SB45, s. 1451
25Section
1451. 49.496 (3) (a) (intro.) of the statutes is amended to read:
SB45,749,4
149.496
(3) (a) (intro.) Except as provided in par. (b), the department shall file
2a claim against the estate of a recipient
or against the estate of the surviving spouse
3of a recipient for all of the following unless already recovered by the department
4under this section:
SB45, s. 1452
5Section
1452. 49.496 (3) (a) 1. of the statutes is amended to read:
SB45,749,96
49.496
(3) (a) 1. The amount of medical assistance paid on behalf of the
7recipient while the recipient resided in a nursing home or while the recipient was an
8inpatient in a
medical institution hospital and was required to contribute to the cost
9of care.
SB45, s. 1453
10Section
1453. 49.496 (3) (a) 2. a. of the statutes is amended to read:
SB45,749,1311
49.496
(3) (a) 2. a. Home-based or community-based services under
42 USC
121396d (a) (7) and (8) and under any waiver granted under
42 USC 1396n (c) (4) (B)
13or
42 USC 1396u.
SB45, s. 1454
14Section
1454. 49.496 (3) (a) 2. d. of the statutes is created to read:
SB45,749,1515
49.496
(3) (a) 2. d. Personal care services under s. 49.46 (2) (b) 6. j.
SB45, s. 1455
16Section
1455. 49.496 (3) (am) (intro.) of the statutes is amended to read:
SB45,749,2017
49.496
(3) (am) (intro.) The court shall reduce the amount of a claim under par.
18(a) by up to
$3,000 the amount specified in s. 861.33 (2) if necessary to allow the
19recipient's heirs or the beneficiaries of the recipient's will to retain the following
20personal property:
SB45, s. 1456
21Section
1456. 49.496 (3) (am) 3. of the statutes is amended to read:
SB45,749,2422
49.496
(3) (am) 3. Other tangible personal property not used in trade,
23agriculture or other business, not to exceed
$1,000 in value
the amount specified in
24s. 861.33 (1) (a) 4.
SB45, s. 1457
25Section
1457. 49.496 (3) (b) of the statutes is amended to read:
SB45,750,2
149.496
(3) (b) A claim under par. (a) is not allowable
if while the decedent has
2a surviving child who is under age 21 or disabled or a surviving spouse.
SB45, s. 1458
3Section
1458. 49.496 (3) (c) of the statutes is renumbered 49.496 (3) (c) 1. and
4amended to read:
SB45,750,115
49.496
(3) (c) 1. If the department's claim is not allowable because of par. (b)
6and the estate includes an interest in a home, the court exercising probate
7jurisdiction shall, in the final judgment
or summary findings and order, assign the
8interest in the home subject to a lien in favor of the department for the amount
9described in par. (a). The personal representative
or petitioner for summary
10settlement or summary assignment of the estate shall record the final judgment as
11provided in s. 863.29
, 867.01 (3) (h) or 867.02 (2) (h).
SB45, s. 1459
12Section
1459. 49.496 (3) (c) 2. of the statutes is created to read:
SB45,750,1913
49.496
(3) (c) 2. If the department's claim is not allowable because of par. (b),
14the estate includes an interest in a home and the personal representative closes the
15estate by sworn statement under s. 865.16, the personal representative shall
16stipulate in the statement that the home is assigned subject to a lien in favor of the
17department for the amount described in par. (a). The personal representative shall
18record the statement in the same manner as described in s. 863.29, as if the
19statement were a final judgment.
SB45, s. 1460
20Section
1460. 49.496 (3) (f) of the statutes is created to read:
SB45,750,2221
49.496
(3) (f) The department may contract with or employ an attorney to
22probate estates to recover under this subsection the costs of care.
SB45, s. 1461
23Section
1461. 49.496 (5) of the statutes is amended to read:
SB45,751,424
49.496
(5) Use of funds. From the appropriation under s. 20.435
(5) (4) (im),
25the department shall pay the amount of the payments under sub. (4) that is not paid
1from federal funds, shall pay to the federal government the amount of the funds
2recovered under this section equal to the amount of federal funds used to pay the
3benefits recovered under this section and shall spend the remainder of the funds
4recovered under this section for medical assistance benefits under this subchapter.
SB45, s. 1463
7Section
1463. 49.499 (1) to (3) of the statutes are renumbered 49.499 (1) (a)
8to (c).
SB45, s. 1464
9Section
1464. 49.499 (2m) of the statutes is created to read:
SB45,751,1210
49.499
(2m) From the appropriation under s. 20.435 (6) (g), the department
11may distribute funds for innovative projects designed to protect the health and
12property of a resident in a nursing facility, as defined in s. 49.498 (1) (i).
SB45, s. 1465
13Section
1465. 49.665 (1) (a) of the statutes is renumbered 49.665 (1) (e) and
14amended to read:
SB45,751,1615
49.665
(1) (e) "
Custodial parent
Parent" has the meaning given in s. 49.141 (1)
16(b) (j).
SB45, s. 1466
17Section
1466. 49.665 (1) (b) of the statutes is repealed and recreated to read:
SB45,751,1818
49.665
(1) (b) "Child" means a person who is under the age of 19.
SB45, s. 1467
19Section
1467. 49.665 (1) (d) of the statutes is amended to read:
SB45,751,2320
49.665
(1) (d) "Family" means a unit that consists of at least one
dependent 21child and his or her
custodial parent or parents
, all of whom reside in the same
22household. "Family" includes the spouse of an individual who is a
custodial parent
23if the spouse resides in the same household as the individual.
SB45, s. 1468
24Section
1468. 49.665 (1) (f) of the statutes is created to read:
SB45,752,2
149.665
(1) (f) "State plan" means the state child health plan under
42 USC
21397aa (b).
SB45, s. 1469
3Section
1469. 49.665 (3) of the statutes is amended to read:
SB45,752,144
49.665
(3) Administration. The department shall administer a program to
5provide the health services and benefits described in s. 49.46 (2) to
families persons 6that meet the eligibility requirements specified in sub. (4). The department shall
7promulgate rules setting forth the application procedures and appeal and grievance
8procedures. The department may promulgate rules limiting access to the program
9under this section to defined enrollment periods. The department may also
10promulgate rules establishing a method by which the department may purchase
11family coverage offered by the employer of a member of an eligible family
or by a
12member of a child's household under circumstances in which the department
13determines that purchasing that coverage would not be more costly than providing
14the coverage under this section.
SB45, s. 1470
15Section
1470. 49.665 (4) (a) 1. of the statutes is amended to read:
SB45,752,2016
49.665
(4) (a) 1. The family's income does not exceed 185% of the poverty line,
17except as provided in par. (at) and except that a family that is already receiving
18health care coverage under this section may have an income that does not exceed
19200% of the poverty line. The department shall establish by rule the criteria to be
20used to determine income.
SB45, s. 1471
21Section
1471. 49.665 (4) (am) of the statutes is created to read:
SB45,752,2422
49.665
(4) (am) A child who does not reside with his or her parent is eligible
23for health care coverage under this section if the child meets all of the following
24requirements:
SB45,753,5
11. The child's income does not exceed 185% of the poverty line, except as
2provided in par. (at) and except that a child that is already receiving health care
3coverage under this section may have an income that does not exceed 200% of the
4poverty line. The department shall use the criteria established under par. (a) 1. to
5determine income under this subdivision.
SB45,753,66
2. The child does not have access to employer-subsidized health care coverage.
SB45,753,97
3. The child has not had access to employer-subsidized health care coverage
8within the time period established by the department under par. (a) 3. The
9department may establish exceptions to this subdivision.
SB45,753,1210
4. The child meets all other requirements established by the department by
11rule. In establishing other eligibility criteria, the department may not include any
12health condition requirements.
SB45, s. 1472
13Section
1472. 49.665 (4) (at) of the statutes is created to read:
SB45,753,1814
49.665
(4) (at) 1. The department shall establish by state plan amendment a
15lower maximum income level for the initial eligibility determination if funding under
16s. 20.435 (4) (bc), (jz) and (p) is insufficient to accommodate the projected enrollment
17levels for the health care program under this section. The adjustment may not be
18greater than necessary to ensure sufficient funding.
SB45,753,2319
2. If, after the department has established a lower maximum income level
20under subd. 1., projections indicate that funding under s. 20.435 (4) (bc), (jz) and (p)
21is sufficient to raise the level, the department shall, by state plan amendment, raise
22the maximum income level for initial eligibility, but not to exceed 185% of the poverty
23line.
SB45,753,2524
3. The department may not adjust the maximum income level of 200% of the
25poverty line for persons already receiving health care coverage under this section.
SB45, s. 1473
1Section
1473. 49.665 (4) (b) of the statutes is amended to read:
SB45,754,42
49.665
(4) (b) Notwithstanding fulfillment of the eligibility requirements
3under this subsection,
a family no person is
not entitled to health care coverage under
4this section.
SB45, s. 1474
5Section
1474. 49.665 (4) (c) of the statutes is amended to read:
SB45,754,86
49.665
(4) (c) No
family person may be denied health care coverage under this
7section solely because of a health condition of
that person or of any family member
8of that person.
SB45, s. 1475
9Section
1475. 49.665 (5) (a) of the statutes is amended to read:
SB45,755,410
49.665
(5) (a) Except as provided in par. (b), a family
that, or child who does
11not reside with his or her parent, who receives health care coverage under this
12section shall pay a percentage of the cost of that coverage in accordance with a
13schedule established by the department by rule. If the schedule established by the
14department requires a family
, or child who does not reside with his or her parent, to
15contribute more than 3% of the family's
or child's income towards the cost of the
16health care coverage provided under this section, the department shall submit the
17schedule to the joint committee on finance for review and approval of the schedule.
18If the cochairpersons of the joint committee on finance do not notify the department
19within 14 working days after the date of the department's submittal of the schedule
20that the committee has scheduled a meeting to review the schedule, the department
21may implement the schedule. If, within 14 days after the date of the department's
22submittal of the schedule, the cochairpersons of the committee notify the department
23that the committee has scheduled a meeting to review the schedule, the department
24may not require a family
, or child who does not reside with his or her parent, to
25contribute more than 3% of the family's
or child's income unless the joint committee
1on finance approves the schedule. The joint committee on finance may not approve
2and the department may not implement a schedule that requires a family
or child 3to contribute more than 3.5% of the family's
or child's income towards the cost of the
4health care coverage provided under this section.
SB45, s. 1476
5Section
1476. 49.665 (5) (b) of the statutes is amended to read:
SB45,755,86
49.665
(5) (b) The department may not require a family
, or child who does not
7reside with his or her parent, with an income below
143% 150% of the poverty line
8to contribute to the cost of health care coverage provided under this section.
SB45, s. 1477
9Section
1477. 49.682 (2) (c) (intro.) of the statutes is amended to read:
SB45,755,1310
49.682
(2) (c) (intro.) The court shall reduce the amount of a claim under par.
11(a) by up to
$3,000 the amount specified in s. 861.33 (2) if necessary to allow the
12client's heirs or the beneficiaries of the client's will to retain the following personal
13property:
SB45, s. 1478
14Section
1478. 49.682 (2) (c) 3. of the statutes is amended to read:
SB45,755,1715
49.682
(2) (c) 3. Other tangible personal property not used in trade, agriculture
16or other business, not to exceed
$1,000 in value
the amount specified in s. 861.33 (1)
17(a) 4.
SB45, s. 1479
18Section
1479. 49.682 (2) (e) of the statutes is renumbered 49.682 (2) (e) 1. and
19amended to read:
SB45,756,220
49.682
(2) (e) 1. If the department's claim is not allowable because of par. (d)
21and the estate includes an interest in a home, the court exercising probate
22jurisdiction shall, in the final judgment
or summary findings and order, assign the
23interest in the home subject to a lien in favor of the department for the amount
24described in par. (a). The personal representative
or petitioner for summary
1settlement or summary assignment of the estate shall record the final judgment as
2provided in s. 863.29
, 867.01 (3) (h) or 867.02 (2) (h).
SB45, s. 1480
3Section
1480. 49.682 (2) (e) 2. of the statutes is created to read:
SB45,756,104
49.682
(2) (e) 2. If the department's claim is not allowable because of par. (d),
5the estate includes an interest in a home and the personal representative closes the
6estate by sworn statement under s. 865.16, the personal representative shall
7stipulate in the statement that the home is assigned subject to a lien in favor of the
8department for the amount described in par. (a). The personal representative shall
9record the statement in the same manner as described in s. 863.29, as if the
10statement were a final judgment.
SB45, s. 1481
11Section
1481. 49.682 (6) of the statutes is created to read:
SB45,756,1312
49.682
(6) The department may contract with or employ an attorney to probate
13estates to recover under this section the costs of care.
SB45, s. 1482
14Section
1482. 49.683 (2) of the statutes is amended to read:
SB45,756,1615
49.683
(2) Approved costs for medical care under sub. (1) shall be paid from the
16appropriation under s. 20.435
(5) (4) (e).
SB45, s. 1483
17Section
1483. 49.687 (2) of the statutes is amended to read:
SB45,756,2518
49.687
(2) The department shall develop and implement a sliding scale of
19patient liability for kidney disease aid under s. 49.68, cystic fibrosis aid under s.
2049.683 and hemophilia treatment under s. 49.685, based on the patient's ability to
21pay for treatment. To ensure that the needs for treatment of patients with lower
22incomes receive priority within the availability of funds under s. 20.435
(5) (4) (e),
23the department shall revise the sliding scale for patient liability by January 1, 1994,
24and shall, every 3 years thereafter by January 1, review and, if necessary, revise the
25sliding scale.
SB45, s. 1484
1Section
1484. 49.775 (4) of the statutes is amended to read:
SB45,757,32
49.775
(4) Payment amount. The payment under sub. (2) is
$100 $150 per
3month per dependent child.
SB45, s. 1485
4Section
1485. 49.85 (2) (a) of the statutes is amended to read:
SB45,757,125
49.85
(2) (a) At least annually, the department of health and family services
6shall certify to the department of revenue the amounts that, based on the
7notifications received under sub. (1) and on other information received by the
8department of health and family services, the department of health and family
9services has determined that it may recover under s.
49.45 (2) (a) 10. or 49.497, except
10that the department of health and family services may not certify an amount under
11this subsection unless it has met the notice requirements under sub. (3) and unless
12its determination has either not been appealed or is no longer under appeal.
SB45, s. 1486
13Section
1486. 49.85 (3) (a) 1. of the statutes is amended to read:
SB45,757,1714
49.85
(3) (a) 1. Inform the person that the department of health and family
15services intends to certify to the department of revenue an amount that the
16department of health and family services has determined to be due under s.
49.45
17(2) (a) 10. or 49.497, for setoff from any state tax refund that may be due the person.
SB45, s. 1487
18Section
1487. 49.855 (7) of the statutes is repealed.
SB45, s. 1488
19Section
1488. 49.857 (1) (d) 3. of the statutes is amended to read:
SB45,757,2020
49.857
(1) (d) 3. A license issued under s. 48.66 (1)
(a) or (b).
SB45, s. 1489
21Section
1489. 49.89 (2) of the statutes is amended to read:
SB45,758,1122
49.89
(2) Subrogation. The department of health and family services, the
23department of workforce development, a county or an elected tribal governing body
24that provides any public assistance under this chapter or under s. 253.05 as a result
25of the occurrence of an injury, sickness or death that creates a claim or cause of action,
1whether in tort or contract, on the part of a public assistance recipient or beneficiary
2or the estate of a recipient or beneficiary against a 3rd party, including an insurer,
3is subrogated to the rights of the recipient, beneficiary or estate and may make a
4claim or maintain an action or intervene in a claim or action by the recipient,
5beneficiary or estate against the 3rd party.
Subrogation under this subsection
6because of the provision of medical assistance under subch. IV constitutes a lien,
7equal to the amount of the medical assistance provided as a result of the injury,
8sickness or death that gave rise to the claim. The lien is on any lump sum payment
9resulting from a judgment or settlement that may be due the obligor. A lien under
10this subsection continues until it is released and discharged by the department of
11health and family services.
SB45, s. 1490
12Section
1490. 49.89 (3m) (bm) of the statutes is created to read:
SB45,758,1813
49.89
(3m) (bm) A person against whom a claim that is subrogated under sub.
14(2) or assigned under sub. (3) is made, or that person's attorney or insurer, shall
15provide notice under par. (c), if that person, attorney or insurer knows, or could
16reasonably determine, that the claimant is a recipient or former recipient of medical
17assistance under subch. IV, or is the estate of a former recipient of medical assistance
18under subch. IV.
SB45, s. 1491
19Section
1491. 49.89 (7) (c) of the statutes is amended to read:
SB45,758,2520
49.89
(7) (c) The incentive payment shall be an amount equal to 15% of the
21amount recovered because of benefits paid under s. 49.19,
49.20, s. 49.20, 1997 stats.,
22and 49.30 or 253.05. The incentive payment shall be taken from the state share of
23the sum recovered, except that the incentive payment for an amount recovered
24because of benefits paid under s. 49.19 shall be considered an administrative cost
25under s. 49.19 for the purpose of claiming federal funding.
SB45, s. 1492
1Section
1492. 50.01 (6h) of the statutes is created to read:
SB45,759,22
50.01
(6h) "Secretary" means the secretary of health and family services.
SB45, s. 1493
3Section
1493. 50.02 (2) (d) of the statutes is created to read:
SB45,759,64
50.02
(2) (d) The department shall promulgate rules that prescribe the time
5periods and the methods of providing information specified in ss. 50.033 (2r) and (2s),
650.034 (5m) and (5n), 50.035 (4m) and (4n) and 50.04 (2g) (a) and (2h) (a).