AB807,15,3
1(d) Study and continuously monitor the unmet health care service needs in the
2region of the regional consumer health council and recommend to the board ways by
3which the needs may be met.
AB807,15,74 (e) Report at least annually to the board with respect to the health care needs,
5problems, and concerns of the region, including any issues elicited at public hearings
6under par. (g), and provide to the board recommendations to alleviate these needs,
7problems, and concerns.
AB807,15,108 (f) Require reports from and advise the member of the staff of the appropriate
9regional office whose duties are specified under s. 152.40 (1), concerning issues that
10arise under pars. (b) to (e).
AB807,15,1411 (g) In at least 2 localities of the region, hold public hearings at least annually
12to elicit public opinion concerning the health plan under this chapter. The council
13shall give notice of each hearing by publishing a class 1 notice, under ch. 985, at least
1415 days before the hearing in a newspaper covering the affected area.
AB807,15,1515 (h) Perform other duties as required by the board.
AB807,15,18 16(2) Each regional consumer health council may, for cause, recall the member
17elected under sub. (1) (a) and may elect another member to fulfill that term on the
18board if all of the following are done:
AB807,15,2019 (a) The elected member of the board for whom recall is sought receives notice
20of the recall at least 10 working days before the meeting at which recall is voted upon.
AB807,15,2321 (b) Notice of the vote to recall the elected member is made on the agenda of the
22meeting of the regional consumer health council that is immediately prior to the
23meeting at which recall is voted upon.
AB807,16,4 24(2m) The regional consumer health council may appoint a regional advisory
25committee. If appointed, the regional advisory committee shall consist of 18

1members who reflect as much as possible a balance of gender, race, age, sexual
2orientation, ethnicity, religion, geographic area, and the interests of management,
3labor, and individuals with disabilities, and may consist of consumer advocates and
4health care providers.
AB807,16,7 5(3) The staff of the appropriate regional office shall provide services to each
6regional consumer health council to deal with issues of health consumer advocacy
7and health ombudsman functions.
AB807,16,12 8152.40 Department of health planning and finance. (1) The department
9shall administer the health plan under this chapter, including establishing a
10regional office in each of the regions specified under s. 15.207 (1) (a) 1. to 6. Each
11regional office shall have at least one staff member who acts in a full-time capacity
12as a regional consumer advocate and health care ombudsman.
AB807,16,15 13(2) The department shall establish provider payment rates, taking into
14consideration regional, rural, and urban differences, and conditions of payment for
15the provision of health care services under the health plan.
AB807,16,17 16(3) The department shall, after review and approval by the board, promulgate
17as rules all of the following:
AB807,16,1918 (a) Guidelines for cost containment under the health plan, including the
19purchasing and distribution of major diagnostic, medical, and surgical equipment.
AB807,16,2320 (b) Criteria, as recommended by the medical advisory committee appointed by
21the secretary under sub. (7), for determining necessity for orthodontia and for the
22performance of reconstructive or cosmetic surgery for coverage under the health
23plan.
AB807,16,25 24(4) The department shall biennially evaluate and recommend to the board cost
25control measures for the health plan.
AB807,17,3
1(5) The department shall, by July 1, 2007, begin implementation of processes,
2in light of policies formulated or revised under s. 152.20 (3), to effect all of the
3following:
AB807,17,74 (a) Specification of the amounts and sources of revenues to finance payment to
5providers under the health plan, which may not include any premiums, copayments,
6deductibles, and other forms of direct payment by patients, and which shall include
7all of the following:
AB807,17,138 1. Use of federal, state, and local moneys that fund, as of July 1, 2008, health
9care services, including medicare, medical assistance, health care services funded by
10a relief block grant under s. 49.02 or 49.025, health care services under s. 49.665,
11veterans medical benefits, services specified in s. 152.10 (2) (k), services provided
12under federal block grants, alcohol and other drug abuse services, and services
13provided by local health departments.
AB807,17,1814 2. Use of revenues from a tax on employers, based on the amount of wages that
15they pay, that generates, in the aggregate, revenues that are at least equal to
16amounts that employers contribute, as of the effective date of this subdivision ....
17[revisor inserts date], for employee health care benefit costs, including the costs of
18worker's compensation attributable to health care for injured employees.
AB807,17,2219 3. Use of revenues from a graduated income tax on individuals that generates,
20in the aggregate, revenues that are not greater than expenditures that individuals
21make, as of July 1, 2008, for health care costs for which coverage under disability
22insurance policies is not obtained.
AB807,17,2523 4. An indexing of the sources of revenues under this paragraph that provides
24for revenue growth that is equivalent to the anticipated growth of health care costs
25under the health plan.
AB807,18,3
1(b) Application for waivers to 42 USC 1396 to 1396v or consideration of the
2feasibility of statutory changes to 42 USC 1396 to 1396v in order to effect all of the
3following:
AB807,18,54 1. Administration of the Medical Assistance program in this state by the
5department, rather than by the department of health and family services.
AB807,18,76 2. Use of federal financial participation to fund a portion of the administrative
7costs, after June 30, 2008, of the department.
AB807,18,128 3. Use of federal financial participation, after June 30, 2008, to fund, under the
9health plan, the health care services received by a percentage of the residents that
10corresponds to the percentage of the residents, as determined by the board, that is
11eligible to receive health care services under the Medical Assistance program on July
121, 2008.
AB807,18,1413 4. The formulation of criteria and procedures for payment of out-of-state
14health care costs incurred by residents specified in subd. 3.
AB807,18,1615 5. Use of federal financial participation to fund the scope, or a portion of the
16scope, of medical services to be provided under the health plan.
AB807,18,1817 (c) Application for waivers to Medicare or consideration of the feasibility of
18statutory changes to 42 USC 1395 to 1395ddd in order to effect all of the following:
AB807,18,2019 1. Administration of the Medicare program in this state by the department,
20rather than by private insurers.
AB807,18,2221 2. Use of federal Medicare funds to fund a portion of the administrative costs,
22after June 30, 2008, of the department.
AB807,18,2523 3. Use of federal Medicare funds to fund, under the health plan, the health care
24services received by residents who are eligible to receive services under Medicare
25beginning on July 1, 2008.
AB807,19,2
14. The formulation of criteria and procedures for payment of out-of-state
2health care costs incurred by residents specified in subd. 3.
AB807,19,43 5. Use of federal Medicare funds to fund the scope, or a portion of the scope, of
4medical services to be provided under the health plan.
AB807,19,65 6. The assignment to the state, as represented by the department, of rights of
6an individual to payment for medical care from any 3rd party.
AB807,19,107 (d) Application for waivers or consideration of the feasibility of statutory
8changes to federal laws, other than those specified in pars. (b) and (c), in order to use
9moneys available under those federal laws for payment of health care services under
10the health plan or in order to provide services to all residents under the health plan.
AB807,19,1311 (e) The establishment and maintenance, with reserves of no less than 5 percent
12of the total annual amount appropriated under s. 20.430 (1) (b), of a health trust fund
13in the department, for receipt of revenues specified in par. (a).
AB807,19,2114 (f) The formulation of criteria for determining payment and the formulation of
15procedures for determining payment and negotiating applicable rates to be used for
16payment for health care providers, including health care facilities, under the health
17plan. The criteria and procedures for determining payment shall include periodic
18overall budgeting, including separately budgeting for operational costs; for health
19care facilities and services; for negotiations with professional groups or associations
20of practitioners; for consideration of inflation costs and increased patient
21populations; and for research and teaching.
AB807,19,2522 (g) The development and implementation of a system to provide an electronic
23or other identification card, bearing a unique number that is not a social security
24number, to each health plan participant, for receipt of benefits under the plan, and
25to each health care provider, for receipt of reimbursement.
AB807,20,4
1(h) The formulation of criteria and procedures to review and to provide funding
2for capital expenditures, from an account separate from that from which health care
3services are paid, for the establishment, maintenance, or expansion of health care
4facilities.
AB807,20,65 (i) The formulation of criteria and procedures for recovery of overpayments
6made to health care providers under the health plan.
AB807,20,87 (j) The determination and use of factors requisite to establishing an annual
8state health budget for the provision of services under the health plan.
AB807,20,119(k) Application for waivers of 29 USC 1144 (a) or consideration of the feasibility
10of statutory change to 29 USC 1144 (a) or the means by which operation of the health
11plan may avoid conflict with 29 USC 1144 (a).
AB807,20,1412 (L) Investigation of the feasibility of providing the state with subrogation
13rights to payments for injury or disease to residents that are provided under motor
14vehicle or other liability insurance policies or plans.
AB807,20,1615 (m) Formulation of criteria and procedures for payment under the health plan
16of out-of-state health care costs incurred by residents.
AB807,20,1817 (n) Establishment of a listing of approved medicinal substances and formulae,
18including all of the following:
AB807,20,2219 1. Negotiation with pharmaceutical manufacturers or distributors to obtain
20the lowest possible cost for each medicinal substance. The negotiation shall include
21as parties on behalf of the health plan the secretary of the department and the
22chairperson of the board.
AB807,20,2423 2. Establishment of a single statewide price, under the health plan, for each
24medicinal substance.
AB807,21,2
13. Monitoring the listing to oversee its currency and revising the listing by
2January 1 and July 1 annually.
AB807,21,43 4. Negotiating a statewide uniform dispensing fee with representatives of
4pharmacists or pharmacies.
AB807,21,55 (p) Exemption of operation of the health plan from ch. 133, if necessary.
AB807,21,66 (q) Other issues relevant to the health plan, as determined by the board.
AB807,21,15 7(6) From the appropriation under s. 20.430 (1) (c), the department shall, in
8cooperation with the department of workforce development and any other applicable
9state agency, as defined in s. 20.001 (1), provide job retraining or job placement
10services to individuals employed by insurers, as defined in s. 600.03 (27) and by
11health care providers whose employment is or will be terminated because of
12implementation of the health plan under this chapter. The department may award
13moneys as grants to applying organizations, under the department's
14request-for-proposal procedures, for the provision of job retraining or placement
15services under this subsection.
AB807,21,17 16(7) The secretary shall create a medical advisory committee and appoint
17members of the committee, to recommend criteria under sub. (3) (b).
AB807, s. 15 18Section 15. Nonstatutory provisions; health planning and finance.
AB807,21,2319 (1) Health policy board; appointment of members. Notwithstanding the
20length of terms specified for the members of the health policy board under section
2115.20 (intro.) of the statutes, as created by this act, the initial members of the health
22policy board shall be appointed or elected by the first day of the 4th month beginning
23after the effective date of this subsection for the following terms:
AB807,22,324 (a) Two members specified under section 15.20 (1) of the statutes, as created
25by this act, one of whom is elected from the northern regional consumer health

1council and one of whom is elected from the southeastern regional health council, and
22 members specified under section 15.20 (2) of the statutes, as created by this act, for
3terms expiring on May 1, 2009.
AB807,22,84 (b) Two members specified under section 15.20 (1) of the statutes, as created
5by this act, one of whom is elected from the northeastern regional consumer health
6council and one of whom is elected from the regional consumer health council for the
7area within Milwaukee County, and 2 members specified under section 15.20 (2) of
8the statutes, as created by this act, for terms expiring on May 1, 2011.
AB807,22,139 (c) Two members specified under section 15.20 (1) of the statutes, as created by
10this act, one of whom is elected from the southern regional consumer health council
11and one of whom is elected from the western regional consumer health council, and
12one member specified under section 15.20 (2) of the statutes, as created by this act,
13for terms expiring on May 1, 2013.
AB807,22,1914 (2) Regional consumer health councils; appointment of members.
15Notwithstanding the length of terms specified for the members of regional consumer
16health councils under section 15.207 (1) (b) of the statutes, as created by this act, the
17initial members of the regional consumer health councils shall be appointed by the
18first day of the 3rd month beginning after the effective date of this subsection for the
19following terms:
AB807,22,2120 (a) For the regional consumer health council under section 15.207 (1) (b) 1. of
21the statutes, as created by this act:
AB807,22,22 221. Five members, for terms expiring on July 1, 2010.
AB807,22,23 232. Five members, for terms expiring on July 1, 2011.
AB807,22,24 243. Six members, for terms expiring on July 1, 2012.
AB807,23,2
1(b) For the regional consumer health council under section 15.207 (1) (b) 2. of
2the statutes, as created by this act:
AB807,23,3 31. Five members, for terms expiring on July 1, 2010.
AB807,23,4 42. Five members, for terms expiring on July 1, 2011.
AB807,23,5 53. Five members, for terms expiring on July 1, 2012.
AB807,23,76 (c) For each regional consumer health council under section 15.207 (1) (b) 3. or
74. of the statutes, as created by this act:
AB807,23,8 81. Five members, for terms expiring on July 1, 2010.
AB807,23,9 92. Five members, for terms expiring on July 1, 2011.
AB807,23,10 103. Seven members, for terms expiring on July 1, 2012.
AB807,23,1211 (d) For each regional consumer health council under section 15.207 (1) (b) 5.
12or 6. of the statutes, as created by this act:
AB807,23,13 131. Four members, for terms expiring on July 1, 2010.
AB807,23,14 142. Four members, for terms expiring on July 1, 2011.
AB807,23,15 153. Four members, for terms expiring on July 1, 2012.
AB807,23,1616 (3) Proposed implementation.
AB807,23,2117 (a) The department of administration shall expedite the creation of regional
18consumer health councils in accord with section 15.207 (1) (b) of the statutes, as
19created by this act, by initiating and making follow-up contacts with boards of
20supervisors in counties other than Milwaukee County and with the county executive
21of Milwaukee County and the mayor of the city of Milwaukee.
AB807,23,2522 (b) The department of administration shall provide staff assistance to complete
23all activities required to create the 6 regional consumer health councils and enable
24each regional consumer health council to elect one member of the health policy board
25as required under section 15.20 (1) of the statutes, as created by this act.
AB807,24,3
1(c) The health policy board shall appoint the secretary of health planning and
2finance within 6 months after the first meeting at which all appointed and at least
33 elected board members assemble.
AB807,24,164 (d) The secretary of health planning and finance and the secretary of
5administration shall, until September 1, 2009, meet at least semimonthly to
6formulate decisions on issues concerning the health plan and the department of
7health planning and finance, as specified in chapter 152 of the statutes, as created
8by this act, and how the scope and functions of the department of health planning
9and finance affect the scope and functions of the department of health and family
10services, the office of the commissioner of insurance, and the board on aging and
11long-term care and the duties or powers of any other state agency. Following
12approval by the health policy board, the department of health planning and finance
13shall convey these decisions to, and cooperate with, the legislative reference bureau
14in the drafting of proposed legislation that is necessary to implement those decisions,
15for introduction in the legislature in 2008 by the appropriate committee of the
16legislature.
AB807,24,2317 (e) Within 2 months after the first day of the 36th month after the appointment
18of the first secretary of health planning and finance under paragraph (c), the health
19policy board shall evaluate, in writing, the performance of the secretary, shall decide
20whether or not to continue the appointment, and shall provide a copy of the
21evaluation to the governor. If the health policy board decides to discontinue the
22appointment, the board shall, within 6 months, implement the decision and appoint
23a successor.
AB807, s. 16 24Section 16. Nonstatutory provisions; legislative reference bureau.
AB807,25,6
1(1) Drafting proposed legislation to implement the health plan. The
2legislative reference bureau shall, after meeting with and receiving the decisions of
3the department of health planning and finance with respect to the health plan, as
4specified in chapter 152 of the statutes, as created by this act, prepare in proper form
5proposed legislation that shall relate to those decisions, for introduction in the
6legislature in 2008 by the appropriate committee of the legislature.
AB807, s. 17 7Section 17. Effective dates. This act takes effect on the day after publication,
8except as follows:
AB807,25,109 (1) The treatment of sections 20.430 (1) (b) and 152.10 of the statutes takes
10effect on July 1, 2008.
AB807,25,1111 (End)
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