Coverage under the Medical Assistance program for incarcerated individuals, the official text

2025 - 2026 LEGISLATURE
LRB-5196/1
JK&SWB:cdc&wlj

2025 ASSEMBLY BILL 604
October 29, 2025 - Introduced by Representatives Moses, Stubbs, Anderson, DeSmidt, Dittrich, Emerson, Hurd, Joers, Kitchens, Kurtz, Mayadev, Novak, Ortiz-Velez, Piwowarczyk, Sheehan, Sinicki, Snyder, Steffen, Stroud, Tenorio, Tucker, Udell, Wittke and Rodriguez, cosponsored by Senators James, Marklein, Keyeski, L. Johnson, Dassler-Alfheim, Drake, Ratcliff, Roys, Smith, Wimberger and Spreitzer. Referred to Committee on Mental Health and Substance Abuse Prevention.

An Act to create 49.45 (62) of the statutes; relating to: coverage under the Medical Assistance program for incarcerated individuals.

Analysis by the Legislative Reference Bureau
This bill requires the Department of Health Services to submit a request to the secretary of the federal Department of Health and Human Services for a waiver of federal Medicaid law to conduct a demonstration project to provide prerelease coverage to incarcerated individuals for case management services, medication-assisted treatment for all types of substance use disorders, and a 30-day supply of prescription medications under the Medical Assistance program for up to 90 days before release if the individual is otherwise eligible for coverage under the Medical Assistance program. The bill provides that if the waiver is approved, DHS must provide reimbursement under the Medical Assistance program for both the federal and nonfederal share of these services, to the extent approved under the waiver. The Medical Assistance program is a joint state and federal program that provides health services to individuals who have limited financial resources. Under the bill, DHS must submit the request for a waiver no later than January 1, 2027.
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:

Section 1. 49.45 (62) of the statutes is created to read:
49.45 (62) Prerelease coverage of incarcerated individuals. (a) The department shall submit to the secretary of the federal department of health and human services a request for a waiver of federal Medicaid law to conduct a demonstration project to provide incarcerated individuals prerelease health care coverage for the following services under the Medical Assistance program for up to 90 days preceding the incarcerated individual’s release if the individual is otherwise eligible for coverage under the Medical Assistance program:
1. Case management services.
2. Medication-assisted treatment for all types of substance use disorders.
3. A 30-day supply of prescription medications.
(b) If a waiver submitted by the department under par. (a) is approved by the federal department of health and human services to provide any or all of the services described in par. (a) 1. to 3., or any portion of those services, the department shall provide reimbursement under the Medical Assistance program for both the federal and nonfederal share of those services provided to incarcerated individuals to the extent approved under the waiver.
Section 2. Nonstatutory provisions.
(1) No later than January 1, 2027, the department of health services shall submit the request for a waiver to provide Medical Assistance coverage with federal funding participation as provided under s. 49.45 (62).
(end)