on an individual provider basis or on the basis

1of provider type, but shall determine the adjustment for all providers in the
2aggregate, subject to s. 149.142 (1) (b).
SB55-ASA1, s. 2850Lm 3Section 2850Lm. 149.144 of the statutes is amended to read:
SB55-ASA1,952,18 4149.144 Adjustments to insurer assessments and provider payment
5rates for premium and deductible reductions.
If the moneys transferred to the
6fund under the appropriation under s. 20.435 (4) (ah) are insufficient to reimburse
7the plan for premium reductions under s. 149.165 and deductible reductions under
8s. 149.14 (5) (a), or the department determines that the moneys transferred or to be
9transferred to the fund under the appropriation under s. 20.435 (4) (ah) will be
10insufficient to reimburse the plan for premium reductions under s. 149.165 and
11deductible reductions under s. 149.14 (5) (a), the department may, by rule, adjust in
12equal proportions the amount of the assessment set under s. 149.143 (2) (a) 3. and
13the provider payment rate set under s. 149.143 (2) (a) 4., subject to s. ss. 149.142 (1)
14(b) and
149.143 (1) (b) 1., sufficient to reimburse the plan for premium reductions
15under s. 149.165 and deductible reductions under s. 149.14 (5) (a). If the department
16makes the adjustment under this section, the department shall notify the
17commissioner so that the commissioner may levy any increase in insurer
18assessments.
SB55-ASA1, s. 2850Ln 19Section 2850Ln. 149.145 of the statutes is amended to read:
SB55-ASA1,953,6 20149.145 Program budget. The department, in consultation with the board,
21shall establish a program budget for each plan year. The program budget shall be
22based on the provider payment rates specified in s. 149.142 and in the most recent
23provider contracts that are in effect and on the funding sources specified in s. 149.143
24(1), including the methodologies specified in ss. 149.143, 149.144 , and 149.146 for
25determining premium rates, insurer assessments, and provider payment rates.

1Except as otherwise provided in s. 149.143 (3) (a) and (b) and subject to s. 149.142
2(1) (b)
, from the program budget the department shall derive the actual provider
3payment rate for a plan year that reflects the providers' proportional share of the
4plan costs, consistent with ss. 149.143 and 149.144. The department may not
5implement a program budget established under this section unless it is approved by
6the board.
SB55-ASA1, s. 2850m 7Section 2850m. 149.146 (1) (b) 1. of the statutes is repealed.
SB55-ASA1, s. 2850p 8Section 2850p. 149.146 (1) (b) 2. of the statutes is renumbered 149.146 (1) (b).
SB55-ASA1, s. 2850q 9Section 2850q. 149.146 (2) (am) 2. of the statutes is amended to read:
SB55-ASA1,953,1310 149.146 (2) (am) 2. Except as provided in subd. subds. 3. and 5., if the covered
11costs incurred by the eligible person exceed the deductible for major medical expense
12coverage in a calendar year, the plan shall pay at least 80% of any additional covered
13costs incurred by the person during the calendar year.
SB55-ASA1, s. 2850r 14Section 2850r. 149.146 (2) (am) 3. of the statutes is amended to read:
SB55-ASA1,953,2015 149.146 (2) (am) 3. If Except as provided in subd. 5., if the aggregate of the
16covered costs not paid by the plan under subd. 2. and the deductible exceeds $3,500
17for any eligible person during a calendar year or $7,000 for all eligible persons in a
18family, the plan shall pay 100% of all covered costs incurred by the eligible person
19during the calendar year after the payment ceilings under this subdivision are
20exceeded.
SB55-ASA1, s. 2850s 21Section 2850s. 149.146 (2) (am) 5. of the statutes is created to read:
SB55-ASA1,954,522 149.146 (2) (am) 5. Subject to s. 149.14 (8) (b), the department may, by rule
23under s. 149.17 (4), establish for prescription drug coverage under this section
24copayment amounts, coinsurance rates, and copayment and coinsurance
25out-of-pocket limits over which the plan will pay 100% of covered costs for

1prescription drugs. Any copayment amount, coinsurance rate, or out-of-pocket
2limit established under this subdivision is subject to the approval of the board.
3Copayments and coinsurance paid by an eligible person under this subdivision are
4separate from and do not count toward the deductible and covered costs not paid by
5the plan under subds. 1. to 3.
SB55-ASA1, s. 2850w 6Section 2850w. 149.15 (1) of the statutes is amended to read:
SB55-ASA1,954,247 149.15 (1) The plan shall have a board of governors consisting of
8representatives of 2 participating insurers which that are nonprofit corporations,
9representatives of 2 other participating insurers, 3 health care provider
10representatives, including one representative of the State Medical Society of
11Wisconsin, one representative of the Wisconsin Health and Hospital Association and
12one representative of an integrated multidisciplinary health system, and 3 4 public
13members, including one representative of small businesses in the state, appointed
14by the secretary for staggered 3-year terms. In addition, the commissioner, or a
15designated representative from the office of the commissioner, and the secretary, or
16a designated representative from the department, shall be members of the board.
17The public members shall not be professionally affiliated with the practice of
18medicine, a hospital, or an insurer. At least 2 one of the public members shall be
19individuals reasonably expected to qualify for an individual who has coverage under
20the plan or the parent or spouse of such an individual. The secretary or the
21secretary's representative shall be the chairperson of the board. Board members,
22except the commissioner or the commissioner's representative and the secretary or
23the secretary's representative, shall be compensated at the rate of $50 per diem plus
24actual and necessary expenses.
SB55-ASA1, s. 2850x 25Section 2850x. 149.25 of the statutes is created to read:
SB55-ASA1,955,1
1149.25 Case management pilot program. (1) Definitions. In this section:
SB55-ASA1,955,52 (a) "Chronic disease" means any disease, illness, impairment, or other physical
3condition that requires health care and treatment over a prolonged period and,
4although amenable to treatment, is irreversible and frequently progresses to
5increasing disability or death.
SB55-ASA1,955,86 (b) "Health professional shortage area" means an area that is designated by the
7federal department of health and human services under 42 CFR part 5, appendix A,
8as having a shortage of medical care professionals.
SB55-ASA1,955,11 9(2) Program and eligibility requirements. (a) The department shall conduct
10a 3-year pilot program, beginning on July 1, 2002, under which eligible persons who
11qualify under par. (b) are provided community-based case management services.
SB55-ASA1,955,1312 (b) To be eligible to participate in the pilot program, an eligible person must
13satisfy any of the following criteria:
SB55-ASA1,955,1414 1. Be diagnosed as having a chronic disease.
SB55-ASA1,955,1515 2. Be taking 2 or more prescribed medications on a regular basis.
SB55-ASA1,955,1816 3. Within 6 months of applying for the pilot program, have been treated 2 or
17more times at a hospital emergency room or have been admitted 2 or more times to
18a hospital as an inpatient.
SB55-ASA1,955,2219 (c) 1. Participation in the pilot program shall be voluntary and limited to no
20more than 300 eligible persons. The department shall ensure that all eligible
21persons are advised in a timely manner of the opportunity to participate in the pilot
22program and of how to apply for participation.
SB55-ASA1,956,223 2. If more than 300 eligible persons apply to participate, the department shall
24select pilot program participants from among those who qualify under par. (b)
25according to standards determined by the department, except that the department

1shall give preference to eligible persons who reside in medically underserved areas
2or health professional shortage areas.
SB55-ASA1,956,6 3(3) Provider organization and services requirements. (a) The department
4shall select and contract with an organization to provide the community-based case
5management services under the pilot program. To be eligible to provide the services,
6an organization must satisfy all of the following criteria:
SB55-ASA1,956,97 1. Be a private, nonprofit, integrated health care system that provides access
8to health care in a medically underserved area of the state or in a health professional
9shortage area.
SB55-ASA1,956,1110 2. Operate an existing community-based case management program with
11demonstrated successful client and program outcomes.
SB55-ASA1,956,1412 3. Demonstrate an ability to assemble and coordinate an interdisciplinary
13team of health care professionals, including physicians, nurses, and pharmacists, for
14assessment of a program participant's treatment plan.
SB55-ASA1,956,1815 (b) The community-based case management services under the pilot program
16shall be provided by a team, consisting of a nurse case manager, a pharmacist, and
17a social worker, working in collaboration with the eligible person's primary care
18physician or other provider. Services to be provided include all of the following:
SB55-ASA1,956,1919 1. An initial intake assessment.
SB55-ASA1,956,2020 2. Development of a treatment plan based on best practices.
SB55-ASA1,956,2121 3. Coordination of health care services.
SB55-ASA1,956,2222 4. Patient education.
SB55-ASA1,956,2323 5. Family support.
SB55-ASA1,956,2424 6. Monitoring and reporting of patient outcomes and costs.
SB55-ASA1,957,2
1(c) The department shall pay contract costs from the appropriation under s.
220.435 (4) (u).
SB55-ASA1,957,11 3(4) Evaluation study. The department shall conduct a study that evaluates the
4pilot program in terms of health care outcomes and cost avoidance. In the study, the
5department shall measure and compare, for pilot program participants and similarly
6situated eligible persons not participating in the pilot program, plan costs and
7utilization of services, including inpatient hospital days, rates of hospital
8readmission within 30 days for the same diagnosis, and prescription drug utilization.
9The department shall submit a report on the results of the study, including the
10department's conclusions and recommendations, to the legislature under s. 13.172
11(2) and to the governor.
SB55-ASA1, s. 2850y 12Section 2850y. 150.345 of the statutes is created to read:
SB55-ASA1,957,15 13150.345 Nursing home bed transfers. (1) Notwithstanding ss. 150.33 and
14150.34, a nursing home may transfer a licensed bed to another nursing home, if all
15of the following apply:
SB55-ASA1,957,1816 (a) The receiving nursing home is within the same area for allocation of nursing
17home beds, as determined by the department, as is the transferring nursing home,
18or is in a county adjoining that area.
SB55-ASA1,957,2019 (b) The transferring nursing home and the receiving nursing home are owned
20by corporations that are owned by the same person.
SB55-ASA1,957,2221 (c) The transferring and receiving nursing homes notify the department of the
22proposed transfer within 30 days before the transfer occurs.
SB55-ASA1,957,2323 (d) The department reviews and approves the transfer.
SB55-ASA1,958,3
1(2) Upon receiving the notification specified in sub. (1) (c), the department shall
2adjust the allocation of licensed beds under s. 150.31 for each nursing home in
3accordance with the transfer that was made.
SB55-ASA1, s. 2852g 4Section 2852g. 157.10 of the statutes is renumbered 157.10 (1) (a) and
5amended to read:
SB55-ASA1,958,96 157.10 (1) (a) While Except as provided in par. (b), while any person is buried
7in a cemetery lot, the cemetery lot shall be inalienable, without the consent of unless
8the cemetery authority, and on the consents to a conveyance of an interest in the
9cemetery lot.
SB55-ASA1,958,12 10(2) Upon the death of the owner of a cemetery lot, ownership of the cemetery
11lot shall descend to the owner's heirs; but and any one or more of such heirs may
12convey to any other heir his or her interest in the cemetery lot.
SB55-ASA1,958,16 13(3) No human remains may be buried in a cemetery lot except the human
14remains of one having an interest in the cemetery lot, or a relative, or the husband
15or wife of such person, or his or her relative, except by the consent of all persons
16having an interest in the cemetery lot.
SB55-ASA1, s. 2852h 17Section 2852h. 157.10 (1) (b) of the statutes is created to read:
SB55-ASA1,958,2018 157.10 (1) (b) A person having an interest in a cemetery lot may, after providing
19written notice to the cemetery authority, convey the interest to his or her spouse,
20child, sibling, or parent without the consent of the cemetery authority.
SB55-ASA1, s. 2852t 21Section 2852t. 157.635 (title) of the statutes is amended to read:
SB55-ASA1,958,23 22157.635 (title) Regulations of religious cemetery affiliated with
23religious society
authorities.
SB55-ASA1, s. 2852u 24Section 2852u. 157.635 of the statutes is renumbered 157.635 (2) and
25amended to read:
SB55-ASA1,959,6
1157.635 (2) Nothing Except as provided in sub. (3), nothing in this subchapter
2prohibits a religious cemetery authority of a cemetery that is affiliated with a
3religious society organized under ch. 187
from prohibiting the burial of the human
4remains of an individual in the cemetery if the individual was in a class of individuals
5who are prohibited under regulations adopted by the religious cemetery authority
6or affiliated religious society from being buried in the cemetery.
SB55-ASA1, s. 2852v 7Section 2852v. 157.635 (1) of the statutes is created to read:
SB55-ASA1,959,88 157.635 (1) In this section:
SB55-ASA1,959,109 (a) "Affiliated religious society" means a religious society organized under ch.
10187 that is affiliated with a religious cemetery authority.
SB55-ASA1,959,1211 (b) "Religious cemetery authority" means a cemetery authority of a cemetery
12that is affiliated with a religious society organized under ch. 187.
SB55-ASA1, s. 2852x 13Section 2852x. 157.635 (3) of the statutes is created to read:
SB55-ASA1,959,1914 157.635 (3) If an individual who is not prohibited under regulations adopted
15by a religious cemetery authority or affiliated religious society from being buried in
16a cemetery conveys his or her interest in a cemetery lot in the cemetery to his or her
17spouse, child, sibling, or parent, the religious cemetery authority may not prohibit
18the burial of the human remains of the spouse, child, sibling, or parent in the
19cemetery.
SB55-ASA1, s. 1413 20Section 1413. 157.70 (2) (i) of the statutes is amended to read:
SB55-ASA1,959,2421 157.70 (2) (i) Cause a cataloged burial site to be recorded by the register of
22deeds of the county in which the burial site is located. The historical society shall
23reimburse the county for the cost of recording under this paragraph from the
24appropriation under s. 20.245 (3) (1) (a).
SB55-ASA1, s. 1414 25Section 1414. 165.055 (3) of the statutes is repealed.
SB55-ASA1, s. 2854m
1Section 2854m. 165.10 of the statutes is created to read:
SB55-ASA1,960,7 2165.10 Civil rights enforcement. If any person, whether or not acting under
3color of law, interferes with the exercise or enjoyment by any individual of a right
4secured by the constitution or laws of the United States, or of a right secured by the
5constitution or laws of this state, the attorney general may bring an action for
6injunction or other appropriate equitable relief to protect the peaceable exercise or
7enjoyment of the right secured.
SB55-ASA1, s. 1415 8Section 1415. 165.25 (4) (ar) of the statutes is amended to read:
SB55-ASA1,960,149 165.25 (4) (ar) The department of justice shall furnish all legal services
10required by the department of agriculture, trade and consumer protection relating
11to the enforcement of ss. 100.171, 100.173, 100.174, 100.175, 100.177, 100.18,
12100.182, 100.20, 100.205, 100.207, 100.209, 100.21, 100.28, 100.37, 100.42, 100.50,
13and 100.51 and chs. 136, 344, 704, 707, and 779, together with any other services as
14are necessarily connected to the legal services.
SB55-ASA1, s. 2856d 15Section 2856d. 165.25 (10) of the statutes is created to read:
SB55-ASA1,960,2416 165.25 (10) Report on restitution. Semiannually submit a report to the
17department of administration and the joint committee on finance regarding money
18received by the department of justice under a court order or a settlement agreement
19for providing restitution to victims. The report shall specify the amount of
20restitution received by the department of justice during the reporting period; the
21persons to whom the department of justice paid restitution and the amount that the
22department of justice paid to each recipient during the reporting period; and the
23department of justice's methodology for selecting recipients and determining the
24amount paid to each recipient.
SB55-ASA1, s. 2857t 25Section 2857t. 165.755 (1) (b) of the statutes is amended to read:
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