AB100, s. 1146 3Section 1146 . 49.45 (24m) (intro.) of the statutes, as affected by 2005
4Wisconsin Act .... (this act), is amended to read:
AB100,559,95 49.45 (24m) Home health care and personal care pilot program. (intro.)
6From the appropriation accounts under s. 20.435 (4) (b), (gp), (o), (r), (rg), and (w),
7in order to test the feasibility of instituting a system of reimbursement for providers
8of home health care and personal care services for medical assistance recipients that
9is based on competitive bidding, the department shall:
AB100, s. 1147 10Section 1147. 49.45 (39) (b) 1. of the statutes is amended to read:
AB100,560,1811 49.45 (39) (b) 1. `Payment for school medical services.' If a school district or a
12cooperative educational service agency elects to provide school medical services and
13meets all requirements under par. (c), the department shall reimburse the school
14district or the cooperative educational service agency for 60% of the federal share of
15allowable charges for the school medical services that it provides and, as specified
16in subd. 2., for allowable administrative costs. If the Wisconsin Center for the Blind
17and Visually Impaired or the Wisconsin Educational Services Program for the Deaf
18and Hard of Hearing elects to provide school medical services and meets all
19requirements under par. (c), the department shall reimburse the department of
20public instruction for 60% of the federal share of allowable charges for the school
21medical services that the Wisconsin Center for the Blind and Visually Impaired or
22the Wisconsin Educational Services Program for the Deaf and Hard of Hearing
23provides and, as specified in subd. 2., for allowable administrative costs. A school
24district, cooperative educational service agency, the Wisconsin Center for the Blind
25and Visually Impaired or the Wisconsin Educational Services Program for the Deaf

1and Hard of Hearing may submit, and the department shall allow, claims for common
2carrier transportation costs as a school medical service unless the department
3receives notice from the federal health care financing administration that, under a
4change in federal policy, the claims are not allowed. If the department receives the
5notice, a school district, cooperative educational service agency, the Wisconsin
6Center for the Blind and Visually Impaired, or the Wisconsin Educational Services
7Program for the Deaf and Hard of Hearing may submit, and the department shall
8allow, unreimbursed claims for common carrier transportation costs incurred before
9the date of the change in federal policy. The department shall promulgate rules
10establishing a methodology for making reimbursements under this paragraph.
11Except as provided in subd. 1m., all All other expenses for the school medical services
12provided by a school district or a cooperative educational service agency shall be paid
13for by the school district or the cooperative educational service agency with funds
14received from state or local taxes. The school district, the Wisconsin Center for the
15Blind and Visually Impaired, the Wisconsin Educational Services Program for the
16Deaf and Hard of Hearing, or the cooperative educational service agency shall
17comply with all requirements of the federal department of health and human
18services for receiving federal financial participation.
AB100, s. 1148 19Section 1148. 49.45 (39) (b) 1m. of the statutes is repealed.
AB100, s. 1149 20Section 1149. 49.45 (39) (b) 2. of the statutes is amended to read:
AB100,561,521 49.45 (39) (b) 2. `Payment for school medical services administrative costs.' The
22department shall reimburse a school district or a cooperative educational service
23agency specified under subds. subd. 1. and 1m. and shall reimburse the department
24of public instruction on behalf of the Wisconsin Center for the Blind and Visually
25Impaired or the Wisconsin Educational Services Program for the Deaf and Hard of

1Hearing for 90% of the federal share of allowable administrative costs, using time
2studies, beginning in fiscal year 1999-2000. A school district or a cooperative
3educational service agency may submit, and the department of health and family
4services shall allow, claims for administrative costs incurred during the period that
5is up to 24 months before the date of the claim, if allowable under federal law.
AB100, s. 1150 6Section 1150. 49.46 (1) (a) 5. of the statutes is amended to read:
AB100,561,97 49.46 (1) (a) 5. Any child in an adoption assistance, foster care, kinship care,
8long-term kinship care or, treatment foster care, or subsidized guardianship
9placement under ch. 48 or 938, as determined by the department.
AB100, s. 1151 10Section 1151. 49.46 (1) (a) 5m. of the statutes is created to read:
AB100,561,1311 49.46 (1) (a) 5m. Any person who is at least 18 years of age but under 20 years
12of age and who, on his or her 18th birthday, was in a foster care or treatment foster
13care placement under ch. 48 or 938, as determined by the department.
AB100, s. 1152 14Section 1152. 49.46 (1) (a) 5m. of the statutes, as created by 2005 Wisconsin
15Act .... (this act), is amended to read:
AB100,561,1816 49.46 (1) (a) 5m. Any person who is at least 18 years of age but under 20 21
17years of age and who, on his or her 18th birthday, was in a foster care or treatment
18foster care placement under ch. 48 or 938, as determined by the department.
AB100, s. 1153 19Section 1153. 49.46 (1) (a) 14. of the statutes is amended to read:
AB100,561,2520 49.46 (1) (a) 14. Any person who would meet the financial and other eligibility
21requirements for home or community-based services under s. 46.27 (11) or, 46.277,
22or 46.2785
but for the fact that the person engages in substantial gainful activity
23under 42 USC 1382c (a) (3), if a waiver under s. 49.45 (38) is in effect or federal law
24permits federal financial participation for medical assistance coverage of the person
25and if funding is available for the person under s. 46.27 (11) or, 46.277, or 46.2785.
AB100, s. 1154
1Section 1154. 49.46 (1) (a) 15. of the statutes is amended to read:
AB100,562,42 49.46 (1) (a) 15. Any individual who is infected with tuberculosis and meets the
3income and resource eligibility requirements for the federal supplemental security
4Supplemental Security Income program under 42 USC 1381 to 1383d.
AB100, s. 1155 5Section 1155. 49.46 (2) (b) 3. of the statutes is renumbered 49.46 (2) (b) 3. a.
6and amended to read:
AB100,562,137 49.46 (2) (b) 3. a. Transportation by emergency medical vehicle to obtain
8emergency medical care, transportation by specialized medical vehicle to obtain
9medical care including the unloaded travel of the specialized medical vehicle
10necessary to provide that transportation or, if authorized in advance by the county
11department under s. 46.215 or 46.22, transportation by common carrier or private
12motor vehicle
and, if transportation by other means is contraindicated, to obtain
13nonemergency medical care.
AB100, s. 1156 14Section 1156. 49.46 (2) (b) 3. b. of the statutes is created to read:
AB100,562,1815 49.46 (2) (b) 3. b. To obtain nonemergency medical services, except as provided
16in subd. 3. a., appropriate transportation that is provided through an entity with
17which the department has contracted to manage transportation services for the
18Medical Assistance program.
AB100, s. 1157 19Section 1157. 49.46 (2) (b) 8. of the statutes is amended to read:
AB100,562,2320 49.46 (2) (b) 8. Home or community-based services, if provided under s. 46.27
21(11), 46.275, 46.277 or, 46.278, or 46.2785, under the family care benefit if a waiver
22is in effect under s. 46.281 (1) (c), or under a waiver requested under 2001 Wisconsin
23Act 16
, section 9123 (16rs), or 2003 Wisconsin Act 33, section 9124 (8c).
AB100, s. 1158 24Section 1158. 49.47 (4) (as) 1. of the statutes is amended to read:
AB100,563,5
149.47 (4) (as) 1. The person would meet the financial and other eligibility
2requirements for home or community-based services under s. 46.27 (11) or, 46.277,
3or 46.2785
or under the family care benefit if a waiver is in effect under s. 46.281 (1)
4(c) but for the fact that the person engages in substantial gainful activity under 42
5USC 1382c
(a) (3).
AB100, s. 1159 6Section 1159. 49.47 (4) (as) 3. of the statutes is amended to read:
AB100,563,97 49.47 (4) (as) 3. Funding is available for the person under s. 46.27 (11) or,
846.277, or 46.2785 or under the family care benefit if a waiver is in effect under s.
946.281 (1) (c).
AB100, s. 1160 10Section 1160. 49.472 (6) (a) of the statutes is amended to read:
AB100,563,1611 49.472 (6) (a) Notwithstanding sub. (4) (a) 3., from the appropriation account
12under s. 20.435 (4) (b), (gp), (r), (rg), or (w), the department shall, on the part of an
13individual who is eligible for medical assistance under sub. (3), pay premiums for or
14purchase individual coverage offered by the individual's employer if the department
15determines that paying the premiums for or purchasing the coverage will not be more
16costly than providing medical assistance.
AB100, s. 1161 17Section 1161 . 49.472 (6) (a) of the statutes, as affected by 2005 Wisconsin Act
18.... (this act), is amended to read:
AB100,563,2419 49.472 (6) (a) Notwithstanding sub. (4) (a) 3., from the appropriation account
20under s. 20.435 (4) (b), (gp), (r), (rg), or (w), the department shall, on the part of an
21individual who is eligible for medical assistance under sub. (3), pay premiums for or
22purchase individual coverage offered by the individual's employer if the department
23determines that paying the premiums for or purchasing the coverage will not be more
24costly than providing medical assistance.
AB100, s. 1162 25Section 1162. 49.472 (6) (b) of the statutes is amended to read:
AB100,564,4
149.472 (6) (b) If federal financial participation is available, from the
2appropriation account under s. 20.435 (4) (b), (gp), (r), (rg), or (w), the department
3may pay medicare Medicare Part A and Part B premiums for individuals who are
4eligible for medicare Medicare and for medical assistance under sub. (3).
AB100, s. 1163 5Section 1163 . 49.472 (6) (b) of the statutes, as affected by 2005 Wisconsin Act
6.... (this act), is amended to read:
AB100,564,107 49.472 (6) (b) If federal financial participation is available, from the
8appropriation account under s. 20.435 (4) (b), (gp), (r), (rg), or (w), the department
9may pay Medicare Part A and Part B premiums for individuals who are eligible for
10Medicare and for medical assistance under sub. (3).
AB100, s. 1164 11Section 1164. 49.473 (5) of the statutes is amended to read:
AB100,564,1612 49.473 (5) The department shall audit and pay, from the appropriation
13accounts under s. 20.435 (4) (b), (gp), and (o), (r), and (rg) allowable charges to a
14provider who is certified under s. 49.45 (2) (a) 11. for medical assistance Medical
15Assistance
on behalf of a woman who meets the requirements under sub. (2) for all
16benefits and services specified under s. 49.46 (2).
AB100, s. 1165 17Section 1165 . 49.473 (5) of the statutes, as affected by 2005 Wisconsin Act ....
18(this act), is amended to read:
AB100,564,2319 49.473 (5) The department shall audit and pay, from the appropriation
20accounts under s. 20.435 (4) (b), (gp), (o), and (r), and (rg) allowable charges to a
21provider who is certified under s. 49.45 (2) (a) 11. for medical assistance on behalf of
22a woman who meets the requirements under sub. (2) for all benefits and services
23specified under s. 49.46 (2).
AB100, s. 1166 24Section 1166. 49.475 (6) of the statutes is created to read:
AB100,565,10
149.475 (6) Sharing information. The department of health and family services
2shall provide to the department of workforce development, for purposes of the
3medical support liability program under s. 49.22, any information that the
4department of health and family services receives under this section. The
5department of workforce development may allow a county child support agency
6under s. 59.53 (5) or a tribal child support agency access to the information, subject
7to the use and disclosure restrictions under s. 49.83, and shall consult with the
8department of health and family services regarding procedures and methods to
9adequately safeguard the confidentiality of the information provided under this
10subsection.
AB100, s. 1167 11Section 1167. 49.497 (title) of the statutes is amended to read:
AB100,565,13 1249.497 (title) Recovery of incorrect medical assistance Medical
13Assistance or Badger Care
payments.
AB100, s. 1168 14Section 1168. 49.497 (1) of the statutes is renumbered 49.497 (1) (a) (intro.)
15and amended to read:
AB100,565,1816 49.497 (1) (a) (intro.) The department may recover any payment made
17incorrectly for benefits specified under s. 49.46, 49.468 or 49.47 provided under this
18subchapter or s. 49.665
if the incorrect payment results from any of the following:
AB100,565,20 191. A misstatement or omission of fact by a person supplying information in an
20application for benefits under s. 49.46, 49.468 or 49.47 this subchapter or s. 49.665.
AB100,565,24 212. The department may also recover if a medical assistance failure of a Medical
22Assistance or Badger Care
recipient or any other person responsible for giving
23information on the recipient's behalf fails to report the receipt of income or assets in
24an amount that would have affected the recipient's eligibility for benefits.
AB100,566,7
1(b) The department's right of recovery is against any medical assistance
2Medical Assistance or Badger Care recipient to whom or on whose behalf the
3incorrect payment was made. The extent of recovery is limited to the amount of the
4benefits incorrectly granted. The county department under s. 46.215 or 46.22 or the
5governing body of a federally recognized American Indian tribe administering
6medical assistance Medical Assistance or Badger Care shall begin recovery actions
7on behalf of the department according to rules promulgated by the department.
AB100, s. 1169 8Section 1169. 49.497 (1) (a) 3. of the statutes is created to read:
AB100,566,139 49.497 (1) (a) 3. The failure of a Medical Assistance or Badger Care recipient
10or any other person responsible for giving information on the recipient's behalf to
11report any change in the recipient's financial or nonfinancial situation or eligibility
12characteristics that would have affected the recipient's eligibility for benefits or the
13recipient's cost-sharing requirements.
AB100, s. 1170 14Section 1170. 49.497 (1m) of the statutes is created to read:
AB100,566,2415 49.497 (1m) (a) If, after notice that an incorrect payment was made, a recipient,
16or parent of a minor recipient, who is liable for repayment of an incorrect payment
17fails to repay the incorrect payment or enter into, or comply with, an agreement for
18repayment, the department may bring an action to enforce the liability or may issue
19an order to compel payment of the liability. Any person aggrieved by an order issued
20by the department under this paragraph may appeal the order as a contested case
21under ch. 227 by filing with the department a request for a hearing within 30 days
22after the date of the order. The only issue at hearing shall be the determination by
23the department that the person has not repaid the incorrect payment or entered into,
24or complied with, an agreement for repayment.
AB100,567,10
1(b) If any recipient, or parent of a minor recipient, named in an order to compel
2payment issued under par. (a) fails to pay the department any amount due under the
3terms of the order and no contested case to review the order is pending and the time
4for filing for a contested case review has expired, the department may present a
5certified copy of the order to the circuit court for any county. The sworn statement
6of the secretary shall be evidence of the incorrect payment. The circuit court shall,
7without notice, render judgment in accordance with the order. A judgment rendered
8under this paragraph shall have the same effect and shall be entered in the judgment
9and lien docket and may be enforced in the same manner as if the judgment had been
10rendered in an action tried and determined by the circuit court.
AB100,567,1211 (c) The recovery procedure under this subsection is in addition to any other
12recovery procedure authorized by law.
AB100, s. 1171 13Section 1171. 49.497 (2) of the statutes is amended to read:
AB100,567,1714 49.497 (2) A county or governing body of a federally recognized American
15Indian tribe may retain 15% of benefits distributed under s. 49.46, 49.468 or 49.47
16provided under this subchapter or s. 49.665 that are recovered under sub. (1) this
17section
due to the efforts of an employee or officer of the county or tribe.
AB100, s. 1172 18Section 1172. 49.497 (4) of the statutes is created to read:
AB100,567,2219 49.497 (4) The department may appear for the state in any and all collection
20matters under this section, and may commence suit in the name of the department
21to recover an incorrect payment from the recipient to whom or on whose behalf it was
22made.
AB100, s. 1173 23Section 1173. 49.497 (5) of the statutes is created to read:
AB100,568,3
149.497 (5) The department may make an agreement with a recipient, or parent
2of a minor recipient, who is liable under sub. (1), providing for repayment of an
3incorrect payment at a specified rate or amount.
AB100, s. 1174 4Section 1174. 49.665 (1) (b) of the statutes is amended to read:
AB100,568,65 49.665 (1) (b) "Child" means a person who is born and who is under the age of
619.
AB100, s. 1175 7Section 1175. 49.665 (1) (g) of the statutes is created to read:
AB100,568,98 49.665 (1) (g) "Unborn child" means a person from the time of conception until
9it is born alive.
AB100, s. 1176 10Section 1176. 49.665 (2) (a) of the statutes is renumbered 49.665 (2) (a) 1. and
11amended to read:
AB100,568,2212 49.665 (2) (a) 1. The department of health and family services shall request a
13waiver from the secretary of the federal department of health and human services
14to permit the department of health and family services to implement, beginning not
15later than July 1, 1998, or the effective date of the waiver, whichever is later, a health
16care program under this section. If a waiver that is consistent with all of the
17provisions of this section, excluding sub. (4) (a) 3m. and (ap) and provisions related
18to sub. (4) (ap)
, is granted and in effect, the department of health and family services
19shall implement the program under this section, subject to subd. 2. The department
20of health and family services may not implement the program under this section
21unless a waiver that is consistent with all of the provisions of this section, excluding
22sub. (4) (a) 3m. and (ap) and provisions related to sub. (4) (ap), is granted and in effect.
AB100, s. 1177 23Section 1177. 49.665 (2) (a) 2. of the statutes is created to read:
AB100,569,224 49.665 (2) (a) 2. The department may not implement sub. (4) (ap) or provisions
25related to the coverage under sub. (4) (ap) unless a state plan amendment

1authorizing the coverage under sub. (4) (ap) is approved by the federal department
2of health and human services.
AB100, s. 1178 3Section 1178. 49.665 (3) of the statutes is amended to read:
AB100,569,164 49.665 (3) Administration. The Subject to sub. (2) (a) 2., the department shall
5administer a program to provide the health services and benefits described in s. 49.46
6(2) to persons that meet the eligibility requirements specified in sub. (4). The
7department shall promulgate rules setting forth the application procedures and
8appeal and grievance procedures. The department may promulgate rules limiting
9access to the program under this section to defined enrollment periods. The
10department may also promulgate rules establishing a method by which the
11department may purchase family coverage offered by the employer of a member of
12an eligible family or by of a member of a an eligible child's household , or family or
13individual coverage offered by the employer of an eligible unborn child's mother or
14her spouse,
under circumstances in which the department determines that
15purchasing that coverage would not be more costly than providing the coverage
16under this section.
AB100, s. 1179 17Section 1179. 49.665 (4) (ap) of the statutes is created to read:
AB100,569,2218 49.665 (4) (ap) An unborn child whose mother is not eligible for health care
19coverage under par. (a) or (am) or for medical assistance under s. 49.46 or 49.47,
20except that she may be eligible for benefits under s. 49.45 (27), is eligible for health
21care coverage under this section, which shall be limited to coverage for prenatal care,
22if all of the following requirements are met:
AB100,570,323 1. The income of the unborn child's mother, mother and her spouse, or mother
24and her family, whichever is applicable, does not exceed 185 percent of the poverty
25line, except as provided in par. (at) and except that, if an unborn child is already

1receiving health care coverage under this section, the applicable specified person or
2persons may have an income that does not exceed 200 percent of the poverty line.
3The department shall establish by rule the criteria to be used to determine income.
AB100,570,64 2. Each of the following applicable persons who is employed provides
5verification from his or her employer, in the manner specified by the department, of
6his or her earnings:
AB100,570,77 a. The unborn child's mother.
AB100,570,88 b. The spouse of the unborn child's mother.
AB100,570,99 c. Members of the unborn child's mother's family.
AB100,570,1110 3. The unborn child's mother provides medical verification of her pregnancy,
11in the manner specified by the department.
AB100,570,1312 4. The unborn child and the mother of the unborn child meet all other
13requirements established by the department by rule except for any of the following:
AB100,570,1514a. The mother is not a U.S. citizen or an alien qualifying for medicaid under 8
15USC 1612
.
AB100,570,1616 b. The mother is an inmate of a public institution.
AB100,570,1817 c. The mother does not provide a social security number, but only if subd. 4. a.
18applies.
AB100, s. 1180 19Section 1180. 49.665 (4) (at) 3. of the statutes is amended to read:
AB100,570,2320 49.665 (4) (at) 3. The department may not adjust the maximum income level
21of 200% of the poverty line for persons already receiving health care coverage under
22this section or for applicable persons specified in par. (ap) 1. with respect to an unborn
23child already receiving health care coverage under this section
.
AB100, s. 1181 24Section 1181. 49.665 (4) (c) of the statutes is amended to read:
AB100,571,3
149.665 (4) (c) No person may be denied health care coverage under this section
2solely because of a health condition of that person or , of any family member of that
3person, or of the mother of an unborn child.
AB100, s. 1182 4Section 1182. 49.665 (4) (d) of the statutes is created to read:
AB100,571,75 49.665 (4) (d) An unborn child's eligibility for coverage under par. (ap) shall not
6begin before the first day of the month in which the unborn child's mother provides
7the medical verification required under par. (ap) 3.
AB100, s. 1183 8Section 1183. 49.665 (5) (ag) of the statutes is amended to read:
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