27,3044b
Section 3044b. 49.482 of the statutes is created to read:
49.482 Recovery from estates.
(1) In this section:
(a) “Client" means a person who receives or received aid under s. 49.48, 49.483 or 49.485.
(b) “Disabled" has the meaning given in s. 49.468 (1) (a) 1.
(c) “Home" means property in which a person has an ownership interest consisting of the person's dwelling and the land used and operated in connection with the dwelling.
(2) (a) Except as provided in par. (d), the department shall file a claim against the estate of a client or against the estate of the surviving spouse of a client for the amount of aid under s. 49.48, 49.483 or 49.485 paid to or on behalf of the client.
(b) The affidavit of a person designated by the secretary to administer this subsection is evidence of the amount of the claim.
(c) The court shall reduce the amount of a claim under par. (a) by up to $3,000 if necessary to allow the client's heirs or the beneficiaries of the client's will to retain the following personal property:
1. The decedent's wearing apparel and jewelry held for personal use.
2. Household furniture, furnishings and appliances.
3. Other tangible personal property not used in trade, agriculture or other business, not to exceed $1,000 in value.
(d) A claim under par. (a) is not allowable if the decedent has a surviving child who is under age 21 or disabled or a surviving spouse.
(e) If the department's claim is not allowable because of par. (d) and the estate includes an interest in a home, the court exercising probate jurisdiction shall, in the final judgment, assign the interest in the home subject to a lien in favor of the department for the amount described in par. (a). The personal representative shall record the final judgment as provided in s. 863.29.
(f) The department may not enforce the lien under par. (e) as long as any of the following survive the decedent:
1. A spouse.
2. A child who is under age 21 or disabled.
(g) The department may enforce a lien under par. (e) by foreclosure in the same manner as a mortgage on real property.
(3) The department shall administer the program under this section and may contract with an entity to administer all or a portion of the program, including gathering and providing the department with information needed to recover payment of aid provided under s. 49.48, 49.483 or 49.485. All funds received under this subsection, net of any amount claimed under s. 867.035 (3), shall be remitted for deposit in the general fund.
(4) (a) The department may recover amounts under this section for the provision of aid provided under s. 49.48, 49.483 or 49.485 paid on and after September 1, 1995.
(b) The department may file a claim under sub. (2) only with respect to a client who dies after September 1, 1995.
(5) The department shall promulgate rules establishing standards for determining whether the application of this section would work an undue hardship in individual cases. If the department determines that the application of this section would work an undue hardship in a particular case, the department shall waive application of this section in that case.
27,3044c
Section 3044c. 49.482 (title) and (1) (intro.) of the statutes, as created by 1995 Wisconsin Act .... (this act), are renumbered 49.682 (title) and (1) (intro.).
27,3044d
Section 3044d. 49.482 (1) (a) of the statutes, as created by 1995 Wisconsin Act .... (this act), is renumbered 49.682 (1) (a) and amended to read:
49.462 (1) (a) “Client" means a person who receives or received aid under s. 49.48, 49.483 or 49.485
49.68, 49.683 or 49.685.
27,3044e
Section 3044e. 49.482 (1) (b) and (c) of the statutes, as created by 1995 Wisconsin Act .... (this act), are renumbered 49.682 (1) (b) and (c).
27,3044f
Section 3044f. 49.482 (2) (a) of the statutes, as created by 1995 Wisconsin Act .... (this act), is renumbered 49.682 (2) (a) and amended to read:
49.682 (2) (a) Except as provided in par. (d), the department shall file a claim against the estate of a client or against the estate of the surviving spouse of a client for the amount of aid under s. 49.48, 49.483 or 49.485
49.68, 49.683 or 49.685 paid to or on behalf of the client.
27,3044g
Section 3044g. 49.482 (2) (b) to (f) of the statutes, as created by 1995 Wisconsin Act .... (this act), are renumbered 49.682 (2) (b) to (f).
27,3044h
Section 3044h. 49.482 (3) of the statutes, as created by 1995 Wisconsin Act .... (this act), is renumbered 49.682 (3) and amended to read:
49.682 (3) The department shall administer the program under this section and may contract with an entity to administer all or a portion of the program, including gathering and providing the department with information needed to recover payment of aid provided under s. 49.48, 49.483 or 49.485 49.68, 49.683 or 49.685. All funds received under this subsection, net of any amount claimed under s. 867.035 (3), shall be remitted for deposit in the general fund.
27,3044i
Section 3044i. 49.482 (4) (a) of the statutes, as created by 1995 Wisconsin Act .... (this act), is renumbered 49.682 (4) (a) and amended to read:
49.682 (4) (a) The department may recover amounts under this section for the provision of aid provided under s. 49.48, 49.483 or 49.485 49.68, 49.683 or 49.685 paid on or after September 1, 1995.
27,3044j
Section 3044j. 49.482 (4) (b) and (5) of the statutes, as created by 1995 Wisconsin Act .... (this act), are renumbered 49.682 (4) (b) and (5).
27,3045
Section 3045
. 49.483 (title) of the statutes is renumbered 49.683 (title).
27,3046
Section 3046
. 49.483 (1) of the statutes is renumbered 49.683 (1) and amended to read:
49.683 (1) The department may provide financial assistance for costs of medical care of persons over the age of 18 years with the diagnosis of cystic fibrosis who meet financial requirements established by the department by rule under s. 49.487 (1) 49.687 (1).
27,3047
Section 3047
. 49.483 (2) of the statutes is renumbered 49.683 (2).
27,3048
Section 3048
. 49.485 (title) of the statutes is renumbered 49.685 (title).
27,3049
Section 3049
. 49.485 (1) of the statutes is renumbered 49.685 (1).
27,3050
Section 3050
. 49.485 (2) of the statutes is renumbered 49.685 (2).
27,3051
Section 3051
. 49.485 (4) of the statutes is renumbered 49.685 (4) and amended to read:
49.685 (4) Eligibility. Any permanent resident of this state who suffers from hemophilia or other related congenital bleeding disorder may participate in the program if that person meets the requirements of this section and s. 49.487 49.687 and the standards set by rule under this section and s. 49.487 49.687. The person shall enter into an agreement with the comprehensive hemophilia treatment center for a maintenance program to be followed by that person as a condition for continued eligibility. The physician director or a designee shall, at least once in each 6-month period, review the maintenance program and verify that the person is complying with the program.
27,3052
Section 3052
. 49.485 (5) of the statutes is renumbered 49.685 (5).
27,3053
Section 3053
. 49.485 (6) of the statutes is renumbered 49.685 (6).
27,3054
Section 3054
. 49.485 (7) (title) of the statutes is renumbered 49.685 (7) (title).
27,3055
Section 3055
. 49.485 (7) (a) 1. of the statutes is renumbered 49.685 (7) (a) 1. and amended to read:
49.685 (7) (a) 1. The percentage of the patient's liability for the reasonable costs for blood products and supplies which are determined to be eligible for reimbursement under sub. (6) shall be based upon the income and the size of the person's family unit, according to standards to be established by the department under s. 49.487 49.687.
27,3056
Section 3056
. 49.485 (7) (a) 2. of the statutes is renumbered 49.685 (7) (a) 2.
27,3057
Section 3057
. 49.485 (7) (a) 4. of the statutes is renumbered 49.685 (7) (a) 4.
27,3058
Section 3058
. 49.485 (7) (a) 5. of the statutes is renumbered 49.685 (7) (a) 5.
27,3059
Section 3059
. 49.485 (7) (b) of the statutes is renumbered 49.685 (7) (b).
27,3060
Section 3060
. 49.485 (8) of the statutes is renumbered 49.685 (8).
27,3061
Section 3061
. 49.486 of the statutes, as affected by 1995 Wisconsin Act .... (this act), is renumbered 49.686.
27,3062
Section 3062
. 49.486 (2) of the statutes is amended to read:
49.486 (2) Reimbursement. From the appropriation under s. 20.435 (1) (am), the department shall distribute not more than $375,600 in fiscal year 1993-94 and not more than $491,500 in fiscal year 1994-95 to may reimburse or supplement the reimbursement of the cost of AZT, the drug pentamidine and any drug approved for reimbursement under sub. (4) (c) for an applying individual who has HIV infection is eligible under sub. (3).
27,3062d
Section 3062d. 49.486 (3) (f) of the statutes is amended to read:
49.486 (3) (f) Is an individual with an whose annual gross household income of $40,000 or less is at or below 200% of the poverty line.
27,3063
Section 3063
. 49.487 (title) of the statutes is renumbered 49.687 (title).
27,3064
Section 3064
. 49.487 (1) of the statutes is renumbered 49.687 (1) and amended to read:
49.687 (1) The department shall promulgate rules that require a person who is eligible for benefits under s. 49.48, 49.483 or 49.485 49.68, 49.683 or 49.685 and whose current income exceeds specified limits to obligate or expend specified portions of the income for medical care for treatment of kidney disease, cystic fibrosis or hemophilia before receiving benefits under s. 49.48, 49.483 or 49.485 49.68, 49.683 or 49.685.
27,3065
Section 3065
. 49.487 (2) of the statutes is renumbered 49.687 (2) and amended to read:
49.687 (2) The department shall develop and implement a sliding scale of patient liability for kidney disease aid under s. 49.48 49.68, cystic fibrosis aid under s. 49.483 49.683 and hemophilia treatment under s. 49.485 49.685, based on the patient's ability to pay for treatment. To ensure that the needs for treatment of patients with lower incomes receive priority within the availability of funds under s. 20.435 (1) (e), the department shall revise the sliding scale for patient liability by January 1, 1994, and shall, every 3 years thereafter by January 1, review and, if necessary, revise the sliding scale.
27,3066
Section 3066
. 49.49 (6) of the statutes is created to read:
49.49 (6) Recovery. In addition to other remedies available under this section, the court may award the department of justice the reasonable and necessary costs of investigation, an amount reasonably necessary to remedy the harmful effects of the violation and the reasonable and necessary expenses of prosecution, including attorney fees, from any person who violates this section. The department of justice shall deposit in the state treasury for deposit in the general fund all moneys that the court awards to the department or the state under this subsection. Ten percent of the money deposited in the general fund that was awarded under this subsection for the costs of investigation and the expenses of prosecution, including attorney fees, shall be credited to the appropriation account under s. 20.455 (1) (gh).
All of the money deposited in the general fund that was awarded under this subsection to remedy the harmful effects of the violation shall be credited to the appropriation account under s. 20.455 (1) (gm).
27,3067
Section 3067
. 49.493 (1) of the statutes is renumbered 49.493 (1) (intro.) and amended to read:
49.493 (1) (intro.) In this section, “uninsured:
(c) “Uninsured health plan" means a partially or wholly uninsured plan, including a plan that is subject to 29 USC 1001 to 1461, providing health care benefits.
27,3068
Section 3068
. 49.493 (1) (a) of the statutes is created to read:
49.493 (1) (a) “Department or contract provider" means the department, the county providing the medical benefits or assistance or a health maintenance organization that has contracted with the department to provide the medical benefits or assistance.
27,3069
Section 3069
. 49.493 (1) (b) of the statutes is created to read:
49.493 (1) (b) “Medical benefits or assistance" means medical benefits under s. 49.02 or 49.046 or medical assistance.
27,3070
Section 3070
. 49.493 (2) of the statutes is amended to read:
49.493 (2) The providing of medical benefits or assistance constitutes an assignment to the department or contract provider, to the extent of the medical benefits or assistance benefits provided, for benefits to which the recipient would be entitled under any uninsured health plan.
27,3071
Section 3071
. 49.493 (3) (d) of the statutes is amended to read:
49.493 (3) (d) Impose on the department or contract provider, as assignee of a person or a person's dependent who is covered under the uninsured health plan and who is eligible for medical benefits or assistance, requirements that are different from those imposed on any other agent or assignee of a person who is covered under the uninsured health plan.
27,3072
Section 3072
. 49.493 (4) of the statutes is amended to read:
49.493 (4) Benefits provided by an uninsured health plan shall be primary to those benefits provided under medical benefits or assistance.
27,3073
Section 3073
. 49.495 of the statutes is amended to read:
49.495 Jurisdiction of the department of justice. The department of justice or the district attorney may institute, manage, control and direct, in the proper county, any prosecution for violation of criminal laws affecting the medical assistance program including but not limited to laws relating to medical assistance contained in this chapter subchapter and laws affecting the health, safety and welfare of recipients of medical assistance. For this purpose the department of justice shall have and exercise all powers conferred upon district attorneys in such cases. The department of justice or district attorney shall notify the medical examining board or the interested affiliated credentialing board of any such prosecution of a person holding a license granted by the board or affiliated credentialing board.
27,3074
Section 3074
. 49.496 (3) (a) 2. a. of the statutes, as created by 1993 Wisconsin Act 437, is amended to read:
49.496 (3) (a) 2. a. Home-based or community-based services under 42 USC 1396d (7) and (8) and under any waiver granted under 42 USC 1396n (c) (4) (B) or 42 USC 1396u.
27,3075
Section 3075
. 49.496 (4) of the statutes is amended to read:
49.496 (4) Administration. The department may require a county department under s. 46.215 or, 46.22 or 46.23 or the governing body of a federally recognized American Indian tribe administering medical assistance to gather and provide the department with information needed to recover medical assistance under this section. The department shall pay to a county department or tribal governing body an amount equal to 5% of the recovery collected by the department relating to a beneficiary for whom the county department or tribal governing body made the last determination of medical assistance eligibility. A county department or tribal governing body may use funds received under this subsection only to pay costs incurred under this subsection and, if any amount remains, to pay for improvements to functions required under s. 46.032 49.33 (2). The department may withhold payments under this subsection for failure to comply with the department's requirements under this subsection. The department shall treat payments made under this subsection as costs of administration of the medical assistance program.
27,3076
Section 3076
. 49.496 (5) of the statutes is amended to read:
49.496 (5) Use of funds. From the appropriation under s. 20.435 (1) (im), the department shall pay the amount of the payments under sub. (4) that is not paid from federal funds, shall pay to the federal government the amount of the funds recovered under this section equal to the amount of federal funds used to pay the benefits recovered under this section and shall spend the remainder of the funds recovered under this section for medical assistance benefits administered under s. 49.45 under this subchapter.
27,3079r
Section 3079r. 49.498 (16m) of the statutes is created to read:
49.498 (16m) Appeals procedures. Appeals procedures under this section shall be consistent with the requirements specified in 42 CFR 431.151 (a) and (b).
27,3080
Section 3080
. The unnumbered subchapter title preceding 49.50 of the statutes is repealed.
27,3081
Section 3081
. 49.50 (title) of the statutes is repealed.
