1 | 1 | | LRB-5402/1 |
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2 | 2 | | SWB:cdc |
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3 | 3 | | 2023 - 2024 LEGISLATURE |
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4 | 4 | | 2023 ASSEMBLY BILL 923 |
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5 | 5 | | January 12, 2024 - Introduced by Representatives SORTWELL, GOEBEN, MURSAU, |
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6 | 6 | | RODRIGUEZ, BALDEH and O'CONNOR, cosponsored by Senators COWLES and |
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7 | 7 | | JAMES. Referred to Committee on Transportation. |
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8 | 8 | | ***AUTHORS SUBJECT TO CHANGE*** |
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9 | 9 | | AN ACT to amend 46.283 (5); and to create 46.283 (4) (k), 46.283 (6m) and 49.45 |
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10 | 10 | | (3d) of the statutes; relating to: specialized transportation assistance pilot |
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11 | 11 | | program. |
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12 | 12 | | Analysis by the Legislative Reference Bureau |
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13 | 13 | | This bill requires the Department of Health Services to establish a specialized |
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14 | 14 | | transportation assistance pilot program through which DHS may allow an aging and |
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15 | 15 | | disability resource center (ADRC) to coordinate or contract with a mobility |
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16 | 16 | | management organization to coordinate the provision of specialized transportation |
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17 | 17 | | assistance services for individuals in need of those services. The bill requires DHS |
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18 | 18 | | to divide the state into three regions to conduct the pilot program. Under the bill, |
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19 | 19 | | specialized transportation assistance programs include nonemergency medical |
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20 | 20 | | transportation (NEMT); transportation waiver services for individuals eligible |
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21 | 21 | | through long-term care programs under the Medical Assistance program; |
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22 | 22 | | specialized transportation assistance programs through the Department of |
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23 | 23 | | Transportation; services provided to assist veterans with nonemergency medical |
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24 | 24 | | transportation; or any other federal, state, or local program that provides specialized |
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25 | 25 | | transportation assistance services to assist the elderly or individuals with |
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26 | 26 | | disabilities or funding for such services. |
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27 | 27 | | The bill requires any ADRC that participates in the program to submit an |
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28 | 28 | | annual report of its activities to DHS and to the Department of Transportation, |
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29 | 29 | | including a description of the number of individuals served by the program and the |
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30 | 30 | | effect of the program on access to specialized transportation assistance services. The |
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34 | 34 | | SWB:cdc |
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35 | 35 | | ASSEMBLY BILL 923 |
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36 | 36 | | bill also requires DHS, in coordination with DOT, to submit an annual report to the |
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37 | 37 | | legislature regarding the status of the program and any recommended changes, |
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38 | 38 | | including information regarding whether the program should be continued. Under |
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39 | 39 | | the bill, DOT is required, in coordination with DHS, to form an advisory group to |
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40 | 40 | | advise both DOT and DHS regarding implementation pilot program, coordinate with |
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41 | 41 | | the pilot regions, and provide recommendations regarding possible changes to the |
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42 | 42 | | program. |
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43 | 43 | | Subject to any necessary federal approval, the bill also requires, in any contract |
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44 | 44 | | for the arrangement and reimbursement of nonemergency medical transportation |
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45 | 45 | | services to recipients of Medical Assistance, that DHS include provisions allowing |
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46 | 46 | | providers of NEMT to offer transportation for purposes other than NEMT, to be paid |
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47 | 47 | | for by the recipient of the transportation or another source, as an extension of an |
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48 | 48 | | NEMT trip. Under the program, DHS would still provide reimbursement under the |
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49 | 49 | | Medical Assistance program only for the NEMT portion of a trip, but a provider of |
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50 | 50 | | NEMT services would be allowed to offer the Medical Assistance recipient—or |
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51 | 51 | | another source on behalf of the recipient—the opportunity to pay to extend the |
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52 | 52 | | transportation for other purposes as part of the same trip at the same rate offered |
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53 | 53 | | for the NEMT under the Medical Assistance program. |
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54 | 54 | | Under the program, DHS must also include in the contract for NEMT services |
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55 | 55 | | provisions requiring providers to collect, for both NEMT services and any extended |
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56 | 56 | | services offered by a provider, information including, if applicable, trip log data, |
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57 | 57 | | summary information on all calls for services and contacts with Medical Assistance |
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58 | 58 | | recipients, encounter data based on Centers for Medicare and Medicaid Services |
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59 | 59 | | 1500 claim form data, network provider information, accident and moving violation |
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60 | 60 | | reports, vehicle reports, complaint summary reports, telecommunications system |
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61 | 61 | | reports, annual fiscal audit reports, and daily reports including numbers of trips, |
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62 | 62 | | canceled trips, denied trips, and complaints. |
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63 | 63 | | To the extent NEMT services for Medical Assistance recipients may be |
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64 | 64 | | permitted to be coordinated with other transportation services needed by Medical |
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65 | 65 | | Assistance recipients, an ADRC may include in its coordination services |
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66 | 66 | | coordination of such specialized transportation assistance services for Medical |
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67 | 67 | | Assistance recipients. |
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68 | 68 | | For further information see the state and local fiscal estimate, which will be |
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69 | 69 | | printed as an appendix to this bill. |
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70 | 70 | | The people of the state of Wisconsin, represented in senate and assembly, do |
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71 | 71 | | enact as follows: |
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72 | 72 | | SECTION 1. 46.283 (4) (k) of the statutes is created to read: |
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73 | 73 | | 46.283 (4) (k) If participating in the specialized transportation assistance pilot |
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74 | 74 | | program under sub. (6m), administer or contract with a mobility management |
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75 | 75 | | organization to administer coordination of specialized transportation assistance |
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79 | 79 | | 4 - 3 -2023 - 2024 Legislature |
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80 | 80 | | LRB-5402/1 |
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81 | 81 | | SWB:cdc |
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82 | 82 | | SECTION 1 |
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83 | 83 | | ASSEMBLY BILL 923 |
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84 | 84 | | services as described under sub. (6m). This paragraph does not apply after June 30, |
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85 | 85 | | 2027. |
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86 | 86 | | SECTION 2. 46.283 (5) of the statutes is amended to read: |
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87 | 87 | | 46.283 (5) FUNDING. From the appropriation accounts under s. 20.435 (1) (n), |
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88 | 88 | | (4) (b), (bd), (bm), (gm), (pa), and (w), and (7) (b) and (md), the department may |
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89 | 89 | | contract with organizations that meet standards under sub. (3) for performance of |
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90 | 90 | | the duties under sub. (4) and shall distribute funds for services provided by resource |
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91 | 91 | | centers, including services under sub. (6m). |
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92 | 92 | | SECTION 3. 46.283 (6m) of the statutes is created to read: |
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93 | 93 | | 46.283 (6m) SPECIALIZED TRANSPORTATION ASSISTANCE PILOT PROGRAM. (a) The |
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94 | 94 | | department shall establish a specialized transportation assistance pilot program |
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95 | 95 | | through which the department may allow a resource center to coordinate or contract |
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96 | 96 | | with a mobility management organization to coordinate the provision of specialized |
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97 | 97 | | transportation assistance services for individuals in need of those services. The |
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98 | 98 | | department shall divide the state into a northeast region, southeast region, and |
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99 | 99 | | western regions to conduct the pilot program under this subsection. For purposes |
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100 | 100 | | of the pilot program under this subsection, specialized transportation assistance |
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101 | 101 | | services include nonemergency medical transportation as described under s. 49.46 |
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102 | 102 | | (2) (b) 3.; transportation waiver services for individuals who meet financial and |
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103 | 103 | | nonfinancial eligibility criteria for long-term care programs under the Medical |
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104 | 104 | | Assistance program; any specialized transportation assistance program |
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105 | 105 | | administered or provided by the department of transportation and described under |
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106 | 106 | | ch. 85, including state paratransit aid under s. 85.205, the county assistance |
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107 | 107 | | program under s. 85.21, the tribal elderly transportation grant program under s. |
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108 | 108 | | 85.215, or enhanced mobility program under s. 85.22; services provided to assist |
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133 | 133 | | 25 - 4 -2023 - 2024 Legislature LRB-5402/1 |
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134 | 134 | | SWB:cdc |
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135 | 135 | | SECTION 3 ASSEMBLY BILL 923 |
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136 | 136 | | veterans with nonemergency medical transportation under s. 45.41 (4) (a) or 45.83 |
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137 | 137 | | (1); or under any other federal, state, or local program that provides specialized |
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138 | 138 | | transportation assistance services to assist the elderly or individuals with |
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139 | 139 | | disabilities or funding for such services. A resource center or an organization |
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140 | 140 | | contracted to provide coordination services under this subsection shall assist |
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141 | 141 | | individuals with utilizing specialized transportation services by coordinating |
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142 | 142 | | payment from existing local, state, and federal funding sources. |
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143 | 143 | | (b) To the extent permitted under s. 49.45 (3d), coordination of specialized |
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144 | 144 | | transportation assistance services under this subsection may include coordination |
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145 | 145 | | of nonemergency medical transportation available to recipients under the Medical |
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146 | 146 | | Assistance program with other transportation services needed by these individuals. |
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147 | 147 | | (c) Any resource center that participates in the program under this subsection |
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148 | 148 | | shall submit an annual report of its activities to the department and to the |
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149 | 149 | | department of transportation, including a description of the number of individuals |
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150 | 150 | | served by the program and the effect of the program on access to specialized |
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151 | 151 | | transportation assistance services. |
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152 | 152 | | (d) Beginning on June 30, 2024, and annually thereafter, the department, in |
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153 | 153 | | coordination with the department of transportation, shall submit a report to the chief |
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154 | 154 | | clerk of each house of the legislature for distribution to the legislature under s. |
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155 | 155 | | 13.172 (2) regarding the status of the program and any recommended changes, |
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156 | 156 | | including information regarding whether the program should be continued. |
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157 | 157 | | (e) This subsection does not apply after June 30, 2027. |
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158 | 158 | | SECTION 4. 49.45 (3d) of the statutes is created to read: |
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159 | 159 | | 49.45 (3d) COORDINATION OF MEDICAL ASSISTANCE NONEMERGENCY MEDICAL |
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160 | 160 | | TRANSPORTATION WITH OTHER TRANSPORTATION. (a) Subject to par. (c), the department |
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185 | 185 | | 25 - 5 -2023 - 2024 Legislature |
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186 | 186 | | LRB-5402/1 |
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187 | 187 | | SWB:cdc |
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188 | 188 | | SECTION 4 |
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189 | 189 | | ASSEMBLY BILL 923 |
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190 | 190 | | shall, to the extent permitted by the contract, modify the contract that is in effect on |
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191 | 191 | | the effective date of this paragraph .... [LRB inserts date], for the arrangement and |
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192 | 192 | | reimbursement of nonemergency medical transportation services to recipients of |
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193 | 193 | | Medical Assistance under this subchapter to allow providers of nonemergency |
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194 | 194 | | medical transportation to offer transportation for purposes other than |
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195 | 195 | | nonemergency medical transportation, to be paid for by the recipient of the |
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196 | 196 | | transportation, either directly or through another source, as an extension of a |
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197 | 197 | | nonemergency medical transportation trip. Subject to par. (c), if the department |
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198 | 198 | | establishes a new contract for the arrangement and reimbursement of |
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199 | 199 | | nonemergency medical transportation services to recipients of Medical Assistance |
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200 | 200 | | under this subchapter, the department shall include in the new contract provisions |
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201 | 201 | | to allow providers of nonemergency medical transportation services to offer |
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202 | 202 | | transportation for purposes other than nonemergency medical transportation, to be |
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203 | 203 | | paid for by the recipient of the transportation, either directly or through another |
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204 | 204 | | source, as an extension of a nonemergency medical transportation trip. Subject to |
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205 | 205 | | par. (c), the department shall provide reimbursement under s. 49.46 (2) (b) 3. for only |
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206 | 206 | | the nonemergency medical transportation portion of a trip, and the recipient of |
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207 | 207 | | Medical Assistance under this subchapter is responsible for payment of any |
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208 | 208 | | remaining costs. The department shall require, in any contract provision regarding |
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209 | 209 | | the arrangement and reimbursement of nonemergency medical transportation |
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210 | 210 | | services to recipients of Medical Assistance under this subchapter, that if a provider |
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211 | 211 | | of nonemergency medical transportation services chooses to offer the additional |
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212 | 212 | | service described under this paragraph, the provider shall offer the service to the |
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213 | 213 | | recipient at the same rate charged for nonemergency medical transportation. |
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237 | 237 | | 24 - 6 -2023 - 2024 Legislature LRB-5402/1 |
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238 | 238 | | SWB:cdc |
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239 | 239 | | SECTION 4 ASSEMBLY BILL 923 |
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240 | 240 | | (b) The department shall include in any contract provisions under this |
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241 | 241 | | subsection a requirement that a nonemergency medical transportation provider |
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242 | 242 | | submit to the department, for both nonemergency medical transportation services |
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243 | 243 | | and any extended services offered as described under par. (a), information |
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244 | 244 | | substantially similar to the information required under the original contract in effect |
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245 | 245 | | on the effective date of this paragraph .... [LRB inserts date], including, if applicable, |
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246 | 246 | | trip log data, summary information on all calls for services and contacts with Medical |
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247 | 247 | | Assistance recipients, encounter data based on Centers for Medicare and Medicaid |
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248 | 248 | | Services 1500 claim form data, network provider information, accident and moving |
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249 | 249 | | violation reports, vehicle reports, complaint summary reports, telecommunications |
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250 | 250 | | system reports, annual fiscal audit reports, and daily reports including numbers of |
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251 | 251 | | trips, canceled trips, denied trips, and complaints. |
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252 | 252 | | (c) The department shall submit to the federal department of health and |
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253 | 253 | | human services any request for a state plan amendment, waiver of federal law, or |
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254 | 254 | | other federal approval necessary to provide reimbursement under par. (a) and allow |
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255 | 255 | | providers of nonemergency medical transportation services to offer transportation |
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256 | 256 | | for purposes other than nonemergency medical transportation to be paid for not by |
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257 | 257 | | the Medical Assistance program under this subchapter, but by the recipient of the |
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258 | 258 | | transportation, either directly or through another source, as an extension of a |
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259 | 259 | | nonemergency medical transportation trip allowed under the Medical Assistance |
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260 | 260 | | program. If the federal department of health and human services approves the |
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261 | 261 | | request or if no federal approval is necessary, the department shall allow |
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262 | 262 | | nonemergency medical transportation services providers to offer the services |
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263 | 263 | | described under par. (a). If the federal department of health and human services |
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287 | 287 | | 24 - 7 -2023 - 2024 Legislature |
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288 | 288 | | LRB-5402/1 |
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289 | 289 | | SWB:cdc |
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290 | 290 | | SECTION 4 |
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291 | 291 | | ASSEMBLY BILL 923 |
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292 | 292 | | disapproves the request, the department may not allow nonemergency medical |
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293 | 293 | | transportation services providers to offer the services described under par. (a). |
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294 | 294 | | SECTION 5.0Nonstatutory provisions. |
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295 | 295 | | (1) SPECIALIZED TRANSPORTATION SERVICES ADVISORY COUNCIL. The secretary of |
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296 | 296 | | transportation shall form, in coordination with the department of health services, an |
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297 | 297 | | advisory group to advise both the department of transportation and the department |
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298 | 298 | | of health services regarding implementation of the specialized transportation |
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299 | 299 | | services pilot program under s. 46.283 (6m), coordinate with the pilot regions |
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300 | 300 | | established by the department of health services for the program, and provide |
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301 | 301 | | recommendations regarding possible changes to the program. |
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302 | 302 | | (END) |
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