SECTION 7. 49.665 (2) (a) 2. of the statutes is created to read:
49.665 (2) (a) 2. The department may not implement sub. (4) (ap) or provisions related to the coverage under sub. (4) (ap) unless a state plan amendment authorizing the coverage under sub. (4) (ap) is approved by the federal department of health and human services.
SECTION 8. 49.665 (3) of the statutes is amended to read:
49.665 (3) ADMINISTRATION. The Subject to sub. (2) (a) 2., the department shall administer a program to provide the health services and benefits described in s. 49.46 (2) to persons that meet the eligibility requirements specified in sub. (4). The department shall promulgate rules setting forth the application procedures and appeal and grievance procedures. The department may promulgate rules limiting access to the program under this section to defined enrollment periods. The department may also promulgate rules establishing a method by which the department may purchase family coverage offered by the employer of a member of an eligible family or by of a member of a an eligible child's household, or family or individual coverage offered by the employer of an eligible unborn child's mother or her spouse, under circumstances in which the department determines that purchasing that coverage would not be more costly than providing the coverage under this section.
SECTION 9. 49.665 (4) (ap) of the statutes is created to read:
49.665 (4) (ap) An unborn child whose mother is not eligible for health care coverage under par. (a) or (am) or for medical assistance under s. 49.46 or 49.47, except that she may be eligible for benefits under s. 49.45 (27), is eligible for health care coverage under this section, which shall be limited to coverage for prenatal care, if all of the following requirements are met:
1. The income of the unborn child's mother, mother and her spouse, or mother and her family, whichever is applicable, does not exceed 185 percent of the poverty line, except as provided in par. (at) and except that, if an unborn child is already receiving health care coverage under this section, the applicable specified person or persons may have an income that does not exceed 200 percent of the poverty line. The department shall establish by rule the criteria to be used to determine income.
2. Each of the following applicable persons who is employed provides verification from his or her employer, in the manner specified by the department, of his or her earnings:
a. The unborn child's mother.
b. The spouse of the unborn child's mother.
c. Members of the unborn child's mother's family.
3. The unborn child's mother provides medical verification of her pregnancy, in the manner specified by the department.
4. The unborn child and the mother of the unborn child meet all other requirements established by the department by rule except for any of the following:
a. The mother is not a U.S. citizen or an alien qualifying for medicaid under 8 USC 1612.
b. The mother is an inmate of a public institution.
c. The mother does not provide a social security number, but only if subd. 4. a. applies.
SECTION 10. 49.665 (4) (at) 3. of the statutes is amended to read:
49.665 (4) (at) 3. The department may not adjust the maximum income level of 200% of the poverty line for persons already receiving health care coverage under this section or for applicable persons specified in par. (ap) 1. with respect to an unborn child already receiving health care coverage under this section.
SECTION 11. 49.665 (4) (c) of the statutes is amended to read:
49.665 (4) (c) No person may be denied health care coverage under this section solely because of a health condition of that person or, of any family member of that person, or of the mother of an unborn child.
SECTION 12. 49.665 (4) (d) of the statutes is created to read:
49.665 (4) (d) An unborn child's eligibility for coverage under par. (ap) shall not begin before the first day of the month in which the unborn child's mother provides the medical verification required under par. (ap) 3.
SECTION 13. 49.665 (5) (ag) of the statutes is amended to read:
49.665 (5) (ag) Except as provided in pars. (am), (b), and (bm), a family, or a child who does not reside with his or her parent, or the mother of an unborn child, who receives health care coverage under this section shall pay a percentage of the cost of that coverage in accordance with a schedule established by the department by rule. The department may not establish or implement a schedule that requires a family or child to contribute contribution, including the amounts required under par. (am), of more than 5% of the family's or child's income of the family, child, or applicable persons specified in sub. (4) (ap) 1. towards the cost of the health care coverage provided under this section.
SECTION 14. 49.665 (5) (am) (intro.) of the statutes is amended to read:
49.665 (5) (am) (intro.) Except as provided in pars. (b) and (bm), a child or, a family member, or the mother of an unborn child, who receives health care coverage under this section shall pay the following cost-sharing amounts:
SECTION 15. 49.665 (5) (b) of the statutes is amended to read:
49.665 (5) (b) The department may not require a family, or child who does not reside with his or her parent, or applicable persons specified in sub. (4) (ap) 1., with an income below 150% of the poverty line, to contribute to the cost of health care coverage provided under this section.
SECTION 16. 49.665 (5) (c) of the statutes is amended to read:
49.665 (5) (c) The department may establish by rule requirements for wage withholding as a means of collecting the a family's or an unborn child's mother's share of the cost of the health care coverage under this section.
SECTION 17. 49.82 (2) of the statutes is amended to read:
49.82 (2) ELIGIBILITY VERIFICATION. Proof shall be provided for each person included in an application for public assistance under this chapter, except for a child who is eligible for medical assistance under s. 49.46 or 49.47 because of 42 USC 1396a (e) (4) or an unborn child who is eligible for coverage under the Badger Care health care program under s. 49.665 (4) (ap), of his or her social security number or that an application for a social security number has been made.
SECTION 9421. Effective dates; health and family services.
(1) BADGER CARE COVERAGE FOR UNBORN CHILDREN. The treatment of sections 49.665 (1) (g), (3), (4) (ap), (at) 3., (c), and (d), and (5) (ag), (am) (intro.), (b), and (c) and 49.82 (2) of the statutes, the renumbering and amendment of section 49.665 (2) (a) of the statutes, and the creation of section 49.665 (2) (a) 2. of the statutes take effect on January 1, 2006.
(End)
LRB-0264LRB-0264/3
PJK:wlj:rs
2005 - 2006 LEGISLATURE
DOA:......Rhodes, BB0016 - MA coverage for youths leaving out-of-home care
For 2005-07 Budget -- Not Ready For Introduction
2005 BILL
AN ACT ...; relating to: the budget.
Analysis by the Legislative Reference Bureau
health and human services
Medical Assistance
Under current law, children who are in foster care, including treatment foster care, are eligible to receive medical assistance. In most cases, this eligibility ends when the child reaches the age of 18.
This bill extends eligibility for medical assistance on January 1, 2007, to an individual who is 18 or 19 years old, and on January 1, 2008, to an individual who is 18, 19, or 20 years old, and who on his or her 18th birthday was in foster care or treatment foster care.
For further information see the state 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. 49.46 (1) (a) 5m. of the statutes is created to read:
49.46 (1) (a) 5m. Any person who is at least 18 years of age but under 20 years of age and who, on his or her 18th birthday, was in a foster care or treatment foster care placement under ch. 48 or 938, as determined by the department.
SECTION 2. 49.46 (1) (a) 5m. of the statutes, as created by 2005 Wisconsin Act .... (this act), is amended to read:
49.46 (1) (a) 5m. Any person who is at least 18 years of age but under 20 21 years of age and who, on his or her 18th birthday, was in a foster care or treatment foster care placement under ch. 48 or 938, as determined by the department.
SECTION 9321. Initial applicability; health and family services.
(1) MEDICAL ASSISTANCE FOR INDIVIDUALS LEAVING OUT-OF-HOME CARE.
(a) The creation of section 49.46 (1) (a) 5m. of the statutes first applies to medical assistance eligibility determinations made on the effective date of this paragraph.
(b) The amendment of section 49.46 (1) (a) 5m. of the statutes first applies to medical assistance eligibility determinations made on the effective date of this paragraph.
SECTION 9421. Effective dates; health and family services.
(1) MEDICAL ASSISTANCE FOR INDIVIDUALS LEAVING OUT-OF-HOME CARE.
(a) The creation of section 49.46 (1) (a) 5m. of the statutes and SECTION 9321 (1) (a) of this act take effect on January 1, 2007.
(b) The amendment of section 49.46 (1) (a) 5m. of the statutes and SECTION 9321 (1) (b) of this act take effect on January 1, 2008.
(End)
LRB-0265LRB-0265/3
PJK&GMM:jld:ch
2005 - 2006 LEGISLATURE
DOA:......Milioto, BB0021 - Administration of SSI program
For 2005-07 Budget -- Not Ready For Introduction
2005 BILL
AN ACT ...; relating to: the budget.
Analysis by the Legislative Reference Bureau
Health and human services
Public assistance
Under one program under current law, low-income individuals who are eligible to receive federal supplemental security income (SSI) because they are blind, disabled, or 65 years of age or older are eligible to receive a state supplemental payment. Under another program under current law, an individual who receives SSI or state supplemental payments, or both, and who is a custodial parent of a dependent child is eligible to receive monthly payments for the support of the dependent child. DHFS administers both of the programs. This bill expressly provides that DHFS shall administer both programs, and authorizes DHFS to promulgate rules to guide the administration of eligibility determinations and benefits payments under the programs.
DHFS administers a number of public assistance programs under current law under which persons who satisfy eligibility criteria receive financial, health care, or other types of assistance. This bill specifically authorizes DHFS to recover benefits incorrectly paid under any of the assistance programs that it administers, and provides that DHFS may recover overpayments by reducing the benefits of a family or individual who received the overpayments and who is still receiving benefits. The bill authorizes DHFS to specify by rule other methods for recovering incorrectly paid benefits, and provides for recovery of these incorrectly paid benefits through a state income tax refund setoff process.
Under current law, DWD is required to investigate suspected fraudulent activity on the part of participants in the Aid to Families with Dependent Children (AFDC) program and participants in the Wisconsin Works (W-2) program and to conduct activities to reduce payment errors in W-2. DHFS is authorized to contract with DWD for DWD to investigate suspected fraudulent activity and to conduct activities to reduce payment errors in two programs administered by DHFS: the MA and the food stamp program.
This bill maintains the requirement for DWD to investigate fraud and conduct error reduction activities and the authorization for DHFS to contract with DWD, but adds an alternative fraud and error reduction scheme for both departments. Under the bill, DHFS is also required to investigate suspected fraudulent activities and to conduct activities to reduce payment errors in the programs that it administers and DWD is authorized to contract with DHFS to investigate suspected fraud and conduct payment error reduction activities in the programs that DWD administers. Thus, each department must either conduct its own investigation and error reduction activities or contract with the other department to do so. In addition, the bill adds three DHFS-administered programs to the programs for which fraudulent activity must be investigated and payment error reduction activities must be conducted: the Badger Care health care program, the program under which DHFS provides state supplemental payments to persons eligible to receive SSI, and the program under which DHFS makes monthly payments for the support of dependent children to custodial parents who are receiving SSI or state supplemental payments.
This bill also changes from annual to continuing a DWD general purpose revenue appropriation that is used primarily for the administration and benefit costs of W-2. The unencumbered balance of an annual appropriation lapses to the fund from which the moneys are appropriated at the end of a fiscal year; continuing appropriation balances do not lapse at the end of a fiscal year or at the end of a biennium and are expendable until fully depleted.
Children
Under current law, DHFS or a county department of human services or social services (county department) provides monthly payments to foster parents, treatment foster parents, kinship care relatives, and long-term kinship care relatives who provide care and maintenance for children. DHFS also provides adoption assistance, including monthly maintenance payments, to adoptive parents to assist in the cost of the care of children with special needs. This bill permits DHFS or a county department to recover an overpayment of foster care, treatment foster care, kinship care, long-term kinship care, and adoption assistance payments from a foster parent, treatment foster parent, kinship care relative, long-term kinship care relative, or adoptive parent who continues to receive those payments by reducing those payments. The bill also permits DHFS to specify by rule other methods for recovering those payments.
For further information see the state 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. 20.435 (4) (L) of the statutes is amended to read:
20.435 (4) (L) Medical assistance and food stamp fraud Fraud and error reduction. All moneys received as the state's share of the recovery of overpayments and incorrect payments under ss. 49.847, 49.497 (1) and (1m), and 49.793 (2) and all moneys received from counties and tribal governing bodies as a result of any error reduction activities in the medical assistance and food stamp programs under ss. 49.45 (2) (a) 3m., 49.197, and 49.79 (9) and 49.845, for any contracts under s. 49.197 (5), for any activities to reduce error and fraud under ss. 49.45 (2) (a) 3m. and 49.79 (9) s. 49.845, to pay federal sanctions under the food stamp program, and for food stamp reinvestment activities under reinvestment agreements with the federal department of agriculture that are designed to improve the food stamp program.
****NOTE: This SECTION involves a change in an appropriation that must be reflected in the revised schedule in s. 20.005, stats.
****NOTE: This is reconciled s. 20.435 (4) (L). This SECTION has been affected by drafts with the following LRB numbers: LRB-0265 and LRB-0879.
SECTION 2. 20.445 (3) (dz) of the statutes is amended to read:
20.445 (3) (dz) Temporary Assistance for Needy Families programs; maintenance of effort. The As a continuing appropriation, the amounts in the schedule, less the amounts withheld under s. 49.143 (3), for administration and benefit payments under Wisconsin Works under ss. 49.141 to 49.161, the learnfare program under s. 49.26, and the work experience program for noncustodial parents under s. 49.36; for payments to local governments, organizations, tribal governing bodies, and Wisconsin Works agencies; and for emergency assistance for families with needy children under s. 49.138; and for job access loans under s. 49.147 (6). Payments may be made from this appropriation for any contracts under s. 49.845 (4) and for any fraud investigation and error reduction activities under s. 49.197 (1m). Moneys appropriated under this paragraph may be used to match federal funds received under par. (md). Notwithstanding ss. 20.001 (3) (a) and 20.002 (1), the department may transfer funds between fiscal years under this paragraph. Notwithstanding ss. 20.001 (3) and 20.002 (1), the department of health and family services shall credit or deposit into this appropriation account funds for the purposes of this appropriation that the department transfers from the appropriation account under s. 20.435 (7) (bc). All funds allocated by the department but not encumbered by December 31 of each year lapse to the general fund on the next January 1 unless transferred to the next calendar year by the joint committee on finance.
****NOTE: This SECTION involves a change in an appropriation that must be reflected in the revised schedule in s. 20.005, stats.
****NOTE: This is reconciled s. 20.445 (3) (dz). This SECTION has been affected by drafts with the following LRB numbers: LRB-0265, -0587, and -1526.
SECTION 3. 20.445 (3) (L) of the statutes is amended to read:
20.445 (3) (L) Public assistance overpayment recovery and fraud and error reduction. All moneys received as the state's share of the recovery of overpayments and incorrect payments under s. 49.191 (3) (c), 1997 stats., and s. 49.195, 1997 stats., for any contracts under s. 49.845 (4) and for any activities to reduce error and fraud under s. 49.197 relating to the Aid to Families with Dependent Children program and the Wisconsin Works program.
SECTION 4. 48.57 (3m) (h) of the statutes is created to read:
48.57 (3m) (h) A county department or, in a county having a population of 500,000 or more, the department may recover an overpayment made under par. (am) from a kinship care relative who continues to receive payments under par. (am) by reducing the amount of the kinship care relative's monthly payment. The department may by rule specify other methods for recovering overpayments made under par. (am). A county department that recovers an overpayment under this paragraph due to the efforts of its officers and employees may retain a portion of the amount recovered, as provided by the department by rule.
SECTION 5. 48.57 (3n) (h) of the statutes is created to read:
48.57 (3n) (h) A county department or, in a county having a population of 500,000 or more, the department may recover an overpayment made under par. (am) from a long-term kinship care relative who continues to receive payments under par. (am) by reducing the amount of the long-term kinship care relative's monthly payment. The department may by rule specify other methods for recovering overpayments made under par. (am). A county department that recovers an overpayment under this paragraph due to the efforts of its officers and employees may retain a portion of the amount recovered, as provided by the department by rule.
SECTION 6. 48.62 (6) of the statutes is created to read:
48.62 (6) The department or a county department may recover an overpayment made under sub. (4) or (5) from a foster parent, treatment foster parent, guardian, or interim caretaker who continues to receive payments under sub. (4) or (5) by reducing the amount of the person's monthly payment. The department may by rule specify other methods for recovering overpayments made under sub. (4) or (5). A county department that recovers an overpayment under this subsection due to the efforts of its officers and employees may retain a portion of the amount recovered, as provided by the department by rule.
****NOTE: This is reconciled s. 48.62 (6). This SECTION has been affected by drafts with the following LRB numbers: LRB-0265/2 and LRB-0084/2.
