AB870,3,1714
(b) Beginning January 1, 2001, the rate for reimbursement for drugs under s.
1549.46 (2) (b) 6. h. in selected categories, as determined by the department, is the
16average wholesale price minus 15% or the maximum allowable cost, as determined
17by the department, whichever is less.
AB870, s. 3
18Section
3. 49.47 (4) (aq) of the statutes is created to read:
AB870,3,2219
49.47
(4) (aq) 1. Subject to subd. 2., an individual who does not meet the
20limitation on income under par. (c) is eligible for medical assistance if the individual
21is 65 years of age or older and the individual's income does not exceed 100% of the
22federal poverty level.
AB870,4,223
2. If a federal waiver is necessary to provide medical assistance to individuals
24specified in subd. 1., the department shall request a waiver from the secretary of the
1federal department of health and human services before providing medical
2assistance under this paragraph.
AB870, s. 4
3Section
4. 49.47 (4) (b) 2m. b. of the statutes is amended to read:
AB870,4,64
49.47
(4) (b) 2m. b. For persons who are eligible under par. (a)
3. or 4.
or (aq),
5motor vehicles are exempt from consideration as an asset to the same extent as
6provided under
42 USC 1381 to
1385.
AB870, s. 5
7Section
5. 49.47 (4) (b) 2r. of the statutes is amended to read:
AB870,4,118
49.47
(4) (b) 2r. For a person who is eligible under par. (a)
3. or 4.
or (aq), the
9value of any burial space or agreement representing the purchase of a burial space
10held for the purpose of providing a place for the burial of the person or any member
11of his or her immediate family.
AB870, s. 6
12Section
6. 49.47 (4) (b) 2w. of the statutes is amended to read:
AB870,4,1513
49.47
(4) (b) 2w. For a person who is eligible under par. (a)
3. or 4.
or (aq), life
14insurance with cash surrender values if the total face value of all life insurance
15policies is not more than $1,500.
AB870, s. 7
16Section
7. 49.47 (4) (b) 3. of the statutes is amended to read:
AB870,4,2117
49.47
(4) (b) 3. For a person who is eligible under par. (a)
3. or 4.
or (aq), funds
18set aside to meet the burial and related expenses of the person and his or her spouse
19in an amount not to exceed $1,500 each, minus the sum of the cash value of any life
20insurance excluded under subd. 2w. and the amount in any irrevocable burial trust
21under s. 445.125 (1) (a).
AB870, s. 8
22Section
8. 49.47 (4) (c) 1. of the statutes is amended to read:
AB870,5,823
49.47
(4) (c) 1. Except as provided in
par. pars. (am)
and (aq) and as limited by
24subd. 3., eligibility exists if income does not exceed 133 1/3% of the maximum aid to
25families with dependent children payment under s. 49.19 (11) for the applicant's
1family size or the combined benefit amount available under supplemental security
2income under
42 USC 1381 to
1383c and state supplemental aid under s. 49.77
3whichever is higher. In this subdivision "income" includes earned or unearned
4income that would be included in determining eligibility for the individual or family
5under s. 49.19 or 49.77, or for the aged, blind or disabled under
42 USC 1381 to
1385.
6"Income" does not include earned or unearned income which would be excluded in
7determining eligibility for the individual or family under s. 49.19 or 49.77, or for the
8aged, blind or disabled individual under
42 USC 1381 to
1385.
AB870, s. 9
9Section
9. 49.47 (4) (c) 3. of the statutes is amended to read:
AB870,5,1310
49.47
(4) (c) 3. Except as provided in
par. pars. (am)
and (aq), no person is
11eligible for medical assistance under this section if the person's income exceeds the
12maximum income levels that the U.S. department of health and human services sets
13for federal financial participation under
42 USC 1396b (f).
AB870, s. 10
14Section
10. 49.47 (4) (i) 2. (intro.) of the statutes is amended to read:
AB870,5,1715
49.47
(4) (i) 2. (intro.) Notwithstanding par. (b) 2r. and 3., a person who is
16described in par. (a)
3. or 4.
or (aq) is not eligible for benefits under this section if any
17of the following criteria is met:
AB870, s. 11
18Section
11. 49.688 of the statutes is created to read:
AB870,5,20
1949.688 Prescription drug charges; low-income elderly persons. (1) In
20this section:
AB870,5,2121
(a) "Prescription drug" has the meaning given in s. 450.01 (20).
AB870,5,2222
(b) "Prescription order" has the meaning given in s. 450.01 (21).
AB870,6,4
23(2) Beginning January 1, 2001, as a condition of participation by a pharmacy
24or pharmacist in the program under ss. 49.45, 49.46 and 49.47, the pharmacy or
25pharmacist may not charge a person who presents a valid prescription order and a
1card indicating that he or she meets eligibility requirements under sub. (3) an
2amount for a prescription drug for outpatient care under the order that exceeds the
3medical assistance reimbursement rate for providing the corresponding legend drug
4under s. 49.46 (2) (b) 6. h.
AB870,6,10
5(3) A person who is at least 65 years of age, who is ineligible for medical
6assistance and whose income does not exceed 185% of the poverty line is eligible to
7purchase a prescription drug at the amount specified in sub. (2). The person may
8apply to the department, on a form provided by the department, for a determination
9of eligibility and issuance of a prescription drug card for purchase of prescription
10drugs under this section.
AB870,6,14
11(4) The department shall devise and distribute a form for application for the
12program under this section, shall determine eligibility of applicants and shall issue
13to eligible persons a prescription drug card for use in purchasing prescription drugs
14at the amount specified in sub. (2).
AB870,6,20
15(5) The department shall, for the purposes of sub. (2), calculate and transmit
16to pharmacies and pharmacists that are certified providers of medical assistance the
17medical assistance reimbursement rates for providing legend drugs under s. 49.46
18(2) (b) 6. h. and any additional discounts on the drugs. The department shall
19periodically update this information and transmit the updated rates to pharmacies
20and pharmacists.
AB870,6,23
21(6) The department shall provide information and education to pharmacies,
22pharmacists and persons aged at least 65 years concerning the program under this
23section and concerning the preferred drugs under s. 49.45 (2) (a) 25.
AB870,7,9
1[1999 [Wisconsin Act 9] Section 9123 (9n)
Limitation on reduction of
2reimbursement for pharmaceutical drugs. During the 1999-2001 fiscal biennium,
3except for pharmaceutical drugs in selected categories, as determined by the
4department, the department of health and family services may not discount the
5average wholesale price of pharmaceutical drugs provided under section 49.45 of the
6statutes to medical assistance recipients by more than 10% if the department
7reimburses for those pharmaceuticals under a formula that takes into account the
8average wholesale price, and the department may not reduce pharmacy dispensing
9fees.
AB870, s. 13
10Section
13.
Appropriation changes; health and family services.
AB870,7,1711
(1)
Prescription drug assistance for elderly; administration. In the schedule
12under section 20.005 (3) of the statutes for the appropriation to the department of
13health and family services under section 20.435 (4) (a) of the statutes, as affected by
14the acts of 1999, the dollar amount is increased by $1,000,000 for fiscal year 1999-00
15and the dollar amount is increased by $1,000,000 for fiscal year 2000-01 to increase
16funding for administration of the prescription drug assistance for elderly program
17under section 49.688 of the statutes, as created by this act.
AB870,7,2218
(2)
Expanded medical assistance eligibility; benefit. In the schedule under
19section 20.005 (3) of the statutes for the appropriation to the department of health
20and family services under section 20.435 (4) (b) of the statutes, as affected by the acts
21of 1999, the dollar amount is increased by $1,2000,000 for fiscal year 2000-01 to
22increase funding for expanded eligibility for medical assistance program benefits.
AB870,8,323
(3)
Expanded medical assistance eligibility; administration. In the schedule
24under section 20.005 (3) of the statutes for the appropriation to the department of
25health and family services under section 20.435 (4) (bm) of the statutes, as affected
1by the acts of 1999, the dollar amount is increased by $1,000,000 for fiscal year
22000-01 to increase funding for administration of expanded eligibility for medical
3assistance program benefits.
AB870,8,75
(1) The treatment of section 49.47 (4) (aq), (b) 2m. b., 2r., 2w. and 3., (c) 1. and
63. and (i) (2) (intro.) of the statutes first applies to eligibility determinations made
7for medical assistance on January 1, 2001.
AB870, s. 15
8Section
15.
Effective dates. This act takes effect on the day after publication,
9except as follows:
AB870,8,1110
(1)
Medical assistance reimbursement for pharmaceutical drugs. The
11treatment of
Section 12 of this act takes effect on January 1, 2001.
