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2023 - 2024 LEGISLATURE
2023 ASSEMBLY BILL 687
November 27, 2023 - Introduced by Representatives SCHUTT, DITTRICH, BARE,
DONOVAN, MURSAU, RETTINGER, ROZAR and SUBECK, cosponsored by Senators
FELZKOWSKI and BALLWEG. Referred to Committee on Health, Aging and
Long-Term Care.
***AUTHORS SUBJECT TO CHANGE***
AN ACT to create 49.45 (49r) of the statutes; relating to: value-based
purchasing arrangements under the Medical Assistance program.
Analysis by the Legislative Reference Bureau
This bill allows the Department of Health Services to enter into a value-based
purchasing arrangement with a drug manufacturer for purposes of the Medical
Assistance program. Under the bill, a value-based purchasing arrangement must
have agreed upon metrics and may include rebates, discounts, price reductions, risk
sharing, reimbursements, payment deferrals or installment payments, guarantees,
shared savings payments, withholds, bonuses, or any other thing of value. The bill
specifies that nothing in the bill may be construed to alter or modify coverage
requirements under the Medical Assistance program. The Medical Assistance
program is a joint federal and state program that provides health services to
individuals who have limited financial resources.
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. 49.45 (49r) of the statutes is created to read:
49.45 (49r) VALUE-BASED PURCHASING. (a) In this subsection, “manufacturer”
has the meaning given in s. 450.01 (12).
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(b) Subject to par. (e), the department may enter into a value-based purchasing
arrangement for the Medical Assistance program by written agreement with a
manufacturer based on agreed upon metrics to which the department and the
manufacturer agree in writing. A value-based purchasing arrangement under this
paragraph may include any of the following:
1. Rebates.
2. Discounts.
3. Price reductions.
4. Risk sharing.
5. Reimbursements.
6. Payment deferrals or installment payments.
7. Guarantees.
8. Shared savings payments.
9. Withholds.
10. Bonuses.
11. Any other thing of value.
(c) Nothing in this subsection may be interpreted to require a manufacturer or
the department to enter into an arrangement described under par. (a).
(d) Nothing in this subsection may be construed to alter or modify coverage
requirements under the Medical Assistance program.
(e) If the department determines it is unable to implement this subsection
without a waiver of federal law, state plan amendment, or other federal approval, the
department shall request from the secretary of the federal department of health and
human services any waiver of federal law, state plan amendment, or other federal
approval necessary to implement this subsection. If the federal department of health
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and human services does not approve a waiver of federal law, state plan amendment,
or other federal approval under this paragraph, the department is not required to
implement this subsection.
(END)
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