LRBb0051/2
RAC/TJD/MES/JTK:all:md
January 2011 Special Session
2011 - 2012 LEGISLATURE
SENATE AMENDMENT 1,
TO SENATE BILL 11
February 17, 2011 - Offered by Joint Committee on Finance.
SB11-SA1,1,11 At the locations indicated, amend the bill as follows:
SB11-SA1,1,2 21. Page 1, line 4: delete "an appropriation" and substitute "appropriations".
SB11-SA1,1,3 32. Page 9, line 21: after that line insert:
SB11-SA1,1,4 4" Section 5m. 13.488 (1) (m) of the statutes is amended to read:
SB11-SA1,2,35 13.488 (1) (m) The duty to compute determine and make payments to the
6United States required under 26 USC 148 (f) so that public debt, revenue obligations
7and operating notes issued pursuant to ch. 18 will not be treated as arbitrage bonds
8for the purpose of exclusion from gross income under 26 USC 103 (b) (2)
so as to avoid
9an adverse effect on any exclusion of interest from gross income for federal income
10tax purposes on public debt, revenue obligations, and operating notes issued
11pursuant to ch. 18, master lease obligations issued pursuant to s. 16.76, and
12appropriation obligations issued pursuant to s. 16.527 and to make any payments to
13advisors that assist in making the determination
. If the proceeds of an obligation are

1utilized for an activity that is financed from program revenue, the building
2commission shall make the payment payments required under this paragraph from
3that revenue, to the extent it is available.".
SB11-SA1,2,5 43. Page 11, line 23: delete the material beginning with that line and ending
5with page 12, line 10.
SB11-SA1,2,7 64. Page 24, line 2: delete "Notwithstanding" and substitute "Except as
7provided in sub. (3m) and notwithstanding".
SB11-SA1,2,8 85. Page 24, line 11: delete lines 11 to 22 and substitute:
SB11-SA1,2,16 9"(2) If there is any outstanding public debt, a portion of which was used to
10finance the acquisition, construction, or improvement of any plant that is sold, or is
11the subject of a contract for operation, under sub. (1), the department shall determine
12any actions that may be necessary or appropriate so as not to adversely affect any
13exclusion of interest on such public debt from gross income for federal income tax
14purposes, including payments to advisors or the federal internal revenue service.
15The department shall apply the net proceeds from any sale of a plant to do all of the
16following:
SB11-SA1,2,1817 (a) To make any payments to advisors or the federal internal revenue service
18determined by the department to be necessary or appropriate.
SB11-SA1,2,2019 (b) If the plant was acquired, constructed, or improved with federal financial
20assistance, to repay the federal government, as required by federal law.
SB11-SA1,2,2421 (c) To deposit a sufficient amount of the net proceeds from any sale of the plant
22in the bond security and redemption fund under s. 18.09 to repay the principal and
23pay the interest on such portion of the public debt, and any premium due upon
24repayment of such portion of the public debt.
SB11-SA1,3,3
1(3) Except as provided in s. 51.06, the department shall deposit in the budget
2stabilization fund any net proceeds in excess of the amount required to be deposited
3or paid under sub. (2).".
SB11-SA1,3,4 46. Page 24, line 22: after that line insert:
SB11-SA1,3,15 5"(3m) If the department proposes to sell, lease, or contract for the operation of
6any plant identified in sub. (1), the department shall first notify the joint committee
7on finance in writing of its proposed action. If the cochairpersons of the committee
8do not notify the department that the committee has scheduled a meeting for the
9purpose of reviewing the proposed sale within 14 working days after the date of the
10department's notification, the plant may be sold by the department. If, within 14
11working days after the date of the department's notification, the cochairpersons of
12the committee notify the department that the committee has scheduled a meeting for
13the purpose of reviewing the proposed sale, the plant may be sold under sub. (1) only
14upon approval of the committee. Together with any notification, the department
15shall also provide all of the following:
SB11-SA1,3,1716 (a) The estimated value of the plant as determined by the department and by
17at least one qualified privately owned assessor.
SB11-SA1,3,1918 (b) The full cost of retiring any remaining public debt incurred to finance the
19acquisition, construction, or improvement of the plant.
SB11-SA1,3,2220 (c) A cost-benefit analysis that considers the short-term and long-term costs
21and benefits to the state from selling, leasing, or contracting for the operation of the
22plant.
SB11-SA1,3,2423 (d) The length and conditions of any proposed sale, lease, or service agreement
24between this state and a proposed purchaser, lessee, or contractor.
SB11-SA1,4,3
1(e) The estimated budgetary impact of the proposed sale, lease, or contractual
2operation upon affected state agencies for at least the current and following fiscal
3biennium.
SB11-SA1,4,44 (f) Any other information requested by the committee.".
SB11-SA1,4,6 57. Page 28, line 9: delete the material beginning with "No moneys" and ending
6with "administration." on line 10.
SB11-SA1,4,7 78. Page 31, line 3: after that line insert:
SB11-SA1,4,8 8" Section 63m. 20.867 (3) (h) of the statutes is amended to read:
SB11-SA1,5,59 20.867 (3) (h) Principal repayment, interest, and rebates, and tax-related
10payments
. A sum sufficient to guarantee full payment of principal and interest costs
11for self-amortizing or partially self-amortizing facilities enumerated under ss.
1220.190 (1) (j), 20.245 (1) (j), 20.285 (1) (im), (je), (jq), (kd), (km), and (ko), 20.370 (7)
13(eq), 20.485 (1) (go), and 20.867 (3) (kd) if moneys available in those appropriations
14are insufficient to make full payment, to make full payment of the amounts
15determined by the building commission under s. 13.488 (1) (m) if the appropriation
16under s. 20.190 (1) (j), 20.245 (1) (j), 20.285 (1) (im), (je), (jq), (kd), (km), or (ko), 20.485
17(1) (g), or 20.867 (3) (kd) is insufficient to make full payment of those amounts, and
18to make payments under an agreement or ancillary arrangement entered into under
19s. 18.06 (8) (a), and to make payments to the federal internal revenue service or to
20advisors determined under s. 16.896 (2) if the net proceeds from a sale under s. 16.896
21are insufficient to make such payments or if there are no net proceeds
. All amounts
22advanced under the authority of this paragraph shall be repaid to the general fund
23whenever the balance of the appropriation for which the advance was made is
24sufficient to meet any portion of the amount advanced. The department of

1administration may take whatever action is deemed necessary including the making
2of transfers from program revenue appropriations and corresponding appropriations
3from program receipts in segregated funds and including actions to enforce
4contractual obligations that will result in additional program revenue for the state,
5to ensure recovery of the amounts advanced.".
SB11-SA1,5,7 69. Page 34, line 22: delete the material beginning with ", other" and ending
7with "230.26" on line 23.
SB11-SA1,5,8 810. Page 37, line 10: delete lines 10 to 24.
SB11-SA1,5,9 911. Page 41, line 16: delete lines 16 to 18.
SB11-SA1,5,10 1012. Page 48, line 2: after that line insert:
SB11-SA1,5,12 11" Section 112d. 49.45 (2m) of the statutes, as created by 2011 Wisconsin Act
12.... (this act), is repealed.".
SB11-SA1,5,13 1313. Page 48, line 5: after that line insert:
SB11-SA1,5,15 14" Section 113d. 49.45 (3) (n) of the statutes, as created by 2011 Wisconsin Act
15.... (this act), is repealed.".
SB11-SA1,5,16 1614. Page 48, line 8: after that line insert:
SB11-SA1,5,18 17" Section 114d. 49.45 (6m) (n) of the statutes, as created by 2011 Wisconsin Act
18.... (this act), is repealed.".
SB11-SA1,5,19 1915. Page 48, line 15: after that line insert:
SB11-SA1,5,21 20" Section 115d. 49.45 (8) (b) of the statutes, as affected by 2011 Wisconsin Act
21.... (this act), is amended to read:
SB11-SA1,6,322 49.45 (8) (b) Unless otherwise provided by the department by rule promulgated
23under sub. (2m) (c), reimbursement
Reimbursement under s. 20.435 (4) (b), (o), and
24(w) for home health services provided by a certified home health agency or

1independent nurse shall be made at the home health agency's or nurse's usual and
2customary fee per patient care visit, subject to a maximum allowable fee per patient
3care visit that is established under par. (c).".
SB11-SA1,6,4 416. Page 48, line 22: after that line insert:
SB11-SA1,6,6 5" Section 116d. 49.45 (8) (c) of the statutes, as affected by 2011 Wisconsin Act
6.... (this act), is amended to read:
SB11-SA1,6,127 49.45 (8) (c) The department shall establish a maximum statewide allowable
8fee per patient care visit, for each type of visit with respect to provider, that may be
9no greater than the cost per patient care visit, as determined by the department from
10cost reports of home health agencies, adjusted for costs related to case management,
11care coordination, travel, record keeping and supervision, unless otherwise provided
12by the department by rule promulgated under sub. (2m) (c)
.".
SB11-SA1,6,13 1317. Page 49, line 6: after that line insert:
SB11-SA1,6,15 14" Section 117d. 49.45 (8r) of the statutes, as affected by 2011 Wisconsin Act ....
15(this act), is amended to read:
SB11-SA1,6,2316 49.45 (8r) Payment for certain obstetric and gynecological care. Unless
17otherwise provided by the department by rule promulgated under sub. (2m) (c), the

18The rate of payment for obstetric and gynecological care provided in primary care
19shortage areas, as defined in s. 36.60 (1) (cm), or provided to recipients of medical
20assistance who reside in primary care shortage areas, that is equal to 125% of the
21rates paid under this section to primary care physicians in primary care shortage
22areas, shall be paid to all certified primary care providers who provide obstetric or
23gynecological care to those recipients.".
SB11-SA1,6,24 2418. Page 49, line 18: after that line insert:
SB11-SA1,7,2
1" Section 118d. 49.45 (8v) of the statutes, as affected by 2011 Wisconsin Act ....
2(this act), is amended to read:
SB11-SA1,7,133 49.45 (8v) Incentive-based pharmacy payment system. The department shall
4establish a system of payment to pharmacies for legend and over-the-counter drugs
5provided to recipients of medical assistance that has financial incentives for
6pharmacists who perform services that result in savings to the medical assistance
7program. Under this system, the department shall establish a schedule of fees that
8is designed to ensure that any incentive payments made are equal to or less than the
9documented savings unless otherwise provided by the department by rule
10promulgated under sub. (2m) (c)
. The department may discontinue the system
11established under this subsection if the department determines, after performance
12of a study, that payments to pharmacists under the system exceed the documented
13savings under the system.".
SB11-SA1,7,14 1419. Page 50, line 7: after that line insert:
SB11-SA1,7,16 15" Section 119d. 49.45 (18) (ac) of the statutes, as affected by 2011 Wisconsin
16Act .... (this act), is amended to read:
SB11-SA1,8,517 49.45 (18) (ac) Except as provided in pars. (am) to (d), and subject to par. (ag),
18any person eligible for medical assistance under s. 49.46, 49.468, or 49.47, or for the
19benefits under s. 49.46 (2) (a) and (b) under s. 49.471 shall pay up to the maximum
20amounts allowable under 42 CFR 447.53 to 447.58 for purchases of services provided
21under s. 49.46 (2). The service provider shall collect the specified or allowable
22copayment, coinsurance, or deductible, unless the service provider determines that
23the cost of collecting the copayment, coinsurance, or deductible exceeds the amount
24to be collected. The department shall reduce payments to each provider by the

1amount of the specified or allowable copayment, coinsurance, or deductible. Unless
2otherwise provided by the department by rule promulgated under sub. (2m) (c), no

3No provider may deny care or services because the recipient is unable to share costs,
4but an inability to share costs specified in this subsection does not relieve the
5recipient of liability for these costs.".
SB11-SA1,8,6 620. Page 50, line 11: after that line insert:
SB11-SA1,8,8 7" Section 120d. 49.45 (18) (ag) (intro.) of the statutes, as affected by 2011
8Wisconsin Act .... (this act), is amended to read:
SB11-SA1,8,119 49.45 (18) (ag) (intro.) Except as provided in pars. (am), (b), and (c), and subject
10to par. (d), a recipient specified in par. (ac) shall pay all of the following, unless
11otherwise provided by the department by rule promulgated under sub. (2m) (c)
:".
SB11-SA1,8,12 1221. Page 50, line 15: after that line insert:
SB11-SA1,8,14 13" Section 121d. 49.45 (18) (b) (intro.) of the statutes, as affected by 2011
14Wisconsin Act .... (this act), is amended to read:
SB11-SA1,8,1715 49.45 (18) (b) (intro.) Unless otherwise provided by the department by rule
16promulgated under sub. (2m) (c), the
The following services are not subject to
17recipient cost sharing under this subsection:".
SB11-SA1,8,18 1822. Page 50, line 21: after that line insert:
SB11-SA1,8,20 19" Section 122d. 49.45 (18) (d) of the statutes, as affected by 2011 Wisconsin Act
20.... (this act), is amended to read:
SB11-SA1,9,221 49.45 (18) (d) No person who designates a pharmacy or pharmacist as his or
22her sole provider of prescription drugs and who so uses that pharmacy or pharmacist
23is liable under this subsection for more than $12 per month for prescription drugs

1received, unless otherwise provided by the department by rule promulgated under
2sub. (2m) (c)
.".
SB11-SA1,9,3 323. Page 51, line 6: after that line insert:
SB11-SA1,9,5 4" Section 123d. 49.45 (23) (a) of the statutes, as affected by 2011 Wisconsin Act
5.... (this act), is amended to read:
SB11-SA1,9,146 49.45 (23) (a) The department shall request a waiver from the secretary of the
7federal department of health and human services to permit the department to
8conduct a demonstration project to provide health care coverage for basic primary
9and preventive care to adults who are under the age of 65, who have family incomes
10not to exceed 200 percent of the poverty line, and who are not otherwise eligible for
11medical assistance under this subchapter, the Badger Care health care program
12under s. 49.665, or Medicare under 42 USC 1395 et seq. If the department
13promulgates a rule under sub. (2m) (c) 10., this paragraph does not apply to the
14extent that it conflicts with the rule.
".
SB11-SA1,9,15 1524. Page 51, line 17: after that line insert:
SB11-SA1,9,17 16" Section 124d. 49.45 (23) (b) of the statutes, as affected by 2011 Wisconsin Act
17.... (this act), is amended to read:
SB11-SA1,9,2418 49.45 (23) (b) If the waiver is granted and in effect, the department may
19promulgate rules defining the health care benefit plan, including more specific
20eligibility requirements and cost-sharing requirements. Unless otherwise provided
21by the department by rule promulgated under sub. (2m) (c), cost
Cost sharing may
22include an annual enrollment fee, which may not exceed $75 per year.
23Notwithstanding s. 227.24 (3), the plan details under this subsection may be
24promulgated as an emergency rule under s. 227.24 without a finding of emergency.

1If the waiver is granted and in effect, the demonstration project under this subsection
2shall begin on January 1, 2009, or on the effective date of the waiver, whichever is
3later.".
SB11-SA1,10,4 425. Page 52, line 3: after that line insert:
SB11-SA1,10,6 5" Section 125d. 49.45 (24g) (c) of the statutes, as affected by 2011 Wisconsin
6Act .... (this act), is amended to read:
SB11-SA1,10,167 49.45 (24g) (c) The department's proposal under par. (a) shall specify increases
8in reimbursement rates for providers that satisfy the conditions under par. (a) 1. or
92., and shall provide for payment of a monthly per-patient care coordination fee to
10those providers. The department shall set the increases in reimbursement rates and
11the monthly per-patient care coordination fee so that together they provide
12sufficient incentive for providers to satisfy a condition under par. (a) 1. or 2. The
13proposal shall specify effective dates for the increases in reimbursement rates and
14the monthly per-patient care coordination fee that are no sooner than July 1, 2011.
15If the department promulgates a rule under sub. (2m) (c) 4., this paragraph does not
16apply to the extent that it conflicts with the rule.
".
SB11-SA1,10,17 1726. Page 52, line 11: after that line insert:
SB11-SA1,10,19 18" Section 126d. 49.45 (24r) (a) of the statutes, as affected by 2011 Wisconsin
19Act .... (this act), is amended to read:
SB11-SA1,11,220 49.45 (24r) (a) The department shall implement any waiver granted by the
21secretary of the federal department of health and human services to permit the
22department to conduct a demonstration project to provide family planning, as
23defined in s. 253.07 (1) (a), under medical assistance to any woman between the ages
24of 15 and 44 whose family income does not exceed 200% of the poverty line for a family

1the size of the woman's family. If the department promulgates a rule under sub. (2m)
2(c) 10., this paragraph does not apply to the extent it conflicts with the rule.
".
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