49.45 (2) (a) 3. Determine the eligibility of persons for medical assistance, rehabilitative, and social services under ss. 49.46, 49.468, and 49.47 and rules and policies adopted by the department and shall may, under a contract under s. 49.33 49.78 (2), designate delegate all, or any portion, of this function to the county department under s. 46.215, 46.22, or 46.23 or a tribal governing body.
SECTION 14. 49.45 (3) (a) of the statutes is amended to read:
49.45 (3) (a) Reimbursement shall be made to each county department under ss. 46.215, 46.22, and 46.23 for the any administrative services performed in the medical assistance Medical Assistance program on the basis of s. 49.33 49.78 (8). For purposes of reimbursement under this paragraph, assessments completed under s. 46.27 (6) (a) are administrative services performed in the medical assistance Medical Assistance program.
SECTION 15. 49.45 (5) (b) 1. (intro.) of the statutes is amended to read:
49.45 (5) (b) 1. (intro.) Upon receipt of a timely petition under par. (a) the department shall give the applicant or recipient reasonable notice and opportunity for a fair hearing. The department may make such additional investigation as it considers necessary. Notice of the hearing shall be given to the applicant or recipient and to the county clerk or, if a Wisconsin works agency, if a county department under s. 46.215, 46.22, or 46.23 is responsible for making the medical assistance determination, the Wisconsin works agency to the county clerk of the county. The county or the Wisconsin works agency may be represented at such hearing. The department shall render its decision as soon as possible after the hearing and shall send a certified copy of its decision to the applicant or recipient, to the county clerk, and to the any county officer or the Wisconsin works agency charged with administration of the medical assistance Medical Assistance program. The decision of the department shall have the same effect as an order of the a county officer or the Wisconsin works agency charged with the administration of the medical assistance Medical Assistance program. The decision shall be final, but may be revoked or modified as altered conditions may require. The department shall deny a petition for a hearing or shall refuse to grant relief if:
SECTION 16. 49.45 (5) (b) 2. (intro.) of the statutes is amended to read:
49.45 (5) (b) 2. (intro.) If a recipient requests a hearing within the timely notice period specified in 42 CFR 431.231 (c), medical assistance coverage shall not be suspended, reduced, or discontinued until a decision is rendered after the hearing but medical assistance payments made pending the hearing decision may be recovered by the department if the contested decision or failure to act is upheld. The department shall promptly notify the county department or, if a Wisconsin works agency If a county department is responsible for making the medical assistance determination, the Wisconsin works agency department shall notify the county department of the county in which the recipient resides that the recipient has requested a hearing. Medical assistance coverage shall be suspended, reduced, or discontinued if:
SECTION 17. 49.45 (19) (bm) of the statutes is amended to read:
49.45 (19) (bm) The department or the county department under s. 46.215 or 46.22 shall notify applicants of the requirements of this subsection at the time of application.
SECTION 18. 49.45 (36) of the statutes is amended to read:
49.45 (36) HOMELESS BENEFICIARIES. A The department or a county department under s. 46.215, 46.22, or 46.23 may not place the word "homeless" on the medical assistance identification card of any person who is determined to be eligible for medical assistance benefits and who is homeless.
SECTION 19. 49.496 (4) of the statutes is amended to read:
49.496 (4) ADMINISTRATION. The department may require a county department under s. 46.215, 46.22, or 46.23 or the governing body of a federally recognized American Indian tribe administering medical assistance to gather and provide the department with information needed to recover medical assistance under this section. The department shall pay to a county department or tribal governing body an amount equal to 5% of the recovery collected by the department relating to a beneficiary for whom the county department or tribal governing body made the last determination of medical assistance eligibility. A county department or tribal governing body may use funds received under this subsection only to pay costs incurred under this subsection and, if any amount remains, to pay for improvements to functions required under s. 49.33 49.78 (2). The department may withhold payments under this subsection for failure to comply with the department's requirements under this subsection. The department shall treat payments made under this subsection as costs of administration of the medical assistance Medical Assistance program.
SECTION 20. 49.79 (4) of the statutes is amended to read:
49.79 (4) DEDUCTIONS FROM COUNTY INCOME MAINTENANCE PAYMENTS. The department shall withhold the value of food stamp losses for which a county or federally recognized American Indian tribe is liable under sub. (3) from the payment to the county or tribe under income maintenance contracts under s. 49.33 49.78 and reimburse the federal government from the funds withheld.
SECTION 21. 59.22 (2) (c) 2. of the statutes is amended to read:
59.22 (2) (c) 2. No action of the board may be contrary to or in derogation of the rules of the department of health and family services workforce development under s. 49.33 49.78 (4) to (7) relating to employees administering old-age assistance, aid to families with dependent children, aid to the blind and, or aid to totally and permanently disabled persons or ss. 63.01 to 63.17.
SECTION 22. 230.45 (1) (e) of the statutes is amended to read:
230.45 (1) (e) Hear appeals, when authorized under county merit system rules under s. 49.33 49.78 (4), from any interested party.
SECTION 9124. Nonstatutory provisions; health and family services.
(1) TRANSFER OF CLIENT ASSISTANCE FOR REEMPLOYMENT AND ECONOMIC SUPPORT SYSTEM. No later than March 1, 2004, the department of health and family services and the department of workforce development shall submit a proposal to the secretary of administration for expenditure and position authority necessary to transfer, effective July 1, 2004, agreed upon administrative functions related to the client assistance for reemployment and economic support system from the department of workforce development to the department of health and family services. If the secretary of administration finds that the proposal would increase the costs of administering the client assistance for reemployment and economic support system, the secretary shall disapprove the plan, and the department of health and family services and the department of workforce development shall resubmit a proposal to the secretary of administration for consideration in the 2005-07 biennial budget bill. If the secretary of administration finds that the proposal would not increase the costs of administering the client assistance for reemployment and economic support system and approves the plan, the secretary shall submit the proposal to the cochairpersons of the joint committee on finance. If the cochairpersons of the committee do not notify the secretary of administration within 14 working days after receiving the proposal that the cochairpersons have scheduled a meeting for the purpose of reviewing the proposal, the secretary of administration shall approve the proposed expenditure and position authority, as authorized under current law. If, within 14 working days after receiving the proposal the cochairpersons notify the secretary of administration that the cochairpersons have scheduled a meeting for the purpose of reviewing the proposal, the secretary of administration may not approve the proposed expenditure and position authority, except as approved by the committee and as authorized under current law.
SECTION 9159. Nonstatutory provisions; workforce development.
(1) RULES RELATED TO INCOME MAINTENANCE TRAINING. All rules of the department of workforce development that are primarily related to competency standards, including training requirements, for income maintenance workers and that are in effect on the effective date of this subsection are transferred to the department of health and family services and remain in effect until their specified expiration dates or until amended or repealed by the department of health and family services.
(End)
LRB-0194LRB-0194/9
DAK:kgx/cs/wlj/jd:rs
2003 - 2004 LEGISLATURE
DOA:......Blaine - BB0033 IGT claims
For 2003-05 Budget -- Not Ready For Introduction
2003 BILL
AN ACT ...; relating to: the budget.
Analysis by the Legislative Reference Bureau
health and human services
Medical Assistance
Under current law, the Medical Assistance (MA) trust fund (MATF) is composed of all public funds that are related to MA nursing home payments and that are transferred to the MATF as the nonfederal share for the purpose of claiming federal moneys, and all of the matching moneys received in return under the federal MA program (commonly known as "Medicaid"). Counties that make these intergovernmental transfers are, in turn, reimbursed by DHFS from an appropriation account of interagency program revenue.
Currently, under a waiver of federal Medicaid laws, DHFS administers a community integration program (commonly known as CIP IA) under which MA recipients who reside in state centers for the developmentally disabled are relocated into their communities by providing to them home and community-based services as part of MA. DHFS administers another community integration program (commonly known as CIP IB) under which persons with developmental disabilities who are relocated from institutions other than state centers for the developmentally disabled or who meet requirements for the care provided in intermediate care facilities for the mentally retarded or brain injury rehabilitation facilities are relocated into their communities by providing to them home and community-based services as part of MA.
This bill creates a sum sufficient appropriation account, from the MATF, for reimbursement to a county of moneys transferred in support of MA payment for nursing home services by the county to the state and used as the nonfederal share of MA payments. Payment to a county under the appropriation account is limited to the amount that the county has transferred.
The bill creates a program revenue account in the general fund to provide supplemental MA program benefits for CIP IA and CIP IB, emergency medical transportation services, alcohol and other drug abuse and mental health treatment and services, and school medical services, as part of a claim for federal Medicaid matching moneys, and to receive moneys that are required, under the bill, to be paid by counties. The moneys required to be paid by counties are related to the federal share of rate increases for CIP IA and CIP IB beginning in 2001, the federal share of rate increases for alcohol and other drug abuse and mental health treatment and services beginning in 2003, and the moneys paid in support of the claim for federal Medicaid matching moneys. Moneys received by DHFS that are in excess of payments for services under this appropriation must be transferred to the MATF. The bill makes annual decreases in the amount paid to school districts for special education by the amount of the supplementary payment for MA school-based services received, and lapses this amount to the general fund. In addition, the bill modifies the accounts within the MATF to eliminate the requirement that limits the MATF to funds that are related to MA nursing home payments; instead, the bill permits the MATF to include moneys that are related to any MA service.
Lastly, the bill authorizes payment from the MATF for grants to counties for mental health community support programs and for distributions to counties and local health departments that are equal to amounts that were distributed in calendar year 2002 to reduce operating deficits.
For further information see the state and local fiscal estimate, which will be printed as an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:
SECTION 1. 20.255 (2) (b) of the statutes is amended to read:
20.255 (2) (b) Aids for special education and school age parents programs. The amounts in the schedule for the payment of aids for special education and school age parents programs under ss. 115.88, 115.93 and 118.255. On dates determined by the secretary of administration, amounts equal to the amounts paid by the department of health and family services under s. 49.45 (39) (b) 1m. shall lapse from this appropriation account to the general fund.
SECTION 2. 20.435 (4) (hm) of the statutes is created to read:
20.435 (4) (hm) Medical Assistance; supplementary payments to counties. All moneys received from a county under s. 59.53 (24), to supplement the state share of Medical Assistance Program benefits administered under ss. 46.275, 46.278, 49.45 (39) (b) 1m., and 49.46 (2) (a) 1., 2., 4. d. and e. and (b) 3., 6. b., c., d., f., fm., j., k., L., and m., 9., 12., 12m., 13., 15., and 16. Notwithstanding s. 20.001 (2) (b) and (3) (b), on dates to be determined by the secretary of administration, amounts equal to amounts received under this paragraph that are in excess of the payments made under this paragraph are transferred to the Medical Assistance trust fund.
****NOTE: This SECTION involves a change in an appropriation that must be reflected in the revised schedule in s. 20.005, stats.
SECTION 3. 20.435 (4) (w) of the statutes, as affected by 2001 Wisconsin Act 16, is amended to read:
20.435 (4) (w) Medical assistance Assistance trust fund. From the medical assistance Medical Assistance trust fund, biennially, the amounts in the schedule for meeting costs of medical assistance administered under ss. 46.27, 46.275 (5), 46.278 (6), 46.283 (5), 46.284 (5), 49.45, and 49.472 (6), and 51.421 (3), for providing distributions under s. 49.45 (6tt), and for administrative costs associated with augmenting the amount of federal moneys received under 42 CFR 433.51.
SECTION 4. 20.435 (4) (wp) of the statutes is created to read:
20.435 (4) (wp) Medical Assistance trust fund; county reimbursement. From the Medical Assistance trust fund, a sum sufficient to provide reimbursement to a county for moneys transferred in support of payment under s. 49.45 (6m) by the county to the Medical Assistance trust fund and used as the nonfederal share of Medical Assistance payments. Payment to a county under this paragraph may not exceed the amount transferred by the county to the Medical Assistance trust fund.
****NOTE: This SECTION involves a change in an appropriation that must be reflected in the revised schedule in s. 20.005, stats.
SECTION 5. 25.77 (1) of the statutes is amended to read:
25.77 (1) All federal moneys received, including moneys that the department of health and family services may transfer from the appropriation under s. 20.435 (4) (o), that are related to payments under s. 49.45 (6m) and are based on public funds that are transferred or certified under 42 CFR 433.51 (b) and used as the non-federal nonfederal share of medical assistance Medical Assistance funding.
SECTION 6. 25.77 (2) of the statutes is amended to read:
25.77 (2) All public funds that are related to payments under s. 49.45 (6m) and that are transferred or certified under 42 CFR 433.51 (b) and used as the non-federal nonfederal and federal share of medical assistance Medical Assistance funding.
SECTION 7. 25.77 (5) of the statutes is created to read:
25.77 (5) All moneys transferred under s. 20.435 (4) (hm).
SECTION 8. 46.275 (5) (a) of the statutes is amended to read:
46.275 (5) (a) Medical assistance Assistance reimbursement for services a county, or the department under sub. (3r), provides under this program is available from the appropriations appropriation accounts under s. 20.435 (4) (b), (gp), (hm), (o), (r), and (w). If 2 or more counties jointly contract to provide services under this program and the department approves the contract, medical assistance Medical Assistance reimbursement is also available for services provided jointly by these counties.
****NOTE: This is reconciled s. 46.275 (5) (a). This SECTION has been affected by drafts with the following LRB numbers: -0194/8, -1755/P2, and -1760/1.
SECTION 9. 46.275 (5) (c) of the statutes is amended to read:
46.275 (5) (c) The total allocation under s. 20.435 (4) (b), (gp), (hm), (o), (r), and (w) to counties and to the department under sub. (3r) for services provided under this section may not exceed the amount approved by the federal department of health and human services. A county may use funds received under this section only to provide services to persons who meet the requirements under sub. (4) and may not use unexpended funds received under this section to serve other developmentally disabled persons residing in the county.
****NOTE: This is reconciled s. 46.275 (5) (c). This SECTION has been affected by drafts with the following LRB numbers: -0194/8, -1755/P2, and -1760/1.
SECTION 10. 49.45 (6tt) of the statutes is created to read:
49.45 (6tt) DISTRIBUTIONS TO COUNTY DEPARTMENTS AND LOCAL HEALTH DEPARTMENTS. From the appropriation under s. 20.435 (4) (w), the department may in each fiscal year distribute moneys to county departments under s. 46.215, 46.22, 46.23, or 51.42 or to local health departments, as defined in s. 250.01 (4), in amounts that are equal to the moneys received by these county departments or local health departments in calendar year 2002 under s. 49.45 (6t), 2001 stats.
SECTION 11. 49.45 (39) (b) 1. of the statutes is amended to read:
49.45 (39) (b) 1. 'Payment for school medical services.' If a school district or a cooperative educational service agency elects to provide school medical services and meets all requirements under par. (c), the department shall reimburse the school district or the cooperative educational service agency for 60% of the federal share of allowable charges for the school medical services that it provides and, as specified in subd. 2., for allowable administrative costs. If the Wisconsin Center for the Blind and Visually Impaired or the Wisconsin Educational Services Program for the Deaf and Hard of Hearing elects to provide school medical services and meets all requirements under par. (c), the department shall reimburse the department of public instruction for 60% of the federal share of allowable charges for the school medical services that the Wisconsin Center for the Blind and Visually Impaired or the Wisconsin Educational Services Program for the Deaf and Hard of Hearing provides and, as specified in subd. 2., for allowable administrative costs. A school district, cooperative educational service agency, the Wisconsin Center for the Blind and Visually Impaired or the Wisconsin Educational Services Program for the Deaf and Hard of Hearing may submit, and the department shall allow, claims for common carrier transportation costs as a school medical service unless the department receives notice from the federal health care financing administration that, under a change in federal policy, the claims are not allowed. If the department receives the notice, a school district, cooperative educational service agency, the Wisconsin Center for the Blind and Visually Impaired, or the Wisconsin Educational Services Program for the Deaf and Hard of Hearing may submit, and the department shall allow, unreimbursed claims for common carrier transportation costs incurred before the date of the change in federal policy. The department shall promulgate rules establishing a methodology for making reimbursements under this paragraph. All Except as provided in subd. 1m., all other expenses for the school medical services provided by a school district or a cooperative educational service agency shall be paid for by the school district or the cooperative educational service agency with funds received from state or local taxes. The school district, the Wisconsin Center for the Blind and Visually Impaired, the Wisconsin Educational Services Program for the Deaf and Hard of Hearing, or the cooperative educational service agency shall comply with all requirements of the federal department of health and human services for receiving federal financial participation.
SECTION 12. 49.45 (39) (b) 1m. of the statutes is created to read:
49.45 (39) (b) 1m. 'Supplementary payment for school medical services.' In addition to the reimbursement the department provides under subd. 1. to a school district or cooperative educational service agency for school medical services, the department may make supplementary payments from the appropriation accounts under s. 20.435 (4) (b) and (o). The total of the supplementary payments and allowable charges paid under subd. 1. may not exceed applicable limitations on payments under 42 USC 1396a (a) (30) (A).
SECTION 13. 49.45 (39) (b) 2. of the statutes is amended to read:
49.45 (39) (b) 2. 'Payment for school medical services administrative costs.' The department shall reimburse a school district or a cooperative educational service agency specified under subd. 1. subds. 1. and 1m. and shall reimburse the department of public instruction on behalf of the Wisconsin Center for the Blind and Visually Impaired or the Wisconsin Educational Services Program for the Deaf and Hard of Hearing for 90% of the federal share of allowable administrative costs, using time studies, beginning in fiscal year 1999-2000. A school district or a cooperative educational service agency may submit, and the department of health and family services shall allow, claims for administrative costs incurred during the period that is up to 24 months before the date of the claim, if allowable under federal law.
SECTION 14. 51.421 (3) (e) of the statutes is amended to read:
51.421 (3) (e) Distribute, from From the appropriation appropriation accounts under s. 20.435 (4) (w) and (o) and (7) (bL), distribute moneys in each fiscal year for community support program services.
SECTION 15. 59.53 (24) of the statutes is created to read:
59.53 (24) COUNTY PAYMENTS MADE UNDER MEDICAL ASSISTANCE. The board shall, upon demand by the department of health and family services, authorize payment to that department not to exceed any of the following:
(a) Home and community based services. For services provided under ss. 46.275 and 46.278 beginning in 2001 and thereafter, any payment made under s. 20.435 (4) (hm), and the portion of the payment made under s. 20.435 (4) (o) for Medical Assistance Program benefits administered under ss. 46.275 and 46.278 that is related to any rates increased for services under s. 46.275 or 46.278 beginning in 2001.
(b) Alcohol and other drug and mental health prevention and treatment services. For alcohol and other drug and mental health prevention and treatment services provided under s. 49.46 (2) (a) 1., 2., and 4. d. and e. and (b) 6. b., c., d., f., fm., j., k., L., and m., 9., 12., 12m., 13., 15., and 16. beginning in 2003 and thereafter, any payment made under s. 20.435 (4) (hm), and the portion of the payment made under s. 20.435 (4) (o) as Medical Assistance Program benefits for the services that is related to any rates increased for these services beginning in 2003.
SECTION 16. 115.882 of the statutes is amended to read:
115.882 Payment of state aid. Funds appropriated under s. 20.255 (2) (b) shall be used first for the purpose of s. 115.88 (4). Costs eligible for reimbursement from the appropriation under s. 20.255 (2) (b) under ss. 115.88 (1m) to (3), (6) and (8), 115.93, and 118.255 (4) shall be reimbursed at a rate set to distribute the full amount appropriated for reimbursement for the costs, less the amount paid by the department of health and family services under s. 20.435 (4) (hm) and (o) under s. 49.45 (39) (b) 1m., not to exceed 100%.
(End)
LRB-0195LRB-0195/2
GMM:jld:rs
2003 - 2004 LEGISLATURE
DOA:......Blaine - BB0034 Medical Assistance administrative funds claiming
For 2003-05 Budget -- Not Ready For Introduction
2003 BILL
AN ACT ...; relating to: the budget.
Analysis by the Legislative Reference Bureau
health and human services
Other health and human services
Under current law, DHFS contracts for activities to augment the amount of moneys received under Title XIX of the federal Social Security Act (generally referred to as Medical Assistance or MA). Current law requires DHFS to use the moneys received as a result of those income augmentation activities to support costs that are exclusively related to the operational costs of those activities and permits DHFS to use those moneys for other purposes if the secretary of administration and JCF, under a 14-day passive review process, approve a plan submitted by DHFS for the proposed use of those moneys. This bill requires DHFS to distribute not less than 50% of the federal MA moneys received as a result of those income augmentation activities to counties that are participating in those activities for social, mental health, developmental disabilities, and alcohol and other drug abuse services.
For further information see the state and local fiscal estimate, which will be printed as an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:
SECTION 1. 46.46 (1) of the statutes is amended to read:
46.46 (1) From the appropriation account under s. 20.435 (8) (mb), the department shall support costs that are exclusively related to the operational costs of augmenting the amount of moneys received under 42 USC 670 to 679a, 42 USC 1395 to 1395ddd, and 42 USC 1396 to 1396v and shall distribute moneys to counties as provided in sub. (1g). In addition, the department may expend moneys from the appropriation account under s. 20.435 (8) (mb) as provided in sub. subs. (1m) and (2).
SECTION 2. 46.46 (1g) of the statutes is created to read:
46.46 (1g) The department shall distribute not less than 50% of the moneys received under 42 USC 1396 to 1396v as a result of the augmentation activities specified in sub. (1) and credited to the appropriation account under s. 20.435 (8) (mb) to counties that are participating in those activities for community social, mental health, developmental disabilities, and alcohol and other drug abuse services under s. 46.40. The department may distribute any moneys received under 42 USC 1396 to 1396v as a result of the augmentation activities specified in sub. (1) and credited to the appropriation account under s. 20.435 (8) (mb) that are not distributed under this subsection to counties that are participating in those activities as provided in sub. (2).
