AB64-ASA1-AA8,26,2423 19. Osteoporosis screening for all women 65 years of age or older and for women
24at high risk for osteoporosis under the age of 65 years.
AB64-ASA1-AA8,26,2525 20. Immunizations in accordance with sub. (14).
AB64-ASA1-AA8,27,3
121. Anemia screening for individuals 6 months of age or older and iron
2supplements for individuals at high risk for anemia and who have attained the age
3of 6 months but have not attained the age of 12 months.
AB64-ASA1-AA8,27,54 22. Fluoride varnish for prevention of tooth decay for minors at the age of
5eruption of their primary teeth.
AB64-ASA1-AA8,27,76 23. Fluoride supplements for prevention of tooth decay for minors 6 months of
7age or older who do not have fluoride in their water source.
AB64-ASA1-AA8,27,88 24. Gonorrhea prophylaxis treatment for newborns.
AB64-ASA1-AA8,27,99 25. Health history and physical exams for prenatal visits and for minors.
AB64-ASA1-AA8,27,1110 26. Length and weight measurements for newborns and height and weight
11measurements for minors.
AB64-ASA1-AA8,27,1312 27. Head circumference and weight for length measurements for newborns and
13minors who have not attained the age of 3 years.
AB64-ASA1-AA8,27,1414 28. Body mass index for minors 2 years of age or older.
AB64-ASA1-AA8,27,1615 29. Blood pressure measurements for minors 3 years of age or older and a blood
16pressure risk assessment at birth.
AB64-ASA1-AA8,27,1817 30. Risk assessment and referral for oral health issues for minors who have
18attained the age of 6 months but have not attained the age of 7 years.
AB64-ASA1-AA8,27,2019 31. Blood screening for newborns and minors who have not attained age 2
20months.
AB64-ASA1-AA8,27,2121 32. Screening for critical congenital health defect for newborns.
AB64-ASA1-AA8,27,2222 33. Lead screenings in accordance with sub. (10).
AB64-ASA1-AA8,27,2423 34. Metabolic and hemoglobin screening and screening for phenylketonuria,
24sickle cell anemia, and congenital hypothyroidism for minors including newborns.
AB64-ASA1-AA8,28,2
135. Tuberculin skin test based on risk assessment for minors one month of age
2or older.
AB64-ASA1-AA8,28,43 36. Tobacco counseling and cessation interventions for individuals who are 5
4years of age or older.
AB64-ASA1-AA8,28,65 37. Vision and hearing screening and assessment for minors including
6newborns.
AB64-ASA1-AA8,28,87 38. Sexually transmitted infection and human immunodeficiency virus
8counseling for sexually active minors.
AB64-ASA1-AA8,28,119 39. Risk assessment for sexually transmitted infection for minors who are 10
10years of age or older and screening for sexually transmitted infection for minors who
11are 16 years of age or older.
AB64-ASA1-AA8,28,1212 40. Alcohol misuse screening and counseling for minors 11 years of age or older.
AB64-ASA1-AA8,28,1413 41. Autism screening for minors who have attained the age of 18 months but
14have not attained the age of 25 months.
AB64-ASA1-AA8,28,1515 42. Developmental screening and surveillance for minors including newborns.
AB64-ASA1-AA8,28,1616 43. Psychosocial and behavioral assessment for minors including newborns.
AB64-ASA1-AA8,28,1817 44. Alcohol misuse screening and counseling for pregnant adults and a risk
18assessment for all adults.
AB64-ASA1-AA8,28,2019 45. Fall prevention and counseling and preventive medication for fall
20prevention for community-dwelling adults 65 years of age or older.
AB64-ASA1-AA8,28,2121 46. Screening and counseling for intimate partner violence for adult women.
AB64-ASA1-AA8,28,2422 47. Well-woman visits for women who have attained the age of 18 years but
23have not attained the age of 65 years and well-woman visits for recommended
24preventive services, preconception care, and prenatal care.
AB64-ASA1-AA8,29,2
148. Counseling on, consultations with a trained provider on, and equipment
2rental for breastfeeding for pregnant and lactating women.
AB64-ASA1-AA8,29,33 49. Folic acid supplement for adult women with reproductive capacity.
AB64-ASA1-AA8,29,44 50. Iron deficiency anemia screening for pregnant and lactating women.
AB64-ASA1-AA8,29,65 51. Preeclampsia preventive medicine for pregnant adult women at high risk
6for preeclampsia.
AB64-ASA1-AA8,29,87 52. Low-dose aspirin after 12 weeks of gestation for pregnant women at high
8risk for miscarriage, preeclampsia, or clotting disorders.
AB64-ASA1-AA8,29,99 53. Screenings for hepatitis B and bacteriuria for pregnant women.
AB64-ASA1-AA8,29,1110 54. Screening for gonorrhea for pregnant and sexually active females 24 years
11of age or younger and females older than 24 years of age who are at risk for infection.
AB64-ASA1-AA8,29,1412 55. Screening for chlamydia for pregnant and sexually active females 24 years
13of age and younger and females older than 24 years of age who are at risk for
14infection.
AB64-ASA1-AA8,29,1615 56. Screening for syphilis for pregnant women and adults who are at high risk
16for infection.
AB64-ASA1-AA8,29,1917 57. Human immunodeficiency virus screening for adults who have attained the
18age of 15 years but have not attained the age of 66 years and individuals at high risk
19of infection who are younger than 15 years of age or older than 65 years of age.
AB64-ASA1-AA8,29,2020 58. All contraceptives and services in accordance with sub. (17).
AB64-ASA1-AA8,29,2221 59. Any services not already specified under this paragraph having an A or B
22rating in current recommendations from the U.S. Preventive Services Task Force.
AB64-ASA1-AA8,29,2523 60. Any preventive services not already specified under this paragraph that are
24recommended by the federal health resources and services administration's Bright
25Futures project.
AB64-ASA1-AA8,30,3
161. Any immunizations, not already specified under sub. (14), that are
2recommended and determined to be for routine use by the Advisory Committee on
3Immunization Practices.
AB64-ASA1-AA8,30,64 (c) Subject to par. (d), no disability insurance policy and no self-insured health
5plan may subject the coverage of any of the preventive services under par. (b) to any
6deductibles, copayments, or coinsurance under the policy or plan.
AB64-ASA1-AA8,30,107 (d) 1. If an office visit and a preventive service specified under par. (b) are billed
8separately by the health care provider, the disability insurance policy or self-insured
9health plan may apply deductibles to and impose copayments or coinsurance on the
10office visit but not on the preventive service.
AB64-ASA1-AA8,30,1311 2. If the primary reason for an office visit is not to obtain a preventive service,
12the disability insurance policy or self-insured health plan may apply deductibles to
13and impose copayments or coinsurance on the office visit.
AB64-ASA1-AA8,30,2214 3. If a preventive service specified under par. (b) is provided by a health care
15provider that is outside the disability insurance policy's or self-insured health plan's
16network of providers, the policy or plan may apply deductibles to and impose
17copayments or coinsurance on the office visit and the preventive service. If a
18preventive service specified under par. (b) is provided by a health care provider that
19is outside the disability insurance policy's or self-insured health plan's network of
20providers because there is no available health care provider in the policy's or plan's
21network of providers that provides the preventive service, the policy or plan may not
22apply deductibles to or impose copayments or coinsurance on preventive service.
AB64-ASA1-AA8,31,223 4. If multiple well-woman visits described under par. (b) 47. are required to
24fulfill all necessary preventive services and are in accordance with clinical
25recommendations, the disability insurance policy or self-insured health plan may

1not apply a deductible or impose a copayment or coinsurance to any of those
2well-woman visits.
AB64-ASA1-AA8,2219d 3Section 2219d. 632.895 (14) (a) 1. i. and j. of the statutes are amended to read:
AB64-ASA1-AA8,31,44 632.895 (14) (a) 1. i. Hepatitis A and B.
AB64-ASA1-AA8,31,55 j. Varicella and herpes zoster.
AB64-ASA1-AA8,2219f 6Section 2219f. 632.895 (14) (a) 1. k. to o. of the statutes are created to read:
AB64-ASA1-AA8,31,77 632.895 (14) (a) 1. k. Human papillomavirus.
AB64-ASA1-AA8,31,88 L. Meningococcal meningitis.
AB64-ASA1-AA8,31,99 m. Pneumococcal pneumonia.
AB64-ASA1-AA8,31,1010 n. Influenza.
AB64-ASA1-AA8,31,1111 o. Rotavirus.
AB64-ASA1-AA8,2219h 12Section 2219h. 632.895 (14) (b) of the statutes is amended to read:
AB64-ASA1-AA8,31,1813 632.895 (14) (b) Except as provided in par. (d), every disability insurance policy,
14and every self-insured health plan of the state or a county, city, town, village, or
15school district, that provides coverage for a dependent of the insured shall provide
16coverage of appropriate and necessary immunizations, from birth to the age of 6
17years,
for an insured or plan participant, including a dependent who is a child of the
18insured or plan participant.
AB64-ASA1-AA8,2219j 19Section 2219j. 632.895 (14) (c) of the statutes is amended to read:
AB64-ASA1-AA8,31,2420 632.895 (14) (c) The coverage required under par. (b) may not be subject to any
21deductibles, copayments, or coinsurance under the policy or plan. This paragraph
22applies to a defined network plan, as defined in s. 609.01 (1b), only with respect to
23appropriate and necessary immunizations provided by providers participating, as
24defined in s. 609.01 (3m), in the plan.
AB64-ASA1-AA8,2219m 25Section 2219m. 632.895 (14) (d) 3. of the statutes is amended to read:
AB64-ASA1-AA8,32,3
1632.895 (14) (d) 3. A health care plan offered by a limited service health
2organization, as defined in s. 609.01 (3), or by a preferred provider plan, as defined
3in s. 609.01 (4), that is not a defined network plan, as defined in s. 609.01 (1b)
.
AB64-ASA1-AA8,2219p 4Section 2219p. 632.895 (16m) (b) of the statutes is amended to read:
AB64-ASA1-AA8,32,95 632.895 (16m) (b) The coverage required under this subsection may be subject
6to any limitations, or exclusions , or cost-sharing provisions that apply generally
7under the disability insurance policy or self-insured health plan. The coverage
8required under this subsection may not be subject to any deductibles, copayments,
9or coinsurance.
AB64-ASA1-AA8,2219r 10Section 2219r. 632.895 (17) (b) 2. of the statutes is amended to read:
AB64-ASA1-AA8,32,1511 632.895 (17) (b) 2. Outpatient consultations, examinations, procedures, and
12medical services that are necessary to prescribe, administer, maintain, or remove a
13contraceptive, if covered for any other drug benefits under the policy or plan
14sterilization procedures, and patient education and counseling for all females with
15reproductive capacity
.
AB64-ASA1-AA8,2219t 16Section 2219t. 632.895 (17) (c) of the statutes is amended to read:
AB64-ASA1-AA8,33,617 632.895 (17) (c) Coverage under par. (b) may be subject only to the exclusions,
18and limitations, or cost-sharing provisions that apply generally to the coverage of
19outpatient health care services, preventive treatments and services, or prescription
20drugs and devices that is provided under the policy or self-insured health plan. A
21disability insurance policy or self-insured health plan may not apply a deductible or
22impose a copayment or coinsurance to at least one of each type of contraceptive
23method approved by the federal food and drug administration for which coverage is
24required under this subsection. The disability insurance policy or self-insured
25health plan may apply reasonable medical management to a method of contraception

1to limit coverage under this subsection that is provided without being subject to a
2deductible, copayment, or coinsurance to prescription drugs without a brand name.
3The disability insurance policy or self-insured health plan may apply a deductible
4or impose a copayment or coinsurance for coverage of a contraceptive that is
5prescribed for a medical need if the services for the medical need would otherwise be
6subject to a deductible, copayment, or coinsurance.
”.
AB64-ASA1-AA8,33,7 727. Page 925, line 14: after that line insert:
AB64-ASA1-AA8,33,8 8 Section 2218s. 609.845 of the statutes is created to read:
AB64-ASA1-AA8,33,10 9609.845 Lifetime and annual limits. Limited service health organizations,
10preferred provider plans, and defined network plans are subject to s. 632.883.
AB64-ASA1-AA8,2218x 11Section 2218x. 632.883 of the statutes is created to read:
AB64-ASA1-AA8,33,15 12632.883 Lifetime and annual limits. (1) No group or individual disability
13insurance policy, as defined in s. 632.895 (1) (a), and no self-insured health plan, as
14defined in s. 632.745 (24), may impose a lifetime limit on the dollar value of benefits
15provided under the policy or plan.
AB64-ASA1-AA8,33,18 16(2) No group or individual disability insurance policy, as defined in s. 632.895
17(1) (a), and no self-insured health plan, as defined in s. 632.745 (24), may impose an
18annual limit on the dollar value of benefits under the policy or plan.”.
AB64-ASA1-AA8,33,19 1928. Page 1015, line 10: after that line insert:
AB64-ASA1-AA8,34,2 20(5r) Extension of prescription drug assistance for elderly. The department
21of health services shall request from the federal secretary of health and human
22services any waiver of federal medicaid laws necessary to permit the department of
23health services to continue administering the program under section 49.688 of the

1statutes for 4 years from the date the waiver under this subsection is granted. The
2department shall implement any waiver received under this subsection.”.
AB64-ASA1-AA8,34,3 329. Page 1015, line 10: after that line insert:
AB64-ASA1-AA8,34,4 4“(5p) Medical Assistance nonemergency medical transportation.
AB64-ASA1-AA8,34,125 (b) The department of health services shall, to the extent permitted by the
6contract, modify the contract that is in effect on the effective date of this paragraph
7for the arrangement and reimbursement of nonemergency medical transportation
8services to recipients of Medical Assistance under subchapter IV of chapter 49 of the
9statutes to exclude recipients of Medical Assistance residing in Buffalo, Eau Claire,
10Jefferson, Kenosha, Milwaukee, Ozaukee, Pepin, Racine, Rock, Trempealeau,
11Walworth, Washington, and Waukesha counties from that contract unless the county
12chooses to remain under the original contract.
AB64-ASA1-AA8,35,413 (c) If the department of health services modifies the contract under paragraph
14(b), the department of health services shall make alternative arrangements with
15counties, health maintenance organizations, or transportation providers to provide
16nonemergency medical transportation services to Medical Assistance recipients who
17reside in the counties specified in paragraph (b ), except any county that chooses to
18remain under the original contract, no later than January 1, 2019. The department
19of health services shall include in any contract for alternative arrangements under
20this paragraph a requirement that the nonemergency medical transportation
21provider submit to the department of health services information substantially
22similar to the information required under the original contract including trip log
23data, summary information on all calls for services and contacts with Medical
24Assistance recipients, encounter data based on Centers for Medicare and Medicaid

1Services 1500 claim form data, network provider information, accident and moving
2violation reports, vehicle reports, complaint summary reports, telecommunications
3system reports, annual fiscal audit reports, and daily reports including numbers of
4trips, canceled trips, denied trips, and complaints.”.
AB64-ASA1-AA8,35,5 530. Page 1015, line 10: after that line insert:
AB64-ASA1-AA8,35,11 6(5t) Increasing Medical Assistance reimbursement rates for personal care
7services.
The department of health services shall increase the reimbursement rates
815 percent under the Medical Assistance program for the 2017-18 biennium for
9personal care services providers and shall increase the reimbursement rates 15
10percent under the Medical Assistance program for the 2018-19 biennium for
11personal care services providers.
AB64-ASA1-AA8,35,16 12(5v) Increasing Medical Assistance reimbursement rates for nursing homes.
13The department of health services shall increase the reimbursement rates 5 percent
14under the Medical Assistance program for the 2017-18 biennium for nursing homes
15and shall increase the reimbursement rates 5 percent under the Medical Assistance
16program for the 2018-19 biennium for nursing homes.”.
AB64-ASA1-AA8,35,17 1731. Page 1016, line 20: after that line insert:
AB64-ASA1-AA8,35,23 18(7g) Increasing Medical Assistance reimbursement rates. The department
19of health services shall increase the reimbursement rates 12 percent under the
20Medical Assistance program for dates of service on and after January 1, 2017, for
21noninstitutional providers who are not personal care services providers, hospitals,
22nursing homes, or providers of services for which reimbursement is made on a basis
23other than a maximum fee schedule.”.
AB64-ASA1-AA8,35,24 2432. Page 1065, line 18: after that line insert:
AB64-ASA1-AA8,36,1
1“(1e) Preexisting conditions.
AB64-ASA1-AA8,36,82 (d) For policies and plans containing inconsistent provisions, the treatment of
3sections 40.51 (8), 40.51 (8m), 66.0137 (4), 120.13 (2) (g), 185.983 (1) (intro.), 609.847,
4625.12 (1) (a) and (e) and (2), 625.15 (1), 628.34 (3) (a), 632.728, 632.746 (1) (a) and
5(b), (2) (a), (c), (d), and (e), (3) (a) and (d) 1., 2. and 3., (5), and (8) (a) (intro.), 632.76
6(2) (a) and (ac) 1., 2., and 3., 632.795 (4) (a), and 632.897 (11) (a) of the statutes first
7applies to policy or plan years beginning on January 1 of the year following the year
8in which this paragraph takes effect, except as provided in paragraph (e).
Loading...
Loading...