SB40: Bill Text

SB40, s. 2852 Section 2852. 146.19 (1) (c) of the statutes is amended to read:

SB40,1331,2 146.19 (1) (c) "Tribal agency" means an agency of the governing body of created by a tribe.

SB40, s. 2853 Section 2853. 146.19 (1) (d) of the statutes is amended to read:

SB40,1331,5 146.19 (1) (d) "Tribe" means the governing body of a federally recognized American Indian tribe or band located in this state.

SB40, s. 2854 Section 2854. 146.19 (2) (intro.) of the statutes is amended to read:

SB40,1331,15 146.19 (2) Cooperative American Indian health project grants. (intro.) From the appropriation under s. 20.435 (5) (ke), the department shall award grants for cooperative American Indian health projects in order to promote cooperation among tribes, tribal agencies, inter-tribal organizations and other agencies and organizations in addressing address specific problem areas in the field of American Indian health. A tribe, tribal agency, or inter-tribal organization may apply, in the manner specified by the department, for a grant of up to $10,000 to conduct a cooperative an American Indian health project , which meets all of the following requirements that is designed to do any of the following:

SB40, s. 2855 Section 2855. 146.19 (2) (a) of the statutes is repealed.

SB40, s. 2856 Section 2856. 146.19 (2) (b) (intro.) of the statutes is repealed.

SB40, s. 2857 Section 2857. 146.19 (2) (b) 1. of the statutes is renumbered 146.19 (2) (am).

SB40, s. 2858 Section 2858. 146.19 (2) (b) 2. of the statutes is renumbered 146.19 (2) (bm) and amended to read:

SB40,1331,22 146.19 (2) (bm) Fund start-up costs of cooperative programs to deliver health care services to American Indians.

SB40, s. 2859 Section 2859. 146.19 (2) (b) 3. of the statutes is renumbered 146.19 (2) (c).

SB40, s. 2860 Section 2860. 146.19 (2) (d) of the statutes is created to read:

SB40,1332,2 146.19 (2) (d) Provide innovative community-based health care services to American Indians.

SB40, s. 2861 Section 2861. 146.19 (4) of the statutes is repealed.

SB40, s. 2862 Section 2862. 146.40 (4d) (am) of the statutes is amended to read:

SB40,1332,11 146.40 (4d) (am) If an individual who applies for a certification or approval under par. (a) does not have a social security number, the individual, as a condition of obtaining certification or approval, shall submit a statement made or subscribed under oath or affirmation to the department that the applicant does not have a social security number. The form of the statement shall be prescribed by the department of workforce development children and families. A certification or approval issued in reliance upon a false statement submitted under this paragraph is invalid.

SB40, s. 2863 Section 2863. 146.51 (1m) of the statutes is amended to read:

SB40,1332,20 146.51 (1m) If an individual who applies for or to renew a license, training permit or certification under sub. (1) does not have a social security number, the individual, as a condition of obtaining the license, training permit or certification, shall submit a statement made or subscribed under oath or affirmation to the department that the applicant does not have a social security number. The form of the statement shall be prescribed by the department of workforce development children and families. A license, training permit or certification issued or renewed in reliance upon a false statement submitted under this subsection is invalid.

SB40, s. 2864 Section 2864. 146.51 (2) of the statutes is amended to read:

SB40,1332,25 146.51 (2) The department of health and family services may not disclose any information received under sub. (1) to any person except to the department of workforce development children and families for the purpose of making certifications required under s. 49.857.

SB40, s. 2865 Section 2865. 146.51 (3) of the statutes is amended to read:

SB40,1333,14 146.51 (3) The department of health and family services shall deny an application for the issuance or renewal of a license, training permit or certification specified in sub. (1), shall suspend a license, training permit or certification specified in sub. (1) or may, under a memorandum of understanding under s. 49.857 (2), restrict a license, training permit or certification specified in sub. (1) if the department of workforce development children and families certifies under s. 49.857 that the applicant for or holder of the license, training permit or certification is delinquent in the payment of court-ordered payments of child or family support, maintenance, birth expenses, medical expenses or other expenses related to the support of a child or former spouse or fails to comply, after appropriate notice, with a subpoena or warrant issued by the department of workforce development children and families or a county child support agency under s. 59.53 (5) and related to paternity or child support proceedings.

SB40, s. 2866 Section 2866. 146.52 (1m) of the statutes is amended to read:

SB40,1333,23 146.52 (1m) If an individual who applies for or to renew a license, training permit or certificate under sub. (1) does not have a social security number, the individual, as a condition of obtaining the license, training permit or certificate, shall submit a statement made or subscribed under oath or affirmation to the department that the applicant does not have a social security number. The form of the statement shall be prescribed by the department of workforce development children and families. A license, training permit or certificate issued or renewed in reliance upon a false statement submitted under this subsection is invalid.

SB40, s. 2867 Section 2867. 146.53 (2) (c) of the statutes is repealed.

SB40, s. 2868 Section 2868. 146.55 (4) (a) of the statutes is amended to read:

SB40,1334,8 146.55 (4) (a) From the appropriation under s. 20.435 (5) (ch) (rb), the department shall annually distribute funds for ambulance service vehicles or vehicle equipment, emergency medical services supplies or equipment or emergency medical training for personnel to an ambulance service provider that is a public agency, a volunteer fire department or a nonprofit corporation, under a funding formula consisting of an identical base amount for each ambulance service provider plus a supplemental amount based on the population of the ambulance service provider's primary service or contract area, as established under s. 146.50 (5).

SB40, s. 2869 Section 2869. 146.55 (5) (a) of the statutes is amended to read:

SB40,1334,16 146.55 (5) (a) From the appropriation under s. 20.435 (5) (ch) (rb), the department shall annually distribute funds to ambulance service providers that are public agencies, volunteer fire departments, or nonprofit corporations to purchase the training required for licensure and renewal of licensure as an emergency medical technician - basic under s. 146.50 (6), and to pay for administration of the examination required for licensure or renewal of licensure as an emergency medical technician - basic under s. 146.50 (6) (a) 3. and (b) 1.

SB40, s. 2870 Section 2870. 146.58 (8) of the statutes is amended to read:

SB40,1334,19 146.58 (8) Review the annual budget prepared by the department for the expenditures under s. 20.435 (5) (ch) (rb).

SB40, s. 2871 Section 2871. 146.75 of the statutes is created to read:

SB40,1334,21 146.75 Health care quality and patient safety council. (1) In this section:

SB40,1334,23 (a) "American Health Information Community" means a panel that is advisory on information technology to the federal department of health and human services.

SB40,1334,24 (b) "Council" means the health care quality and patient safety council.

SB40,1335,3 (2) Acting in an advisory capacity, the council shall lead implementation efforts for an action plan for health care quality and patient safety by doing all of the following:

SB40,1335,4 (a) Identifying strategies and actions necessary to do all of the following:

SB40,1335,7 1. Attempt to achieve goals established by the Institute of Medicine of the National Academy of Sciences for health care that is safe, effective, patient-centered, timely, efficient, and equitable.

SB40,1335,10 2. Extend health care information systems statewide so as to optimize the improvement of health care quality, safety, and efficiency within a reasonable period of time and with reasonable financial investment.

SB40,1335,13 (b) Considering the most cost-effective means of implementing a statewide integrated or interoperable health care information system, including all of the following:

SB40,1335,15 1. Assessing the benefits of an integrated or interoperable system for supporting rapid deployment of health care providers.

SB40,1335,17 2. Promoting accurate and appropriate shared information about individual patients among health care providers.

SB40,1335,19 3. Creating points of reference for performance indicators among health care provider organizations for organizational performance improvement.

SB40,1335,21 4. Reporting to the public on health care quality, safety, and efficiency data for consumer and purchaser decision making.

SB40,1335,22 (3) The council shall advise the secretary on all of the following:

SB40,1335,23 (a) A communication and marketing plan.

SB40,1335,25 (b) Annually, on recommendations to improve the committee organizational structure of the council.

SB40,1336,2 (c) The distribution of funding to entities to promote the health information technology agenda of the governor.

SB40,1336,6 (d) Whether a health facility, as defined in s. 231.01 (5), or a participating health institution, as defined in s. 231.01 (6), that seeks financial assistance from the Wisconsin Health and Educational Facilities Authority under s. 231.03 demonstrates progress in improving medical information systems technology.

SB40,1336,9 (4) By January 1, 2008, and at least annually thereafter, the council shall report to the legislature under s. 13.172 (3) and to the governor on the council's plans, activities, accomplishments, and recommendations.

SB40,1336,11 (5) Any subcommittee of the council shall align its work with recommendations of the American Health Information Community.

SB40, s. 2872 Section 2872. 146.76 of the statutes is created to read:

SB40,1336,21 146.76 Approval of certain financial assistance. The secretary shall determine whether a health facility, as defined in s. 231.01 (5), or a participating health institution, as defined in s. 231.01 (6), that seeks financial assistance from the Wisconsin Health and Educational Facilities Authority under s. 231.03 demonstrates progress in improving medical information systems technology and shall inform the Wisconsin Health and Educational Facilities Authority of his or her determination. In making a determination under this section, the secretary shall consider as a factor the advice of the health care quality and patient safety council, as provided under s. 146.75 (3) (d).

SB40, s. 2873 Section 2873. 146.91 (2) (c) of the statutes is repealed.

SB40, s. 2874 Section 2874. 146.91 (5) of the statutes is repealed.

SB40, s. 2875 Section 2875. 146.99 of the statutes is repealed.

SB40, s. 2876 Section 2876. 149.11 (2) (a) 1. of the statutes is amended to read:

SB40,1337,2 149.11 (2) (a) 1. Insurer assessments under s. 149.13, paid to the authority under s. 20.145 (5) (g).

SB40, s. 2877 Section 2877. 149.11 (2) (a) 3. of the statutes is repealed and recreated to read:

SB40,1337,5 149.11 (2) (a) 3. Moneys received from the federal government in high risk pool grants.

SB40, s. 2878 Section 2878. 149.11 (2) (b) of the statutes is amended to read:

SB40,1337,10 149.11 (2) (b) The authority controls the assets of the fund and shall select regulated financial institutions in this state that receive deposits in which to establish and maintain accounts for assets needed on a current basis. If practicable, the accounts shall earn interest.

SB40, s. 2879 Section 2879. 149.12 (2) (e) of the statutes is renumbered 149.12 (2) (e) 1. and amended to read:

SB40,1337,16 149.12 (2) (e) 1. No Subject to subd. 2., no person who is eligible for creditable coverage, other than those benefits specified in s. 632.745 (11) (b) 1. to 12., that is provided by an employer on a self-insured basis or through health insurance is eligible for coverage under the plan.

SB40, s. 2880 Section 2880. 149.12 (2) (e) 2. of the statutes is created to read:

SB40,1337,19 149.12 (2) (e) 2. The board may specify other types of coverage provided by an employer that do not render a person ineligible for coverage under the plan.

SB40, s. 2881 Section 2881. 149.12 (2) (f) 2. g. of the statutes is created to read:

SB40,1337,22 149.12 (2) (f) 2. g. Benefits under the demonstration project for childless adults under s. 49.45 (23).

SB40, s. 2882 Section 2882. 149.12 (2) (g) 3. of the statutes is amended to read:

SB40,1338,3 149.12 (2) (g) 3. Services provided under a waiver requested under 2001 Wisconsin Act 16, section 9123 (16rs), or 2003 Wisconsin Act 33, section 9124 (8c) the disabled children's long-term support program, as defined in s. 46.011 (1g).

SB40, s. 2883 Section 2883. 149.12 (3) (a) of the statutes is amended to read:

SB40,1338,10 149.12 (3) (a) Except as provided in pars. (b) and (bm) to (c), no person is eligible for coverage under the plan for whom a premium, deductible, or coinsurance amount is paid or reimbursed by a federal, state, county, or municipal government or agency as of the first day of any term for which a premium amount is paid or reimbursed and as of the day after the last day of any term during which a deductible or coinsurance amount is paid or reimbursed.

SB40, s. 2884 Section 2884. 149.12 (3) (c) of the statutes is created to read:

SB40,1338,15 149.12 (3) (c) Persons for whom premium costs for health insurance coverage and copayments for certain prescription drugs are paid under the pilot program under s. 49.686 (6) are not ineligible for coverage under the plan by reason of such payments.

SB40, s. 2885 Section 2885. 149.13 (3) (a) of the statutes is amended to read:

SB40,1338,22 149.13 (3) (a) Each insurer's proportion of participation under sub. (2) shall be determined annually by the commissioner based on annual statements and other reports filed by the insurer with the commissioner. The commissioner shall assess an insurer for the insurer's proportion of participation based on the total assessments estimated by the authority. An insurer shall pay the amount of the assessment directly to the authority.

SB40, s. 2886 Section 2886. 149.14 (2) (c) 1. of the statutes is renumbered 149.14 (2) (c).

SB40, s. 2887 Section 2887. 149.14 (2) (c) 2. of the statutes is repealed.

SB40, s. 2888 Section 2888. 149.14 (3) (intro.) of the statutes is amended to read:

SB40,1339,8 149.14 (3) Covered expenses. (intro.) Covered expenses for coverage under the plan shall be the payment rates established by the authority for services provided by persons licensed under ch. 446 and certified under s. 49.45 (2) (a) 11. Covered expenses for coverage under the plan shall also be the payment rates established by the authority for, at a minimum, the following services and articles if the service or article is prescribed by a physician who is licensed under ch. 448 or in another state and who is certified under s. 49.45 (2) (a) 11. and, except as provided in sub. (3m), if the service or article is provided by a provider certified under s. 49.45 (2) (a) 11.:

SB40, s. 2889 Section 2889. 149.14 (3m) of the statutes is created to read:

SB40,1339,17 149.14 (3m) Pharmacy network. Covered expenses for prescription drugs shall be the payment rates established by the authority for prescription drugs that are provided to eligible persons by a network of pharmacists and pharmacies approved by the board, regardless of whether the provider of the drug is certified under s. 49.45 (2) (a) 11. The network of pharmacists and pharmacies approved by the board shall include, at a minimum, all pharmacists licensed under s. 450.03 who are certified under s. 49.45 (2) (a) 11. and all pharmacies licensed under s. 450.06 that are certified under s. 49.45 (2) (a) 11.

SB40, s. 2890 Section 2890. 149.14 (5) (a) of the statutes is amended to read:

SB40,1339,21 149.14 (5) (a) The authority shall establish and provide subsidies for deductibles paid by eligible persons with coverage under s. 149.14 (2) (a) and household incomes specified in s. 149.165 (2) (a) 1. to 5.

SB40, s. 2891 Section 2891. 149.142 (1) of the statutes is amended to read:

SB40,1340,8 149.142 (1) Establishment of rates. The authority shall establish provider payment rates for covered expenses that consist of the allowable charges paid under s. 49.46 (2) usual and customary payment rates, as determined by the authority, for the services and articles provided plus an enhancement adjustment determined by the authority. The rates shall be based on the allowable charges paid under s. 49.46 (2), projected plan costs, and trend factors. Using the same methodology that applies to medical assistance under subch. IV of ch. 49, the authority shall establish hospital outpatient per visit reimbursement rates and hospital inpatient reimbursement rates that are specific to diagnostically related groups of eligible persons. The adjustments to the usual and customary rates shall be sufficient to cover the portion of plan costs specified in s. 149.143 (1) (c) and (2) (b).

SB40, s. 2892 Section 2892. 149.143 (1) (intro.) of the statutes is amended to read:

SB40,1340,15 149.143 (1) Costs excluding subsidies. (intro.) The authority shall pay plan costs, excluding any premium, deductible, and copayment subsidies, first from any federal funds, if any, that are transferred to the fund under s. 20.145 (5) (m) and under s. 149.11 (2) (a) 3. that exceed premium, deductible, and copayment subsidy costs in a policy year. The remainder of the plan costs, excluding premium, deductible, and copayment subsidy costs, shall be paid as follows: