SB40: Bill Text

SB40,1385,23 (4) "Small group market" has the meaning given in s. 632.745 (26).

SB40,1386,3 238.05 Creation and organization of authority. (1) There is created a public body corporate and politic to be known as the "Healthy Wisconsin Authority." The board of directors of the authority shall consist of the commissioner of insurance, or his or her designee, as a nonvoting member, and the following 13 members, who shall serve 4-year terms:

SB40,1386,4 (a) One majority party senator appointed by the senate majority leader.

SB40,1386,5 (b) One minority party senator appointed by the senate minority leader.

SB40,1386,7 (c) One majority party representative to the assembly appointed by the speaker of the assembly.

SB40,1386,9 (d) One minority party representative to the assembly appointed by the assembly minority leader.

SB40,1386,11 (e) Nine nominees of the governor, appointed with the advice and consent of the senate, consisting of all of the following:

SB40,1386,12 1. One health care provider.

SB40,1386,14 2. One representative of a Wisconsin health insurance company that offers coverage in the small group market.

SB40,1386,15 3. One representative of a Wisconsin small employer.

SB40,1386,16 4. One representative of Wisconsin labor unions.

SB40,1386,17 5. One representative of health benefit purchasing cooperatives.

SB40,1386,18 6. Four other members who represent the public interest.

SB40,1386,25 (2) Each member of the board shall hold office until a successor is appointed and qualified unless the member vacates or is removed from his or her office. A member who serves as a result of holding another office or position vacates his or her office as a member when he or she vacates the other office or position. A member who ceases to qualify for office vacates his or her office. A vacancy on the board shall be filled in the same manner as the original appointment to the board for the remainder of the unexpired term, if any.

SB40,1387,2 (3) Annually, the governor shall appoint one member as chairperson, and the members of the board may elect other officers as they consider appropriate.

SB40,1387,15 (4) The board shall appoint an executive director. The executive director shall not be a member of the board and shall serve at the pleasure of the board. The authority may delegate by resolution to one or more of its members or its executive director any powers and duties that it considers proper. The executive director shall receive such compensation as may be determined by the board. The executive director or other person designated by resolution of the board shall keep a record of the proceedings of the authority and shall be custodian of all books, documents, and papers filed with the authority, the minute book or journal of the authority, and its official seal. The executive director or other person may cause copies to be made of all minutes and other records and documents of the authority and may give certificates under the official seal of the authority to the effect that such copies are true copies, and all persons dealing with the authority may rely upon such certificates.

SB40,1387,20 (5) A majority of the members of the board constitutes a quorum for the purpose of conducting its business and exercising its powers and for all other purposes, notwithstanding the existence of any vacancies. Action may be taken by the board upon a vote of a majority of the members present. Meetings of the members of the board may be held anywhere within or without the state.

SB40,1387,24 (6) A member of the board may not be compensated for his or her services but shall be reimbursed for actual and necessary expenses incurred in the performance of his or her duties, including travel expenses, subject to uniform travel schedule amounts approved under s. 20.916 (8).

SB40,1388,4 (7) No cause of action may arise against and no civil liability may be imposed upon a member or executive director of the authority for any act or omission in the performance of his or her powers and duties under this chapter, unless the person asserting liability proves that the act or omission constitutes willful misconduct.

SB40,1388,8 238.10 Powers of authority. (1) Except as restricted under sub. (2), the authority shall have all the powers necessary or convenient to carry out the purposes and provisions of this chapter. In addition to all other powers granted by this chapter, the authority may:

SB40,1388,10 (a) Adopt, amend, and repeal bylaws and policies and procedures for the regulation of its affairs and the conduct of its business.

SB40,1388,11 (b) Have a seal and alter the seal at pleasure.

SB40,1388,12 (c) Maintain an office.

SB40,1388,13 (d) Sue and be sued.

SB40,1388,15 (e) Accept gifts, grants, loans, or other contributions from private or public sources.

SB40,1388,17 (f) Establish the authority's annual budget and monitor the fiscal management of the authority.

SB40,1388,19 (g) Execute contracts and other instruments, including contracts for any professional services required for the authority.

SB40,1388,21 (h) Employ any officers, agents, and employees that it may require and determine their qualifications and compensation.

SB40,1388,22 (i) Procure liability insurance.

SB40,1388,23 (2) The authority may not issue bonds.

SB40,1388,25 238.15 Catastrophic health care reinsurance program. (1) In addition to all other duties under this chapter, the authority shall do all of the following:

SB40,1389,4 (a) Study options and develop recommendations for implementing a reinsurance program to provide reinsurance to groups or individuals, or both, in this state for catastrophic claims under group or individual, or both, health insurance policies.

SB40,1389,7 (b) No later than September 15, 2008, submit to the secretary of administration a report with its recommendations for implementing a reinsurance program described in par. (a).

SB40,1389,9 (c) Develop and administer a reinsurance program in accordance with any legislation enacted that requires or authorizes the authority to do so.

SB40,1389,11 (2) (a) In developing its recommendations for a reinsurance program under sub. (1), the authority shall do all of the following:

SB40,1389,12 1. Develop guidelines for defining high-cost claims and attachment points.

SB40,1389,14 2. Set premiums to be paid for the reinsurance coverage, based on the number of covered lives included in the reinsurance pool.

SB40,1389,15 3. Set coinsurance rates for claims paid.

SB40,1389,16 4. Design all other program features.

SB40,1389,17 (b) The authority may do all of the following:

SB40,1389,20 1. Consider the impact of, and make recommendations to the governor on, allowing health benefit purchasing cooperatives to participate in a reinsurance program implemental under this section.

SB40,1389,24 2. Evaluate the challenges faced by American Indian tribes and bands in this state and other sectors of the group health insurance market and make recommendations to the governor on proposals to reduce health insurance premiums for the tribes and bands and other sectors.

SB40,1390,3 3. Explore other ways to lower health care costs and to increase access to and improve the quality of health care, including considering options for comprehensive health care reform.

SB40,1390,7 (3) The authority may contract with a vendor to administer any reinsurance program implemented under this section, including the performance of such responsibilities as estimating reinsurance premiums, paying claims, customer service, and day-to-day administration.

SB40,1390,19 238.20 Annual evaluations. Annually, after implementation of any reinsurance program under this section, the authority shall contract with an independent entity to conduct an evaluation of the program and a financial audit of the most recent fiscal year ending before the audit. The program evaluation shall include a review of best practices that may impact appropriate use of health care and disease management. The authority shall make any necessary adjustments or improvements if, as a result of the evaluation or audit, problems or deficiencies are determined to exist. After each evaluation and audit, the authority shall explore the feasibility of expanding the program to cover more state residents. The authority shall submit to the governor a report of the results of each evaluation and audit no later than January 1 of the year beginning after the year in which the evaluation and audit are conducted.

SB40, s. 3031 Section 3031. 250.041 (1m) of the statutes is amended to read:

SB40,1391,4 250.041 (1m) If an individual who applies for or to renew a registration, license, certification, approval, permit or certificate under sub. (1) does not have a social security number, the individual, as a condition of obtaining the registration, license, certification, approval, 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 registration, license, certification, approval, permit or certificate issued or renewed in reliance upon a false statement submitted under this subsection is invalid.

SB40, s. 3032 Section 3032. 250.041 (2) of the statutes is amended to read:

SB40,1391,9 250.041 (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. 3033 Section 3033. 250.041 (3) of the statutes is amended to read:

SB40,1391,23 250.041 (3) The department of health and family services shall deny an application for the issuance or renewal of a registration, license, certification, approval, permit or certificate specified in sub. (1) or may, under a memorandum of understanding under s. 49.857 (2), suspend or restrict a registration, license, certification, approval, permit or certificate 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 registration, license, certification, approval, permit or certificate 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. 3034 Section 3034. 250.17 of the statutes is created to read:

SB40,1392,5 250.17 Translational research program. (1) In this section, "translational research" means the transfer of knowledge gained from basic research to new and improved methods of preventing, diagnosing, or treating disease, as well as the transfer of clinical insights into hypotheses that can be tested and validated in the basic research laboratory.

SB40,1392,8 (2) The Medical College of Wisconsin, Inc., shall use the moneys appropriated under s. 20.250 (2) (b) for translational research projects. These moneys may not be used to supplant funds available for translational research from other sources.

SB40,1392,12 (3) Annually by January 1, the Medical College of Wisconsin, Inc., shall report to the appropriate standing committees of the legislature under s. 13.172 (3) and to the governor on the translational research projects it has conducted under sub. (2) in the previous fiscal year.

SB40, s. 3035 Section 3035. 252.04 (11) of the statutes is repealed.

SB40, s. 3036 Section 3036. 252.12 (2) (c) 1. (intro.) of the statutes is amended to read:

SB40,1392,18 252.12 (2) (c) 1. (intro.) From the appropriation under s. 20.435 (3) (5) (md), the department shall award to applying nonprofit corporations or public agencies up to $75,000 in each fiscal year, on a competitive basis, as grants for services to prevent HIV. Criteria for award of the grants shall include all of the following:

SB40, s. 3037 Section 3037. 252.16 (1) (d) of the statutes is amended to read:

SB40,1392,22 252.16 (1) (d) "Medicare" has the meaning given in s. 49.498 (1) (f) means coverage under part A, part B, or part D of Title XVIII of the federal Social Security Act, 42 USC 1395 to 1395hhh.

SB40, s. 3038 Section 3038. 252.16 (4) (a) of the statutes is amended to read:

SB40,1393,11 252.16 (4) (a) Except as provided in pars. (b) and (d), if an individual satisfies sub. (3), the department shall pay the full amount of each premium payment for the individual's health insurance coverage under the group health plan or individual health policy under sub. (3) (dm), on or after the date on which the individual becomes eligible for a subsidy under sub. (3). Except as provided in pars. (b) and (d), the department shall pay the full amount of each premium payment regardless of whether the individual's health insurance coverage under sub. (3) (dm) includes coverage of the individual's dependents. Except as provided in par. (b), the department shall terminate the payments under this section when the individual's health insurance coverage ceases or when the individual no longer satisfies sub. (3), whichever occurs first. The department may not make payments under this section for premiums for medicare, except for premiums for coverage for part D of Title XVIII of the federal Social Security Act, 42 USC 1395 to 1395hhh.

SB40, s. 3039 Section 3039. 252.241 (1m) of the statutes is amended to read:

SB40,1393,19 252.241 (1m) If an individual who applies for or to renew a license under sub. (1) does not have a social security number, the individual, as a condition of obtaining the license, 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 issued or renewed in reliance upon a false statement submitted under this subsection is invalid.

SB40, s. 3040 Section 3040. 253.06 (title) of the statutes is renumbered 49.17 (title).

SB40, s. 3041 Section 3041. 253.06 (1) of the statutes is renumbered 49.17 (1).

SB40, s. 3042 Section 3042. 253.06 (2) of the statutes is renumbered 49.17 (2) and amended to read:

SB40,1394,8 49.17 (2) Use of funds. From the appropriation under s. 20.435 (5) 20.437 (2) (em), the department shall supplement the provision of supplemental foods, nutrition education, and other services, including nutritional counseling, to low-income women, infants, and children who meet the eligibility criteria under the federal special supplemental food program for women, infants, and children authorized under 42 USC 1786. To the extent that funds are available under this section and to the extent that funds are available under 42 USC 1786, the department shall provide the supplemental food, nutrition education , and other services authorized under this section and shall administer that provision in every county. The department may enter into contracts for this purpose.

SB40, s. 3043 Section 3043. 253.06 (3) of the statutes is renumbered 49.17 (3).

SB40, s. 3044 Section 3044. 253.06 (3m) of the statutes is renumbered 49.17 (3m).

SB40, s. 3045 Section 3045. 253.06 (4) of the statutes is renumbered 49.17 (4).

SB40, s. 3046 Section 3046. 253.06 (5) (title) of the statutes is renumbered 49.17 (5) (title).

SB40, s. 3047 Section 3047. 253.06 (5) (a) of the statutes is renumbered 49.17 (5) (a).

SB40, s. 3048 Section 3048. 253.06 (5) (b) of the statutes is renumbered 49.17 (5) (b).

SB40, s. 3049 Section 3049. 253.06 (5) (c) of the statutes is renumbered 49.17 (5) (c).

SB40, s. 3050 Section 3050. 253.06 (5) (d) of the statutes is renumbered 49.17 (5) (d).

SB40, s. 3051 Section 3051. 253.06 (5) (e) of the statutes is renumbered 49.17 (5) (e) and amended to read:

SB40,1395,5 49.17 (5) (e) The suspension or termination of authorization of a vendor or eligibility of a participant shall be effective beginning on the 15th day after receipt of the notice of suspension or termination. All forfeitures, recoupments, and enforcement assessments shall be paid to the department within 15 days after receipt of notice of assessment or, if the forfeiture, recoupment, or enforcement assessment is contested under sub. (6), within 10 days after receipt of the final decision after exhaustion of administrative review, unless the final decision is adverse to the department or unless the final decision is appealed and the decision is stayed by court order under sub. (7). The department shall remit all forfeitures paid to the secretary of administration for deposit in the school fund. The department shall deposit all enforcement assessments in the appropriation under s. 20.435 (1) 20.437 (2) (gr).

SB40, s. 3052 Section 3052. 253.06 (5) (f) of the statutes is renumbered 49.17 (5) (f).

SB40, s. 3053 Section 3053. 253.06 (6) of the statutes is renumbered 49.17 (6).

SB40, s. 3054 Section 3054. 253.06 (7) of the statutes is renumbered 49.17 (7).

SB40, s. 3055 Section 3055. 253.06 (8) of the statutes is renumbered 49.17 (8).

SB40, s. 3056 Section 3056. 253.10 (3) (d) 1. of the statutes is amended to read:

SB40,1396,19 253.10 (3) (d) 1. Geographically indexed materials that are designed to inform a woman about public and private agencies, including adoption agencies, and services that are available to provide information on family planning, as defined in s. 253.07 (1) (a), including natural family planning information, to provide ultrasound imaging services, to assist her if she has received a diagnosis that her unborn child has a disability or if her pregnancy is the result of sexual assault or incest and to assist her through pregnancy, upon childbirth and while the child is dependent. The materials shall include a comprehensive list of the agencies available, a description of the services that they offer and a description of the manner in which they may be contacted, including telephone numbers and addresses, or, at the option of the department, the materials shall include a toll-free, 24-hour telephone number that may be called to obtain an oral listing of available agencies and services in the locality of the caller and a description of the services that the agencies offer and the manner in which they may be contacted. The materials shall provide information on the availability of governmentally funded programs that serve pregnant women and children. Services identified for the woman shall include medical assistance for pregnant women and children under s. 49.47 (4) (am) and 49.471, the availability of family or medical leave under s. 103.10, the Wisconsin works program under ss. 49.141 to 49.161, child care services, child support laws and programs and the credit for expenses for household and dependent care and services necessary for gainful employment under section 21 of the internal revenue code. The materials shall state that it is unlawful to perform an abortion for which consent has been coerced, that any physician who performs or induces an abortion without obtaining the woman's voluntary and informed consent is liable to her for damages in a civil action and is subject to a civil penalty, that the father of a child is liable for assistance in the support of the child, even in instances in which the father has offered to pay for an abortion, and that adoptive parents may pay the costs of prenatal care, childbirth and neonatal care. The materials shall include information, for a woman whose pregnancy is the result of sexual assault or incest, on legal protections available to the woman and her child if she wishes to oppose establishment of paternity or to terminate the father's parental rights. The materials shall state that fetal ultrasound imaging and auscultation of fetal heart tone services are obtainable by pregnant women who wish to use them and shall describe the services.

SB40, s. 3057 Section 3057. 253.115 of the statutes is repealed.

SB40, s. 3058 Section 3058. 253.12 (4) (d) of the statutes is repealed.

SB40, s. 3059 Section 3059 . 253.15 (2) of the statutes is amended to read:

SB40,1397,20 253.15 (2) Informational materials. The board shall purchase or prepare or arrange with a nonprofit organization to prepare printed and audiovisual materials relating to shaken baby syndrome and impacted babies. The materials shall include information regarding the identification and prevention of shaken baby syndrome and impacted babies, the grave effects of shaking or throwing on an infant or young child, appropriate ways to manage crying, fussing, or other causes that can lead a person to shake or throw an infant or young child, and a discussion of ways to reduce the risks that can lead a person to shake or throw an infant or young child. The materials shall be prepared in English, Spanish, and other languages spoken by a significant number of state residents, as determined by the board. The board shall make those written and audiovisual materials available to all hospitals, maternity homes, and nurse-midwives licensed under s. 441.15 that are required to provide or make available materials to parents under sub. (3) (a) 1., to the department and to all county departments and nonprofit organizations that are required to provide the materials to day care providers under sub. (4), and to all school boards and nonprofit organizations that are permitted to provide the materials to pupils in one of grades 5 to 8 and in one of grades 10 to 12 under sub. (5). The board shall also make those written materials available to all county departments and Indian tribes that are providing home visitation services under s. 46.515 48.983 (4) (b) 1. or 2. and to all providers of prenatal, postpartum, and young child care coordination services under s. 49.45 (44). The board may make available the materials required under this subsection to be made available by making those materials available at no charge on the board's Internet site.

SB40, s. 3060 Section 3060 . 253.15 (2) of the statutes, as affected by 2007 Wisconsin Act .... (this act), is amended to read: