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2023 - 2024 LEGISLATURE
2023 ASSEMBLY BILL 259
May 8, 2023 - Introduced by Representatives HURD, EDMING, SCHRAA, ARMSTRONG,
MACCO, MOSES, NOVAK, CALLAHAN, TITTL, MICHALSKI, O'CONNOR, KITCHENS,
MURPHY, ROZAR, TRANEL, GREEN, SAPIK, MURSAU, GUNDRUM, SUMMERFIELD,
BRANDTJEN, DUCHOW, PETRYK, RETTINGER, PLUMER, BROOKS, SCHMIDT, TUSLER
and MAXEY, cosponsored by Senators QUINN, WANGGAARD, FEYEN, JACQUE,
JAMES, CABRAL-GUEVARA, TOMCZYK, COWLES and MARKLEIN. Referred to
Committee on Health, Aging and Long-Term Care.
***AUTHORS SUBJECT TO CHANGE***
AN ACT to create 49.688 (3m) of the statutes; relating to: 100-day prescription
drug supplies under SeniorCare and amending an administrative rule related
to 100-day prescription drug supplies permitted under SeniorCare.
Analysis by the Legislative Reference Bureau
This bill allows SeniorCare participants to purchase, per a prescription order
by the prescribing health care provider, 100-day supplies of prescription drugs
authorized under administrative rules promulgated by the Department of Health
Services and otherwise covered through the SeniorCare program, at the rates
provided under the program. The bill requires DHS to apply for any waiver or
amendment to a waiver of federal Medicaid laws necessary to permit DHS to
implement the provisions of the bill.
The SeniorCare program provides assistance to the elderly in the purchase of
prescription drugs. Under current law, to be eligible for SeniorCare, a person must
be a resident of the state, be at least 65 years of age, not be a recipient of prescription
drug coverage through Medical Assistance, have a household income that does not
exceed 240 percent of the federal poverty line, and pay a program enrollment fee.
Under current law, under the SeniorCare program, only certain maintenance drugs
specified by DHS may be dispensed in amounts up to a 100-day supply. All other
prescription drugs dispensed under the SeniorCare program may be dispensed only
in amounts not to exceed a 34-day supply.
Contingent upon approval by the federal secretary of health and human
services of a waiver or amendment to a waiver requested as required under the bill,
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ASSEMBLY BILL 259
the bill amends the existing DHS administrative rule that allows SeniorCare
providers to dispense certain maintenance drugs in amounts up to but not exceeding
a 100-day supply, as prescribed by a physician. As amended under the bill, the DHS
administrative rule would allow SeniorCare providers to dispense the maintenance
drugs allowed under current law, or any other drug, as determined by DHS on the
basis of clinical considerations, safety, costs, and other factors. If the federal
secretary of health and human services denies the request for a waiver or an
amendment to a waiver, the bill's treatment of the administrative rule is void.
For further information see the state fiscal estimate, which will be printed as
an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SECTION 1. 49.688 (3m) of the statutes is created to read:
49.688 (3m) Per a prescription order by the prescribing health care provider,
a person eligible under sub. (2) may purchase, and a pharmacist, pharmacy, or
dispensing physician may dispense, a prescription drug authorized under
administrative rules promulgated by the department and otherwise covered under
this section at the rates provided in this section in amounts up to a 100-day supply.
SECTION 2. DHS 109.31 (3) (e) of the administrative code is amended to read:
DHS 109.31 (3) (e) SeniorCare providers may dispense certain maintenance
drugs specified under s. DHS 107.10 (3) (e) or any other drug, as determined by the
department on the basis of clinical considerations, safety, costs, and other factors, in
amounts up to but not to exceed a 100-day supply, as prescribed by a physician.
SECTION 3.0Nonstatutory provisions.
(1) SENIORCARE 100-DAY PRESCRIPTION DRUG SUPPLIES. The department of health
services shall request from the federal secretary of health and human services any
waiver of federal medicaid laws or amendment to a waiver of federal medicaid laws
necessary to permit the department of health services to implement s. 49.688 (3m).
The department shall implement any waiver or amendment to a waiver received
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SECTION 3
ASSEMBLY BILL 259
under this subsection. The department shall notify the legislative reference bureau
of the approval or denial of any waiver or amendment to a waiver received under this
subsection. If a waiver or amendment to a waiver under this subsection is approved,
the legislative reference bureau shall publish the notice in the Wisconsin
Administrative Register with a statement of the date on which the treatment of the
administrative rules takes effect, as determined under SECTION 4 of this act.
SECTION 4.0Effective dates. This act takes effect on the day after publication,
except as follows:
(1) The treatment of administrative rules takes effect upon approval by the
federal secretary of health and human services of a waiver or amendment to a waiver
requested under SECTION 3 (1). If a waiver or amendment to a waiver requested
under Section 3 (1) is denied, the treatment of administrative rules is void.
(END)
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