49.84(6)(c)3.
3. The part of the prescription drug assistance for elderly persons program under
s. 49.688 that is supported by a Medical Assistance waiver under
42 USC 1315 (a), as authorized under
s. 49.688 (11).
49.84(6)(d)
(d) Satisfactory documentary evidence that an applicant or a recipient is a citizen or national of the United States consists of the documents or other forms of evidence specified in
42 CFR 435.407.
49.845
49.845
Fraud investigation and error reduction. 49.845(1)(1)
Fraud investigation. From the appropriations under
s. 20.435 (4) (bn),
(kz),
(L), and
(nn), the department of health services shall establish a program to investigate suspected fraudulent activity on the part of recipients of medical assistance under
subch. IV, food stamp benefits under the food stamp program under
7 USC 2011 to
2036, supplemental security income payments under
s. 49.77, payments for the support of children of supplemental security income recipients under
s. 49.775, and health care benefits under the Badger Care health care program under
s. 49.665 and, if the department of children and families contracts with the department of health services under
sub. (4), on the part of recipients of aid to families with dependent children under
s. 49.19 and participants in the Wisconsin Works program under
ss. 49.141 to
49.161. The activities of the department of health services under this subsection may include comparisons of information provided to the department by an applicant and information provided by the applicant to other federal, state, and local agencies, development of an advisory welfare investigation prosecution standard, and provision of funds to county departments under
ss. 46.215,
46.22, and
46.23 and to Wisconsin Works agencies to encourage activities to detect fraud. The department of health services shall cooperate with district attorneys regarding fraud prosecutions.
49.845(2)
(2) State error reduction activities. The department of health services shall conduct activities to reduce payment errors in the Medical Assistance program under
subch. IV, the food stamp program under
7 USC 2011 to
2036, the supplemental security income payments program under
s. 49.77, the program providing payments for the support of children of supplemental security income recipients under
s. 49.775, and the Badger Care health care program under
s. 49.665 and, if the department of children and families contracts with the department of health services under
sub. (4), in Wisconsin Works under
ss. 49.141 to
49.161.
49.845(3)
(3) Wisconsin Works agency error reduction. If the department of children and families contracts with the department of health services under
sub. (4), the department of health services shall provide funds from the appropriation under
s. 20.435 (4) (kz) to Wisconsin Works agencies to offset the administrative costs of reducing payment errors in Wisconsin Works under
ss. 49.141 to
49.161.
49.845(4)(a)1.1. Notwithstanding
s. 49.197 (1m) and
(3), the department of children and families may contract with the department of health services to investigate suspected fraudulent activity on the part of recipients of aid to families with dependent children under
s. 49.19 and participants in Wisconsin Works under
ss. 49.141 to
49.161 and to conduct activities to reduce payment errors in Wisconsin Works under
ss. 49.141 to
49.161, as provided in this section. If any employee of the department of health services reasonably suspects that fraudulent activity as described in this subdivision has occurred or is occurring, the employee shall immediately report the facts and circumstances contributing to that suspicion to the employee's immediate supervisor.
49.845(4)(a)2.
2. An immediate supervisor who receives a report under
subd. 1. shall immediately evaluate the report to determine whether there is reason to suspect that the fraudulent activity has occurred or is occurring. If the immediate supervisor determines that there is reason to suspect that the fraudulent activity has occurred or is occurring, the immediate supervisor shall immediately report the facts and circumstances contributing to that suspicion to the sheriff and to the unit of the department of health services that is responsible for investigating suspected fraudulent activity as described in
subd. 1.
49.845(4)(a)3.
3. Except as provided in
subd. 2., an immediate supervisor who receives a report under
subd. 1. shall keep the identity of the reporter confidential. A sheriff or unit of the department of health services that receives a report under
subd. 2. shall keep the identity of the employee reporting under
subd. 1. and the immediate supervisor reporting under
subd. 2. confidential until the sheriff or unit determines that the report merits further investigation. If the sheriff or unit conducts a full investigation, the sheriff or unit shall keep the identity of that employee and immediate supervisor confidential if it is reasonably possible to do so. Any person who fails to report as required in
subd. 1. or
2. may be required to forfeit not more than $1,000.
49.845(4)(b)
(b) Any person participating in good faith in the making of a report under
par. (a) 1. or
2. or in initiating, participating in, or testifying in, any action or proceeding in which fraudulent activity as described in
par. (a) 1. is alleged shall have immunity from any liability, civil or criminal, that results by reason of the action. For the purpose of any proceeding, civil or criminal, the good faith of any person reporting under
par. (a) 1. or
2. shall be presumed.
49.845(4)(c)
(c) The department of health services or an employee of that department may not take disciplinary action against, or threaten to take disciplinary action against, any person because the person in good faith reported any information under
par. (a) 1. or
2. or initiated, participated in, or testified in, any action or proceeding in which fraudulent activity as described in
par. (a) 1. was alleged or because that department or employee believes that the person in good faith reported any information under
par. (a) 1. or
2. or initiated, participated in, or testified in, such an action or proceeding.
49.845(4)(d)
(d) Any person who is subjected to disciplinary action, or who is threatened with disciplinary action, in violation of
par. (c) may file a complaint with the department of workforce development under
s. 106.54 (9). If that department finds that a violation of
par. (c) has been committed, that department may take such action under
s. 111.39 as will effectuate the purpose of this section.
Section 111.322 (2m) applies to a disciplinary action arising in connection with any proceeding under this paragraph.
49.845 Note
NOTE: Par. (a) 2. and 3., (b), (c), and (d) were created as s. 49.895 (4) (a) 2. and 3., (b), (c), and (d) by
2009 Wis. Act 76 and renumbered by the legislative reference bureau under s. 13.92 (1) (bm) 2.
49.845 History
History: 2005 a. 25;
2007 a. 20 ss.
1681 to
1684,
9121 (6) (a);
2009 a. 76 ss.
37q to
37t; s. 13.92 (1) (bm) 2.
49.847
49.847
Recovery of incorrect payments under certain public assistance programs. 49.847(1)
(1) Subject to
ss. 49.497 (1) and
49.793 (1), the department of health services, or a county or elected governing body of a federally recognized American Indian tribe or band acting on behalf of the department, may recover benefits incorrectly paid under any of the programs administered by the department under this chapter.
49.847(2)
(2) The department, county, or elected governing body may recover an overpayment from a family or individual who continues to receive benefits under any program administered by the department under this chapter by reducing the family's or individual's benefit amount. Subject to
s. 49.793 (1), the department may by rule specify other methods for recovering incorrectly paid benefits.
49.847(3)(a)(a) Subject to
ss. 49.497 (2) and
49.793 (2), and except as provided in
par. (b), a county or elected governing body may retain a portion of an amount recovered under this section due to the efforts of an employee or officer of the county, tribe, or band, as provided by the department by rule.
49.847(3)(b)
(b) Any amount that Milwaukee County would otherwise be entitled to retain under
par. (a) for the recovery of an amount under this section due to the efforts of a department employee or officer, or a county employee or officer under the management of the department, shall be credited to the appropriation account under
s. 20.435 (4) (L).
49.847 Cross-reference
Cross-reference: See also ch.
DHS 2, Wis. adm. code.
49.85
49.85
Certification of certain public assistance overpayments and delinquent loan repayments. 49.85(1)
(1)
Department notification requirement. If a county department under
s. 46.215,
46.22, or
46.23 or a governing body of a federally recognized American Indian tribe or band determines that the department of health services may recover an amount under
s. 49.497,
49.793, or
49.847, or that the department of children and families may recover an amount under
s. 49.161 or
49.195 (3) or collect an amount under
s. 49.147 (6) (cm), the county department or governing body shall notify the affected department of the determination. If a Wisconsin Works agency determines that the department of children and families may recover an amount under
s. 49.161 or
49.195 (3), or collect an amount under
s. 49.147 (6) (cm), the Wisconsin Works agency shall notify the department of children and families of the determination.
49.85(2)(a)(a) At least annually, the department of health services shall certify to the department of revenue the amounts that, based on the notifications received under
sub. (1) and on other information received by the department of health services, the department of health services has determined that it may recover under
s. 49.45 (2) (a) 10.,
49.497,
49.793, or
49.847, except that the department of health services may not certify an amount under this subsection unless all of the following apply:
49.85(2)(a)2.
2. The department's determination has either not been appealed or is no longer under appeal.
49.85(2)(b)
(b) At least annually, the department of children and families shall certify to the department of revenue the amounts that, based on the notifications received under
sub. (1) and on other information received by the department of children and families, the department of children and families has determined that it may recover under
ss. 49.161 and
49.195 (3) and collect under
s. 49.147 (6) (cm), except that the department of children and families may not certify an amount under this subsection unless it has met the notice requirements under
sub. (3) and unless its determination has either not been appealed or is no longer under appeal.
49.85(3)(a)(a) At least 30 days before certification of an amount, the department of health services shall send a notice to the last-known address of the person from whom that department intends to recover the amount. The notice shall do all of the following:
49.85(3)(a)1.
1. Inform the person that the department of health services intends to certify to the department of revenue an amount that the department of health services has determined to be due under
s. 49.45 (2) (a) 10.,
49.497,
49.793, or
49.847, for setoff from any state tax refund that may be due the person.
49.85(3)(a)2.
2. Inform the person that he or she may appeal the determination of the department of health services to certify the amount by requesting a hearing under
sub. (4) within 30 days after the date of the letter and inform the person of the manner in which he or she may request a hearing.
49.85(3)(a)3.
3. Inform the person that, if the determination of the department of health services is appealed, that department will not certify the amount to the department of revenue while the determination of the department of health services is under appeal.
49.85(3)(a)4.
4. Inform the person that, unless a contested case hearing is requested to appeal the determination of the department of health services, the person may be precluded from challenging any subsequent setoff of the certified amount by the department of revenue, except on the grounds that the certified amount has been partially or fully paid or otherwise discharged, since the date of the notice.
49.85(3)(a)5.
5. Request that the person inform the department of health services if a bankruptcy stay is in effect with respect to the person or if the claim has been discharged in bankruptcy.
49.85(3)(a)6.
6. Inform the person that the person may need to contact the department of revenue in order to protect the refunds of spouses who are not liable for the claim.
49.85(3)(b)
(b) At least 30 days before certification of an amount, the department of children and families shall send a notice to the last-known address of the person from whom that department intends to recover or collect the amount. The notice shall do all of the following:
49.85(3)(b)1.
1. Inform the person that the department of children and families intends to certify to the department of revenue an amount that the department of children and families has determined to be due under
s. 49.161 or
49.195 (3) or to be delinquent under a repayment agreement for a loan under
s. 49.147 (6), for setoff from any state tax refund that may be due the person.
49.85(3)(b)2.
2. Inform the person that he or she may appeal the determination of the department of children and families to certify the amount by requesting a hearing under
sub. (4) within 30 days after the date of the letter and inform the person of the manner in which he or she may request a hearing.
49.85(3)(b)3.
3. Inform the person that, if the determination of the department of children and families is appealed, that department will not certify the amount to the department of revenue while the determination of the department of children and families is under appeal.
49.85(3)(b)4.
4. Inform the person that, unless a contested case hearing is requested to appeal the determination of the department of children and families, the person may be precluded from challenging any subsequent setoff of the certified amount by the department of revenue, except on the grounds that the certified amount has been partially or fully paid or otherwise discharged, since the date of the notice.
49.85(3)(b)5.
5. Request that the person inform the department of children and families if a bankruptcy stay is in effect with respect to the person or if the claim has been discharged in bankruptcy.
49.85(3)(b)6.
6. Inform the person that the person may need to contact the department of revenue in order to protect the refunds of spouses who are not liable for the claim.
49.85(4)(a)(a) If a person has requested a hearing under this subsection, the department of health services shall hold a contested case hearing under
s. 227.44, except that the department of health services may limit the scope of the hearing to exclude issues that were presented at a prior hearing or that could have been presented at a prior opportunity for hearing.
49.85(4)(b)
(b) If a person has requested a hearing under this subsection, the department of children and families shall hold a contested case hearing under
s. 227.44, except that the department of children and families may limit the scope of the hearing to exclude issues that were presented at a prior hearing or that could have been presented at a prior opportunity for hearing.
49.85(5)
(5) Effect of certification. Receipt of a certification by the department of revenue shall constitute a lien, equal to the amount certified, on any state tax refunds or credits owed to the obligor. The lien shall be foreclosed by the department of revenue as a setoff under
s. 71.93. Certification of an amount under this section does not prohibit the department of health services or the department of children and families from attempting to recover or collect the amount through other legal means. The department of health services or the department of children and families shall promptly notify the department of revenue upon recovery or collection of any amount previously certified under this section.
49.85 Cross-reference
Cross-reference: See also ch.
DHS 2, Wis. adm. code.
49.852
49.852
Delinquent support payments; pension plans. 49.852(1c)(1c) In this section, "department" means the department of children and families.
49.852(1m)
(1m) The department may direct the department of employee trust funds, the retirement system of any 1st class city, any retirement system established under
chapter 201, laws of 1937, or the administrator of any other pension plan to withhold the amount specified in the statewide support lien docket under
s. 49.854 (2) (b) from any lump sum payment from a pension plan that may be paid a delinquent support obligor, except that the department may not direct that an amount be withheld under this subsection unless it has met the notice requirements under
sub. (2) and unless the amount specified has either not been appealed or is no longer under appeal under
s. 49.854.
49.852(2)
(2) The department shall send a notice to the last-known address of the person from whom the department intends to recover the amount specified in the statewide support lien docket under
s. 49.854 (2) (b). The notice shall do all of the following:
49.852(2)(a)
(a) Inform the person that the department of employee trust funds, the retirement system of any 1st class city, any retirement system established under
chapter 201, laws of 1937, or the administrator of any other pension plan, whichever is appropriate, shall withhold the amount specified in the statewide support lien docket under
s. 49.854 (2) (b) from any lump sum payment from a pension plan that may be paid the person.
49.852(2)(b)
(b) Inform the person that he or she may, within 20 business days after the date of the notice, request a court hearing on the issue of whether the person owes the amount specified in the statewide support lien docket under
s. 49.854 (2) (b). The request shall be in writing and the person shall mail or deliver a copy of the request to the county child support agency under
s. 59.53 (5).
49.852(2)(c)
(c) Request that the person inform the department or the appropriate county child support agency under
s. 59.53 (5) if a bankruptcy stay is in effect with respect to the person.
49.852(3)
(3) If a person has requested a hearing pursuant to
sub. (2) (b), the hearing shall be conducted before the circuit court that rendered the initial order to pay support. The court shall schedule a hearing within 10 business days after receiving a request for a hearing. A circuit court commissioner may conduct the hearing. If the court determines that the person owes the amount specified in the statewide support lien docket under
s. 49.854 (2) (b), the department may direct the department of employee trust funds, the retirement system of any 1st class city, any retirement system established under
chapter 201, laws of 1937, or the administrator of any other pension plan, whichever is appropriate, to withhold the amount from any lump sum payment from a pension plan that may be paid the person. If the court determines that the person does not owe the amount specified in the statewide support lien docket under
s. 49.854 (2) (b), the department may not direct the department of employee trust funds, the retirement system of any 1st class city, any retirement system established under
chapter 201, laws of 1937, or the administrator of any other pension plan, whichever is appropriate, to withhold the amount from any lump sum payment from a pension plan that may be paid the person.
49.852(4)(a)(a) If the department directs the department of employee trust funds, the retirement system of any 1st class city, any retirement system established under
chapter 201, laws of 1937, or the administrator of any other pension plan to withhold the amount specified in the statewide support lien docket under
s. 49.854 (2) (b), this directive shall constitute a lien, equal to the amount specified in the statewide support lien docket, on any lump sum payment from a pension plan that may be paid the person.
49.852(4)(b)
(b) If the department directs the department of employee trust funds, the retirement system of any 1st class city, any retirement system established under
chapter 201, laws of 1937, or the administrator of any other pension plan to withhold the amount specified in the statewide support lien docket under
s. 49.854 (2) (b), the department of employee trust funds, the retirement system of any 1st class city, any retirement system established under
chapter 201, laws of 1937, or the administrator of any other pension plan shall deduct from any lump sum payment that may be paid the person the amount specified in the statewide support lien docket, less any amount specified under
par. (d). If the amount specified in the statewide support lien docket under
s. 49.854 (2) (b), less any amount specified under
par. (d), exceeds the lump sum payment, the department of employee trust funds, the retirement system of any 1st class city, any retirement system established under
chapter 201, laws of 1937, or the administrator of any other pension plan shall deduct the entire lump sum payment, less any withholdings otherwise required by law. The amount deducted under this paragraph shall be remitted to the department.
49.852(4)(c)
(c) A directive to the department of employee trust funds, the retirement system of any 1st class city, any retirement system established under
chapter 201, laws of 1937, or the administrator of any other pension plan to withhold the amount specified in the statewide support lien docket under
s. 49.854 (2) (b) under this section does not prohibit the department from attempting to recover the amount through other legal means.
49.852(4)(d)
(d) The department shall promptly notify the department of employee trust funds, the retirement system of any 1st class city, any retirement system established under
chapter 201, laws of 1937, or the administrator of any other pension plan upon recovery of any amount previously specified in the statewide support lien docket under
s. 49.854 (2) (b).
49.853
49.853
Financial record matching program. 49.853(1)(a)
(a) "Account" means a demand deposit account, checking or negotiable withdrawal order account, savings account, time deposit account or money market mutual fund account.
49.853(1)(b)
(b) "Department" means the department of children and families.
49.853(1)(c)
(c) "Financial institution" means any of the following:
49.853(1)(c)5.
5. A benefit association, insurance company, safe deposit company, money market mutual fund or similar entity authorized to do business in this state.
49.853(1)(dm)
(dm) "Ownership interest" has the meaning specified by the department by rule.
49.853(2)
(2) Financial record matching program and agreements. The department shall operate a financial record matching program under this section. The department shall promulgate rules specifying procedures under which the department shall enter into agreements with financial institutions doing business in this state to operate the financial record matching program under this section. The agreement shall require the financial institution to participate in the financial record matching program under this section by electing either the financial institution matching option under
sub. (3) or the state matching option under
sub. (4). The department shall reimburse a financial institution up to $125 per quarter for participating in the financial record matching program under this section.
49.853(3)
(3) Financial institution matching option.
