Amendment SSA1-SB21

SB21-SSA1,1350,15 618.43 (1) (a) 2. The insurance is transacted by an unauthorized insurer which that is a risk retention group, including a foreign risk retention group authorized to provide health care liability insurance under s. 655.23 (3) (am) that has not been issued a certificate of authority under s. 618.12.

SB21-SSA1,4588 Section 4588. 632.697 of the statutes is amended to read:

SB21-SSA1,1350,24 632.697 Benefits subject to department's right to recover. Death benefits payable under a life insurance policy or an annuity are subject to the right of the department of health services to recover under s. 46.27 (7g), 49.496, 49.682, or 49.849 an amount equal to the medical assistance that is recoverable under s. 49.496 (3) (a), an amount equal to aid under s. 49.68, 49.683, or 49.685, or 49.785 that is recoverable under s. 49.682 (2) (a) or (am), or an amount equal to long-term community support services under s. 46.27 that is recoverable under s. 46.27 (7g) (c) 1. and that was paid on behalf of the deceased policyholder or annuitant.

SB21-SSA1,4590p Section 4590p. 632.865 of the statutes is created to read:

SB21-SSA1,1351,1 632.865 Pharmacy benefit managers. (1) Definitions. In this section:

SB21-SSA1,1351,2 (a) "Pharmacist" has the meaning given in s. 450.01 (15).

SB21-SSA1,1351,3 (b) "Pharmacy" means an entity licensed under s. 450.06 or 450.065.

SB21-SSA1,1351,7 (c) "Pharmacy benefit manager" means an entity doing business in this state that contracts to administer or manage prescription drug benefits on behalf of any insurer or other entity that provides prescription drug benefits to residents of this state.

SB21-SSA1,1351,8 (d) "Prescribed drug or device" has the meaning given in s. 450.01 (18).

SB21-SSA1,1351,10 (e) "Prescription drug benefit" means coverage of or payment or assistance for prescribed drugs or devices.

SB21-SSA1,1351,12 (2) Pricing transparency. (a) The pharmacy benefit manager shall agree in each contract or renewal to do all of the following:

SB21-SSA1,1351,16 1. Update maximum allowable cost pricing information for prescribed drugs or devices at least every 7 business days and provide a means by which contracted pharmacies may promptly review pricing updates in a format that is readily available and accessible.

SB21-SSA1,1351,19 2. Reimburse pharmacists and pharmacies for prescribed drugs or devices subject to maximum allowable cost information that has been updated at least every 7 business days.

SB21-SSA1,1351,22 3. Eliminate prescribed drugs or devices from the maximum allowable cost information or modify maximum allowable cost in a timely fashion consistent with availability of prescribed drugs or devices and pricing changes in the marketplace.

SB21-SSA1,1351,25 (b) A pharmacy benefit manger shall include in each contract with a pharmacy a process to appeal, investigate, and resolve disputes regarding maximum allowable cost pricing that includes all of the following:

SB21-SSA1,1352,1 1. A 21-day limit on the right to appeal following the initial claim.

SB21-SSA1,1352,3 2. A requirement that the appeal be investigated and resolved within 21 days after the date of the appeal.

SB21-SSA1,1352,5 3. A dedicated telephone number at which the pharmacy may contact the pharmacy benefit manager to speak to a person responsible for processing appeals.

SB21-SSA1,1352,9 4. A requirement that a pharmacy benefit manager provide a reason for any appeal denial and the national drug code published in a directory by the federal food and drug administration of a prescribed drug or device that may be purchased by retail network pharmacies at a price at or below the maximum allowable cost.

SB21-SSA1,1352,11 5. A requirement that a pharmacy benefit manager make a pricing adjustment no later than one day after the date of the final determination of the appeal.

SB21-SSA1,4590r Section 4590r. 632.876 of the statutes is created to read:

SB21-SSA1,1352,17 632.876 Independent dispute resolution process relating to chiropractic treatment. The commissioner shall promulgate rules that provide for a fast, fair, cost-effective, and binding independent process for resolving disputes related to insurer conduct under s. 632.87 (3). The rules shall include at least all of the following:

SB21-SSA1,1352,20 (1) The procedures for making a request to the commissioner for an independent dispute resolution, including specification of who is eligible to request an independent dispute resolution.

SB21-SSA1,1352,23 (2) A requirement that individuals requesting an independent dispute resolution must first exhaust any internal grievance procedure established by the insurer for grievances related to conduct under s. 632.87 (3).

SB21-SSA1,1353,2 (3) The application procedure and qualifications, including conflict of interest provisions, for individuals to act as independent reviewers under the independent dispute resolution process and the inclusion of retired members of the state judiciary as individuals who are eligible to act as independent reviewers.

SB21-SSA1,1353,4 (4) The procedure for selecting an independent reviewer to review a particular complaint.

SB21-SSA1,1353,8 (5) The procedures, including timelines, that an independent reviewer must follow when reviewing a complaint and a requirement that an independent reviewer must render a decision regarding a particular complaint within 9 months after the commissioner receives the request for independent dispute resolution.

SB21-SSA1,1353,9 (6) Procedures for setting and paying the fees of the independent reviewers.

SB21-SSA1,1353,11 (7) A requirement that the insurer about which the independent dispute resolution is requested pay the fees of the independent reviewer.

SB21-SSA1,1353,14 (8) The relief to which an individual who requests independent dispute resolution and who prevails is entitled, including injunctive and declaratory relief and monetary relief due to underpayments by the insurer.

SB21-SSA1,4591 Section 4591. 632.895 (10) (a) of the statutes is amended to read:

SB21-SSA1,1353,24 632.895 (10) (a) Except as provided in par. (b), every disability insurance policy and every health care benefits plan provided on a self-insured basis by a county board under s. 59.52 (11), by a city or village under s. 66.0137 (4), by a political subdivision local governmental unit or technical college district under s. 66.0137 (4m), by a town under s. 60.23 (25), or by a school district under s. 120.13 (2) shall provide coverage for blood lead tests for children under 6 years of age, which shall be conducted in accordance with any recommended lead screening methods and intervals contained in any rules promulgated by the department of health services under s. 254.158.

SB21-SSA1,4594g Section 4594g. 655.001 (8c) of the statutes is created to read:

SB21-SSA1,1354,2 655.001 (8c) "Insurer" includes a foreign insurer that is a risk retention group that issues health care liability insurance under this chapter.

SB21-SSA1,4594m Section 4594m. 655.23 (3) (am) of the statutes is created to read:

SB21-SSA1,1354,10 655.23 (3) (am) For purposes of par. (a) only, a foreign insurer that is a risk retention group and that has not been issued a certificate of authority under s. 618.12 is authorized to do business in this state if the risk retention group is registered with the commissioner, is approved by the commissioner to provide health care liability insurance coverage under this chapter, and has and maintains a risk-based capital ratio of at least 300 percent as determined under the risk-based capital instructions adopted by the National Association of Insurance Commissioners.

SB21-SSA1,4594r Section 4594r. 703.195 (1) (c) of the statutes is amended to read:

SB21-SSA1,1354,13 703.195 (1) (c) "Condemnor" means a person specified in s. 32.01 (1) who has the authority to condemn property under ch. 32.

SB21-SSA1,4595 Section 4595. 705.04 (2g) of the statutes is amended to read:

SB21-SSA1,1354,22 705.04 (2g) Notwithstanding subs. (1) and (2), the department of health services may collect, from funds of a decedent that are held by the decedent immediately before death in a joint account or a P.O.D. account, an amount equal to the medical assistance that is recoverable under s. 49.496 (3) (a), an amount equal to aid under s. 49.68, 49.683, or 49.685, or 49.785 that is recoverable under s. 49.682 (2) (a) or (am), or an amount equal to long-term community support services under s. 46.27 that is recoverable under s. 46.27 (7g) (c) 1. and that was paid on behalf of the decedent or the decedent's spouse.

SB21-SSA1,4595c Section 4595c. 706.22 of the statutes is created to read:

SB21-SSA1,1354,25 706.22 Prohibition on imposing time-of-sale requirements. (1) Definitions. In this section:

SB21-SSA1,1355,7 (a) "Actions with respect to the property" include such actions as having an inspection made by an employee or agent of, or contractor with, the local governmental unit; making improvements or repairs; removing junk or debris; mowing or pruning; performing maintenance or upkeep activities; weatherproofing; upgrading electrical systems; paving; painting; repairing or replacing appliances; replacing or installing fixtures or other items; and actions relating to compliance with building codes or other property condition standards.

SB21-SSA1,1355,8 (b) "Local governmental unit" means any of the following:

SB21-SSA1,1355,9 1. A political subdivision of this state.

SB21-SSA1,1355,10 2. A special purpose district in this state.

SB21-SSA1,1355,12 3. An agency or corporation of a political subdivision or special purpose district in this state.

SB21-SSA1,1355,13 4. A combination or subunit of any entity under subds. 1. to 3.

SB21-SSA1,1355,14 5. An employee or committee of any entity under subds. 1. to 4.

SB21-SSA1,1355,22 (2) Requirements tied to sale of property prohibited. (a) Except as provided in par. (b), no local governmental unit may by ordinance, resolution, or any other means restrict the ability of an owner of real property to sell or otherwise transfer title to or refinance the property by requiring the owner or an agent of the owner to take certain actions with respect to the property or pay a related fee, to show compliance with taking certain actions with respect to the property, or to pay a fee for failing to take certain actions with respect to the property, at any of the following times:

SB21-SSA1,1355,23 1. Before the owner may sell, refinance, or transfer title to the property.

SB21-SSA1,1355,24 2. At the time of the sale or refinancing of, or the transfer of title to, the property.

SB21-SSA1,1356,2 3. Within a certain period of time after selling, refinancing, or transferring title to the property.

SB21-SSA1,1356,6 (b) Paragraph (a) does not prohibit a local governmental unit from requiring a real property owner or the owner's agent to take certain actions with respect to the property not in connection with the sale or refinancing of, or the transfer of title to, the property.

SB21-SSA1,1356,10 (3) Existing ordinance, resolution, or policy unenforceable. If a local governmental unit has in effect on the effective date of this subsection .... [LRB inserts date], an ordinance, resolution, or policy that is inconsistent with sub. (2) (a), the ordinance, resolution, or policy does not apply and may not be enforced.

SB21-SSA1,4598 Section 4598. 753.061 (5) of the statutes is repealed.

SB21-SSA1,4601b Section 4601b. 758.19 (5) (a) of the statutes is repealed.

SB21-SSA1,4601e Section 4601e. 758.19 (5) (b) of the statutes is repealed and recreated to read:

SB21-SSA1,1356,17 758.19 (5) (b) From the appropriation under s. 20.625 (1) (d), the director of state courts shall make payments to counties for circuit court costs. The director of state courts, at the direction of the supreme court, shall define circuit court costs for the purposes of this subsection.

SB21-SSA1,4601h Section 4601h. 758.19 (5) (b) of the statutes, as affected by 2015 Wisconsin Act .... (this act), is amended to read:

SB21-SSA1,1356,23 758.19 (5) (b) From the appropriation under s. 20.625 (1) (d) (cg), the director of state courts shall make payments to counties for circuit court costs. The director of state courts, at the direction of the supreme court, shall define circuit court costs for the purposes of this subsection.

SB21-SSA1,4601L Section 4601L. 758.19 (5) (c) of the statutes is repealed.

SB21-SSA1,4601p Section 4601p. 758.19 (5) (d) of the statutes is repealed.

SB21-SSA1,4601r Section 4601r. 758.19 (5) (f) of the statutes is amended to read:

SB21-SSA1,1357,7 758.19 (5) (f) A county that fails to meet the requirements under par. (e) is not eligible for a payment under par. (b) for one fiscal year, as defined in s. 237.01 (3), after the May 15 that the information was not provided, or until the information is provided, whichever is earlier. Except as provided in this paragraph and par. (g), the information regarding the amount of actual costs reported under par. (e) does not affect the amount paid to a county under par. (b).

SB21-SSA1,4601u Section 4601u. 758.19 (5) (g) of the statutes is repealed.

SB21-SSA1,4601y Section 4601y. 758.19 (5) (h) of the statutes is repealed.

SB21-SSA1,4602 Section 4602. 758.19 (6) of the statutes is repealed.

SB21-SSA1,4603 Section 4603. 758.19 (8) of the statutes is repealed.

SB21-SSA1,4603m Section 4603m. 758.20 of the statutes is created to read:

SB21-SSA1,1357,17 758.20 Consolidated court automation programs. (1) In this section, "Wisconsin Circuit Court Access Internet site" means the Internet site of the consolidated court automation programs, which is the statewide circuit court automated information system established under s. 758.19 (4) and maintained by the director of state courts.

SB21-SSA1,1357,20 (2) The director of state courts shall remove from the Wisconsin Circuit Court Access Internet site all information relating to a criminal case if all of the following apply:

SB21-SSA1,1357,21 (a) All charges in the case were dismissed by the court before trial.

SB21-SSA1,1357,23 (b) All charges that were dismissed were for offenses for which the maximum period of imprisonment was 6 years or fewer.

SB21-SSA1,1357,25 (c) No charge that was dismissed was for a violent offense, as defined in s. 301.048 (2) (bm) 1.

SB21-SSA1,1358,2 (d) A court having jurisdiction has entered an order for removal of the information.

SB21-SSA1,1358,4 (e) All charges that were dismissed were filed against the person before he or she attained the age of 25.

SB21-SSA1,4605 Section 4605. 767.75 (1f) of the statutes is amended to read:

SB21-SSA1,1358,15 767.75 (1f) Payment order as assignment of income. A payment order constitutes an assignment of all commissions, earnings, salaries, wages, pension benefits, income continuation insurance benefits under s. 40.62, duty disability benefits under s. 40.65, benefits under ch. 102 or 108, lottery prizes that are payable in installments, and other money due or to be due in the future to the department or its designee. The assignment shall be for an amount sufficient to ensure payment under the order, obligation, or stipulation and to pay any arrearages due at a periodic rate not to exceed 50% of the amount of support due under the order, obligation, or stipulation so long as the addition of the amount toward arrearages does not leave the party at an income below the poverty line established under 42 USC 9902 (2).

SB21-SSA1,4606 Section 4606. 767.75 (2m) (a) 1. of the statutes is amended to read:

SB21-SSA1,1358,22 767.75 (2m) (a) 1. An obligation to pay unpaid fees under s. 767.57 (1e) (b) 1m. constitutes an assignment of all commissions, earnings, salaries, wages, pension benefits, income continuation insurance benefits under s. 40.62, duty disability benefits under s. 40.65, benefits under ch. 102 or 108, lottery prizes that are payable in installments, and other money due or to be due in the future to the department or its designee.

SB21-SSA1,4607 Section 4607. 767.75 (2m) (a) 2. of the statutes is amended to read:

SB21-SSA1,1359,4 767.75 (2m) (a) 2. An obligation to pay unpaid fees under s. 767.57 (1e) (b) 2m. constitutes an assignment of all commissions, earnings, salaries, wages, pension benefits, income continuation insurance benefits under s. 40.62, duty disability benefits under s. 40.65, benefits under ch. 102 or 108, lottery prizes that are payable in installments, and other money due or to be due in the future to the clerk of court to whom the fees are owed, or to his or her successor.

SB21-SSA1,4610b Section 4610b. 800.09 (1j) of the statutes is amended to read:

SB21-SSA1,1359,17 800.09 (1j) If the court orders the defendant to perform community service work in lieu of making restitution or of paying the forfeiture, surcharges, fees and costs, or both, the court may order that the defendant perform community service work for a public agency or a nonprofit charitable organization that is approved by the court and agreed to by the public agency or nonprofit charitable organization. Community service work may be in lieu of restitution only if also agreed to by the person to whom restitution is owed. The number of hours of community service work required may not exceed the number determined by dividing the amount owed on the forfeiture by the minimum wage established under ch. 104 for adults in nonagriculture, nontipped employment s. 104.035 (1). The court shall ensure that the defendant is provided a written statement of the terms of the community service order and that the community service order is monitored.

SB21-SSA1,4610d Section 4610d. 800.095 (1) (d) of the statutes is amended to read:

SB21-SSA1,1360,4 800.095 (1) (d) That the defendant perform community service work for a public agency or nonprofit charitable organization approved by the court and agreed to by the agency or nonprofit charitable organization. If the community service work is in lieu of restitution, then the person to whom restitution is owed must agree; the defendant shall be given credit at the rate of not less than the minimum wage established under ch. 104 for adults in nonagriculture, nontipped employment s. 104.035 (1) for each one hour of community service completed. The defendant shall be given a written statement of the community service order. Nothing in this paragraph makes the defendant an employee or agent of the court or the municipality. The defendant shall be responsible for providing the court with proof that the community service hours have been completed.

SB21-SSA1,4610f Section 4610f. 801.02 (1) of the statutes is amended to read:

SB21-SSA1,1360,10 801.02 (1) Except as provided in s. 20.931 (5) (b), a A civil action in which a personal judgment is sought is commenced as to any defendant when a summons and a complaint naming the person as defendant are filed with the court, provided service of an authenticated copy of the summons and of the complaint is made upon the defendant under this chapter within 90 days after filing.