SB45, s. 1345
3Section
1345. 49.195 (3p) of the statutes is created to read:
SB45,714,54
49.195
(3p) The availability of the remedies under subs. (3m) and (3n) does not
5abridge the right of the department to pursue other remedies.
SB45, s. 1346
6Section
1346. 49.195 (3r) of the statutes is created to read:
SB45,714,107
49.195
(3r) From the appropriation under s. 20.445 (3) (L) the department may
8contract with or employ a collection agency or other person to enforce a repayment
9obligation of a person who is found liable under sub. (3) who is delinquent in making
10repayments.
SB45, s. 1349
13Section
1349. 49.23 (1) of the statutes is amended to read:
SB45,715,414
49.23
(1) From the appropriation under s. 20.445 (3)
(cb) (k), the department
15shall award grants to counties for programs to revise child support orders. Each
16county receiving a grant shall review child support orders awarded to persons who
17receive benefits under s. 48.57 (3m) or (3n) or 49.148 or whose children receive
18benefits under s. 49.19 and to persons who do not receive benefits under s. 48.57 (3m)
19or (3n) or 49.148 and whose children do not receive benefits under s. 49.19 and shall
20initiate actions to revise the orders based on that review. Each county receiving a
21grant shall review child support orders awarded to persons who receive benefits
22under s. 48.57 (3m) or (3n) or 49.148 or whose children receive benefits under s. 49.19
23and child support orders awarded to persons who do not receive benefits under s.
2448.57 (3m) or (3n) or 49.148 and whose children do not receive benefits under s. 49.19
25in proportion to the number of those 2 categories of orders in the county's child
1support case load. Before a county may initiate an action to revise a child support
2order under this subsection for a person who does not receive benefits under s. 48.57
3(3m) or (3n) or 49.148 and whose children do not receive benefits under s. 49.19, the
4custodial parent of the children must voluntarily consent to the revision.
SB45, s. 1350
5Section
1350. 49.23 (2) (a) (intro.) of the statutes is amended to read:
SB45,715,106
49.23
(2) (a) (intro.) From the appropriation under s. 20.445 (3)
(cb) (k), the
7department shall provide state incentive payments, in a total amount of not less than
8$259,000 in each fiscal year, to counties that meet the child support collection and
9child support administrative efficiency criteria, according to a distribution formula
10determined by the department that does all of the following:
SB45, s. 1351
11Section
1351. 49.23 (2) (a) 3. of the statutes is repealed.
SB45,715,1814
49.24
(1) From the appropriation under s. 20.445 (3) (k), the department shall
15provide child support incentive payments to counties to offset reduced federal child
16support incentive payments. Total payments under this subsection may not exceed
17$3,178,000 $3,850,000 in fiscal year
1997-98 1999-2000 or $3,850,000 in fiscal year
181998-99 2000-01.
SB45, s. 1354
20Section
1354. 49.26 (1) (h) 1. as. of the statutes is amended to read:
SB45,716,221
49.26
(1) (h) 1. as. The individual has failed to request a hearing or has failed
22to show good cause for not cooperating with case management efforts in a hearing.
23If the individual is a recipient of aid under s. 49.19, the hearing shall be requested
24and held under s. 49.21 (1). If the individual is a member of a Wisconsin works group,
1as defined in s. 49.141 (1) (s), the The hearing shall be requested and held under s.
249.152. The department shall determine by rule the criteria for good cause.
SB45, s. 1356
4Section
1356. 49.30 (1m) (c) of the statutes is created to read:
SB45,716,85
49.30
(1m) (c) If a request for payment under sub. (1) is made more than 12
6months after the death of the recipient, the county or applicable tribal governing
7body or organization responsible for burial of the recipient is not required to make
8a payment for cemetery, funeral or burial expenses.
SB45, s. 1357
9Section
1357. 49.36 (2) of the statutes is amended to read:
SB45,716,1710
49.36
(2) The department may contract with any county
or Wisconsin works
11agency to administer a work experience and job training program for parents who
12are not custodial parents and who fail to pay child support or to meet their children's
13needs for support as a result of unemployment or underemployment. The program
14may provide the kinds of work experience and job training services available from
15the program under s. 49.193
, 1997 stats., or
s. 49.147 (3) or (4). The program may
16also include job search and job orientation activities. The department shall fund the
17program from the appropriation under s. 20.445 (3) (dz).
SB45, s. 1358
18Section
1358. 49.36 (3) (g) of the statutes is repealed.
SB45, s. 1359
19Section
1359. 49.36 (7) of the statutes is amended to read:
SB45,716,2420
49.36
(7) The department shall pay a county or Wisconsin works agency
$200 21$400 for each person who participates in the program under this section in the region
22in which the county or Wisconsin works agency administers the program under this
23section. The county or Wisconsin works agency shall pay any additional costs of the
24program.
SB45, s. 1361
1Section
1361. 49.43 (8) of the statutes is amended to read:
SB45,717,42
49.43
(8) "Medical assistance" means any services or items under ss. 49.45 to
349.47 49.472, except s. 49.472 (6), and
under ss. 49.49 to 49.497, or any payment or
4reimbursement made for such services or items.
SB45, s. 1362
5Section
1362. 49.45 (2) (a) 4. of the statutes is amended to read:
SB45,717,96
49.45
(2) (a) 4. To the extent funds are available under s. 20.435
(1) (4) (bm),
7certify all proper charges and claims for administrative services to the department
8of administration for payment and the department of administration shall draw its
9warrant forthwith.
SB45, s. 1363
10Section
1363. 49.45 (2) (a) 9. of the statutes is amended to read:
SB45,717,1211
49.45
(2) (a) 9. Periodically
set forth prescribe conditions of participation and
12terms of reimbursement
in a contract with provider of service under this section.
SB45, s. 1364
13Section
1364. 49.45 (2) (a) 10. of the statutes is renumbered 49.45 (2) (a) 10.
14a. and amended to read:
SB45,717,2015
49.45
(2) (a) 10. a.
After reasonable notice and opportunity for hearing, recover 16Recover money improperly or erroneously paid
, or overpayments to a provider
either 17by offsetting or adjusting amounts owed the provider under the program, crediting
18against a provider's future claims for reimbursement for other services or items
19furnished by the provider under the program
, or by
or requiring the provider to make
20direct payment to the department or its fiscal intermediary.
SB45, s. 1365
21Section
1365. 49.45 (2) (a) 10. b. of the statutes is created to read:
SB45,717,2522
49.45
(2) (a) 10. b. Promptly afford the provider an opportunity to present
23information and argument regarding a recovery imposed under this subdivision, but
24the department need not stay collection of the amount to be recovered pending that
25opportunity.
SB45, s. 1366
1Section
1366. 49.45 (2) (a) 10. c. of the statutes is created to read:
SB45,718,52
49.45
(2) (a) 10. c. Establish a deadline for payment of a recovery imposed under
3this subdivision and, if a provider fails to pay all of the amount to be recovered by the
4deadline, require payment by the provider of interest on any delinquent amount at
5the rate of 1% per month or fraction of a month from the date of the overpayment.
SB45, s. 1367
6Section
1367. 49.45 (2) (a) 11. of the statutes is amended to read:
SB45,718,107
49.45
(2) (a) 11. Establish criteria for
the certification of
eligible providers of
8services under Title XIX of the social security act
medical assistance and, except as
9provided in
par. (b) 6. and 7. and s. 49.48, certify
such eligible providers
who meet
10the criteria.
SB45, s. 1368
11Section
1368. 49.45 (2) (a) 12. of the statutes is amended to read:
SB45,718,2512
49.45
(2) (a) 12. Decertify
or suspend under this subdivision a provider from
13or restrict a provider's participation in the medical assistance program, if after
14giving reasonable notice and opportunity for hearing
, the department finds that the
15provider has violated
a federal
statute or regulation or
a state
law
statute or
16administrative rule and
such violations are the violation is by
law statute, regulation
17or rule grounds for decertification or
suspension
restriction. The department shall
18suspend the provider pending the hearing under this subdivision if the department
19includes in its decertification notice findings that the provider's continued
20participation in the medical assistance program pending hearing is likely to lead to
21the irretrievable loss of public funds and is unnecessary to provide adequate access
22to services to medical assistance recipients. As soon as practicable after the hearing,
23the department shall issue a written decision. No payment may be made under the
24medical assistance program with respect to any service or item furnished by the
25provider subsequent to decertification or during the period of suspension.
SB45, s. 1369
1Section
1369. 49.45 (2) (a) 13. of the statutes is amended to read:
SB45,719,52
49.45
(2) (a) 13. Impose additional sanctions for noncompliance with the
3conditions of participation and terms of
provider agreements reimbursement under
4subd. 9. or certification criteria established under subd. 11.
and, if prescribed by the
5department, under par. (b) 6. or 7.
SB45, s. 1370
6Section
1370. 49.45 (2) (a) 14. of the statutes is repealed.
SB45, s. 1371
7Section
1371. 49.45 (2) (a) 17. of the statutes is amended to read:
SB45,719,118
49.45
(2) (a) 17. Notify the governor, the joint committee on legislative
9organization, the joint committee on finance and appropriate standing committees,
10as determined by the presiding officer of each house, if the appropriation under s.
1120.435
(5) (4) (b) is insufficient to provide the state share of medical assistance.
SB45, s. 1372
12Section
1372. 49.45 (2) (b) 6. of the statutes is created to read:
SB45,719,1713
49.45
(2) (b) 6. Prescribe criteria for certification of providers of medical
14assistance that limit the number of providers of particular services or that limit the
15amount of resources, including employes and equipment, that a certified provider
16may use to provide particular services to medical assistance recipients, if the
17department finds all of the following:
SB45,719,2018
a. That existing certified providers and resources provide services that are
19adequate in quality and amount to meet the need of medical assistance recipients for
20the particular services.
SB45,719,2221
b. That the potential for medical assistance fraud or abuse exists if additional
22providers are certified or additional resources are used by certified providers.
SB45, s. 1373
23Section
1373. 49.45 (2) (b) 7. of the statutes is created to read:
SB45,720,1124
49.45
(2) (b) 7. Require, as a condition of certification under par. (a) 11., all
25providers of a specific service that is among those enumerated under s. 49.46 (2) (b)
1or 49.47 (6) (a), as specified in this subdivision, to file with the department a surety
2bond issued by a surety company licensed to do business in this state. Providers
3subject to this subdivision provide those services specified under s. 49.46 (2) (b) or
449.47 (6) (a) for which providers have demonstrated significant potential to violate
5s. 49.489 (2) or (3) or 49.49 (1) (a), (2) (a) or (b), (3), (3m) (a), (3p), (4) (a) or (4m) (a),
6to require recovery under par. (a) 10. or to need additional sanctions under par. (a)
713. The surety bond shall be payable to the department and in an amount that would
8reasonably pay the amount of a recovery and the department's costs to pursue
9recovery under par. (a) 10. or to investigate and pursue allegations of violations of
10s. 49.489 or 49.49. The department shall promulgate rules under this subdivision
11that specify all of the following:
SB45,720,1512
a. Services under medical assistance for which providers have demonstrated
13significant potential to violate s. 49.489 (2) or (3) or 49.49 (1) (a), (2) (a) or (b), (3), (3m)
14(a), (3p), (4) (a) or (4m) (a), to require recovery under par. (a) 10. or to need additional
15sanctions under par. (a) 13.
SB45,720,1616
b. The amount or amounts of the surety bonds.
SB45,720,1917
c. Terms of the surety bond, including amounts, if any, without interest to be
18refunded to the provider upon withdrawal or decertification from the medical
19assistance program.
SB45, s. 1374
20Section
1374. 49.45 (3) (ag) of the statutes is amended to read:
SB45,720,2321
49.45
(3) (ag) Reimbursement shall be made to each entity contracted with
22under s.
46.271 (2m) 46.281 (1) (d) for
assessments completed functional screens
23performed under s.
46.271 (2m) (a) 2. 46.281 (1) (d).
SB45, s. 1375
24Section
1375. 49.45 (3) (am) 1. of the statutes is amended to read:
SB45,721,5
149.45
(3) (am) 1. From the appropriation under s. 20.435
(1) (4) (bm), the
2department shall make incentive payments to counties to encourage counties to
3identify medical assistance applicants and recipients who have other health care
4coverage and the providers of the health care coverage and give that information to
5the department.
SB45, s. 1376
6Section
1376. 49.45 (3) (f) 3. of the statutes is amended to read:
SB45,721,107
49.45
(3) (f) 3. Contractors under sub. (2) (b) shall maintain records as required
8by the department for audit purposes.
Contractors
Upon request of the department,
9contractors shall
immediately provide the department access to the records
upon
10request of the department, and, which the department may audit
the records.
SB45, s. 1377
11Section
1377. 49.45 (3) (g) of the statutes is amended to read:
SB45,722,812
49.45
(3) (g) The secretary may
appoint authorize personnel to audit or
13investigate and report to the department on any matter involving violations or
14complaints alleging violations of
laws statutes, regulations, or rules applicable to
15Title XIX of the federal social security act or the medical assistance program and to
16perform such investigations or audits as are required to verify the actual provision
17of services or items available under the medical assistance program and the
18appropriateness and accuracy of claims for reimbursement submitted by providers
19participating in the program. Department employes
appointed authorized by the
20secretary under this paragraph shall be issued
, and shall possess at all times
during
21which while they are performing their investigatory or audit functions under this
22section
, identification
, signed by the secretary
which, that specifically designates the
23bearer as possessing the authorization to conduct medical assistance investigations
24or audits.
Pursuant to Under the request of a designated person and upon
25presentation of
that the person's authorization, providers and
medical assistance
1recipients shall
immediately accord
such the person access to any
provider
2personnel, records, books
, recipient medical records, or documents or other
3information needed.
Under the written request of a designated person and upon
4presentation of the person's authorization, providers and recipients shall
5immediately accord the person access to any needed patient health care records of
6a recipient. Authorized employes
shall have authority to may hold hearings,
7administer oaths, take testimony and perform all other duties necessary to bring
8such the matter before the department for final adjudication and determination.
SB45, s. 1378
9Section
1378. 49.45 (3) (h) 1. of the statutes is repealed.
SB45, s. 1379
10Section
1379. 49.45 (3) (h) 2. of the statutes is repealed.
SB45, s. 1380
11Section
1380. 49.45 (3) (h) 3. of the statutes is renumbered 49.45 (3) (h) and
12amended to read:
SB45,722,2113
49.45
(3) (h) The failure or refusal of a
person to purge himself or herself of
14contempt found under s. 885.12 and perform the act as required by law shall
15constitute provider immediately to accord department auditors under par. (f) 3. or
16investigators under par. (g) access to any provider personnel, records, books, patient
17health care records of medical assistance recipients or documents or other
18information requested constitutes grounds for decertification or suspension of
that
19person the provider from participation in the medical assistance program and no
20payment may be made for services rendered by
that person subsequent to the
21provider following decertification or during the period of suspension.
SB45, s. 1381
22Section
1381. 49.45 (3) (j) of the statutes is amended to read:
SB45,722,2423
49.45
(3) (j) Reimbursement for administrative contract costs under this
24section is limited to the funds available under s. 20.435
(1) (4) (bm).
SB45, s. 1382
1Section
1382. 49.45 (5m) (a) of the statutes is renumbered 49.45 (5m) (am) and
2amended to read:
SB45,723,103
49.45
(5m) (am) Notwithstanding sub. (3) (e), from the appropriations under
4s. 20.435
(5) (4) (b) and (o) the department shall distribute not more than $2,256,000
5in each fiscal year, to provide supplemental funds to rural hospitals that, as
6determined by the department, have high utilization of inpatient services by
7patients whose care is provided from governmental sources,
and to provide
8supplemental funds to critical access hospitals, except that the department may not
9distribute funds to a rural hospital
or to a critical access hospital to the extent that
10the distribution would exceed any limitation under
42 USC 1396b (i) (3).
SB45, s. 1383
11Section
1383. 49.45 (5m) (ag) of the statutes is created to read:
SB45,723,1312
49.45
(5m) (ag) In this subsection, "critical access hospital" has the meaning
13given in s. 50.33 (1g).
SB45, s. 1384
14Section
1384. 49.45 (5m) (b) of the statutes is amended to read:
SB45,723,1815
49.45
(5m) (b) The supplemental funding
for rural hospitals under par.
(a) (am) 16shall be based on the utilization, by recipients of medical assistance, of the total
17inpatient days of a rural hospital in relation to that utilization in other rural
18hospitals.
SB45, s. 1385
19Section
1385. 49.45 (6b) (intro.) of the statutes is renumbered 49.45 (6b) and
20amended to read:
SB45,724,221
49.45
(6b) Centers for the developmentally disabled. From the
22appropriation under s. 20.435 (2) (gk), the department may reimburse the cost of
23services provided by the centers for the developmentally disabled. Reimbursement
24to the centers for the developmentally disabled shall be reduced following each
25placement made under s. 46.275
which that involves a relocation from a center for
1the developmentally disabled,
as follows:
by $184 per day, beginning in fiscal year
21999-2000, and by $190 per day, beginning in fiscal year 2000-01.
SB45, s. 1386
3Section
1386. 49.45 (6b) (a) of the statutes is repealed.
SB45, s. 1387
4Section
1387. 49.45 (6b) (b) of the statutes is repealed.
SB45, s. 1388
5Section
1388. 49.45 (6b) (c) of the statutes is repealed.
SB45, s. 1389
6Section
1389. 49.45 (6m) (ag) (intro.) of the statutes is amended to read:
SB45,724,137
49.45
(6m) (ag) (intro.) Payment for care provided in a facility under this
8subsection made under s. 20.435
(1) (p) or (5) (b)
(4) (b), (pa) or (o) shall, except as
9provided in pars. (bg), (bm) and (br), be determined according to a prospective
10payment system updated annually by the department. The payment system shall
11implement standards that are necessary and proper for providing patient care and
12that meet quality and safety standards established under subch. II of ch. 50 and ch.
13150. The payment system shall reflect all of the following:
SB45, s. 1390
14Section
1390. 49.45 (6m) (ag) 3m. of the statutes is repealed.
SB45, s. 1391
15Section
1391. 49.45 (6m) (ag) 8. of the statutes is repealed.
SB45, s. 1392
16Section
1392. 49.45 (6m) (ar) 1. a. of the statutes is amended to read:
SB45,724,2417
49.45
(6m) (ar) 1. a. The department shall establish standards for payment of
18allowable direct care costs, for facilities that do not primarily serve the
19developmentally disabled, that
are not less than the median for take into account 20direct care costs for a sample of all of those facilities in this state and separate
21standards for payment of allowable direct care costs, for facilities that primarily
22serve the developmentally disabled, that
are not less than the median for take into
23account direct care costs for a sample of all of those facilities in this state. The
24standards shall be adjusted by the department for regional labor cost variations.
SB45, s. 1393
25Section
1393. 49.45 (6m) (ar) 1. cm. of the statutes is amended to read:
SB45,725,5
149.45
(6m) (ar) 1. cm.
Notwithstanding the limitations under par. (ag) 8.,
2funding Funding distributed to facilities for the provision of active treatment to
3residents with a diagnosis of developmental disability shall be distributed in
4accordance with a method developed by the department which is consistent with a
5prudent buyer approach to payment for services.
SB45, s. 1394
6Section
1394. 49.45 (6m) (ar) 2. a. of the statutes is amended to read: