Amendment ASA1-AB100

AB100-ASA1,836,2 (b) In developing the pilot project under this subsection, the department shall provide that recipients who are subject to the pilot project are required to select a dental provider from among those dentists participating in the pilot project. The department shall also provide that, if a recipient does not make a selection, a dental provider will be assigned to the recipient.

AB100-ASA1,836,4 (c) If the department is able to implement the pilot project under this subsection, the department shall contract with a person to do all of the following:

AB100-ASA1,836,6 1. Accept a capitation payment from the department for each recipient who is subject to the pilot project.

AB100-ASA1,836,7 2. Enroll dentists to be participating providers under the pilot project.

AB100-ASA1,836,9 3. Coordinate with county departments to provide outreach and education to recipients and persons who are eligible to be recipients.

AB100-ASA1,836,12 4. Pay all allowable charges on a fee-for-service basis to participating dentists on behalf of recipients in the pilot counties for dental services received by those recipients.

AB100-ASA1, s. 1548 Section 1548. 49.45 (24m) (intro.) of the statutes is amended to read:

AB100-ASA1,836,18 49.45 (24m) Home health care and personal care pilot program. (intro.) From the appropriations under s. 20.435 (1) (5) (b) and (o), in order to test the feasibility of instituting a system of reimbursement for providers of home health care and personal care services for medical assistance recipients that is based on competitive bidding, the department shall:

AB100-ASA1, s. 1943c Section 1943c. 49.45 (24r) of the statutes is created to read:

AB100-ASA1,837,4 49.45 (24r) Family planning demonstration project. No later than January 1, 1998, the department shall request a waiver from the secretary of the federal department of health and human services to permit the department to conduct a demonstration project to provide family planning services under medical assistance to any woman between the ages of 15 and 44 whose family income does not exceed 185% of the poverty line for a family the size of the woman's family. If the waiver is granted, the department shall submit to the chief clerk of each house of the legislature, for distribution to the appropriate standing committees under s. 13.172 (3), proposed legislation to enable the department to implement the demonstration project.

AB100-ASA1, s. 1549 Section 1549. 49.45 (25) (am) 14. of the statutes is created to read:

AB100-ASA1,837,8 49.45 (25) (am) 14. Is a woman who is aged 45 to 64 and who is not a resident of a nursing home or otherwise receiving case management services under this paragraph.

AB100-ASA1, s. 1550 Section 1550. 49.45 (25) (b) of the statutes is amended to read:

AB100-ASA1,837,18 49.45 (25) (b) A county, city, village or , town or, in a county having a population of 500,000 or more, the department may elect to make case management services under this subsection available in the county, city, village or town to one or more of the categories of beneficiaries under par. (am) through the medical assistance program. A county, city, village or, town or, in a county having a population of 500,000 or more, the department that elects to make the services available shall reimburse a case management provider for the amount of the allowable charges for those services under the medical assistance program that is not provided by the federal government.

AB100-ASA1, s. 1551 Section 1551. 49.45 (25) (be) of the statutes is amended to read:

AB100-ASA1,837,25 49.45 (25) (be) A private nonprofit agency that is a certified case management provider may elect to provide case management services to medical assistance beneficiaries who have HIV infection, as defined in s. 252.01 (2). The amount of the allowable charges for those services under the medical assistance program that is not provided by the federal government shall be paid from the appropriation under s. 20.435 (1) (5) (am).

AB100-ASA1, s. 1946m Section 1946m. 49.45 (30e) of the statutes is created to read:

AB100-ASA1,838,5 49.45 (30e) Community-based psychosocial service programs. (a) When services are reimbursable. Services under s. 49.46 (2) (b) 6. Lm. provided to an individual are reimbursable under the medical assistance program only if all of the following conditions are met:

AB100-ASA1,838,8 1. Reimbursement for the services under s. 49.46 (2) (b) 6. Lm. in the manner provided under this subsection is permitted pursuant to federal law or pursuant to a waiver from the secretary of the federal department of health and human services.

AB100-ASA1,838,11 2. The county in which the individual resides elects to make the services under s. 49.46 (2) (b) 6. Lm. available in the county through the medical assistance program.

AB100-ASA1,838,14 3. The individual's psychosocial health needs require more than outpatient counseling, but less than the services provided by a community support program under s. 51.421.

AB100-ASA1,838,17 4. The psychosocial services are provided by a community-based psychosocial service program certified under rules promulgated by the department under par. (b) 3.

AB100-ASA1,838,19 (b) Rules. The department shall promulgate rules regarding all of the following:

AB100-ASA1,838,21 1. Standards for determining whether an individual is eligible under par. (a) 3.

AB100-ASA1,838,23 2. The scope of psychosocial services that may be provided under s. 49.46 (2) (b) 6. Lm.

AB100-ASA1,838,25 3. Requirements for certification of community-based psychosocial service programs.

AB100-ASA1,839,7 (c) Provider reimbursement. A county that elects to make the services under s. 49.46 (2) (b) 6. Lm. available shall reimburse a provider of the 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 only for the amount of the allowable charges for those services under the medical assistance program that is provided by the federal government.

AB100-ASA1, s. 1948m Section 1948m. 49.45 (45) of the statutes is created to read:

AB100-ASA1,839,12 49.45 (45) In-home and community mental health and alcohol and other drug abuse services. (a) Services under s. 49.46 (2) (b) 6. fm. provided to an individual are reimbursable under the medical assistance program only if all of the following conditions are met:

AB100-ASA1,839,15 1. Reimbursement for the services under s. 49.46 (2) (b) 6. fm. in the manner provided under this subsection is permitted pursuant to federal law or pursuant to a waiver from the secretary of the federal department of health and human services.

AB100-ASA1,839,18 2. The county, city, town or village in which the individual resides elects to make the services under s. 49.46 (2) (b) 6. fm. available in the county, city, town or village through the medical assistance program.

AB100-ASA1,839,24 (b) A county, city, town or village that elects to make the services under s. 49.46 (2) (b) 6. fm. available shall reimburse a provider of the 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 only for the amount of the allowable charges for those services under the medical assistance program that is provided by the federal government.

AB100-ASA1, s. 1552 Section 1552. 49.46 (1) (a) 1. of the statutes is amended to read:

AB100-ASA1,840,6 49.46 (1) (a) 1. Any person included in the grant of aid to families with dependent children and any person who does not receive such aid solely because of the application of s. 49.19 (11) (a) 7. This If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, this subdivision does not apply beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a).

AB100-ASA1, s. 1553 Section 1553. 49.46 (1) (a) 1m. of the statutes is amended to read:

AB100-ASA1,840,14 49.46 (1) (a) 1m. Any pregnant woman who meets the resource and income limits under s. 49.19 (4) (bm) and (es) and whose pregnancy is medically verified. Eligibility continues to the last day of the month in which the 60th day after the last day of the pregnancy falls. This If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, this subdivision does not apply beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a).

AB100-ASA1, s. 1554 Section 1554. 49.46 (1) (a) 4m. of the statutes is created to read:

AB100-ASA1,840,16 49.46 (1) (a) 4m. Any child for whom a payment is made under s. 49.775.

AB100-ASA1, s. 1555 Section 1555. 49.46 (1) (a) 6. of the statutes is amended to read:

AB100-ASA1,840,24 49.46 (1) (a) 6. Any person not described in pars. (c) to (e) who is considered, under federal law, to be receiving aid to families with dependent children for the purpose of determining eligibility for medical assistance. This If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, this subdivision does not apply beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a).

AB100-ASA1, s. 1556 Section 1556. 49.46 (1) (a) 9. of the statutes is amended to read:

AB100-ASA1,841,6 49.46 (1) (a) 9. Any pregnant woman not described under subd. 1. or 1m. whose family income does not exceed 133% of the poverty line for a family the size of the woman's family. This If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, this subdivision does not apply beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a).

AB100-ASA1, s. 1954b Section 1954b. 49.46 (1) (a) 10. of the statutes is repealed.

AB100-ASA1, s. 1557 Section 1557. 49.46 (1) (a) 11. of the statutes is amended to read:

AB100-ASA1,841,15 49.46 (1) (a) 11. Any child not described under subd. 1. who was born after September 30, 1983, who has attained the age of 6 but has not attained the age of 19 and whose family income does not exceed 100% of the poverty line for a family the size of the child's family. This If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, this subdivision does not apply beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a).

AB100-ASA1, s. 1955b Section 1955b. 49.46 (1) (a) 11. of the statutes, as affected by 1995 Wisconsin Act .... (this act), is amended to read:

AB100-ASA1,841,24 49.46 (1) (a) 11. Any child not described under subd. 1. who was born after September 30, 1983, who has attained the age of 6 but has not attained the age of 19 and whose family income does not exceed 100% 200% of the poverty line for a family the size of the child's family. If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, this subdivision does not apply beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.153 (1m) (a).

AB100-ASA1, s. 1558 Section 1558. 49.46 (1) (a) 12. of the statutes is amended to read:

AB100-ASA1,842,6 49.46 (1) (a) 12. Any child not described under subd. 1. who is under 19 years of age and who meets the resource and income limits under s. 49.19 (4). This If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, this subdivision does not apply beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a).

AB100-ASA1, s. 1559 Section 1559. 49.46 (1) (a) 13. of the statutes is amended to read:

AB100-ASA1,842,13 49.46 (1) (a) 13. Any child who is under one year of age, whose mother was determined to be eligible under subd. 9. and who lives with his or her mother. This If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, this subdivision does not apply beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a).

AB100-ASA1, s. 1957g Section 1957g. 49.46 (1) (am) 1. b. of the statutes is repealed.

AB100-ASA1, s. 1560 Section 1560. 49.46 (1) (am) 3. of the statutes is amended to read:

AB100-ASA1,842,18 49.46 (1) (am) 3. This If a waiver under s. 49.153 (1m) (a) is granted and in effect, this paragraph does not apply beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a).

AB100-ASA1, s. 1561 Section 1561. 49.46 (1) (c) (intro.) of the statutes is amended to read:

AB100-ASA1,842,24 49.46 (1) (c) (intro.) Except as provided under pars. par. (co) and (cs), a family that becomes ineligible for aid to families with dependent children under s. 49.19 because of increased income from employment or increased hours of employment or because of the expiration of the time during which the disregards under s. 49.19 (5) (a) 4. or 4m. or (am) apply shall receive medical assistance for:

AB100-ASA1, s. 1562 Section 1562. 49.46 (1) (cb) of the statutes is amended to read:

AB100-ASA1,843,4 49.46 (1) (cb) Paragraph If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, par. (c) does not apply beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a).

AB100-ASA1, s. 1563 Section 1563. 49.46 (1) (cg) of the statutes is amended to read:

AB100-ASA1,843,17 49.46 (1) (cg) Except as provided in par. (cs), medical Medical assistance shall be provided to a dependent child, a relative with whom the child is living or the spouse of the relative, if the spouse meets the requirements of s. 49.19 (1) (c) 2. a. or b., for 4 calendar months beginning with the month in which the child, relative or spouse is ineligible for aid to families with dependent children because of the collection or increased collection of maintenance or support, if the child, relative or spouse received aid to families with dependent children in 3 or more of the 6 months immediately preceding the month in which that ineligibility begins. This If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, this paragraph does not apply beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a).

AB100-ASA1, s. 1564 Section 1564. 49.46 (1) (co) 1. of the statutes is amended to read:

AB100-ASA1,844,2 49.46 (1) (co) 1. Except as provided under subd. 2. and par. (cs), medical assistance shall be provided to a family for 12 consecutive calendar months following the month in which the family becomes ineligible for aid to families with dependent children because of increased income from employment, because the family no longer receives the earned income disregard under s. 49.19 (5) (a) 4. or 4m. or (am) due to the expiration of the time limit during which the disregards are applied or because of the application of the monthly employment time eligibility limitation under 45 CFR 233.100 (a) (1) (i).

AB100-ASA1, s. 1565 Section 1565. 49.46 (1) (co) 4. of the statutes is amended to read:

AB100-ASA1,844,7 49.46 (1) (co) 4. This If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, this paragraph does not apply beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a).

AB100-ASA1, s. 1566 Section 1566. 49.46 (1) (cr) of the statutes is repealed.

AB100-ASA1, s. 1567 Section 1567. 49.46 (1) (cs) of the statutes is repealed.

AB100-ASA1, s. 1568 Section 1568. 49.46 (1) (e) 2. of the statutes is amended to read:

AB100-ASA1,844,16 49.46 (1) (e) 2. Beginning If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a), this paragraph does not apply with respect to a person who has income and resources within the limitations of s. 49.19 whether or not the person requests or receives a grant of aid under that section.

AB100-ASA1, s. 1966m Section 1966m. 49.46 (1) (k) 1. of the statutes is repealed.

AB100-ASA1, s. 1966n Section 1966n. 49.46 (1) (k) 2. of the statutes is renumbered 49.46 (1) (k).

AB100-ASA1, s. 1569 Section 1569. 49.46 (2) (a) 4. d. of the statutes is amended to read:

AB100-ASA1,844,22 49.46 (2) (a) 4. d. Home health services, subject to the limitations limitation under s. 49.45 (8) and (8e), or, if a home health agency is unavailable, nursing services, subject to the limitations under s. 49.45 (8e).

AB100-ASA1, s. 1967m Section 1967m. 49.46 (2) (b) 6. fm. of the statutes is created to read:

AB100-ASA1,845,2 49.46 (2) (b) 6. fm. Subject to the limitations under s. 49.45 (45), mental health services and alcohol and other drug abuse services, including services provided by a psychiatrist, to an individual who is 21 years of age or older in the individual's home or in the community.

AB100-ASA1, s. 1570 Section 1570. 49.46 (2) (b) 6. j. of the statutes is amended to read:

AB100-ASA1,845,5 49.46 (2) (b) 6. j. Personal care services, subject to the limitations limitation under s. 49.45 (8e) and (42).

AB100-ASA1, s. 1968m Section 1968m. 49.46 (2) (b) 6. Lm. of the statutes is created to read:

AB100-ASA1,845,9 49.46 (2) (b) 6. Lm. Subject to the limitations under s. 49.45 (30e), psychosocial services, including case management services, provided by the staff of a community-based psychosocial service program.

AB100-ASA1, s. 1571 Section 1571. 49.465 (7) of the statutes is amended to read:

AB100-ASA1,845,14 49.465 (7) This If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, this section does not apply beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a).

AB100-ASA1, s. 1572 Section 1572. 49.47 (1) of the statutes is amended to read:

AB100-ASA1,845,23 49.47 (1) Purpose. Medical assistance as set forth herein shall be provided to persons over 65, if eligible under this section, all disabled children under 18, if eligible under this section, and persons who are blind or disabled , if eligible under this section. Unless a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, medical assistance as set forth herein shall also be provided to all children under 18 who are eligible under this section and, if a child is dependent pursuant to s. 49.19, the relatives enumerated in s. 49.19 with whom the child is living.

AB100-ASA1, s. 1573 Section 1573. 49.47 (4) (ag) of the statutes is amended to read:

AB100-ASA1,846,5 49.47 (4) (ag) No If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.153 (1m) (a), no individual is eligible for medical assistance in a month that the individual is eligible for health care coverage under s. 49.153.

AB100-ASA1, s. 1574 Section 1574. 49.47 (4) (an) of the statutes is amended to read:

AB100-ASA1,846,10 49.47 (4) (an) Paragraph If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, par. (am) does not apply beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a).

AB100-ASA1, s. 1575 Section 1575. 49.47 (4) (c) 2. of the statutes is amended to read:

AB100-ASA1,846,21 49.47 (4) (c) 2. Whenever an applicant has excess income under subd. 1. or par. (am), no certification may be issued until the excess income above the applicable limits has been obligated or expended for medical care or for any other type of remedial care recognized under state law or for personal health insurance premiums or both. No If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, no individual is eligible for medical assistance under this subdivision in a month in which the individual is eligible for health care coverage under s. 49.153 beginning on first day of the 6th month beginning after the date stated in the notice under s. 49.153 (1m) (a).

AB100-ASA1, s. 1576 Section 1576. 49.496 (5) of the statutes is amended to read: