Legislation

AB 871 (SB 742 merged with this bill) – Wisconsin

Status: Enacted
Year Introduced: 2018
Link: http://docs.legis.wisconsin.gov/2017/proposals/reg/asm/bill/ab871

This bill requires the Department of Health Services to create a program to reimburse hospitals and health care systems for intensive care coordination services provided to Medical Assistance recipients. Subject to some limitations, DHS must develop a process for selecting hospitals and health care systems that submit an application including a description of their programs as specified in the bill, including a statement that the hospital or health care system will use emergency department utilization data to identify Medical Assistance recipients to receive intensive care coordination to reduce use of the emergency department.

Under the bill, DHS reimburses a hospital or health care system participating in the program $250 initially for each Medical Assistance recipient who is not a Medicare recipient who is enrolled in intensive care coordination for six months. If the participant demonstrates progress in reducing emergency department visits for at least half of its enrollee population, the participant receives an additional $250 per enrollee. The program participant may enroll each Medical Assistance recipient in the program for an additional six months for an additional initial reimbursement of $250 per enrollee and, if the participant demonstrates progress in reducing emergency department visits for at least half of its enrollee population, $250 per enrollee at the end of the additional six months.

Enacted at Wis. Stat. §§ 49.45 (26g), 946.91 (3)(c)3, and 946.93(5)(c)3.


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