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2023 - 2024 LEGISLATURE
2023 ASSEMBLY BILL 923
January 12, 2024 - Introduced by Representatives SORTWELL, GOEBEN, MURSAU,
RODRIGUEZ, BALDEH and O'CONNOR, cosponsored by Senators COWLES and
JAMES. Referred to Committee on Transportation.
***AUTHORS SUBJECT TO CHANGE***
AN ACT to amend 46.283 (5); and to create 46.283 (4) (k), 46.283 (6m) and 49.45
(3d) of the statutes; relating to: specialized transportation assistance pilot
program.
Analysis by the Legislative Reference Bureau
This bill requires the Department of Health Services to establish a specialized
transportation assistance pilot program through which DHS may allow an aging and
disability resource center (ADRC) to coordinate or contract with a mobility
management organization to coordinate the provision of specialized transportation
assistance services for individuals in need of those services. The bill requires DHS
to divide the state into three regions to conduct the pilot program. Under the bill,
specialized transportation assistance programs include nonemergency medical
transportation (NEMT); transportation waiver services for individuals eligible
through long-term care programs under the Medical Assistance program;
specialized transportation assistance programs through the Department of
Transportation; services provided to assist veterans with nonemergency medical
transportation; or any other federal, state, or local program that provides specialized
transportation assistance services to assist the elderly or individuals with
disabilities or funding for such services.
The bill requires any ADRC that participates in the program to submit an
annual report of its activities to DHS and to the Department of Transportation,
including a description of the number of individuals served by the program and the
effect of the program on access to specialized transportation assistance services. The
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bill also requires DHS, in coordination with DOT, to submit an annual report to the
legislature regarding the status of the program and any recommended changes,
including information regarding whether the program should be continued. Under
the bill, DOT is required, in coordination with DHS, to form an advisory group to
advise both DOT and DHS regarding implementation pilot program, coordinate with
the pilot regions, and provide recommendations regarding possible changes to the
program.
Subject to any necessary federal approval, the bill also requires, in any contract
for the arrangement and reimbursement of nonemergency medical transportation
services to recipients of Medical Assistance, that DHS include provisions allowing
providers of NEMT to offer transportation for purposes other than NEMT, to be paid
for by the recipient of the transportation or another source, as an extension of an
NEMT trip. Under the program, DHS would still provide reimbursement under the
Medical Assistance program only for the NEMT portion of a trip, but a provider of
NEMT services would be allowed to offer the Medical Assistance recipient—or
another source on behalf of the recipient—the opportunity to pay to extend the
transportation for other purposes as part of the same trip at the same rate offered
for the NEMT under the Medical Assistance program.
Under the program, DHS must also include in the contract for NEMT services
provisions requiring providers to collect, for both NEMT services and any extended
services offered by a provider, information including, if applicable, trip log data,
summary information on all calls for services and contacts with Medical Assistance
recipients, encounter data based on Centers for Medicare and Medicaid Services
1500 claim form data, network provider information, accident and moving violation
reports, vehicle reports, complaint summary reports, telecommunications system
reports, annual fiscal audit reports, and daily reports including numbers of trips,
canceled trips, denied trips, and complaints.
To the extent NEMT services for Medical Assistance recipients may be
permitted to be coordinated with other transportation services needed by Medical
Assistance recipients, an ADRC may include in its coordination services
coordination of such specialized transportation assistance services for Medical
Assistance recipients.
For further information see the state and local 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. 46.283 (4) (k) of the statutes is created to read:
46.283 (4) (k) If participating in the specialized transportation assistance pilot
program under sub. (6m), administer or contract with a mobility management
organization to administer coordination of specialized transportation assistance
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services as described under sub. (6m). This paragraph does not apply after June 30,
2027.
SECTION 2. 46.283 (5) of the statutes is amended to read:
46.283 (5) FUNDING. From the appropriation accounts under s. 20.435 (1) (n),
(4) (b), (bd), (bm), (gm), (pa), and (w), and (7) (b) and (md), the department may
contract with organizations that meet standards under sub. (3) for performance of
the duties under sub. (4) and shall distribute funds for services provided by resource
centers, including services under sub. (6m).
SECTION 3. 46.283 (6m) of the statutes is created to read:
46.283 (6m) SPECIALIZED TRANSPORTATION ASSISTANCE PILOT PROGRAM. (a) The
department shall establish a specialized transportation assistance pilot program
through which the department may allow a resource center to coordinate or contract
with a mobility management organization to coordinate the provision of specialized
transportation assistance services for individuals in need of those services. The
department shall divide the state into a northeast region, southeast region, and
western regions to conduct the pilot program under this subsection. For purposes
of the pilot program under this subsection, specialized transportation assistance
services include nonemergency medical transportation as described under s. 49.46
(2) (b) 3.; transportation waiver services for individuals who meet financial and
nonfinancial eligibility criteria for long-term care programs under the Medical
Assistance program; any specialized transportation assistance program
administered or provided by the department of transportation and described under
ch. 85, including state paratransit aid under s. 85.205, the county assistance
program under s. 85.21, the tribal elderly transportation grant program under s.
85.215, or enhanced mobility program under s. 85.22; services provided to assist
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veterans with nonemergency medical transportation under s. 45.41 (4) (a) or 45.83
(1); or under any other federal, state, or local program that provides specialized
transportation assistance services to assist the elderly or individuals with
disabilities or funding for such services. A resource center or an organization
contracted to provide coordination services under this subsection shall assist
individuals with utilizing specialized transportation services by coordinating
payment from existing local, state, and federal funding sources.
(b) To the extent permitted under s. 49.45 (3d), coordination of specialized
transportation assistance services under this subsection may include coordination
of nonemergency medical transportation available to recipients under the Medical
Assistance program with other transportation services needed by these individuals.
(c) Any resource center that participates in the program under this subsection
shall submit an annual report of its activities to the department and to the
department of transportation, including a description of the number of individuals
served by the program and the effect of the program on access to specialized
transportation assistance services.
(d) Beginning on June 30, 2024, and annually thereafter, the department, in
coordination with the department of transportation, shall submit a report to the chief
clerk of each house of the legislature for distribution to the legislature under s.
13.172 (2) regarding the status of the program and any recommended changes,
including information regarding whether the program should be continued.
(e) This subsection does not apply after June 30, 2027.
SECTION 4. 49.45 (3d) of the statutes is created to read:
49.45 (3d) COORDINATION OF MEDICAL ASSISTANCE NONEMERGENCY MEDICAL
TRANSPORTATION WITH OTHER TRANSPORTATION. (a) Subject to par. (c), the department
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shall, to the extent permitted by the contract, modify the contract that is in effect on
the effective date of this paragraph .... [LRB inserts date], for the arrangement and
reimbursement of nonemergency medical transportation services to recipients of
Medical Assistance under this subchapter to allow providers of nonemergency
medical transportation to offer transportation for purposes other than
nonemergency medical transportation, to be paid for by the recipient of the
transportation, either directly or through another source, as an extension of a
nonemergency medical transportation trip. Subject to par. (c), if the department
establishes a new contract for the arrangement and reimbursement of
nonemergency medical transportation services to recipients of Medical Assistance
under this subchapter, the department shall include in the new contract provisions
to allow providers of nonemergency medical transportation services to offer
transportation for purposes other than nonemergency medical transportation, to be
paid for by the recipient of the transportation, either directly or through another
source, as an extension of a nonemergency medical transportation trip. Subject to
par. (c), the department shall provide reimbursement under s. 49.46 (2) (b) 3. for only
the nonemergency medical transportation portion of a trip, and the recipient of
Medical Assistance under this subchapter is responsible for payment of any
remaining costs. The department shall require, in any contract provision regarding
the arrangement and reimbursement of nonemergency medical transportation
services to recipients of Medical Assistance under this subchapter, that if a provider
of nonemergency medical transportation services chooses to offer the additional
service described under this paragraph, the provider shall offer the service to the
recipient at the same rate charged for nonemergency medical transportation.
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(b) The department shall include in any contract provisions under this
subsection a requirement that a nonemergency medical transportation provider
submit to the department, for both nonemergency medical transportation services
and any extended services offered as described under par. (a), information
substantially similar to the information required under the original contract in effect
on the effective date of this paragraph .... [LRB inserts date], including, if applicable,
trip log data, summary information on all calls for services and contacts with Medical
Assistance recipients, encounter data based on Centers for Medicare and Medicaid
Services 1500 claim form data, network provider information, accident and moving
violation reports, vehicle reports, complaint summary reports, telecommunications
system reports, annual fiscal audit reports, and daily reports including numbers of
trips, canceled trips, denied trips, and complaints.
(c) The department shall submit to the federal department of health and
human services any request for a state plan amendment, waiver of federal law, or
other federal approval necessary to provide reimbursement under par. (a) and allow
providers of nonemergency medical transportation services to offer transportation
for purposes other than nonemergency medical transportation to be paid for not by
the Medical Assistance program under this subchapter, but by the recipient of the
transportation, either directly or through another source, as an extension of a
nonemergency medical transportation trip allowed under the Medical Assistance
program. If the federal department of health and human services approves the
request or if no federal approval is necessary, the department shall allow
nonemergency medical transportation services providers to offer the services
described under par. (a). If the federal department of health and human services
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disapproves the request, the department may not allow nonemergency medical
transportation services providers to offer the services described under par. (a).
SECTION 5.0Nonstatutory provisions.
(1) SPECIALIZED TRANSPORTATION SERVICES ADVISORY COUNCIL. The secretary of
transportation shall form, in coordination with the department of health services, an
advisory group to advise both the department of transportation and the department
of health services regarding implementation of the specialized transportation
services pilot program under s. 46.283 (6m), coordinate with the pilot regions
established by the department of health services for the program, and provide
recommendations regarding possible changes to the program.
(END)
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