LRB-1911/1
DAK:lmk:nwn
2007 - 2008 LEGISLATURE
April 13, 2007 - Introduced by Senators Roessler, Darling, Olsen and Schultz,
cosponsored by Representatives
Strachota and Albers. Referred to
Committee on Health and Human Services.
SB147,1,3
1An Act to create 49.45 (55), 49.45 (56), 49.665 (4g) and 49.665 (4m) of the
2statutes;
relating to: requiring a disease management program and health
3risk assessments.
Analysis by the Legislative Reference Bureau
Currently, the Department of Health and Family Services (DHFS) administers
the Medical Assistance (MA) program and the Badger Care health care program,
which provide health care benefits for eligible individuals (generally, pregnant
women, certain children, and elderly or disabled individuals, all of whom must meet
specific low-income or low asset requirements). Families, children who do not reside
with their parents, and unborn children whose mothers are not eligible for MA or
Badger Care may be eligible for Badger Care if their incomes do not exceed 185
percent of the federal poverty line and they meet certain nonfinancial criteria.
This bill requires that a physical health risk assessment be performed for every
individual who is eligible for MA or for Badger Care. Based on the health conditions
identified by the health risk assessments, DHFS must develop and implement, for
MA and Badger Care recipients, disease management programs. These programs
must use information science to improve health care delivery; educate health care
providers on health care process improvement by developing best practice models;
improve and expand care management programs; establish a system of provider
compensation that is aligned with clinical quality, practice management, and care
cost; and focus on patient care interventions for certain chronic conditions.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SB147, s. 1
1Section
1. 49.45 (55) of the statutes is created to read:
SB147,2,82
49.45
(55) Disease management program. Based on the health conditions
3identified by the physical health risk assessments required to be performed under
4sub. (56), the department shall develop and implement, for Medical Assistance
5recipients, disease management programs that are similar to that developed and
6followed by the Marshfield Clinic in this state under the Physician Group Practice
7Demonstration Program authorized under
42 USC 1315 (e) and (f). These programs
8shall have at least the following characteristics:
SB147,2,119
(a) The use of information science to improve health care delivery by
10summarizing a patient's health status and providing reminders for preventive
11measures.
SB147,2,1312
(b) Educating health care providers on health care process improvement by
13developing best practice models.
SB147,2,1614
(c) The improvement and expansion of care management programs to assist in
15standardization of best practices, patient education, support systems, and
16information gathering.
SB147,2,1817
(d)
Establishment of a system of provider compensation that is aligned with
18clinical quality, practice management, and cost of care.
SB147,2,2019
(e) Focus on patient care interventions for certain chronic conditions, to reduce
20hospital admissions.
SB147, s. 2
21Section
2. 49.45 (56) of the statutes is created to read:
SB147,3,3
149.45
(56) Physical health risk assessment. For each individual who is
2determined to be eligible for Medical Assistance, the department shall cause to be
3performed a physical health risk assessment.
SB147, s. 3
4Section
3. 49.665 (4g) of the statutes is created to read:
SB147,3,115
49.665
(4g) Disease management program. Based on the health conditions
6identified by the physical health risk assessments required to be performed under
7sub. (4m), the department shall develop and implement, for individuals who are
8eligible under sub. (4), disease management programs that are similar to that
9developed and followed by the Marshfield Clinic in this state under the Physician
10Group Practice Demonstration Program authorized under
42 USC 1315 (e) and (f).
11These programs shall have at least the following characteristics:
SB147,3,1412
(a) The use of information science to improve health care delivery by
13summarizing a patient's health status and providing reminders for preventive
14measures.
SB147,3,1615
(b) Educating health care providers on health care process improvement by
16developing best practice models.
SB147,3,1917
(c) The improvement and expansion of care management programs to assist in
18standardization of best practices, patient education, support systems, and
19information gathering.
SB147,3,2120
(d)
Establishment of a system of provider compensation that is aligned with
21clinical quality, practice management, and cost of care.
SB147,3,2322
(e) Focus on patient care interventions for certain chronic conditions, to reduce
23hospital admissions.
SB147, s. 4
24Section
4. 49.665 (4m) of the statutes is created to read:
SB147,4,3
149.665
(4m) Health risk assessment required. For each individual who is
2determined to be eligible under sub. (4), the department shall cause to be performed
3a physical health risk assessment.
SB147, s. 5
4Section
5.
Effective dates. This act takes effect on the day after publication,
5except as follows:
SB147,4,86
(1)
Disease management programs. The treatment of sections 49.45 (55) and
749.665 (4) of the statutes takes effect on the first day of the 7th month beginning after
8publication.
