SB70-AA3,107,87
(a) The cost for an individual to complete an instructional program for nurse
8aides in a program approved under s. 146.40 (3) and (3g).
SB70-AA3,107,109
(b) The cost for an individual to complete a competency evaluation for nurse
10aides in a program approved under s. 146.40 (3m).
SB70-AA3,107,1211
(c) A retention bonus for an individual who has worked for at least 6 months
12as a nurse aide in a nursing home.
SB70-AA3,107,16
13(3) The department may partner with nonprofit organizations, private entities,
14the board on aging and long term care, and the technical college system board to
15award the grants under sub. (2) and recruit individuals to work as nurse aides in
16nursing homes.”.
SB70-AA3,107,19
18“
Section
118. 20.005 (3) (schedule) of the statutes: at the appropriate place,
19insert the following amounts for the purposes indicated:
-
See PDF for table ![PDF](https://docs.legis.wisconsin.gov/assets/image/file_acrobat.gif)
SB70-AA3,119
20Section
119. 20.145 (1) (a) of the statutes is created to read:
SB70-AA3,108,2
120.145
(1) (a)
State operations. The amounts in the schedule for general
2program operations.
SB70-AA3,120
3Section
120. 20.145 (1) (g) (intro.) of the statutes is amended to read:
SB70-AA3,108,134
20.145
(1) (g)
General program operations. (intro.) The amounts in the
5schedule for general program operations, including organizational support services
6and, oversight of care management organizations,
development of a public option
7health insurance plan, and operation of a state-based exchange under s. 601.59, and
8for transferring to the appropriation account under s. 20.435 (4) (kv) the amount
9allocated by the commissioner of insurance. Notwithstanding s. 20.001 (3) (a), at the
10end of each fiscal year, the unencumbered balance in this appropriation account that
11exceeds 10 percent of that fiscal year's expenditure under this appropriation shall
12lapse to the general fund. All of the following shall be credited to this appropriation
13account:
SB70-AA3,121
14Section
121. 20.145 (1) (g) 4. of the statutes is created to read:
SB70-AA3,108,1515
20.145
(1) (g) 4.
All moneys received under s. 601.59.
SB70-AA3,122
16Section
122. 40.51 (8) of the statutes is amended to read:
SB70-AA3,108,2117
40.51
(8) Every health care coverage plan offered by the state under sub. (6)
18shall comply with ss. 631.89, 631.90, 631.93 (2), 631.95, 632.72 (2),
632.728, 632.729,
19632.746 (1) to (8) and (10), 632.747, 632.748, 632.798, 632.83, 632.835, 632.85,
20632.853, 632.855, 632.861,
632.862, 632.867, 632.87 (3) to
(6) (8), 632.871, 632.885,
21632.89, 632.895 (5m) and (8) to (17), and 632.896.
SB70-AA3,123
22Section
123. 40.51 (8m) of the statutes is amended to read:
SB70-AA3,109,223
40.51
(8m) Every health care coverage plan offered by the group insurance
24board under sub. (7) shall comply with ss. 631.95,
632.728, 632.729, 632.746 (1) to
25(8) and (10), 632.747, 632.748, 632.798, 632.83, 632.835, 632.85, 632.853, 632.855,
1632.861,
632.862, 632.867,
632.87 (7) and (8), 632.871, 632.885, 632.89, and 632.895
2(11) (8) and (10) to (17).
SB70-AA3,124
3Section
124. 66.0137 (4) of the statutes is amended to read:
SB70-AA3,109,104
66.0137
(4) Self-insured health plans. If a city, including a 1st class city, or
5a village provides health care benefits under its home rule power, or if a town
6provides health care benefits, to its officers and employees on a self-insured basis,
7the self-insured plan shall comply with ss. 49.493 (3) (d), 631.89, 631.90, 631.93 (2),
8632.728, 632.729, 632.746
(1) and (10) (a) 2. and (b) 2., 632.747 (3), 632.798, 632.85,
9632.853, 632.855, 632.861,
632.862, 632.867, 632.87 (4) to
(6) (8), 632.871, 632.885,
10632.89, 632.895
(9) (8) to (17), 632.896, and 767.513 (4).
SB70-AA3,125
11Section
125. 120.13 (2) (g) of the statutes is amended to read:
SB70-AA3,109,1612
120.13
(2) (g) Every self-insured plan under par. (b) shall comply with ss.
1349.493 (3) (d), 631.89, 631.90, 631.93 (2),
632.728, 632.729, 632.746
(1) and (10) (a)
142. and (b) 2., 632.747 (3), 632.798, 632.85, 632.853, 632.855, 632.861,
632.862, 15632.867, 632.87 (4) to
(6) (8), 632.871, 632.885, 632.89, 632.895
(9) (8) to (17),
16632.896, and 767.513 (4).
SB70-AA3,126
17Section
126. 185.983 (1) (intro.) of the statutes is amended to read:
SB70-AA3,109,2518
185.983
(1) (intro.) Every voluntary nonprofit health care plan operated by a
19cooperative association organized under s. 185.981 shall be exempt from chs. 600 to
20646, with the exception of ss. 601.04, 601.13, 601.31, 601.41, 601.42, 601.43, 601.44,
21601.45, 611.26, 611.67, 619.04, 623.11, 623.12, 628.34 (10), 631.17, 631.89, 631.93,
22631.95, 632.72 (2),
632.728, 632.729, 632.745 to 632.749, 632.775, 632.79, 632.795,
23632.798, 632.85, 632.853, 632.855, 632.861,
632.862, 632.867, 632.87 (2) to
(6) (8),
24632.871, 632.885, 632.89, 632.895 (5) and (8) to (17), 632.896, and 632.897 (10) and
25chs. 609, 620, 630, 635, 645, and 646, but the sponsoring association shall:
SB70-AA3,127
1Section
127. 601.31 (1) (mv) of the statutes is created to read:
SB70-AA3,110,42
601.31
(1) (mv) For initial issuance or renewal of a license as a pharmacy
3benefit management broker or consultant under s. 628.495, amounts to be set by the
4commissioner by rule.
SB70-AA3,128
5Section
128. 601.31 (1) (nv) of the statutes is created to read:
SB70-AA3,110,76
601.31
(1) (nv) For issuing or renewing a license as a pharmaceutical
7representative under s. 632.863, an amount to be set by the commissioner by rule.
SB70-AA3,129
8Section
129. 601.31 (1) (nw) of the statutes is created to read:
SB70-AA3,110,119
601.31
(1) (nw) For issuing or renewing a license as a pharmacy services
10administrative organization under s. 632.864, an amount to be set by the
11commissioner by rule.
SB70-AA3,130
12Section
130. 601.575 of the statutes is created to read:
SB70-AA3,110,18
13601.575 Prescription drug importation program. (1) Importation
14program requirements. The commissioner, in consultation with persons interested
15in the sale and pricing of prescription drugs and appropriate officials and agencies
16of the federal government, shall design and implement a prescription drug
17importation program for the benefit of residents of this state, that generates savings
18for residents, and that satisfies all of the following:
SB70-AA3,110,2119
(a) The commissioner shall designate a state agency to become a licensed
20wholesale distributor or to contract with a licensed wholesale distributor and shall
21seek federal certification and approval to import prescription drugs.
SB70-AA3,110,2322(b) The program shall comply with relevant requirements of
21 USC 384,
23including safety and cost savings requirements.
SB70-AA3,110,2524
(c) The program shall import prescription drugs from Canadian suppliers
25regulated under any appropriate Canadian or provincial laws.
SB70-AA3,111,2
1(d) The program shall have a process to sample the purity, chemical
2composition, and potency of imported prescription drugs.
SB70-AA3,111,63
(e) The program shall import only those prescription drugs for which
4importation creates substantial savings for residents of this state and only those
5prescription drugs that are not brand-name drugs and that have fewer than 4
6competitor prescription drugs in the United States.
SB70-AA3,111,87
(f) The commissioner shall ensure that prescription drugs imported under the
8program are not distributed, dispensed, or sold outside of this state.
SB70-AA3,111,99
(g) The program shall ensure all of the following:
SB70-AA3,111,1110
1. Participation by any pharmacy or health care provider in the program is
11voluntary.
SB70-AA3,111,1312
2. Any pharmacy or health care provider participating in the program has the
13appropriate license or other credential in this state.
SB70-AA3,111,1614
3. Any pharmacy or health care provider participating in the program charges
15a consumer or health plan the actual acquisition cost of the imported prescription
16drug that is dispensed.
SB70-AA3,111,2017
(h) The program shall ensure that a payment by a health plan or health
18insurance policy for a prescription drug imported under the program reimburses no
19more than the actual acquisition cost of the imported prescription drug that is
20dispensed.
SB70-AA3,111,2221
(i) The program shall ensure that any health plan or health insurance policy
22participating in the program does all of the following:
SB70-AA3,111,2423
1. Maintains a formulary and claims payment system with current information
24on prescription drugs imported under the program.
SB70-AA3,112,3
12. Bases cost-sharing amounts for participants or insureds under the plan or
2policy on no more than the actual acquisition cost of the prescription drug imported
3under the program that is dispensed to the participant or insured.
SB70-AA3,112,64
3. Demonstrates to the commissioner or a state agency designated by the
5commissioner how premiums under the plan or policy are affected by savings on
6prescription drugs imported under the program.
SB70-AA3,112,97
(j) Any wholesale distributor importing prescription drugs under the program
8shall limit its profit margin to the amount established by the commissioner or a state
9agency designated by the commissioner.
SB70-AA3,112,1110
(k) The program may not import any generic prescription drug that would
11violate federal patent laws on branded products in the United States.
SB70-AA3,112,1612(L) The program shall comply with tracking and tracing requirements of
21
13USC 360eee and
360eee-1, to the extent practical and feasible, before the
14prescription drug to be imported comes into the possession of this state's wholesale
15distributor and fully after the prescription drug to be imported is in the possession
16of this state's wholesale distributor.
SB70-AA3,112,1817
(m) The program shall establish a fee or other mechanism to finance the
18program that does not jeopardize significant savings to residents of this state.
SB70-AA3,112,1919
(n) The program shall have an audit function that ensures all of the following:
SB70-AA3,112,2120
1. The commissioner has a sound methodology to determine the most
21cost-effective prescription drugs to include in the program.
SB70-AA3,112,2322
2. The commissioner has a process in place to select Canadian suppliers that
23are high quality, high performing, and in full compliance with Canadian laws.
SB70-AA3,112,2524
3. Prescription drugs imported under the program are pure, unadulterated,
25potent, and safe.
SB70-AA3,113,1
14. The program is complying with the requirements of this subsection.
SB70-AA3,113,32
5. The program is adequately financed to support administrative functions of
3the program while generating significant cost savings to residents of this state.
SB70-AA3,113,54
6. The program does not put residents of this state at a higher risk than if the
5program did not exist.
SB70-AA3,113,76
7. The program provides and is projected to continue to provide substantial cost
7savings to residents of this state.
SB70-AA3,113,10
8(2) Anticompetitive behavior. The commissioner, in consultation with the
9attorney general, shall identify the potential for and monitor anticompetitive
10behavior in industries affected by a prescription drug importation program.
SB70-AA3,113,20
11(3) Approval of program design; certification. No later than the first day of
12the 7th month beginning after the effective date of this subsection .... [LRB inserts
13date], the commissioner shall submit to the joint committee on finance a report that
14includes the design of the prescription drug importation program in accordance with
15this section. The commissioner may not submit the proposed program to the federal
16department of health and human services unless the joint committee on finance
17approves the proposed program. Within 14 days of the date of approval by the joint
18committee on finance of the proposed program, the commissioner shall submit to the
19federal department of health and human services a request for certification of the
20approved program.
SB70-AA3,114,3
21(4) Implementation of certified program. After the federal department of
22health and human services certifies the prescription drug importation program
23submitted under sub. (3), the commissioner shall begin implementation of the
24program, and the program shall be fully operational by 180 days after the date of
25certification by the federal department of health and human services. The
1commissioner shall do all of the following to implement the program to the extent the
2action is in accordance with other state laws and the certification by the federal
3department of health and human services:
SB70-AA3,114,64
(a) Become a licensed wholesale distributor, designate another state agency to
5become a licensed wholesale distributor, or contract with a licensed wholesale
6distributor.
SB70-AA3,114,87
(b) Contract with one or more Canadian suppliers that meet the criteria in sub.
8(1) (c) and (n).
SB70-AA3,114,119
(c) Create an outreach and marketing plan to communicate with and provide
10information to health plans and health insurance policies, employers, pharmacies,
11health care providers, and residents of this state on participating in the program.
SB70-AA3,114,1412
(d) Develop and implement a registration process for health plans and health
13insurance policies, pharmacies, and health care providers interested in participating
14in the program.
SB70-AA3,114,1615
(e) Create a publicly accessible source for listing prices of prescription drugs
16imported under the program.
SB70-AA3,114,1917
(f) Create, publicize, and implement a method of communication to promptly
18answer questions from and address the needs of persons affected by the
19implementation of the program before the program is fully operational.
SB70-AA3,114,2120
(g) Establish the audit functions under sub. (1) (n) with a timeline to complete
21each audit function every 2 years.
SB70-AA3,114,2322
(h) Conduct any other activities determined by the commissioner to be
23important to successful implementation of the program.
SB70-AA3,114,25
24(5) Report. By January 1 and July 1 of each year, the commissioner shall
25submit to the joint committee on finance a report including all of the following:
SB70-AA3,115,2
1(a) A list of prescription drugs included in the prescription drug importation
2program under this section.
SB70-AA3,115,53
(b) The number of pharmacies, health care providers, and health plans and
4health insurance policies participating in the prescription drug importation program
5under this section.
SB70-AA3,115,106
(c) The estimated amount of savings to residents of this state, health plans and
7health insurance policies, and employers resulting from the implementation of the
8prescription drug importation program under this section reported from the date of
9the previous report under this subsection and from the date the program was fully
10operational.
SB70-AA3,115,1211
(d) Findings of any audit functions under sub. (1) (n) completed since the date
12of the previous report under this subsection.
SB70-AA3,115,14
13(6) Rulemaking. The commissioner may promulgate any rules necessary to
14implement this section.
SB70-AA3,131
15Section
131. 601.59 of the statutes is created to read:
SB70-AA3,115,16
16601.59 State-based exchange. (1) Definitions. In this section:
SB70-AA3,115,1717
(a) “Exchange” has the meaning given in
45 CFR 155.20.
SB70-AA3,115,2018
(b) “State-based exchange on the federal platform” means an exchange that is
19described in and meets the requirements of
45 CFR 155.200 (f) and is approved by
20the federal secretary of health and human services under
45 CFR 155.106.
SB70-AA3,115,2421
(c) “State-based exchange without the federal platform” means an exchange,
22other than one described in
45 CFR 155.200 (f), that performs all the functions
23described in
45 CFR 155.200 (a) and is approved by the federal secretary of health
24and human services under
45 CFR 155.106.
SB70-AA3,116,7
1(2) Establishment and operation of state-based exchange. The commissioner
2shall establish and operate an exchange that at first is a state-based exchange on
3the federal platform and then subsequently transitions to a state-based exchange
4without the federal platform. The commissioner shall develop procedures to address
5the transition from the state-based exchange on the federal platform to the
6state-based exchange without the federal platform, including the circumstances
7that shall be met in order for the transition to occur.
SB70-AA3,116,10
8(3) Agreement with federal government. The commissioner may enter into
9any agreement with the federal government necessary to facilitate the
10implementation of this section.
SB70-AA3,116,16
11(4) User fees. The commissioner shall impose a user fee, as authorized under
1245 CFR 155.160 (b) (1), on each insurer that offers a health plan through the
13state-based exchange on the federal platform or the state-based exchange without
14the federal platform. The user fee shall be applied at one of the following rates on
15the total monthly premiums charged by an insurer for each policy under the plan for
16which enrollment is through the exchange:
SB70-AA3,116,1817
(a) For any plan year for which the commissioner operates a state-based
18exchange on the federal platform, the rate is 0.5 percent.
SB70-AA3,116,2219
(b) For the first 2 plan years for which the commissioner operates a state-based
20exchange without the federal platform, the rate is equal to the user fee rate the
21federal department of health and human services specifies under
45 CFR 156.50 (c)
22(1) for the federally facilitated exchanges for the applicable plan year.
SB70-AA3,116,2523
(c) Beginning with the 3rd plan year for which the commissioner operates a
24state-based exchange without the federal platform and for each plan year thereafter,
25the rate shall be set by the commissioner by rule.
SB70-AA3,117,2
1(5) Rules. The commissioner may promulgate rules necessary to implement
2this section.
SB70-AA3,132
3Section
132. 601.83 (1) (h) of the statutes is renumbered 601.83 (1) (h) (intro.)
4and amended to read:
SB70-AA3,117,105
601.83
(1) (h) (intro.)
In 2019 and in each subsequent year Unless the joint
6committee on finance under s. 13.10 increases the amount upon request by the
7commissioner, the commissioner may expend no more than
$200,000,000 the
8following amounts from all revenue sources for the healthcare stability plan under
9this section
, unless the joint committee on finance under s. 13.10 has increased this
10amount upon request by the commissioner.:
SB70-AA3,117,14
11(he) The commissioner shall ensure that sufficient funds are available for the
12healthcare stability plan under this section to operate as described in the approval
13of the federal department of health and human services dated July 29, 2018
, and in
14any waiver extension approvals.