AB955,6,10 1052.01 Definitions. In this chapter:
AB955,6,11 11(1) "Block grant" has the meaning given in s. 16.54 (2) (a) 3.
AB955,6,12 12(2) "Board" means the health policy board.
AB955,6,13 13(3) "Department" means the department of health planning and finance.
AB955,6,14 14(4) "Disability insurance policy" has the meaning given in s. 632.895 (1) (a).
AB955,6,16 15(5) "Medicare" means coverage under part A or part B of Title XVIII of the
16federal social security act, 42 USC 1395 to 1395ddd.
AB955,6,17 17(6) "Resident" means an individual who lives or is employed within this state.
AB955,6,23 1852.10 Universal health plan. There is created a universal health plan in this
19state, under which each resident shall receive reasonable medical service necessary
20to maintain health, enable diagnosis or provide treatment or rehabilitation for an
21injury, disability or disease, paid for by a single payer, except that no coverage is
22provided for orthodontia for persons who are age 18 or older that is not medically
23necessary or for the performance of cosmetic surgery.
AB955,7,3
152.20 Health policy board; powers and duties. The board shall consider
2and formulate policy on at least all of the following issues with respect to the
3formation of a universal health plan in this state:
AB955,7,7 4(1) Other than premiums, copayments, deductibles or other forms of direct
5payment by patients, the sources of revenues for the administration of the
6department and the board and for financing the payment of medical services that are
7provided to residents under the universal health plan, including all of the following:
AB955,7,138 (a) Use of federal, state and local moneys that fund, as of the effective date of
9this paragraph .... [revisor inserts date], health care services, including medicare,
10medical assistance, health care services under ss. 49.025, 49.027 and 49.029,
11services under the health care program for low-income families under s. 49.665,
12services provided under federal block grants, alcohol and other drug abuse services
13and services provided by local public health agencies.
AB955,7,1814 (b) Imposition of a tax on employers, based on the amount of wages that they
15pay, that generates, in the aggregate, revenues that are at least equal to amounts
16that employers contribute, as of the effective date of this paragraph .... [revisor
17inserts date], for employe health care benefit costs, including the costs of worker's
18compensation attributable to health care for injured employes.
AB955,7,2219 (c) Imposition of a graduated income tax on individuals that generates, in the
20aggregate, revenues that are not greater than expenditures that individuals make,
21as of the effective date of this paragraph .... [revisor inserts date], for health care costs
22for which coverage under disability insurance policies is not obtained.
AB955,7,2523 (d) An indexing of the sources of revenues under this subsection that provides
24for revenue growth that is equivalent to the anticipated growth of health care costs
25under the universal health plan.
AB955,8,3
1(2) The likelihood of and procedures necessary for obtaining waivers to 42 USC
21396
to 1396v or statutory changes to 42 USC 1396 to 1396v in order to effect all of
3the following:
AB955,8,54 (a) Administration of the medical assistance program in this state by the
5department, rather than by the department of health and family services.
AB955,8,76 (b) Use of federal financial participation to fund a portion of the administrative
7costs, after June 30, 2000, of the department.
AB955,8,138 (c) Use of federal financial participation, after June 30, 2001, to fund, under the
9universal health plan, the health care services received by a percentage of the
10residents that corresponds to the percentage of the residents, as determined by the
11board, that is eligible to receive health care services under the medical assistance
12program or under the health care program for low-income families under s. 49.665
13on July 1, 2001.
AB955,8,1514 (d) The formulation of criteria and procedures for payment of out-of-state
15health care costs incurred by residents specified in par. (c).
AB955,8,1716 (e) Use of federal financial participation to fund the scope, or a portion of the
17scope, of medical services to be provided under the universal health plan.
AB955,8,20 18(3) The likelihood of and procedures necessary for obtaining waivers to 42 USC
191395
to 1395ddd or statutory changes to 42 USC 1395 to 1395ddd in order to effect
20all of the following:
AB955,8,2221 (a) Administration of the medicare program in this state by the department,
22rather than by private insurers.
AB955,8,2423(b) Use of federal funds under 42 USC 1395 to 1395ddd to fund a portion of the
24administrative costs, after June 30, 2000, of the department.
AB955,9,3
1(c) Use of federal funds under 42 USC 1395 to 1395ddd to fund, under the
2universal health plan, the health care services received by residents who are eligible
3to receive services under 42 USC 1395 to 1395ddd beginning on July 1, 2001.
AB955,9,54 (d) The formulation of criteria and procedures for payment of out-of-state
5health care costs incurred by residents specified in par. (c).
AB955,9,86(e) Use of federal funds under 42 USC 1395 to 1395ddd to fund the scope, or
7a portion of the scope, of medical services to be provided under the universal health
8plan.
AB955,9,109 (f) The assignment to the state, as represented by the department, of rights of
10an individual to payment for medical care from any 3rd party.
AB955,9,15 11(4) The likelihood of and procedures necessary for obtaining waivers or
12statutory changes to federal laws, other than those specified in subs. (2) and (3), in
13order to use moneys available under those federal laws for payment of health care
14services or mental health services under the universal health plan or in order to
15provide services to all residents under the universal health plan.
AB955,9,17 16(5) The establishment and maintenance of a health trust fund in the
17department, for receipt of revenues for the purposes specified in sub. (1).
AB955,9,20 18(6) The scope of health care services and other benefits, if any, that shall be
19required to be provided under the universal health plan, including all of the
20following:
AB955,9,2321 (a) Services of all persons licensed, certified, registered or permitted to treat
22the sick under chs. 441, 446, 447, 448, 449, 450, 451, 455 and 459 and services of
23professional counselors and marriage and family therapists under ch. 457.
AB955,9,2524 (b) Health care and mental health treatment services provided by facilities or
25services governed under ss. 45.365, 46.03 (1), 49.70, 49.72 (1), 50.02, 50.03, 50.033,

150.034, 50.32 to 50.39, 50.49, 50.50, 50.91, 51.038, 51.08, 51.09, 58.05, 58.06, 251.05,
2252.073, 252.076, 252.10 and 301.02 and the offices and clinics of persons licensed,
3certified, registered or permitted to treat the sick under chs. 441, 446, 447, 448, 449,
4450, 451, 455 and 459.
AB955,10,55 (c) Services provided by social workers certified under ch. 457.
AB955,10,66 (d) Preventive health care services and health promotional programs.
AB955,10,97 (e) Long-term care and services provided in institutional and
8community-based settings as convalescent or custodial care or care for a chronic
9condition or terminal illness.
AB955,10,1010 (f) Eyeglasses and contact lenses.
AB955,10,1111 (g) Hearing aids, as defined in s. 459.01 (2).
AB955,10,1212 (h) Prescription drugs, as defined in s. 450.01 (20).
AB955,10,1313 (i) Prostheses, including dental prostheses.
AB955,10,1414 (j) Medical supplies and equipment.
AB955,10,16 15(7) The definition of the terms "health care provider", "health care facility" and
16"cosmetic surgery" for purposes of reimbursement under the universal health plan.
AB955,10,22 17(8) The formulation of criteria for determining payment and the formulation
18of procedures for determining payment and negotiating applicable rates to be used
19for payment for health care providers, including health care facilities, under the
20universal health plan. The criteria and procedures for determining payment shall
21include the concept of periodic budgeting, including separately budgeting for
22operational costs, for health care facilities.
AB955,11,2 23(9) The formulation of criteria and procedures to review and to provide funding
24for capital expenditures, from an account separate from that from which health care

1services are paid, for the establishment, maintenance or expansion of health care
2facilities.
AB955,11,4 3(10) The formulation of prohibitions on issuance of disability insurance policies
4that duplicate the coverage provided under the universal health plan.
AB955,11,6 5(11) The formulation of criteria and procedures for recovery of overpayments
6made to health care providers under the universal health plan.
AB955,11,8 7(12) The creation of a timetable for the phasing in, no later than July 1, 2004,
8of services under the universal health plan for each of the following groups:
AB955,11,109 (a) Individuals, other than those specified in par. (b), who have no coverage
10under disability insurance policies.
AB955,11,1411 (b) Individuals who have no coverage under disability insurance policies and
12who receive federally funded, state-funded or locally funded health care, treatment
13for nervous or mental disorders or treatment or prevention services for alcohol and
14other drug abuse.
AB955,11,1815 (c) Individuals who are employes of state, county, city, village or town
16government and who, as a benefit of the employment, have coverage for themselves
17and family members under provisions of group disability insurance policies or under
18self-insured health plans.
AB955,11,2119 (d) Individuals, other than those specified in par. (c) or (h), who, by reason of
20their employment or as family members of individuals who are employed, have
21coverage under group disability insurance policies.
AB955,11,2322 (e) Individuals who have coverage under individual disability insurance
23policies.
AB955,11,2524 (f) Individuals who have coverage under the mandatory health insurance
25risk-sharing plan under ch. 149.
AB955,12,3
1(g) Individuals who are eligible for benefits or services under s. 49.46, 49.47 or
249.665, medicare or federal block grants that provide health care services or mental
3health services.
AB955,12,64 (h) Individuals who are employes of self-insured employers, other than those
5specified in par. (c), and who receive health care benefits for themselves and family
6members under self-insured health plans.
AB955,12,77 (i) Individuals who receive medical benefits under worker's compensation.
AB955,12,9 8(13) The determination of factors requisite to establishing an annual state
9health budget for the provision of services under the universal health plan.
AB955,12,13 10(14) The scope of functions of the department and the attendant reduction of
11scope of the functions of the department of health and family services, the office of
12the commissioner of insurance, the board on aging and long-term care and any other
13applicable state agency powers or responsibilities.
AB955,12,15 14(15) The solicitation and use of information provided by the health policy
15councils.
AB955,12,18 16(16) The likelihood of and procedures necessary to obtain waivers or statutory
17change to 29 USC 1144 (a), or, alternatively, the means by which operation of the
18universal health plan may avoid conflict with 29 USC 1144 (a).
AB955,12,20 19(17) The necessity of exempting operation of the universal health plan from ch.
20133.
AB955,12,23 21(18) Investigation of the feasibility of providing the state with subrogation
22rights to payments for injury or disease to residents that are provided under motor
23vehicle or other liability insurance policies or plans.
AB955,13,2 24(19) Development of a system for determination and periodic review of areas
25in this state, and specific populations within those areas, that are medically

1underserved; and development of plans for providing health care services to those
2areas and populations that include establishment of community health centers.
AB955,13,5 3(20) Development of a system for periodic reviews and evaluations of all
4aspects of the operation of the universal health plan, including the adequacy,
5effectiveness and quality of health care services provided.
AB955,13,8 6(21) Development of a notice and hearing procedure for review of complaints
7of residents under the universal health plan, in accordance with the requirements
8of ch. 227.
AB955,13,10 9(22) Means of containing costs for services provided under the universal health
10plan.
AB955,13,12 11(23) Formulation of criteria and procedures for payment under the universal
12health plan of out-of-state health care costs incurred by residents.
AB955,13,14 13(24) Other issues that the board determines are relevant to the universal
14health plan.
AB955,13,15 15(25) State statutory changes that may be necessary to effect subs. (1) to (24).
AB955,13,17 1652.30 Regional health councils; powers and duties. (1) Each regional
17health council shall do all of the following:
AB955,13,2218 (a) Appoint one member of the regional health council to serve as a member of
19the board under s. 15.20 (1) (a). If the term of the member who is so appointed expires
20with respect to the regional health council or with respect to the board under s. 15.20
21(1) (a), the regional health council shall appoint a current member of the council to
22serve as a member of the board in his or her stead.
AB955,14,223 (b) Study and continuously monitor the delivery and quality of and access to
24health care services in the region of the regional health council and recommend to

1the board ways to improve the quality of and help ensure access to health care
2services.
AB955,14,53 (c) Study and continuously monitor the unmet health care service needs in the
4region of the regional health council and recommend to the board ways by which the
5needs may be met.
AB955,14,86 (d) Report at least annually to the board with respect to the health care needs,
7problems and concerns of the region and provide to the board recommendations to
8alleviate these needs, problems and concerns.
AB955,14,99 (e) Perform other duties as required by the board.
AB955,14,12 10(2) Each regional health council may, for cause, recall the member appointed
11under sub. (1) (a) and may appoint another member to fulfill that term on the board
12if all of the following are done:
AB955,14,1413 (a) The appointed member of the board for whom recall is sought receives notice
14of the recall prior to the meeting at which recall is voted upon.
AB955,14,1715 (b) Notice of the recall of the appointed member is made on the agenda of the
16meeting of the regional health council that is immediately prior to the meeting at
17which recall is voted upon.
AB955, s. 11 18Section 11. 59.17 (2) (c) of the statutes is amended to read:
AB955,14,2319 59.17 (2) (c) Appoint the members of all boards and, commissions and councils
20where appointments are required and where the statutes provide that the
21appointments are made by the county board or by the chairperson of the county
22board. All appointments to boards and, commissions and councils by the county
23executive are subject to confirmation by the county board.
AB955, s. 12 24Section 12. 59.53 (24) of the statutes is created to read:
AB955,15,2
159.53 (24) Regional health council. Each board shall appoint members of a
2regional health council, as specified in s. 15.207 (1) (b).
AB955, s. 13 3Section 13. 62.09 (8) (cm) of the statutes is created to read:
AB955,15,64 62.09 (8) (cm) The mayor of a 1st class city may, with the advice and consent
5of the common council of that city, appoint 6 members of a regional health council,
6as specified under s. 15.207 (1) (b) 6.
AB955, s. 14 7Section 14. Nonstatutory provisions; health planning and financed.
AB955,15,128 (1) Health policy board; appointment of members. Notwithstanding the
9length of terms specified for the voting members of the health policy board under
10section 15.20 (1) (intro.) of the statutes, as created by this act, the initial members
11of the health policy board shall be appointed by the first day of the 3rd month
12beginning after the effective date of this subsection for the following terms:
AB955,15,1713 (a) Two members specified under section 15.20 (1) (b) of the statutes, as created
14by this act, and 2 members specified under section 15.20 (1) (a) of the statutes, as
15created by this act, one of whom is appointed from the northern regional council and
16one of whom is appointed from the southeastern regional council, for terms expiring
17on May 1, 2002.
AB955,15,2218 (b) Two members specified under section 15.20 (1) (b) of the statutes, as created
19by this act, and 2 members specified under section 15.20 (1) (a) of the statutes, as
20created by this act, one of whom is appointed from the northeastern regional council
21and one of whom is appointed from the regional council within the area of Milwaukee
22County, for terms expiring on May 1, 2004.
AB955,16,223 (c) One member specified under section 15.20 (1) (b) of the statutes, as created
24by this act, and 2 members specified under section 15.20 (1) (a) of the statutes, as
25created by this act, one of whom is appointed from the southern regional council and

1one of whom is appointed from the western regional council, for terms expiring on
2May 1, 2006.
AB955,16,103 (2) Health policy board; proposed legislation. The health policy board shall,
4beginning on January 1, 1999, and ending on September 1, 1999, meet at least
5semimonthly to formulate decisions on issues concerning the Wisconsin universal
6health plan, as specified in section 52.20 (1) to (24) of the statutes, as created by this
7act. The health policy board shall convey these decisions to and cooperate with the
8legislative reference bureau in the drafting of proposed legislation that is necessary
9to meet those issues, for introduction in the legislature on or before January 11, 2000,
10by the appropriate committee of the legislature.
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