AB150: Bill Text

AB150, s. 2987 Section 2987. 49.45 (8) (title) of the statutes is amended to read:

AB150,1075,18 49.45 (8) (title) Home Per-visit limits on home health services reimbursement.

AB150, s. 2988 Section 2988. 49.45 (8e) of the statutes is created to read:

AB150,1075,24 49.45 (8e) Monthly limits on home health, and private-duty nursing services reimbursement. (a) Except as provided in par. (b), reimbursement under s. 20.435 (1) (b) and (o) for home health and private-duty nursing services provided to a medical assistance recipient in a month may not exceed the average monthly cost of nursing home care, as determined by the department.

AB150,1075,25 (b) This subsection does not apply to any of the following:

AB150,1076,1 1. A medical assistance recipient under the age of 22.

AB150,1076,3 2. A ventilator-dependent individual under s. 49.46 (2) (b) 6. m. or 49.47 (6) (a) 1.

AB150,1076,7 3. An individual not covered under subds. 1. and 2., if the department determines that the cost of providing the individual with nursing home care would exceed the cost of providing the individual with home health and private-duty nursing services.

****Note: This is reconciled s. 49.45 (8e). It has been affected by drafts with the following LRB numbers: -1137/2 and-2408/1.

AB150, s. 2989 Section 2989. 49.45 (8m) (intro.) of the statutes is amended to read:

AB150,1076,14 49.45 (8m) Rates for respiratory care services. (intro.) Notwithstanding a determination by the department of a maximum rate the limits under sub. subs. (8) and (8e), the rates under sub. (8) and rates charged by providers under s. 49.46 (2) (a) 4. d. that are not home health agencies, for reimbursement for respiratory care services for ventilator-dependent individuals under ss. 49.46 (2) (b) 6. m. and 49.47 (6) (a) 1., shall be as follows:

AB150, s. 2990 Section 2990. 49.45 (11) of the statutes is amended to read:

AB150,1076,18 49.45 (11) Penalty. Any person who receives or assists another in receiving assistance under this section, to which the recipient is not entitled, shall be subject to the penalties under s. 49.12 49.95.

****Note: This is reconciled s. 49.45 (11). This Section has been affected by drafts with the following LRB numbers: -1701/3 and -2153/1.

AB150, s. 2991 Section 2991. 49.45 (12) (c) of the statutes is amended to read:

AB150,1077,4 49.45 (12) (c) The department shall request proposals for a system of machine-readable identification cards for medical assistance recipients and a computerized support system for the cards that will accept and respond to electronically conveyed requests from health care providers for information related to medical assistance recipients, such as eligibility, coverages and authorizations. The request for proposals shall specify that the systems are to be operating by January 1, 1996 1997.

AB150, s. 2992 Section 2992. 49.45 (24m) (a) of the statutes is amended to read:

AB150,1077,9 49.45 (24m) (a) By September 1, 1990, select a county in this state and solicit bids from providers of home health care and personal care services in that county for the provision, on a contractual basis, of home health and personal care services authorized under ss. 49.46 (2) (a) 4. d. and (b) 6. j. and 49.47 (6) (a) 1.

AB150, s. 2993 Section 2993. 49.45 (25) (am) of the statutes is renumbered 49.45 (25) (am) (intro.) and amended to read:

AB150,1077,17 49.45 (25) (am) (intro.) Except as provided under pars. (be) and (bg) and sub. (24), case management services under s. 49.46 (2) (b) 9. and (bm) are reimbursable under medical assistance only if provided to a medical assistance beneficiary who receives case management services from or through a certified case management provider in a county, city, village or town that elects, under par. (b), to make the services available and who has meets at least one of the following conditions:

AB150,1077,18 1. Has a developmental disability, as defined under s. 51.01 (5) (a),.

AB150,1077,19 2. Has a chronic mental illness, as defined under s. 51.01 (3g), or.

AB150,1077,20 3. Has Alzheimer's disease, as defined under s. 46.87 (1) (a), is.

AB150,1077,21 4. Is an alcoholic, as defined under s. 51.01 (1) , or.

AB150,1077,22 5. Is drug dependent, as defined under s. 51.01 (8), is.

AB150,1077,23 6. Is physically disabled, as defined by the department, is.

AB150,1077,24 7. Is a severely emotionally disturbed child, is.

AB150,1077,25 8. Is age 65 or over or, after December 31, 1991, has.

AB150,1078,1 10. Has HIV infection, as defined in s. 252.01 (2).

AB150, s. 2994 Section 2994. 49.45 (25) (am) 9. of the statutes is created to read:

AB150,1078,4 49.45 (25) (am) 9. Is a member of a family that has a child who is at risk of serious physical, mental or emotional dysfunction, as defined by the department.

AB150, s. 2995 Section 2995. 49.45 (25) (am) 11. of the statutes is created to read:

AB150,1078,7 49.45 (25) (am) 11. Is a child who is eligible for early intervention services under s. 51.44.

AB150, s. 2996 Section 2996. 49.45 (25) (am) 12. of the statutes is created to read:

AB150,1078,9 49.45 (25) (am) 12. Is infected with tuberculosis.

AB150, s. 2997 Section 2997. 49.45 (25) (bg) of the statutes is amended to read:

AB150,1078,18 49.45 (25) (bg) An independent living center, as defined in s. 46.96 (1) (a), that is a certified case management provider may elect to provide case management services to one or more of the categories of medical assistance beneficiaries specified under par. (am). The amount of allowable charges for the services under the medical assistance program that is not provided by the federal government shall be paid from nonfederal, public funds received by the independent living center from a county, city, village or town or from funds distributed under the appropriation under s. 20.435 (5) (bm) or as a grant under s. 46.96.

AB150, s. 2998 Section 2998. 49.45 (25) (bm) (intro.) of the statutes is amended to read:

AB150,1078,22 49.45 (25) (bm) (intro.) Case management services under this subsection may not be provided to a person under the category of severely emotionally disturbed child par. (am) 7. unless any of the following is true:

AB150, s. 2999 Section 2999. 49.45 (34) of the statutes is amended to read:

AB150,1079,3 49.45 (34) Medical assistance manual. The department shall prepare a medical assistance manual that is clear, comprehensive and consistent with ss. 49.43 to 49.47 this subchapter and 42 USC 1396a to 1396u and shall, no later than July 1, 1992, provide the manual to counties for use by county employes who administer the medical assistance program.

AB150, s. 3000 Section 3000. 49.45 (39) of the statutes is created to read:

AB150,1079,5 49.45 (39) School medical services. (a) Definitions. In this subsection:

AB150,1079,9 1. "School" means a public school described under s. 115.01 (1) or a charter school, as defined in s. 115.001 (1). It includes school-operated early childhood programs for developmentally delayed and disabled 4-year-old and 5-year-old children.

AB150,1079,12 2. "School medical services" means health care services that are provided in a school to children who are eligible for medical assistance and that are appropriate to a school setting, under rules promulgated by the department.

AB150,1079,22 (b) Payment for school medical services. If a school district elects to provide school medical services and meets all requirements under par. (c), the department shall reimburse the school district for the federal share of allowable charges for the school medical services that it provides and for allowable administrative costs. The department shall promulgate rules establishing a methodology for making reimbursements under this paragraph. All other expenses for the school medical services shall be paid for by the school district with funds received from state or local taxes. The school district shall comply with all requirements of the federal department of health and human services for receiving federal financial participation.

AB150,1079,25 (c) Certification and reporting requirements. The department shall promulgate rules establishing specific certification and reporting requirements with respect to school medical services under this subsection.

AB150, s. 3001 Section 3001. 49.45 (40) of the statutes is created to read:

AB150,1080,4 49.45 (40) Periodic record matches. The department shall cooperate with the department of industry, labor and human relations in matching records of medical assistance recipients under s. 49.32 (7).

AB150, s. 3002 Section 3002. 49.45 (41) of the statutes is created to read:

AB150,1080,16 49.45 (41) Mental health crisis intervention services. A county, city, village or town may elect to make mental health crisis intervention services under this subsection available in the county, city, village or town to medical assistance recipients through the medical assistance program. A county, city, village or town that elects to make the services available shall reimburse the provider of the mental health crisis intervention services for the amount of the allowable charges for those services under the medical assistance program that is not provided by the federal government. The department shall reimburse the provider of mental health crisis intervention services under this subsection only for the amount of the allowable charges for those services under the medical assistance program that is provided by the federal government.

AB150, s. 3003 Section 3003. 49.455 (4) (c) of the statutes is repealed and recreated to read:

AB150,1080,23 49.455 (4) (c) 1. For all years other than 1996 and 1997, the minimum monthly maintenance needs allowance equals $1,500 increased by the same percentage as the percentage increase in the consumer price index between September 1988 and September of the year before the year involved. For 1996 and 1997, the minimum monthly maintenance needs allowance equals the lesser of the amount determined under subd. 2., or the sum of the following:

AB150,1080,24 a. One-twelfth of 200% of the poverty line for a family of 2 persons.

AB150,1080,25 b. Any excess shelter allowance under par. (d).

AB150,1081,4 2. The minimum monthly maintenance needs allowance in a year may not exceed $1,500 increased by the same percentage as the percentage increase in the consumer price index between September 1988 and September of the year before the year involved.

AB150,1081,7 3. In making the calculation under subd. 1. a., when the poverty line is revised the department shall use the revised amount starting on the first day of the 2nd calendar quarter beginning after the date of publication of the revision.

AB150, s. 3004 Section 3004. 49.455 (4) (d) of the statutes is created to read:

AB150,1081,10 49.455 (4) (d) The excess shelter allowance equals the amount by which 30% of the amount determined under par. (c) 1. a. is exceeded by the sum of the following:

AB150,1081,13 1. The community spouse's expenses for rent or mortgage principal and interest, taxes and insurance for his or her principal residence and, if the community spouse lives in a condominium or cooperative, any required maintenance charge.

AB150,1081,18 2. The standard utility allowance established under 7 USC 2014 (e), except that if the community spouse lives in a condominium or cooperative for which the maintenance charge includes utility expenses, the standard utility allowance under 7 USC 2014 (e) is reduced by the amount of the utility expenses included in the maintenance charge.

AB150, s. 3005 Section 3005. 49.455 (6) (b) 1. of the statutes is amended to read:

AB150,1081,25 49.455 (6) (b) 1. In 1989, $60,000; in a calendar year after 1989, 1996 and 1997, $12,000 increased by the same percentage as the percentage increase in the consumer price index between September 1988 and September of the year before the year involved. In all other years, $60,000 increased by the same percentage as the percentage increase in the consumer price index between September 1988 and September of the year before the year involved.

AB150, s. 3006 Section 3006. 49.455 (6) (b) 2. of the statutes is created to read:

AB150,1082,2 49.455 (6) (b) 2. The lesser of the following:

AB150,1082,3 a. The spousal share computed under sub. (5) (a) 1.

AB150,1082,6 b. In any year, $60,000 increased by the same percentage as the percentage increase in the consumer price index between September 1988 and September of the year before the year involved.

AB150, s. 3007 Section 3007. 49.46 (1) (a) 4. of the statutes is amended to read:

AB150,1082,9 49.46 (1) (a) 4. Any person receiving benefits under s. 49.177 49.77 or federal Title XVI.

AB150, s. 3008 Section 3008. 49.46 (1) (a) 15. of the statutes is created to read:

AB150,1082,13 49.46 (1) (a) 15. Any individual who is infected with tuberculosis and meets the income and resource eligibility requirements for the federal supplemental security program under 42 USC 1381 to 1383d.

AB150, s. 3009 Section 3009. 49.46 (1) (d) 4. of the statutes is amended to read:

AB150,1082,16 49.46 (1) (d) 4. A child who meets the conditions under 42 USC 1396a (e) 3. (3) shall be considered a recipient of benefits under s. 49.177 49.77 or federal Title XVI.

AB150, s. 3010 Section 3010. 49.46 (1) (e) of the statutes is amended to read:

AB150,1082,23 49.46 (1) (e) If an application under s. 49.47 (3) shows that the person has income and resources within the limitations of s. 49.19, federal Title XVI or s. 49.177 49.77, or that the person is an essential person, an accommodated person or a patient in a public medical institution, the person shall be granted the benefits enumerated under sub. (2) whether or not the person requests or receives a grant of any of such aids.

AB150, s. 3011 Section 3011. 49.46 (2) (a) 2. of the statutes is amended to read:

AB150,1083,4 49.46 (2) (a) 2. Early and periodic screening and diagnosis, including case management services, of persons under 21 years of age and all medical treatment and dentists' services specified in par. (b) 1. found necessary by this screening and diagnosis.

AB150, s. 3012 Section 3012. 49.46 (2) (a) 4. d. of the statutes is amended to read:

AB150,1083,8 49.46 (2) (a) 4. d. Home health services, subject to the limitations under s. 49.45 (8) and (8e), or nursing services, if a home health agency is unavailable, nursing services, subject to the limitation under s. 49.45 (8e).

AB150, s. 3013 Section 3013. 49.46 (2) (a) 4. g. of the statutes is renumbered 49.46 (2) (a) 4m. and amended to read:

AB150,1083,11 49.46 (2) (a) 4m. Nurse midwifery Nurse-midwifery services.

AB150, s. 3014 Section 3014. 49.46 (2) (b) 1. a. of the statutes is repealed.

AB150, s. 3015 Section 3015. 49.46 (2) (b) 1. b. of the statutes is repealed.

AB150, s. 3016 Section 3016. 49.46 (2) (b) 1. c. of the statutes is repealed.

AB150, s. 3017 Section 3017. 49.46 (2) (b) 1. d. of the statutes is repealed.