LRBs0201/1
TJD:eev:rs
2013 - 2014 LEGISLATURE
SENATE SUBSTITUTE AMENDMENT 1,
TO SENATE BILL 410
November 22, 2013 - Offered by Senator Petrowski.
SB410-SSA1,1,3 1An Act to create 49.45 (29w) of the statutes; relating to: mental health benefits
2and reimbursement for mental health services under the Medical Assistance
3program.
Analysis by the Legislative Reference Bureau
Under current law, the Department of Health Services (DHS) administers the
Medical Assistance (MA) program, which is a joint federal and state program that
provides health and long-term care services to individuals who have limited
resources. The MA program reimburses certified providers for providing services to
MA recipients. Among the health benefits provided to MA recipients are mental
health services including, among others, mental health day treatment services and
alcohol and other drug abuse services; psychiatric services; mental health and
psychosocial rehabilitative services and case management services provided by a
community support program; psychosocial and case management services provided
by a community-based psychosocial service program; and mental health crisis
intervention services.
This substitute amendment makes changes to MA program mental health
benefits and reimbursement for certain mental health services. The substitute
amendment requires DHS to allow a child experiencing a severe emotional
disturbance to access in-home therapy without first showing a failure to succeed in
outpatient therapy. DHS is required, under the substitute amendment, to allow

certain families to participate in in-home therapy even if one of the children is
enrolled in a day treatment program.
The substitute amendment also specifies mental health services provided
through telehealth that are reimbursable by the MA program. Telehealth, as defined
in the substitute amendment, is a service provided from a remote location using a
combination of interactive video, audio, and externally acquired images through a
networking environment between an individual at an originating site and a provider
at a remote location with the service being of sufficient audio and visual fidelity and
clarity as to be functionally equivalent to face-to-face contact. To be eligible for
reimbursement by the MA program, the mental health services provided through
telehealth must be provided by a provider who is a certified provider of MA in this
state, currently holds a credential in his or her profession in this state, and is located
in the United States but not necessarily Wisconsin.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SB410-SSA1,1 1Section 1. 49.45 (29w) of the statutes is created to read:
SB410-SSA1,2,32 49.45 (29w) Mental health services. (a) In providing mental health benefits
3under this subchapter, the department shall do all of the following:
SB410-SSA1,2,64 1. Allow a severely emotionally disturbed child, as defined in sub. (25) (a), to
5access in-home therapy without having to show a failure to succeed in outpatient
6therapy.
SB410-SSA1,2,87 2. Allow qualifying families to participate in in-home therapy even if a child
8in that family is enrolled in a day treatment program.
SB410-SSA1,2,159 (b) 1. In this paragraph, "telehealth" is a service provided from a remote
10location using a combination of interactive video, audio, and externally acquired
11images through a networking environment between an individual at an originating
12site and a provider at a remote location with the service being of sufficient audio and
13visual fidelity and clarity as to be functionally equivalent to face-to-face contact.
14"Telehealth" does not include telephone conversations or Internet-based
15communications between providers or between providers and individuals.
SB410-SSA1,3,3
12. Mental health services provided through telehealth are reimbursable by the
2Medical Assistance program under this subchapter if the provider of the service
3through telehealth satisfies all of the following criteria:
SB410-SSA1,3,44 a. The provider is a certified provider of Medical Assistance in this state.
SB410-SSA1,3,65 b. The provider is currently licensed, certified, or registered in his or her
6profession in this state.
SB410-SSA1,3,87 c. The provider is located in the United States. The provider is not required to
8be located in this state.
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