SB44-SSA1, s. 1333 19Section 1333. 49.45 (6m) (ag) 3r. of the statutes, as created by 2003 Wisconsin
20Act .... (this act), is amended to read:
SB44-SSA1,526,2221 49.45 (6m) (ag) 3r. Flat-rate payment, as determined by the department, for
22all costs specified under par. (am) 1. a. and 2.
SB44-SSA1, s. 1333d 23Section 1333d. 49.45 (6m) (ag) 8. of the statutes is created to read:
SB44-SSA1,527,3
149.45 (6m) (ag) 8. Maintenance of the identical proportion of payment for direct
2care costs, as specified in par. (am) 1., to total payment for all costs specified in par.
3(am) as that made in state fiscal year 2002-03.
SB44-SSA1, s. 1334 4Section 1334. 49.45 (6m) (am) 1. a. of the statutes is amended to read:
SB44-SSA1,527,95 49.45 (6m) (am) 1. a. Personal comfort supplies; medical supplies;
6over-the-counter drugs; and nonbillable services of a ward clerk, activity person,
7recreation person, social worker, volunteer coordinator, teacher for residents aged 22
8and older, vocational counselor for residents aged 22 and older, religious person,
9therapy aide, therapy assistant, and counselor on resident living
.
SB44-SSA1, s. 1335 10Section 1335. 49.45 (6m) (am) 1. b. of the statutes is repealed.
SB44-SSA1, s. 1336 11Section 1336. 49.45 (6m) (am) 1. bm. of the statutes is created to read:
SB44-SSA1,527,1312 49.45 (6m) (am) 1. bm. Nonbillable services of a registered nurse, licensed
13practical nurse and nurse's assistant.
SB44-SSA1, s. 1337 14Section 1337. 49.45 (6m) (am) 1. d. of the statutes is repealed.
SB44-SSA1, s. 1338 15Section 1338. 49.45 (6m) (am) 1. e. of the statutes is repealed.
SB44-SSA1, s. 1339 16Section 1339. 49.45 (6m) (am) 3. (intro.) of the statutes is renumbered 49.45
17(6m) (am) 2. c. and amended to read:
SB44-SSA1,527,2018 49.45 (6m) (am) 2. c. Allowable fuel and utility costs, including the facility
19expenses that the department determines are allowable for the provision of:
20electrical service, water and sewer services, and heat.
SB44-SSA1, s. 1340 21Section 1340. 49.45 (6m) (am) 3. a. of the statutes is repealed.
SB44-SSA1, s. 1341 22Section 1341. 49.45 (6m) (am) 3. b. of the statutes is repealed.
SB44-SSA1, s. 1342 23Section 1342. 49.45 (6m) (am) 3. c. of the statutes is repealed.
SB44-SSA1, s. 1343 24Section 1343. 49.45 (6m) (am) 4. of the statutes is amended to read:
SB44-SSA1,528,2
149.45 (6m) (am) 4. Net property Property tax or allowable municipal service
2costs incurred paid by the owner of the facility for the facility.
SB44-SSA1, s. 1344 3Section 1344. 49.45 (6m) (am) 5. of the statutes is renumbered 49.45 (6m) (am)
42. d.
SB44-SSA1, s. 1346d 5Section 1346d. 49.45 (6m) (ar) 1. a. of the statutes is amended to read:
SB44-SSA1,528,166 49.45 (6m) (ar) 1. a. The department shall establish standards for payment of
7allowable direct care costs under par. (am) 1. bm., for facilities that do not primarily
8serve the developmentally disabled, that take into account direct care costs for a
9sample of all of those facilities in this state and separate standards for payment of
10allowable direct care costs, for facilities that primarily serve the developmentally
11disabled, that take into account direct care costs for a sample of all of those facilities
12in this state. The standards shall be adjusted by the department for regional labor
13cost variations. For facilities in Douglas, Pierce, and St. Croix counties, the
14department shall perform the adjustment by use of the wage index that is used by
15the federal department of health and human services for hospital reimbursement
16under 42 USC 1395 to 1395ggg.
SB44-SSA1, s. 1347 17Section 1347. 49.45 (6m) (ar) 2. (intro.) and 2. a. of the statutes are
18consolidated, renumbered 49.45 (6m) (ar) 2. and amended to read:
SB44-SSA1,528,2119 49.45 (6m) (ar) 2. For support service costs: 2. a. The, the department shall
20establish one or more standards for the payment of support service costs that take
21into account support service costs for a sample of all facilities within the state.
SB44-SSA1, s. 1348 22Section 1348. 49.45 (6m) (ar) 2. b. of the statutes is repealed.
SB44-SSA1, s. 1349 23Section 1349. 49.45 (6m) (ar) 2. d. of the statutes is repealed.
SB44-SSA1, s. 1350 24Section 1350. 49.45 (6m) (ar) 3. of the statutes is repealed.
SB44-SSA1, s. 1351 25Section 1351. 49.45 (6m) (ar) 5. of the statutes is repealed.
SB44-SSA1, s. 1352
1Section 1352. 49.45 (6m) (av) 1. of the statutes is renumbered 49.45 (6m) (av)
2and amended to read:
SB44-SSA1,529,73 49.45 (6m) (av) The department shall calculate a payment rate for a facility by
4applying the criteria set forth under pars. (ag) 1. to 5. and 7., (am) 1. to 5. bm., 4., 5m.
5and 6.,
and (ar) 1. to 5., 4., and 6. to information from cost reports submitted by the
6facility, as affected by any adjustment for ancillary services and materials under par.
7(b)
.
SB44-SSA1, s. 1353 8Section 1353. 49.45 (6m) (av) 2. of the statutes is repealed.
SB44-SSA1, s. 1354 9Section 1354. 49.45 (6m) (av) 3. of the statutes is repealed.
SB44-SSA1, s. 1355 10Section 1355. 49.45 (6m) (av) 4. of the statutes is repealed.
SB44-SSA1, s. 1356 11Section 1356. 49.45 (6m) (av) 5. of the statutes is repealed.
SB44-SSA1, s. 1357 12Section 1357. 49.45 (6m) (av) 5m. of the statutes is repealed.
SB44-SSA1, s. 1358 13Section 1358. 49.45 (6m) (av) 6. of the statutes is repealed.
SB44-SSA1, s. 1359 14Section 1359. 49.45 (6m) (bc) of the statutes is repealed.
SB44-SSA1, s. 1360 15Section 1360. 49.45 (6t) of the statutes, as affected by 2001 Wisconsin Act 16,
16is renumbered 49.45 (6t) (a), and 49.45 (6t) (a) 2. (intro.), 3. and 4., as renumbered,
17are amended to read:
SB44-SSA1,529,2218 49.45 (6t) (a) 2. (intro.) Based on the amount estimated to be available under
19par. (a) subd. 1., develop a method, which need not be promulgated as rules under
20ch. 227, to distribute this allocation to the individual county departments under s.
2146.215, 46.22, 46.23 or 51.42 or to local health departments that have incurred
22operating deficits that shall include all of the following:
SB44-SSA1,529,2423 3. Except as provided in par. (d) subd. 4., distribute the allocation under the
24distribution method that is developed.
SB44-SSA1,530,5
14. If the federal department of health and human services approves for state
2expenditure in a fiscal year amounts under s. 20.435 (4) (o) that result in a lesser
3allocation amount than that allocated under this subsection or disallows use of the
4allocation of federal medicaid funds under par. (c) subd. 3., reduce allocations under
5this subsection and distribute on a prorated basis, as determined by the department.
SB44-SSA1, s. 1361 6Section 1361. 49.45 (6t) (b) of the statutes is created to read:
SB44-SSA1,530,87 49.45 (6t) (b) If 2003 Wisconsin Act .... (this act), section 9124 (8) (a) applies,
8this subsection does not apply.
SB44-SSA1, s. 1362 9Section 1362. 49.45 (6tt) of the statutes is created to read:
SB44-SSA1,530,1410 49.45 (6tt) Distributions to county departments and local health
11departments.
From the appropriation under s. 20.435 (4) (w), the department may
12in each fiscal year distribute moneys to county departments under s. 46.215, 46.22,
1346.23, or 51.42 or to local health departments, as defined in s. 250.01 (4), under a plan
14developed by the department.
SB44-SSA1, s. 1363 15Section 1363. 49.45 (6u) (am) (intro.) of the statutes is amended to read:
SB44-SSA1,531,216 49.45 (6u) (am) (intro.) Notwithstanding sub. (6m), in state fiscal years in
17which less than $1 in federal financial participation relating to facilities is received
18under 42 CFR 433.51,
from the appropriations under s. 20.435 (4) (o), (w), and (wm),
19for reduction of operating deficits, as defined under the methodology used by the
20department in December, 2000, incurred by a facility that is established under s.
2149.70 (1) or that is owned and operated by a city, village, or town, and as payment
22to care management organizations,
the department may not distribute to these
23facilities and to care management organizations more than $37,100,000 in each
24fiscal year, as determined by the department. The total amount that a county
25certifies under this subsection may not exceed 100% of otherwise-unreimbursed

1care. In distributing funds under this subsection, the department shall perform all
2of the following:
SB44-SSA1, s. 1364 3Section 1364. 49.45 (6u) (bm) of the statutes is repealed.
SB44-SSA1, s. 1365 4Section 1365. 49.45 (6v) (b) of the statutes is amended to read:
SB44-SSA1,531,105 49.45 (6v) (b) The department shall, each year, submit to the joint committee
6on finance a report for the previous fiscal year, except for the 1997-98 fiscal year, that
7provides information on the utilization of beds by recipients of medical assistance in
8facilities and a discussion and detailed projection of the likely balances,
9expenditures, encumbrances and carry over of currently appropriated amounts in
10the appropriation accounts under s. 20.435 (4) (b), (gp), and (o).
SB44-SSA1, s. 1366 11Section 1366. 49.45 (6x) (a) of the statutes is amended to read:
SB44-SSA1,531,1712 49.45 (6x) (a) Notwithstanding sub. (3) (e), from the appropriations
13appropriation accounts under s. 20.435 (4) (b), (gp), (o), and (w), the department shall
14distribute not more than $4,748,000 in each fiscal year, to provide funds to an
15essential access city hospital, except that the department may not allocate funds to
16an essential access city hospital to the extent that the allocation would exceed any
17limitation under 42 USC 1396b (i) (3).
SB44-SSA1, s. 1367 18Section 1367. 49.45 (6y) (a) of the statutes is amended to read:
SB44-SSA1,532,319 49.45 (6y) (a) Notwithstanding sub. (3) (e), from the appropriations
20appropriation accounts under s. 20.435 (4) (b), (gp), (o), and (w), the department shall
21distribute funding in each fiscal year to provide supplemental payment to hospitals
22that enter into a contract under s. 49.02 (2) to provide health care services funded
23by a relief block grant, as determined by the department, for hospital services that
24are not in excess of the hospitals' customary charges for the services, as limited under
2542 USC 1396b (i) (3). If no relief block grant is awarded under this chapter or if the

1allocation of funds to such hospitals would exceed any limitation under 42 USC
21396b
(i) (3), the department may distribute funds to hospitals that have not entered
3into a contract under s. 49.02 (2).
SB44-SSA1, s. 1368 4Section 1368. 49.45 (6y) (am) of the statutes is amended to read:
SB44-SSA1,532,125 49.45 (6y) (am) Notwithstanding sub. (3) (e), from the appropriations
6appropriation accounts under s. 20.435 (4) (b), (h), (gp), (o), and (w), the department
7shall distribute funding in each fiscal year to provide supplemental payments to
8hospitals that enter into contracts under s. 49.02 (2) with a county having a
9population of 500,000 or more to provide health care services funded by a relief block
10grant, as determined by the department, for hospital services that are not in excess
11of the hospitals' customary charges for the services, as limited under 42 USC 1396b
12(i) (3).
SB44-SSA1, s. 1369 13Section 1369. 49.45 (6z) (a) (intro.) of the statutes is amended to read:
SB44-SSA1,532,2414 49.45 (6z) (a) (intro.) Notwithstanding sub. (3) (e), from the appropriations
15appropriation accounts under s. 20.435 (4) (b), (gp), (o), and (w), the department shall
16distribute funding in each fiscal year to supplement payment for services to hospitals
17that enter into a contract under s. 49.02 (2) to provide health care services funded
18by a relief block grant under this chapter, if the department determines that the
19hospitals serve a disproportionate number of low-income patients with special
20needs. If no medical relief block grant under this chapter is awarded or if the
21allocation of funds to such hospitals would exceed any limitation under 42 USC
221396b
(i) (3), the department may distribute funds to hospitals that have not entered
23into a contract under s. 49.02 (2). The department may not distribute funds under
24this subsection to the extent that the distribution would do any of the following:
SB44-SSA1, s. 1372 25Section 1372. 49.45 (8) (b) of the statutes is amended to read:
SB44-SSA1,533,5
149.45 (8) (b) Reimbursement under s. 20.435 (4) (b), (gp), (o), and (w) for home
2health services provided by a certified home health agency or independent nurse
3shall be made at the home health agency's or nurse's usual and customary fee per
4patient care visit, subject to a maximum allowable fee per patient care visit that is
5established under par. (c).
SB44-SSA1, s. 1373 6Section 1373. 49.45 (18) (intro.) of the statutes is renumbered 49.45 (18) (ac)
7and amended to read:
SB44-SSA1,533,198 49.45 (18) (ac) Except as provided in pars. (a) (am) to (d), and subject to par.
9(ag),
any person eligible for medical assistance under s. 49.46, 49.468, or 49.47 shall
10pay up to the maximum amounts allowable under 42 CFR 447.53 to 447.58 for
11purchases of services provided under s. 49.46 (2). The service provider shall collect
12the specified or allowable copayment, coinsurance , or deductible, unless the service
13provider determines that the cost of collecting the copayment, coinsurance, or
14deductible exceeds the amount to be collected. The department shall reduce
15payments to each provider by the amount of the specified or allowable copayment,
16coinsurance, or deductible. No provider may deny care or services because the
17recipient is unable to share costs, but an inability to share costs specified in this
18subsection does not relieve the recipient of liability for these costs. Liability under
19this subsection is limited by the following provisions:
SB44-SSA1, s. 1374 20Section 1374. 49.45 (18) (a) of the statutes is renumbered 49.45 (18) (am).
SB44-SSA1, s. 1375 21Section 1375. 49.45 (18) (ag) of the statutes is created to read:
SB44-SSA1,533,2322 49.45 (18) (ag) Except as provided in pars. (am), (b), and (c), and subject to par.
23(d), a recipient specified in par. (ac) shall pay all of the following:
SB44-SSA1,533,2524 1. A copayment of $1 for each prescription of a drug that bears only a generic
25name, as defined in s. 450.12 (1) (b).
SB44-SSA1,534,2
12. A copayment of $3 for each prescription of a drug that bears a brand name,
2as defined in s. 450.12 (1) (a).
SB44-SSA1, s. 1376 3Section 1376. 49.45 (18) (d) of the statutes is amended to read:
SB44-SSA1,534,74 49.45 (18) (d) No person who designates a pharmacy or pharmacist as his or
5her sole provider of prescription drugs and who so uses that pharmacy or pharmacist
6is liable under this subsection for more than $5 $12 per month for prescription drugs
7received.
SB44-SSA1, s. 1377 8Section 1377. 49.45 (19) (bm) of the statutes is amended to read:
SB44-SSA1,534,119 49.45 (19) (bm) The department or the county department under s. 46.215 or
1046.22 shall notify applicants of the requirements of this subsection at the time of
11application.
SB44-SSA1, s. 1378 12Section 1378. 49.45 (24m) (intro.) of the statutes is amended to read:
SB44-SSA1,534,1713 49.45 (24m) Home health care and personal care pilot program. (intro.)
14From the appropriations appropriation accounts under s. 20.435 (4) (b), (gp), (o), and
15(w), in order to test the feasibility of instituting a system of reimbursement for
16providers of home health care and personal care services for medical assistance
17recipients that is based on competitive bidding, the department shall:
SB44-SSA1, s. 1379 18Section 1379. 49.45 (25) (am) (intro.) of the statutes is amended to read:
SB44-SSA1,534,2519 49.45 (25) (am) (intro.) Except as provided under pars. (be) and, (bg), and (bj)
20and sub. (24), case management services under s. 49.46 (2) (b) 9. and (bm) are
21reimbursable under medical assistance Medical Assistance only if provided to a
22medical assistance Medical Assistance beneficiary who receives case management
23services from or through a certified case management provider in a county, city,
24village, or town that elects, under par. (b), to make the services available and who
25meets at least one of the following conditions:
SB44-SSA1, s. 1380
1Section 1380. 49.45 (25) (bj) of the statutes is created to read:
SB44-SSA1,535,92 49.45 (25) (bj) The department of corrections may elect to provide case
3management services under this subsection to persons who are under the
4supervision of that department under s. 938.183, 938.34 (4h), (4m), or (4n), or
5938.357 (4), who are Medical Assistance beneficiaries, and who meet one or more of
6the conditions specified in par. (am). The amount of the allowable charges for those
7services under the Medical Assistance program that is not provided by the federal
8government shall be paid from the appropriation account under s. 20.410 (3) (hm),
9(ho), or (hr).
SB44-SSA1, s. 1381 10Section 1381. 49.45 (25) (c) of the statutes is amended to read:
SB44-SSA1,535,1511 49.45 (25) (c) Except as provided in pars. (b), (be) and, (bg), and (bj), the
12department shall reimburse a provider of case management services under this
13subsection only for the amount of the allowable charges for those services under the
14medical assistance Medical Assistance program that is provided by the federal
15government.
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