Date of enactment:
2023 Senate Bill 592 Date of publication*:
2023 WISCONSIN ACT
AN ACT to create 49.45 (9r) (f) of the statutes; relating to: reimbursement under the Medical Assistance program
for complex rehabilitation technology wheelchair repairs and accessories.
The people of the state of Wisconsin, represented in
senate and assembly, do enact as follows:
SECTION 1. 49.45 (9r) (f) of the statutes is created to
read:
49.45 (9r) (f) 1. In this paragraph, “KU modifier”
means a modifier used in the federal Medicare program
related to an exemption from competitive bidding pric-
ing.
2. For dates of service beginning on the effective date
of this subdivision .... [LRB inserts date], the department
shall, for healthcare common procedure coding system
codes relating to complex rehabilitation technology
wheelchair repair and accessories, apply a reimburse-
ment rate under the Medical Assistance program equiva-
lent to the maximum fee paid in Wisconsin under the fed-
eral Medicare program, including fees under the KU
modifier, if applicable.
3. Beginning July 1, 2025, and annually thereafter,
the department shall submit to the chief clerk of each
house of the legislature for distribution to the legislature
under s. 13.172 (2) a report that includes all of the follow-
ing information:
a. The total number of units.
b. The total number of claims.
c. The total number of claims per provider.
d. The average dollar amount of all paid claims.
e. The average dollar amount of claims paid per
provider.
f. The total dollar amount paid per provider.
g. A calculation of the amount paid to the provider
compared to the amount paid to the provider if the reim-
bursement were through fee−for−service under the Medi-
cal Assistance program under this subchapter.
h. The number of repairs done per unit during the last
year.
SECTION 1m.0Nonstatutory provisions.
(1) No later than July 1, 2025, the department of
health services shall, in the manner provided under s.
13.172 (3), submit to the appropriate standing committee
in each house of the legislature with jurisdiction over
health issues a report that describes all of the following
regarding complex rehabilitation technology under the
Medical Assistance program under subch. IV of ch. 49:
(a) The number of complex rehabilitation technology
suppliers certified as providers for the Medical Assist-
ance program in the state as of December 31, 2024, com-
pared to December 31, 2017.
(b) The effect of 2017 Wisconsin Act 306 on the
access and availability of complex rehabilitation technol-
ogy for recipients under the Medical Assistance program.
(2) The report under sub. (1) shall include an assess-
ment of whether payment rates for complex rehabilitation
* Section 991.11, WISCONSIN STATUTES: Effective date of acts. “Every act and every portion of an act enacted by the legislature over the governor’s
partial veto which does not expressly prescribe the time when it takes effect shall take effect on the day after its date of publication.” − 2 −2023 Wisconsin Act 2023 Senate Bill 592
technology are adequate to ensure complex needs patients
have access to complex rehabilitation technology.
SECTION 2.0Initial applicability.
(1) The reimbursement rate under s. 49.45 (9r) (f)
first applies to a 3rd−party payer with which the depart-
ment of health services contracts under s. 49.45 (2) (b) 2.
for the provision of health care to Medical Assistance
recipients on the day on which that 3rd−party payer’s
contract with the department is newly established,
extended, modified, or renewed.