AB1-SSA1-SA2,180,188
45.43
(1) (a) Except as provided under par. (b), the county board shall elect a
9county veterans' service officer who shall be a Wisconsin resident who served on
10active duty
, other than active duty for training, under honorable conditions in the
11U.S. armed forces or in forces incorporated as part of the U.S. armed forces
for 2
12consecutive years, except service on active duty for training purposes. An individual
13who is discharged for reasons of hardship or a service-connected disability or
14released due to a reduction in the U.S. armed forces or for the good of the service prior
15to the completion of the required period of service is eligible for election to the office,
16regardless of the actual time served and who meets at least one of the conditions
17listed in s. 45.35 (5) (a) 1. a. to d. and at least one of the conditions listed in s. 45.35
18(5) (a) 2. a. to c.
AB1-SSA1-SA2,180,2520
45.43
(1) (am) Except as provided under par. (b), the county board may appoint
21assistant county veterans' service officers who shall be Wisconsin residents who
22served on active duty, other than active duty for training, under honorable conditions
23in the U.S. armed forces or in forces incorporated as part of the U.S. armed forces and
24who meet at least one of the conditions listed in s. 45.35 (5) (a) 1. a. to d. and at least
25one of the conditions listed in s. 45.35 (5) (a) 2. a. to c.
AB1-SSA1-SA2,181,83
45.43
(7m) (a) Annually, from the appropriation under s. 20.485 (2) (s), the
4department shall award grants to counties that are not served by transportation
5services provided by the Wisconsin department of Disabled American Veterans to
6develop, maintain, and expand transportation services for
disabled veterans. The
7grants may be used to support
multi-county multicounty cooperative transportation
8services.".
AB1-SSA1-SA2,181,1511
46.10
(8) (d) After due regard to the case and to a spouse and minor children
12who are lawfully dependent on the property for support, compromise or waive any
13portion of any claim of the state or county for which a person specified under sub. (2)
14is liable, but not any claim payable by an insurer under s. 632.89 (2) or
(2m) (4m) or
15by any other 3rd party.
AB1-SSA1-SA2,182,617
46.10
(14) (a) Except as provided in pars. (b) and (c), liability of a person
18specified in sub. (2) or s. 46.03 (18) for inpatient care and maintenance of persons
19under 18 years of age at community mental health centers, a county mental health
20complex under s. 51.08, the centers for the developmentally disabled, Mendota
21mental health institute
, and Winnebago mental health institute or care and
22maintenance of persons under 18 years of age in residential, nonmedical facilities
23such as group homes, foster homes, treatment foster homes, child caring institutions
, 24and juvenile correctional institutions is determined in accordance with the
1cost-based fee established under s. 46.03 (18). The department shall bill the liable
2person up to any amount of liability not paid by an insurer under s. 632.89 (2) or
(2m) 3(4m) or by other 3rd party benefits, subject to rules which include formulas governing
4ability to pay promulgated by the department under s. 46.03 (18). Any liability of the
5patient not payable by any other person terminates when the patient reaches age 18,
6unless the liable person has prevented payment by any act or omission.".
AB1-SSA1-SA2,182,8
8"
Section 119g. 49.152 (title) of the statutes is renumbered 49.16 (title).
AB1-SSA1-SA2, s. 119gd
9Section 119gd. 49.152 (1) of the statutes is renumbered 49.16 (1) and
10amended to read:
AB1-SSA1-SA2,182,1911
49.16
(1) Petition for review. Any individual whose application for any
12component of Wisconsin works is not acted upon by the Wisconsin works agency with
13reasonable promptness after the filing of the application, as defined by the
14department by rule, or is denied in whole or in part, whose benefit is modified or
15canceled, or who believes that the benefit was calculated incorrectly or that the
16employment position in which the individual was placed is inappropriate, may
17petition the
Wisconsin works agency department for a review of such action. Review
18is unavailable if the action by the Wisconsin works agency occurred more than 45
19days prior to submission of the petition for review.
AB1-SSA1-SA2, s. 119gj
21Section 119gj. 49.152 (3) (title) and (b) of the statutes are consolidated,
22renumbered 49.16 (3) and amended to read:
AB1-SSA1-SA2,183,1023
49.16
(3) Remedies. (b) If, following review under sub. (2), the
Wisconsin works
24agency or the department determines that
an individual's application was not acted
1upon with reasonable promptness or was improperly denied in whole or in part, that 2a participant's benefit was improperly modified or canceled
, or was calculated
3incorrectly
, or that a participant was placed in an inappropriate Wisconsin works
4employment position, the Wisconsin works agency shall
restore the benefit to the
5level determined to be appropriate by the Wisconsin works agency or by the
6department grant the appropriate benefit, retroactive to the date on which the
7individual's application was first not acted upon with reasonable promptness or
8improperly denied in whole or in part, the individual's benefit was first improperly
9modified or canceled or incorrectly calculated
, or the individual was first placed in
10an inappropriate Wisconsin works position.
AB1-SSA1-SA2,183,2413
49.16
(2) Review. The department shall give an applicant or participant who
14files a timely petition under sub. (1) an opportunity for a fair hearing. Upon receipt
15of a timely petition under sub. (1), the department shall provide reasonable notice
16of the hearing to the applicant or participant, the Wisconsin works agency, and, if
17appropriate, the county clerk. The department may make any additional
18investigation that it considers necessary. The Wisconsin works agency and, if
19appropriate, the county may be represented at the hearing. The department shall
20render its decision as soon as possible after the hearing and shall send a certified copy
21of its decision to the applicant or participant, the Wisconsin works agency, and, if
22appropriate, the county clerk. The decision of the department shall be final, but may
23be revoked or modified as altered conditions may require. The department shall deny
24a petition for a hearing or shall refuse to grant relief if any of the following applies:
AB1-SSA1-SA2,183,2525
(a) The applicant or participant withdraws the petition in writing.
AB1-SSA1-SA2,184,3
1(b) The sole issue in the petition concerns an automatic grant adjustment or
2change for a class of participants as required by state or federal law, unless the issue
3concerns an incorrect computation of the participant's benefit.
AB1-SSA1-SA2,184,74
(c) The applicant or participant abandons the petition. Abandonment occurs
5if the applicant or participant fails to appear in person or by a representative at a
6scheduled hearing without providing the department with good cause for that failure
7to appear.
AB1-SSA1-SA2,184,9
8(4) Nonentitlement. This section does not create an entitlement to any
9services or benefits under Wisconsin works.".
AB1-SSA1-SA2,184,1713
49.175
(1) (z)
Community youth grant. For a competitive grant program
14administered by the department to fund programs that improve social, academic and
15employment skills of youth who are eligible to receive temporary assistance for needy
16families under
42 USC 601 et seq.,
$7,579,700 $7,829,700 in fiscal year 2001-02 and
17$50,000 $300,000 fiscal year 2002-03.".
AB1-SSA1-SA2,185,821
49.195
(3) A county, tribal governing body, Wisconsin works agency or the
22department shall determine whether an overpayment has been made under s. 49.19,
2349.148, 49.155 or 49.157 and, if so, the amount of the overpayment. The county, tribal
24governing body, Wisconsin works agency or department shall provide notice of the
1overpayment to the liable person. The department shall give that person an
2opportunity for a review following the procedure specified under s.
49.152 49.16, if
3the person received the overpayment under s. 49.141 to 49.161, and for a hearing
4under ch. 227. Notwithstanding s. 49.96, the department shall promptly recover all
5overpayments made under s. 49.19, 49.148, 49.155 or 49.157 that have not already
6been received under s. 49.161 or 49.19 (17) and shall promulgate rules establishing
7policies and procedures to administer this subsection. The rules shall include
8notification procedures similar to those established for child support collections.".
AB1-SSA1-SA2,185,1411
49.26
(1) (h) 1. as. The individual has failed to request a hearing or has failed
12to show good cause for not cooperating with case management efforts in a hearing.
13The hearing shall be requested and held under s.
49.152 49.16. The department shall
14determine by rule the criteria for good cause.".
AB1-SSA1-SA2,185,2017
49.45
(2) (a) 9. Periodically set forth conditions of participation and
18reimbursement
in a contract with provider for contracts with providers of service
19under this section.
The department shall promulgate rules that specify criteria for
20and required procedures for submittal of appropriate claims for reimbursement.
AB1-SSA1-SA2,186,523
49.45
(2) (a) 10. After reasonable notice and opportunity for
a hearing
24conducted as a class 2 proceeding under ch. 227, recover money improperly or
1erroneously paid or overpayments to a provider by offsetting or adjusting amounts
2owed the provider under the program, crediting against a provider's future claims
3for reimbursement for other services or items furnished by the provider under the
4program, or requiring the provider to make direct payment to the department or its
5fiscal intermediary.
AB1-SSA1-SA2,186,1412
49.45
(2) (a) 11. Establish criteria for
the certification of
eligible providers of
13medical assistance and, except as provided in
par. (b) 6m. and s. 49.48
, and subject
14to par. (b) 7. and 8., certify providers who meet the criteria.
AB1-SSA1-SA2,187,719
49.45
(2) (a) 12. Decertify
or suspend under this subdivision a provider from
20or restrict a provider's participation in the medical assistance program, if after
21giving reasonable notice and opportunity for hearing the department finds that the
22provider has violated a federal statute or regulation or a state statute or
23administrative rule and the violation is by statute, regulation, or rule grounds for
24decertification or
restriction. The department shall suspend the provider pending
25the hearing under this subdivision if the department includes in its decertification
1notice findings that the provider's continued participation in the medical assistance
2program pending hearing is likely to lead to the irretrievable loss of public funds and
3is unnecessary to provide adequate access to services to medical assistance
4recipients. As soon as practicable after the hearing, the department shall issue a
5written decision suspension. No payment may be made under the medical assistance
6program with respect to any service or item furnished by the provider subsequent to
7decertification or during the period of suspension.
AB1-SSA1-SA2,187,1311
49.45
(2) (a) 14. Assure due process in implementing subds. 12. and 13. by
12providing written notice
, a fair hearing and a written decision and a hearing
13conducted as a class 2 proceeding under ch. 227.
AB1-SSA1-SA2,188,1824
49.45
(3) (g) The secretary may authorize personnel to audit or investigate and
25report to the department on any matter involving violations or complaints alleging
1violations of statutes, regulations, or rules applicable to the medical assistance
2program and to perform such investigations or audits as are required to verify the
3actual provision of services or items available under the medical assistance program
4and the appropriateness and accuracy of claims for reimbursement submitted by
5providers participating in the program. Department employees authorized by the
6secretary under this paragraph shall be issued, and shall possess at all times while
7they are performing their investigatory or audit functions under this section,
8identification, signed by the secretary, that specifically designates the bearer as
9possessing the authorization to conduct medical assistance investigations or audits.
10Under the request of a designated person and upon presentation of the person's
11authorization, providers and medical assistance recipients shall accord the person
12access to any
provider personnel, records, books, or documents or other information
13needed. Under the written request of a designated person and upon presentation of
14the person's authorization, providers and recipients shall accord the person access
15to any needed patient health care records of a recipient. Authorized employees may
16hold hearings, administer oaths, take testimony, and perform all other duties
17necessary to bring the matter before the department for final adjudication and
18determination.
AB1-SSA1-SA2,189,722
49.45
(3) (h) 1. For purposes of any audit, investigation, examination, analysis,
23review, or other function authorized by law with respect to the medical assistance
24program, the secretary shall have the power to sign and issue subpoenas to any
25person requiring the production of any pertinent books, records, patient health care
1records, or other information. Subpoenas so issued shall be served by anyone
2authorized by the secretary by delivering a copy to the person named in the
3subpoena, or by registered mail or certified mail addressed to the person at his or her
4last-known residence or principal place of business. A verified return by the person
5serving the subpoena setting forth the manner of service, or, in the event service is
6by registered or certified mail, the return post-office receipt signed by the person
7served constitutes proof of service.
AB1-SSA1-SA2,189,1910
49.45
(3) (h) 3. The failure or refusal of a
provider to accord department
11auditors or investigators access as required under par. (g) to any provider personnel,
12records, books, patient health care records of medical assistance recipients, or
13documents or other information requested constitutes person to purge himself or
14herself of contempt found under s. 885.12 and perform the act as required by law
15shall constitute grounds for decertification or suspension of
the provider that person 16from participation in the medical assistance program. No payment may be made for
17services rendered by
the provider that person following decertification
, or during the
18period of suspension
, or during any period of provider failure or refusal to accord
19access as required under par. (g).
AB1-SSA1-SA2,190,223
49.45
(3) (h) 2. In the event of contumacy or refusal to obey a subpoena issued
24under this paragraph and duly served upon any person, any judge in a court of record
1in the county in which the person was served may enforce the subpoena in accordance
2with s. 885.12.
AB1-SSA1-SA2,190,65
49.45
(21) (title)
Taking over provider's operation Transfer of business,
6liability for; repayments required.
AB1-SSA1-SA2,190,1911
49.45
(21) (a)
Before a person may take over the operation of a provider that
12is If any provider liable for repayment of improper or erroneous payments or
13overpayments under ss. 49.43 to 49.497
, full repayment shall be made. Upon
14request, the department shall notify the provider or the person that intends to take
15over the operation of the provider as to whether the provider
sells or otherwise
16transfers ownership of his or her business or all or substantially all of the assets of
17the business, the transferor and transferee are each liable for the repayment. Prior
18to final transfer, the transferee is responsible for contacting the department and
19ascertaining if the transferor is liable
under this paragraph.
AB1-SSA1-SA2,191,622
49.45
(21) (b)
If, notwithstanding the prohibition under par. (ar), a person takes
23over the operation of a provider If a transfer occurs and the applicable amount under
24par.
(ar) (a) has not been repaid, the department may
, in addition to withholding
25certification as authorized under sub. (2) (b) 8., proceed against
the provider or the
1person either the transferor or the transferee. Within 30 days after
the certified
2provider receives receiving notice from the department, the
transferor or the
3transferee shall pay the amount
shall be repaid in full.
If the amount is not repaid
4in full Upon failure to comply, the department may bring an action to compel
5payment
,. If a transferor fails to pay within 90 days after receiving notice from the
6department, the department may proceed under sub. (2) (a) 12.
, or may do both.
AB1-SSA1-SA2,191,1212
49.45
(49) Prescription drug prior authorization. (a) In this subsection:
AB1-SSA1-SA2,191,1413
1. "Average manufacturer price" has the meaning given in
42 USC 1396r-8 (k)
14(1).
AB1-SSA1-SA2,191,1515
2. "HIV infection" has the meaning given in s. 252.01 (2).
AB1-SSA1-SA2,191,1616
3. "Institution for mental diseases" has the meaning given in s. 46.011 (1m).
AB1-SSA1-SA2,191,1817
4. "Intermediate care facility for the mentally retarded" has the meaning given
18in s. 46.278 (1m) (am).
AB1-SSA1-SA2,191,1919
5. "Nursing home" has the meaning given in s. 50.01 (3).
AB1-SSA1-SA2,191,2020
6. "Pharmacist" has the meaning given in s. 450.01 (15).
AB1-SSA1-SA2,191,2121
7. "Physician" has the meaning given in s. 448.01 (5).
AB1-SSA1-SA2,191,2322
8. "Preferred prescription drug list" means a list of prescription drugs to which
23prior authorization does not apply.
AB1-SSA1-SA2,191,2424
9. "Prescription drug" has the meaning given in s. 450.01 (20).
AB1-SSA1-SA2,192,3
1(b) Except for all of the following, beginning July 1, 2003, the department shall
2subject all prescription drugs that are prescribed for medical assistance recipients
3to requirements of prior authorization:
AB1-SSA1-SA2,192,54
1. Prescription drugs that are used to treat mental illness, including anxiety,
5depression, or psychosis, or to treat HIV infection.
AB1-SSA1-SA2,192,86
2. Prescription drugs that are prescribed for residents of nursing homes, of
7institutions for mental diseases, and of intermediate care facilities for the mentally
8retarded.
AB1-SSA1-SA2,192,109
3. Prescription drugs that are included in a preferred prescription drug list of
10the department under par. (f).
AB1-SSA1-SA2,192,1311
(c) The secretary shall exercise his or her authority under s. 15.04 (1) (c) to
12create a prescription drug prior authorization committee and shall appoint as
13members at least all of the following:
AB1-SSA1-SA2,192,1414
1. Two physicians who are currently in practice.
AB1-SSA1-SA2,192,1515
2. Two pharmacists.