2023 - 2024 LEGISLATURE
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2023 SENATE BILL 242
April 14, 2023 - Introduced by Senators COWLES and QUINN, cosponsored by
Representatives SORTWELL, ARMSTRONG, BEHNKE, BROOKS, DONOVAN, GREEN,
KITCHENS, MURPHY, MURSAU and ALLEN. Referred to Committee on Licensing,
Constitution and Federalism.
1 AN ACT to create 49.45 (30d) of the statutes; relating to: reimbursement of
2 behavioral health services in school-based settings under the Medical
3 Assistance program.
Analysis by the Legislative Reference Bureau
Previously, under federal law, services that were provided to a Medical
Assistance recipient that were available without charge to the recipient or that were
obligated to be paid by a third party were generally not covered under the Medical
Assistance program. This policy was interpreted by the federal Centers for Medicare
and Medicaid Services to generally prevent schools from receiving reimbursement
for services provided to students who were enrolled under the Medical Assistance
program if the school did not bill for those services or if the school was obligated to
provide the services, even if the services provided were otherwise reimbursable
under the Medical Assistance program. CMS withdrew its prior guidance on this
policy on December 15, 2014.
This bill requires the Department of Health Services to submit to the federal
Department of Health and Human Services a state plan amendment to allow any
school to seek reimbursement under the Medical Assistance program for behavioral
health services provided in a school-based setting to a student who is a Medical
Assistance recipient that would otherwise be covered under the Medical Assistance
program. The Medical Assistance program is a joint federal and state program that
provides health services to individuals who have limited financial resources.
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SENATE BILL 242
For further information see the state fiscal estimate, which will be printed as
an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
1 SECTION 1. 49.45 (30d) of the statutes is created to read:
2 49.45 (30d) SCHOOL-BASED BEHAVIORAL HEALTH SERVICES. The department shall
3 submit to the federal department of health and human services a state plan
4 amendment to allow any school to seek reimbursement under the Medical Assistance
5 program for behavioral health services provided in a school-based setting to a
6 student who is a Medical Assistance recipient that would otherwise be covered under
7 the Medical Assistance program. If the state plan amendment under this subsection
8 is approved, the department shall implement the amendment described in this
9 subsection. If the federal department of health and human services disapproves the
10 state plan amendment, the department may not implement the amendment
11 described in this subsection.
12 (END)