LRB-2665/1
JPC:cjs
2023 - 2024 LEGISLATURE
April 14, 2023 - Introduced by Senators Stafsholt, Cabral-Guevara, Felzkowski,
Nass and Stroebel, cosponsored by Representatives Penterman, Macco,
Allen, Behnke, Bodden, Born, Brandtjen, Dittrich, Edming, Green,
Gundrum, Knodl, Magnafici, Moses, Nedweski, Petersen, Plumer,
Rettinger, Rozar, Snyder, Sortwell, Steffen, Tittl and Wichgers. Referred
to Committee on Economic Development and Technical Colleges.
SB245,1,5 1An Act to renumber and amend 49.823; and to create 49.45 (2) (a) 3m., 49.471
2(4d) and (4j) and 49.823 (2) of the statutes; relating to: disenrollment of
3ineligible individuals from and redeterminations of eligibility for the
4BadgerCare Plus program and database confirmation for public assistance
5program eligibility.
Analysis by the Legislative Reference Bureau
This bill makes various changes to eligibility determinations for public
assistance programs and, specifically, the BadgerCare Plus program. Currently, the
Department of Health Services administers the Medical Assistance program, a joint
federal and state program that provides health services to individuals who have
limited financial resources. Some services are provided through programs that
operate under a waiver of federal Medicaid laws, including the BadgerCare Plus
program. Under current law, certain children, pregnant women, parents and
caretaker relatives, former foster care youth, and adults aged 19 to 64 who are not
receiving Medicare and who do not have dependent children are eligible for benefits
under the BadgerCare Plus program if they meet certain financial criteria.
The bill prohibits DHS from automatically renewing the eligibility of a
recipient under the BadgerCare Plus program. DHS must determine an individual's
eligibility every six months under the bill. DHS is also prohibited from using
prepopulated forms or otherwise supplying information, except for name and
address, to a recipient under the BadgerCare Plus program that has been supplied

to DHS. Additionally, any recipient under the BadgerCare Plus program that fails
to timely report to DHS or its designee any change that may affect eligibility is
ineligible for benefits for six months from the date DHS discovers the failure to report
the change. Under current law, knowingly concealing or failing to disclose any event
that an individual knows affects the initial or continued right to a Medical Assistance
benefit is subject to a forfeiture of not less than $100 nor more than $15,000 for each
concealment or failure.
The bill requires DHS to enter data sharing agreements with any agency that
maintains a database of financial or personal information about residents of this
state. DHS must confirm the information of an applicant for a public assistance
program against the information contained in those databases. The bill also requires
DHS to share data for this purpose of confirming eligibility for public assistance
programs. Current law requires DHS and the Department of Children and Families
to compare each department's respective databases against the databases of death
records to identify deceased participants.
The bill requires DHS to promptly remove from eligibility for the BadgerCare
Plus program any individual who enrolled in the program and who has been
determined to be ineligible for the program. Under the federal Families First
Coronavirus Act, during a federally declared public health emergency, a state may
receive an enhanced amount of federal financial participation in its Medical
Assistance program if the state complies with certain criteria, including refraining
from disenrolling individuals from the program. Under the federal Consolidated
Appropriation Act, 2023, enhanced federal financial participation ends for all states
after December 31, 2023. Under the bill, if the disenrollment or any other part of the
bill would cause the state not to qualify for enhanced federal financial participation
under federal law, that portion of the bill that does not comply with federal law may
not be implemented until January 1, 2024. During the period in which any portion
of the bill is not implemented due to a conflict with federal law, DHS must audit
BadgerCare Plus eligibility and report quarterly to the legislature the number of
individuals who are ineligible for benefits under the BadgerCare Plus program but
who are receiving benefits.
If DHS determines that it is necessary to obtain permission from the federal
Department of Health and Human Services to implement any portion of this bill, the
bill requires DHS to request any state plan amendment, waiver of federal law, or
other federal approval to implement that portion of the bill.
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:
SB245,1 1Section 1 . 49.45 (2) (a) 3m. of the statutes is created to read:
SB245,3,3
149.45 (2) (a) 3m. Remove promptly from eligibility for the Medical Assistance
2program under sub. (23) or s. 49.471 any individual who has been determined to be
3ineligible.
SB245,2 4Section 2 . 49.471 (4d) and (4j) of the statutes are created to read:
SB245,3,135 49.471 (4d) Redetermination of eligibility. The department may not
6automatically renew the eligibility of a recipient of Medical Assistance benefits
7under this section or s. 49.45 (23). The department shall redetermine eligibility for
8the Medical Assistance program under this section or s. 49.45 (23) for each individual
9every 6 months. In collecting information from a recipient of Medical Assistance
10benefits or an applicant, the department may not use any form that is prepopulated
11with, or otherwise provide to the recipient or applicant, information that has been
12supplied to the department except for the recipient's or applicant's name and
13address.
SB245,3,19 14(4j) Failure to report. Any recipient of Medical Assistance benefits under this
15section or s. 49.45 (23) who fails to timely report to the department or an entity
16designated by the department any change that may affect the recipient's eligibility
17for benefits shall be ineligible for benefits under this section or s. 49.45 (23) for 6
18months following the date that the department discovers the failure to report the
19change.
SB245,3 20Section 3 . 49.823 of the statutes is renumbered 49.823 (1) and amended to
21read:
SB245,4,622 49.823 (1) The department of health services and the department of children
23and families shall, at least once every 3 months, perform a comparison of each
24department's respective public benefit database information against nationally
25recognized databases that contain information on death records, including the

1federal social security administration's Death Master File, to identify participants
2in public benefit programs that are deceased. If a department determines during a
3review under this section subsection that a participant is deceased, the department
4shall designate that individual as ineligible for benefits in any applicable database.
5The requirements under this section subsection do not apply to the department of
6children and families with regard to child care subsidies under s. 49.155.
SB245,4 7Section 4 . 49.823 (2) of the statutes is created to read:
SB245,4,168 49.823 (2) The department of health services shall enter a data sharing
9agreement with the department of children and families, the department of
10workforce development, and any other agency that maintains a database of financial
11or personal information about residents of this state. The department of health
12services, through the data sharing agreement, shall confirm the information
13submitted by the applicant for a public assistance program with the information
14contained in other databases held by other agencies. The department of health
15services shall share data with other agencies for the purposes of confirming
16eligibility for public assistance programs.
SB245,5 17Section 5 . Nonstatutory provisions.
SB245,5,418 (1) Effective date of disenrollment; report on ineligibility. If
19implementation of s. 49.45 (2) (a) 3m. or any other part of this act does not comply
20with section 6008 (b) or (f) of the federal Families First Coronavirus Response Act,
21P.L. 116-127, as amended by the federal Consolidated Appropriations Act, 2021, P.L.
22116-260, and the federal Consolidated Appropriations Act, 2023, P.L. 117-328, to
23receive an enhanced federal medical assistance percentage, the department of
24health services shall implement any part of the act that does not comply beginning
25January 1, 2024. During any period in which any provision of this act is not

1implemented, the department of health services shall perform an audit of Medical
2Assistance eligibility and report quarterly to the legislature under s. 13.172 (2) the
3number of individuals who are ineligible for Medical Assistance under s. 49.45 (23)
4or 49.471 but who are still receiving benefits pursuant to s. 49.45 (23) or 49.471.
SB245,5,115 (2) Federal approval. If the department of health services determines that it
6is necessary to obtain permission from the federal department of health and human
7services to implement any portion of this act, the department shall request any state
8plan amendment, waiver of federal law, or other federal approval to implement that
9portion of the act. If federal approval is necessary under this subsection but not
10obtained, the department of health services is not required to implement the portion
11of the act for which approval is not obtained.
SB245,5,1212 (End)
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