Wisconsin 2023-2024 Regular Session

Wisconsin Senate Bill SB434 Compare Versions

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Old	New	Differences
1	1	LRB-1406/3
2	2	JPC:cdc&amn
3	3	2023 - 2024 LEGISLATURE
4	4	2023 SENATE BILL 434
5	5	September 20, 2023 - Introduced by Senators FELZKOWSKI, TESTIN, BALLWEG,
6	6	COWLES, FEYEN, MARKLEIN, NASS, STAFSHOLT and TAYLOR, cosponsored by
7	7	Representatives PLUMER, SPIROS, BEHNKE, BRANDTJEN, BROOKS, DONOVAN,
8	8	EDMING, GOEBEN, MAGNAFICI, MURPHY, NOVAK, O'CONNOR, ROZAR and MURSAU.
9	9	Referred to Committee on Insurance and Small Business.
10	10	*AUTHORS SUBJECT TO CHANGE*
11	11	AN ACT to amend 49.45 (9r) (e) (intro.); and to create 49.45 (9r) (dm) of the
12	12	statutes; relating to: repair of complex rehabilitation technology under the
13	13	Medical Assistance program.
14	14	Analysis by the Legislative Reference Bureau
15	15	Under current law, the Department of Health Services is required to
16	16	promulgate rules that establish which medical supplies and equipment are covered
17	17	by Medical Assistance and under what conditions they will be reimbursed. This bill
18	18	prohibits DHS from requiring a prescription and prior authorization before
19	19	reimbursing a provider for the repair of complex rehabilitation technology if the
20	20	complex rehabilitation technology was previously prescribed and reimbursed under
21	21	Medical Assistance, unless the complex rehabilitation technology is intended for use
22	22	by an individual who is enrolled in a managed care organization. Under current law,
23	23	“complex rehabilitation technology” is defined to mean items classified within
24	24	Medicare as durable medical equipment that are individually configured for
25	25	individuals to meet their specific and unique medical, physical, and functional needs
26	26	and capacities for basic activities of daily living and instrumental activities of daily
27	27	living identified as medically necessary. The Medical Assistance program is a joint
28	28	federal and state program administered by DHS that provides health services to
29	29	individuals who have limited financial resources.
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32	32	3 - 2 -2023 - 2024 Legislature LRB-1406/3
33	33	JPC:cdc&amn
34	34	SENATE BILL 434
35	35	For further information see the state fiscal estimate, which will be printed as
36	36	an appendix to this bill.
37	37	The people of the state of Wisconsin, represented in senate and assembly, do
38	38	enact as follows:
39	39	SECTION 1. 49.45 (9r) (dm) of the statutes is created to read:
40	40	49.45 (9r) (dm) The department may not require a prescription or prior
41	41	authorization to reimburse a provider for the repair of complex rehabilitation
42	42	technology if the complex rehabilitation technology has been prescribed and
43	43	reimbursed as provided in this subsection. This paragraph does not apply to the
44	44	repair of complex rehabilitation technology if the complex rehabilitation technology
45	45	is intended for use by an individual who is enrolled in a managed care organization.
46	46	SECTION 2. 49.45 (9r) (e) (intro.) of the statutes is amended to read:
47	47	49.45 (9r) (e) (intro.) The Except as provided in par. (dm), the department shall,
48	48	consistent with this subsection and without imposing any additional requirements
49	49	or restrictions under this subsection, reimburse a provider for a complex
50	50	rehabilitation technology with prior authorization when prescribed by a physician,
51	51	medically necessary, and used by a recipient of Medical Assistance who is a resident
52	52	of a nursing home if the complex rehabilitation technology will do any of the
53	53	following:
54	54	(END)
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