AB75-SSA1, s. 1299 25Section 1299. 49.45 (18) (b) 2. of the statutes is amended to read:
AB75-SSA1,611,4
149.45 (18) (b) 2. Any service provided to a person who is less than 18 years old.
2This subdivision does not apply if the person's family income exceeds 100 percent of
3the poverty line and he or she is eligible for the benefits under s. 49.46 (2) (a) and (b)
4under s. 49.471.
AB75-SSA1, s. 1301 5Section 1301. 49.45 (23) (b) of the statutes is amended to read:
AB75-SSA1,611,136 49.45 (23) (b) If the waiver is granted and in effect, the department may
7promulgate rules defining the health care benefit plan, including more specific
8eligibility requirements and cost-sharing requirements. Cost sharing may include
9an annual enrollment fee, which may not exceed $75 per year.
Notwithstanding s.
10227.24 (3), the plan details under this subsection may be promulgated as an
11emergency rule under s. 227.24 without a finding of emergency. If the waiver is
12granted and in effect, the demonstration project under this subsection shall begin on
13January 1, 2009, or on the effective date of the waiver, whichever is later.
AB75-SSA1, s. 1301e 14Section 1301e. 49.45 (24g) of the statutes is created to read:
AB75-SSA1,611,1715 49.45 (24g) Physician practice payment pilot. (a) The department shall
16develop a proposal to increase medical assistance reimbursement to providers to
17which at least one of the following applies:
AB75-SSA1,611,1918 1. The provider is recognized by the National Committee on Quality Assurance
19as a Patient-Centered Medical Home.
AB75-SSA1,611,2120 2. The secretary determines that the provider performs well with respect to all
21of the following aspects of care:
AB75-SSA1,611,2222 a. Adoption of written standards for patient access and patient communication.
AB75-SSA1,611,2423 b. Use of data to show that standards for patient access and patient
24communication are satisfied.
AB75-SSA1,611,2525 c. Use of paper or electronic charting tools to organize clinical information.
AB75-SSA1,612,2
1d. Use of data to identify diagnoses and conditions among the provider's
2patients that have a lasting detrimental effect on health.
AB75-SSA1,612,43 e. Adoption and implementation of guidelines that are based on evidence for
4treatment and management of at least 3 chronic conditions.
AB75-SSA1,612,55 f. Active support of patient self-management.
AB75-SSA1,612,76 g. Systematic tracking of patient test results and systematic identification of
7abnormal patient test results.
AB75-SSA1,612,88 h. Systematic tracking of referrals using a paper or electronic system.
AB75-SSA1,612,119 i. Measuring the quality of the performance of the physician practice and of
10individual physicians within the practice, including with respect to provision of
11clinical services, patient outcomes, and patient safety.
AB75-SSA1,612,1312 j. Reporting to members of the physician practice and to other persons on the
13quality of the performance of the physician practice and of individual physicians.
AB75-SSA1,612,2114 (c) The department's proposal under par. (a) shall specify increases in
15reimbursement rates for providers that satisfy the conditions under par. (a) 1. or 2.,
16and shall provide for payment of a monthly per-patient care coordination fee to those
17providers. The department shall set the increases in reimbursement rates and the
18monthly per-patient care coordination fee so that together they provide sufficient
19incentive for providers to satisfy a condition under par. (a) 1. or 2. The proposal shall
20specify effective dates for the increases in reimbursement rates and the monthly
21per-patient care coordination fee that are no sooner than July 1, 2011.
AB75-SSA1,613,1322 (d) By the date that is 60 days after the effective date of this paragraph .... [LRB
23inserts date], the department shall submit the proposal under par. (a) to the joint
24committee on finance. If the cochairpersons of the committee do not notify the
25department within 14 working days after the date of the department's submittal that

1the committee has scheduled a meeting for the purpose of reviewing the proposal, the
2department shall, subject to approval by the U.S. department of health and human
3services of any required waiver of federal law relating to medical assistance and any
4required amendment to the state plan for medical assistance under 42 USC 1396a,
5implement the proposal beginning January 1, 2010. If, within 14 working days after
6the date of the department's submittal, the cochairpersons of the committee notify
7the department that the committee has scheduled a meeting for the purpose of
8reviewing the proposal, the department may implement the proposal only upon
9approval of the committee. If the committee reviews the proposal and approves it,
10the department shall, subject to approval by the U.S. department of health and
11human services of any required waiver of federal law relating to medical assistance
12and any required amendment to the state plan for medical assistance under 42 USC
131396a
, implement the proposal beginning January 1, 2010.
AB75-SSA1,614,214 (e) By the first day of the 39th month beginning after the effective date of this
15paragraph .... [LRB inserts date], the department shall, if it was required under par.
16(d) to increase reimbursement to providers that satisfy a condition under par. (a) 1.
17or 2., submit a report to the joint committee on finance on whether the increased
18reimbursement results in net cost reductions for the Medical Assistance program
19under this subchapter and a recommendation as to whether to continue the
20increased reimbursement. If the cochairpersons of the committee do not notify the
21department within 14 working days after the date of the department's submittal that
22the committee has scheduled a meeting for the purpose of reviewing the report and
23recommendation, the department may implement its recommendation. If, within 14
24working days after the date of the department's submittal, the cochairpersons of the
25committee notify the department that the committee has scheduled a meeting for the

1purpose of reviewing the report and recommendation, the department may
2discontinue the increased reimbursement only upon the approval of the committee.
AB75-SSA1, s. 1302 3Section 1302. 49.45 (24r) of the statutes is renumbered 49.45 (24r) (a) and
4amended to read:
AB75-SSA1,614,115 49.45 (24r) (a) The department shall request a implement any waiver from
6granted by the secretary of the federal department of health and human services to
7permit the department to conduct a demonstration project to provide family
8planning, as defined in s. 253.07 (1) (a), under medical assistance to any woman
9between the ages of 15 and 44 whose family income does not exceed 200% of the
10poverty line for a family the size of the woman's family. The department shall
11implement any waiver granted.
AB75-SSA1, s. 1303 12Section 1303. 49.45 (24r) (b) of the statutes is created to read:
AB75-SSA1,614,1713 49.45 (24r) (b) The department may request an amended waiver from the
14secretary to permit the department to conduct a demonstration project to provide
15family planning to any man between the ages of 15 and 44 whose family income does
16not exceed 200 percent of the poverty line for a family the size of the man's family.
17If the amended waiver is granted, the department may implement the waiver.
AB75-SSA1, s. 1304 18Section 1304. 49.45 (25) (be) of the statutes is amended to read:
AB75-SSA1,614,2419 49.45 (25) (be) A private nonprofit agency that is a certified case management
20provider may elect to provide case management services to medical assistance
21beneficiaries who have HIV infection, as defined in s. 252.01 (2). The amount of the
22allowable charges for those services under the medical assistance program that is not
23provided by the federal government shall be paid from the appropriation account
24under s. 20.435 (5) (1) (am).
AB75-SSA1, s. 1305 25Section 1305. 49.45 (25) (bg) of the statutes is amended to read:
AB75-SSA1,615,8
149.45 (25) (bg) An independent living center, as defined in s. 46.96 (1) (ah), that
2is a certified case management provider and satisfies the criteria in s. 46.96 (3m) (a)
31. to 3. and (am)
may elect to provide case management services to one or more of the
4categories of medical assistance beneficiaries specified under par. (am). The amount
5of allowable charges for the services under the medical assistance program that is
6not provided by the federal government shall be paid from nonfederal, public funds
7received by the independent living center from a county, city, village or town or from
8funds distributed as a grant under s. 46.96.
AB75-SSA1, s. 1305r 9Section 1305r. 49.45 (30f) of the statutes is created to read:
AB75-SSA1,615,2310 49.45 (30f) Psychotherapy and alcohol and other drug abuse services. The
11department shall include licensed mental health professionals, as defined in s.
12632.89 (1) (dm), and licensed psychologists, as defined in s. 455.01 (4), as providers
13of psychotherapy and of alcohol and other drug abuse services. Except for services
14provided under sub. (30e), the department may not require that licensed mental
15health professionals or licensed psychologists be supervised; may not require that
16clinical psychotherapy or alcohol and other drug abuse services be provided under
17a certified program; and, notwithstanding subs. (9) and (9m), may not require that
18a physician or other health care provider first prescribe psychotherapy or alcohol and
19other drug abuse services to be provided by a licensed mental health professional or
20licensed psychologist before the professional or psychologist may provide the
21services to the recipient. This subsection does not affect the department's powers
22under ch. 50 or 51 to establish requirements for facilities that are licensed, certified,
23or operated by the department.
AB75-SSA1, s. 1306 24Section 1306. 49.45 (30g) of the statutes is created to read:
AB75-SSA1,616,4
149.45 (30g) Community recovery services. (a) When services are reimbursable.
2Community recovery services under s. 49.46 (2) (b) 6. Lo. provided to an individual
3are reimbursable under the Medical Assistance program only if all of the following
4conditions are met:
AB75-SSA1,616,75 1. An approved amendment to the state medical assistance plan submitted
6under 42 USC 1396n (i) permits reimbursement for the services under s. 49.46 (2)
7(b) 6. Lo. in the manner provided under this subsection.
AB75-SSA1,616,108 2. The county in which the individual resides elects to provide the community
9recovery services under s. 49.46 (2) (b) 6. Lo. through the Medical Assistance
10program.
AB75-SSA1,616,1311 3. The individual, the community recovery services, and the community
12recovery services provider meet any condition set forth in the approved amendment
13to the medical assistance plan submitted under 42 USC 1396n (i).
AB75-SSA1,616,2214 (b) Limit on the amount of reimbursement. If community recovery services are
15reimbursable under par. (a), the department shall reimburse each participating
16county for the portion of the federal share of allowable charges for the community
17recovery services provided by the county that exceeds that county's proportionate
18share of $600,000 in fiscal year 2010-2011 and for 95 percent of the federal share of
19allowable charges for the community recovery services provided by the county in
20each fiscal year thereafter. The portion of the federal share of allowable charges not
21reimbursed to counties shall be transferred to the appropriation account under s.
2220.435 (5) (kx).
AB75-SSA1, s. 1307 23Section 1307. 49.45 (30m) (am) of the statutes is renumbered 49.45 (30m) (am)
241.
AB75-SSA1, s. 1308 25Section 1308. 49.45 (30m) (am) 2. of the statutes is created to read:
AB75-SSA1,617,6
149.45 (30m) (am) 2. For individuals receiving the family care benefit under s.
246.286, the care management organization that manages the family care benefit for
3the recipient shall pay the portion of the payment that is not covered by the federal
4government for services that are described under par. (a) 1. and are covered services
5under the family care benefit; the department shall pay the remainder of the portion
6of the payment that is not covered by the federal government.
AB75-SSA1, s. 1309 7Section 1309. 49.45 (30r) of the statutes is created to read:
AB75-SSA1,617,108 49.45 (30r) Services in a mental health institute. A county shall provide the
9portion of payment that is not provided by the federal government for services under
10s. 49.46 (2) (b) 6. e. in a mental health institute under s. 51.05.
AB75-SSA1, s. 1310 11Section 1310. 49.45 (41) (b) of the statutes is amended to read:
AB75-SSA1,617,2112 49.45 (41) (b) If a county elects to become certified as a provider of mental
13health crisis intervention services, the county may provide mental health crisis
14intervention services under this subsection in the county to medical assistance
15recipients through the medical assistance program. A county that elects to provide
16the services shall pay the amount of the allowable charges for the services under the
17medical assistance program that is not provided by the federal government. The
18From the appropriation account under s. 20.435 (5) (bL), the department shall
19reimburse the county under this subsection only for the amount of the allowable
20charges for those services under the medical assistance program that is provided by
21the federal government.
AB75-SSA1, s. 1311 22Section 1311. 49.45 (42) of the statutes is renumbered 49.45 (42) (d).
AB75-SSA1, s. 1312 23Section 1312. 49.45 (42) (c) of the statutes is created to read:
AB75-SSA1,618,3
149.45 (42) (c) The department may charge a fee to certify a provider of personal
2care services described under par. (d) 3. e. Fees collected under this paragraph shall
3be credited to the appropriation account under s. 20.435 (6) (jm).
AB75-SSA1, s. 1313 4Section 1313. 49.45 (42) (d) 3. of the statutes is created to read:
AB75-SSA1,618,65 49.45 (42) (d) 3. The provider of the personal care services is one of the
6following:
AB75-SSA1,618,87 a. An independent living center meeting the criteria to receive a grant under
8s. 46.96.
AB75-SSA1,618,99 b. A county department under s. 46.215, 46.22, 46.23, 51.42, or 51.437.
AB75-SSA1,618,1110 c. A federally recognized American Indian tribe or band certified to provide
11services to medical assistance beneficiaries.
AB75-SSA1,618,1212 d. A home health agency licensed under s. 50.49.
AB75-SSA1,618,1413 e. Any other entity certified under sub. (2) (a) 11. to provide personal care
14services under s. 49.46 (2) (b) 6. j.
AB75-SSA1, s. 1313k 15Section 1313k. 49.45 (44) of the statutes is amended to read:
AB75-SSA1,619,316 49.45 (44) Prenatal, postpartum and young child care coordination.
17Providers in Milwaukee County that are certified to provide care coordination
18services under s. 49.46 (2) (b) 12. may be certified to provide to medical assistance
19recipients prenatal and postpartum care coordination services and care coordination
20services for children who have not attained the age of 7. Providers in the city of
21Racine that are certified to provide care coordination services under s. 49.46 (2) (b)
2212. and are participating in a program under s. 253.16 may be certified to provide to
23medical assistance recipients prenatal and postpartum care coordination services
24and care coordination services for children who have not attained the age of 2.
A
25provider of those care coordination services shall provide to a person receiving those

1services the information relating to shaken baby syndrome and impacted babies
2required under s. 253.15 (6). The department shall provide reimbursement for those
3care coordination services only if at least one of the following conditions is met:
AB75-SSA1,619,74 (a) The recipient is a resident of Milwaukee County or the city of Racine and
5has received services under s. 49.46 (2) (b) 12. and is pregnant or has given birth
6within 8 weeks after the individual ceased to receive services under s. 49.46 (2) (b)
712.
AB75-SSA1,619,98 (b) The recipient is a resident of Milwaukee County or the city of Racine, is
9pregnant and has received a risk assessment approved by the department.
AB75-SSA1,619,1210 (c) The recipient is a resident of Milwaukee County or the city of Racine, has
11given birth within the 8 weeks immediately preceding the request for services under
12s. 49.46 (2) (b) 12m. and has received a risk assessment approved by the department.
AB75-SSA1, s. 1314 13Section 1314. 49.45 (47) (c) of the statutes is amended to read:
AB75-SSA1,619,1614 49.45 (47) (c) The biennial fee for the certification required under par. (b) of an
15adult day care center is $100 $127. Fees collected under this paragraph shall be
16credited to the appropriation account under s. 20.435 (6) (jm).
AB75-SSA1, s. 1315 17Section 1315. 49.45 (47) (e) of the statutes is created to read:
AB75-SSA1,619,2218 49.45 (47) (e) If the department takes enforcement action against an adult day
19care center for violating a certification requirement established under s. 49.45 (2) (a)
2011., and the department subsequently conducts an on-site inspection of the adult day
21care center to review the adult day care center's action to correct the violation, the
22department may impose a $200 inspection fee on the adult day care center.
AB75-SSA1, s. 1316 23Section 1316. 49.45 (52) of the statutes, as affected by 2009 Wisconsin Act 2,
24is amended to read:
AB75-SSA1,620,12
149.45 (52) Payment adjustments. Beginning on January 1, 2003, the
2department may, from the appropriation account under s. 20.435 (7) (b), make
3Medical Assistance payment adjustments to county departments under s. 46.215,
446.22, 46.23, or 51.42, or 51.437 or to local health departments, as defined in s. 250.01
5(4), as appropriate, for covered services under s. 49.46 (2) (a) 2. and 4. d. and f. and
6(b) 6. b., c., f., fm., g., j., k., L., Lm., and m., 9., 12., 12m., 13., 15., and 16, except for
7services specified under s. 49.46 (2) (b) 6. b. and c. provided to children participating
8in the early intervention program under s. 51.44
. Payment adjustments under this
9subsection shall include the state share of the payments. The total of any payment
10adjustments under this subsection and Medical Assistance payments made from
11appropriation accounts under s. 20.435 (4) (b), (o), and (w), may not exceed applicable
12limitations on payments under 42 USC 1396a (a) (30) (A).
AB75-SSA1, s. 1317 13Section 1317. 49.45 (54) of the statutes is created to read:
AB75-SSA1,620,2514 49.45 (54) Therapy for children participating in the birth to 3 program. (a)
15Federal share for county expenditures. If a county certifies to the department that
16the amount the county expended to provide services specified under s. 49.46 (2) (b)
176. b. and c. to children participating in the early intervention program under s. 51.44
18exceeds the amount the county received as reimbursement under this section, based
19on reimbursement rates established by the department for those services, and the
20federal government pays the state the federal share of Medical Assistance for the
21amount by which the county expenditures exceed the reimbursement, the
22department may disburse the federal share to the county. A county that receives
23moneys under this paragraph shall expend the moneys for early intervention
24services under s. 51.44 or for services under the disabled children's long-term
25support program, as defined in s. 46.011 (1g).
AB75-SSA1,621,12
1(b) Services provided by special educators. If a county provides services to
2assess and promote skill acquisition to children who are participating in the early
3intervention program under s. 51.44 and the services are provided by a special
4educator who is a certified provider of medical assistance, the department shall
5reimburse the county the federal share of medical assistance for the county's
6allowable charges for providing the services. The county shall pay the the remaining
7expenses for the services. The department shall promulgate rules establishing
8certification requirements for special educators who provide service under this
9paragraph, and requirements for county reporting of expenditures for services under
10this paragraph. A county that receives moneys under this paragraph shall expend
11the moneys for early intervention services under s. 51.44 or for services under the
12disabled children's long-term support program, as defined in s. 46.011 (1g).
AB75-SSA1, s. 1318 13Section 1318. 49.46 (1) (a) 5. of the statutes is amended to read:
AB75-SSA1,621,1614 49.46 (1) (a) 5. Any child in an adoption assistance, foster care, treatment foster
15care,
or subsidized guardianship placement under ch. 48 or 938, as determined by
16the department.
AB75-SSA1, s. 1319 17Section 1319. 49.46 (1) (a) 16. of the statutes is repealed.
AB75-SSA1, s. 1320 18Section 1320. 49.46 (1) (d) 1. of the statutes is amended to read:
AB75-SSA1,621,2419 49.46 (1) (d) 1. Children who are placed in licensed foster homes or licensed
20treatment foster homes
by the department and who would be eligible for payment
21of aid to families with dependent children in foster homes or treatment foster homes
22except that their placement is not made by a county department under s. 46.215,
2346.22, or 46.23 will be considered as recipients of aid to families with dependent
24children.
AB75-SSA1, s. 1321 25Section 1321. 49.46 (2) (b) 3. of the statutes is amended to read:
AB75-SSA1,622,6
149.46 (2) (b) 3. Transportation by emergency medical vehicle to obtain
2emergency medical care, transportation by specialized medical vehicle to obtain
3medical care including the unloaded travel of the specialized medical vehicle
4necessary to provide that transportation, or, if authorized in advance by the county
5department under s. 46.215 or 46.22,
transportation by common carrier or private
6motor vehicle to obtain medical care.
AB75-SSA1, s. 1321r 7Section 1321r. 49.46 (2) (b) 6. (intro.) of the statutes is amended to read:
AB75-SSA1,622,98 49.46 (2) (b) 6. (intro.) The following services if that, other than under subd.
96. f., fm., k., and Lr., are
prescribed by a physician:
AB75-SSA1, s. 1322 10Section 1322. 49.46 (2) (b) 6. e. of the statutes is amended to read:
AB75-SSA1,622,1511 49.46 (2) (b) 6. e. Inpatient Subject to the limitation under s. 49.45 (30r),
12inpatient
hospital, skilled nursing facility and intermediate care facility services for
13patients of any institution for mental diseases who are under 21 years of age, are
14under 22 years of age and who were receiving these services immediately prior to
15reaching age 21, or are 65 years of age or older.
AB75-SSA1, s. 1323 16Section 1323. 49.46 (2) (b) 6. Lo. of the statutes is created to read:
AB75-SSA1,622,1817 49.46 (2) (b) 6. Lo. Subject to the limitations under s. 49.45 (30g), community
18recovery services.
AB75-SSA1, s. 1323c 19Section 1323c. 49.46 (2) (b) 6. Lr. of the statutes is created to read:
AB75-SSA1,622,2120 49.46 (2) (b) 6. Lr. Psychotherapy and alcohol and other drug abuse services,
21as specified under s. 49.45 (30f).
AB75-SSA1, s. 1324 22Section 1324. 49.46 (2) (b) 8. of the statutes is amended to read:
AB75-SSA1,623,223 49.46 (2) (b) 8. Home or community-based services, if provided under s. 46.27
24(11), 46.275, 46.277, 46.278, or 46.2785, 46.99, or under the family care benefit if a

1waiver is in effect under s. 46.281 (1d), or under the disabled children's long-term
2support program, as defined in s. 46.011 (1g).
AB75-SSA1, s. 1325 3Section 1325. 49.46 (2) (b) 17. of the statutes is created to read:
AB75-SSA1,623,54 49.46 (2) (b) 17. Services under s. 49.45 (54) (b) for children participating in the
5early intervention program under s. 51.44, that are provided by a special educator.
AB75-SSA1, s. 1326 6Section 1326. 49.46 (2) (d) of the statutes is amended to read:
AB75-SSA1,623,127 49.46 (2) (d) Benefits authorized under this subsection may not include
8payment for that part of any service payable through 3rd-party liability or any
9federal, state, county, municipal, or private benefit system to which the beneficiary
10is entitled. "Benefit system" does not include any public assistance program such as,
11but not limited to, Hill-Burton benefits under 42 USC 291c (e), in effect on April 30,
121980, or relief funded by a relief block grant.
Loading...
Loading...