SB40-CSA1,704,2522 (c) If the department issues an order to compel payment under par. (a), interest
23at the rate of 12 percent per year shall be computed by the department and added
24at the time of payment to the person's liability. That interest shall begin on the date
25on which payment was due and shall end on the day before the date of final payment.
SB40-CSA1,705,9
1(5) If any person named in an order to compel payment issued under sub. (4)
2(a) fails to pay the department any amount due under the terms of the order, and no
3contested case to review the order is pending, and the time for filing for a contested
4case review has expired, the department may present a certified copy of the order to
5the circuit court for any county. The circuit court shall, without notice, render
6judgment in accordance with the order. A judgment rendered under this subsection
7shall have the same effect and shall be entered in the judgment and lien docket and
8may be enforced in the same manner as if the judgment had been rendered in an
9action tried and determined by the circuit court.
SB40-CSA1,705,12 10(6) The sworn statement of the collection and deportation counsel, or of the
11secretary, shall be evidence of the fee and of the care and services received by the
12person.
SB40-CSA1,705,22 13(7) The department shall administer and enforce this section. It shall appoint
14an attorney to be designated "collection and deportation counsel" and other
15necessary assistants. The department may delegate to the collection and
16deportation counsel such other powers and duties as it considers advisable. The
17collection and deportation counsel or any of the assistants may administer oaths,
18take affidavits and testimony, examine public records, and subpoena witnesses and
19the production of books, papers, records, and documents material to any matter of
20proceeding relating to payments for the cost of maintenance. The department shall
21encourage agreements or settlements with the liable person, having due regard to
22ability to pay and the present needs of lawful dependents.
SB40-CSA1,705,23 23(8) The department may do any of the following:
SB40-CSA1,706,3
1(a) Appear for the state in any and all collection and deportation matters
2arising in the several courts, and may commence suit in the name of the department
3to recover the cost of maintenance against the person liable therefor.
SB40-CSA1,706,74 (b) Determine whether any person is subject to deportation, and on behalf of
5this state enter into reciprocal agreements with other states for deportation and
6importation of persons who are public charges, upon such terms as will protect the
7state's interests and promote mutual amicable relations with other states.
SB40-CSA1,706,128 (c) From time to time investigate the financial condition and needs of persons
9liable under sub. (2), their present ability to maintain themselves, the persons legally
10dependent upon them for support, the protection of the property and investments
11from which they derive their living and their care and protection, for the purpose of
12ascertaining the person's ability to make payment in whole or in part.
SB40-CSA1,706,1713 (d) After due regard to the case and to a spouse and minor children who are
14lawfully dependent on the property for support, compromise or waive any portion of
15any claim of the state or county for which a person specified under sub. (2) is liable,
16but not any claim payable by an insurer under s. 632.89 (2) or (2m) or by any other
173rd party.
SB40-CSA1,706,2018 (e) Make an agreement with a person who is liable under sub. (2), or who may
19be willing to assume the cost of maintenance of any person, providing for the
20payment of such costs at a specified rate or amount.
SB40-CSA1,706,2221 (f) Make adjustment and settlement with the several counties for their proper
22share of all moneys collected.
SB40-CSA1,706,2523 (g) Pay quarterly from the appropriation under s. 20.437 (1) (gg) the collection
24moneys due county departments under ss. 46.22 and 46.23. Payments shall be made
25as soon after the close of each quarter as is practicable.
SB40-CSA1,707,10
1(9) Any person who willfully testifies falsely as to any material matter in an
2investigation or proceeding under this section shall be guilty of perjury. Banks,
3employers, insurers, savings banks, savings and loan associations, brokers, and
4fiduciaries, upon request of the department, shall furnish in writing and duly
5certified, full information regarding the property, earnings, or income or any funds
6deposited to the credit of or owing to any person liable under sub. (2). That certified
7statement shall be admissible in evidence in any action or proceeding to compel
8payment under this section, and shall be evidence of the facts stated in the certified
9statement, if a copy of the statement is served upon the party sought to be charged
10not less than 3 days before the hearing.
SB40-CSA1,707,13 11(10) The department shall make all reasonable and proper efforts to collect all
12claims for maintenance, to keep payments current, and periodically to review all
13unpaid claims.
SB40-CSA1,707,15 14(11) (a) Except as provided in par. (b), in any action to recover from a person
15liable under this section, the statute of limitations may be pleaded in defense.
SB40-CSA1,707,1916 (b) If a person who is liable under this section is deceased, a claim may be filed
17against the decedent's estate and the statute of limitations specified in s. 859.02 shall
18be exclusively applicable. This paragraph applies to liability incurred on or after
19July 20, 1985.
SB40-CSA1,708,5 20(14) (a) Except as provided in pars. (b) and (c), liability of a person specified in
21sub. (2) or s. 49.32 (1) for care and maintenance of persons under 18 years of age in
22residential, nonmedical facilities such as group homes, foster homes, treatment
23foster homes, subsidized guardianship homes, and residential care centers for
24children and youth is determined in accordance with the cost-based fee established
25under s. 49.32 (1). The department shall bill the liable person up to any amount of

1liability not paid by an insurer under s. 632.89 (2) or (2m) or by other 3rd-party
2benefits, subject to rules that include formulas governing ability to pay established
3by the department under s. 49.32 (1). Any liability of the person not payable by any
4other person terminates when the person reaches age 18, unless the liable person has
5prevented payment by any act or omission.
SB40-CSA1,708,136 (b) Except as provided in par. (c), and subject to par. (cm), liability of a parent
7specified in sub. (2) or s. 49.32 (1) for the care and maintenance of the parent's minor
8child who has been placed by a court order under s. 48.355 or 48.357 in a residential,
9nonmedical facility such as a group home, foster home, treatment foster home,
10subsidized guardianship home, or residential care center for children and youth
11shall be determined by the court by using the percentage standard established by the
12department under s. 49.22 (9) and by applying the percentage standard in the
13manner established by the department under par. (g).
SB40-CSA1,708,1714 (c) Upon request by a parent, the court may modify the amount of child support
15payments determined under par. (b), subject to par. (cm), if, after considering the
16following factors, the court finds by the greater weight of the credible evidence that
17the use of the percentage standard is unfair to the child or to either of the parents:
SB40-CSA1,708,1818 1. The needs of the child.
SB40-CSA1,708,2019 2. The physical, mental, and emotional health needs of the child, including any
20costs for the child's health insurance provided by a parent.
SB40-CSA1,708,2321 3. The standard of living and circumstances of the parents, including the needs
22of each parent to support himself or herself at a level equal to or greater than that
23established under 42 USC 9902 (2).
SB40-CSA1,708,2424 4. The financial resources of the parents.
SB40-CSA1,709,3
15. The earning capacity of each parent, based on each parent's education,
2training, and work experience and based on the availability of work in or near the
3parent's community.
SB40-CSA1,709,44 6. The need and capacity of the child for education, including higher education.
SB40-CSA1,709,55 7. The age of the child.
SB40-CSA1,709,66 8. The financial resources and the earning ability of the child.
SB40-CSA1,709,87 9. The needs of any person, including dependent children other than the child,
8whom either parent is legally obligated to support.
SB40-CSA1,709,149 10. The best interests of the child, including, but not limited to, the impact on
10the child of expenditures by the family for improvement of any conditions in the home
11that would facilitate the reunification of the child with the child's family, if
12appropriate, and the importance of a placement that is the least restrictive of the
13rights of the child and the parents and the most appropriate for meeting the needs
14of the child and the family.
SB40-CSA1,709,1515 11. Any other factors that the court in each case determines are relevant.
SB40-CSA1,709,2316 (cm) 1. Except as provided in subd. 2., if a parent who is required to pay child
17support under par. (b) or (c) is receiving adoption assistance under s. 48.975 for the
18child for whom support is ordered, the amount of the child support payments
19determined under par. (b) or (c) may not exceed the amount of the adoption assistance
20maintenance payments under s. 48.975 (3) (a). If an agreement under s. 48.975 (4)
21is in effect that provides for a payment of $0 under s. 48.975 (3) (a), the payment of
22$0 shall be considered to be an adoption assistance maintenance payment for
23purposes of this subdivision.
SB40-CSA1,710,324 2. Subdivision 1. does not apply if, after considering the factors under par. (c)
251. to 11., the court finds by the greater weight of the credible evidence that limiting

1the amount of the child support payments to the amount of the adoption assistance
2maintenance payments under s. 48.975 (3) (a) is unfair to the child or to either of the
3parents.
SB40-CSA1,710,104 (d) If the court finds under par. (c) that use of the percentage standard is unfair
5to the minor child or either of the parents, the court shall state in writing or on the
6record the amount of support that would be required by using the percentage
7standard, the amount by which the court's order deviates from that amount, its
8reasons for finding that use of the percentage standard is unfair to the child or the
9parent, its reasons for the amount of the modification, and the basis for the
10modification.
SB40-CSA1,710,1811 (e) 1. An order issued under s. 48.355 (2) (b) 4., 48.357 (5m) (a), or 48.363 (2)
12for support determined under this subsection constitutes an assignment of all
13commissions, earnings, salaries, wages, pension benefits, benefits under ch. 102 or
14108, and other money due or to be due in the future to the county department under
15s. 46.22 or 46.23 in the county where the order was entered or to the department,
16depending upon the placement of the child as specified by rules promulgated under
17subd. 5. The assignment shall be for an amount sufficient to ensure payment under
18the order.
SB40-CSA1,710,2219 2. Except as provided in subd. 3., for each payment made under the assignment,
20the person from whom the payer under the order receives money shall receive an
21amount equal to the person's necessary disbursements, not to exceed $3, which shall
22be deducted from the money to be paid to the payer.
SB40-CSA1,711,223 3. Benefits under ch. 108 may be assigned and withheld only in the manner
24provided in s. 108.13 (4). Any order to withhold benefits under ch. 108 shall be for
25an amount certain. When money is to be withheld from these benefits, no fee may

1be deducted from the amount withheld and no fine may be levied for failure to
2withhold the money.
SB40-CSA1,711,113 4. No employer may use an assignment under this paragraph as a basis for the
4denial of employment to a person, the discharge of an employee, or any disciplinary
5action against an employee. An employer who denies employment or discharges or
6disciplines an employee in violation of this subdivision may be fined not more than
7$500 and may be required to make full restitution to the aggrieved person, including
8reinstatement and back pay. Except as provided in this subdivision, restitution shall
9be in accordance with s. 973.20. An aggrieved person may apply to the district
10attorney or to the department of workforce development for enforcement of this
11subdivision.
SB40-CSA1,711,1312 5. The department shall promulgate rules for the operation and
13implementation of assignments under this paragraph.
SB40-CSA1,711,1914 (f) If the amount of the child support determined under this subsection is
15greater than the cost for the care and maintenance of the minor child in the
16residential, nonmedical facility, the assignee under par. (e) 1. shall expend or
17otherwise dispose of any funds that are collected in excess of the cost of such care and
18maintenance in a manner that the assignee determines will serve the best interests
19of the minor child.
SB40-CSA1,712,3 20(16) The department shall delegate to county departments under ss. 46.22 and
2146.23 or the local providers of care and services meeting the standards established
22by the department under s. 49.34 the responsibilities vested in the department under
23this section for collection of fees for services other than those provided at state
24facilities, if the county departments or providers meet the conditions that the
25department determines are appropriate. The department may delegate to county

1departments under ss. 46.22 and 46.23 the responsibilities vested in the department
2under this section for collection of fees for services provided at the state facilities if
3the necessary conditions are met.
SB40-CSA1, s. 1508 4Section 1508. 49.35 (1) (a) of the statutes is amended to read:
SB40-CSA1,712,105 49.35 (1) (a) The department shall supervise the administration of programs
6under this subchapter and ch. 48. The department shall submit to the federal
7authorities state plans for the administration of programs under this subchapter and
8ch. 48
in such form and containing such information as the federal authorities
9require, and shall comply with all requirements prescribed to ensure their
10correctness.
SB40-CSA1, s. 1509 11Section 1509. 49.35 (1) (b) of the statutes is amended to read:
SB40-CSA1,712,1912 49.35 (1) (b) All records of the department and all county records relating to
13programs under this subchapter and ch. 48 and aid under s. 49.18, 1971 stats., s.
1449.20, 1971 stats., and s. 49.61, 1971 stats., as affected by chapter 90, laws of 1973,
15shall be open to inspection at all reasonable hours by authorized representatives of
16the federal government. Notwithstanding ss. 48.396 (2) and 938.396 (2), all county
17records relating to the administration of the services and public assistance specified
18in this paragraph shall be open to inspection at all reasonable hours by authorized
19representatives of the department.
SB40-CSA1, s. 1510 20Section 1510. 49.35 (2) of the statutes is amended to read:
SB40-CSA1,712,2321 49.35 (2) The county administration of all laws relating to programs under this
22subchapter and ch. 48 shall be vested in the officers and agencies designated in the
23statutes.
SB40-CSA1, s. 1511 24Section 1511. 49.36 (2) of the statutes is amended to read:
SB40-CSA1,713,9
149.36 (2) The department may contract with any county, tribal governing body,
2or Wisconsin Works agency to administer a work experience and job training
3program for parents who are not custodial parents and who fail to pay child support
4or to meet their children's needs for support as a result of unemployment or
5underemployment. The program may provide the kinds of work experience and job
6training services available from the program under s. 49.193, 1997 stats., or s. 49.147
7(3), (3m), or (4). The program may also include job search and job orientation
8activities. The department shall fund the program from the appropriations under
9s. 20.445 (3) (dz) and (k).
SB40-CSA1, s. 1512 10Section 1512 . 49.36 (2) of the statutes, as affected by 2007 Wisconsin Act ....
11(this act), is amended to read:
SB40-CSA1,713,2012 49.36 (2) The department may contract with any county, tribal governing body,
13or Wisconsin Works agency to administer a work experience and job training
14program for parents who are not custodial parents and who fail to pay child support
15or to meet their children's needs for support as a result of unemployment or
16underemployment. The program may provide the kinds of work experience and job
17training services available from the program under s. 49.193, 1997 stats., or s. 49.147
18(3), (3m), or (4). The program may also include job search and job orientation
19activities. The department shall fund the program from the appropriations under
20s. 20.445 (3) 20.437 (2) (dz) and (k).
SB40-CSA1, s. 1513 21Section 1513. 49.45 (2) (a) 1. of the statutes is amended to read:
SB40-CSA1,713,2422 49.45 (2) (a) 1. Exercise responsibility relating to fiscal matters, the eligibility
23for benefits under standards set forth in ss. 49.46 to 49.47 49.471, and general
24supervision of the medical assistance program.
SB40-CSA1, s. 1514 25Section 1514. 49.45 (2) (a) 3. of the statutes is amended to read:
SB40-CSA1,714,5
149.45 (2) (a) 3. Determine the eligibility of persons for medical assistance,
2rehabilitative, and social services under ss. 49.46, 49.468, and 49.47, and 49.471 and
3rules and policies adopted by the department and may, under a contract under s.
449.78 (2), delegate all, or any portion, of this function to the county department under
5s. 46.215, 46.22, or 46.23 or a tribal governing body.
SB40-CSA1, s. 1516 6Section 1516. 49.45 (2) (b) 3. of the statutes is amended to read:
SB40-CSA1,714,87 49.45 (2) (b) 3. Audit all claims filed by any contractor making the payment of
8benefits paid under ss. 49.46 to 49.47 49.471 and make proper fiscal adjustments.
SB40-CSA1, s. 1517 9Section 1517. 49.45 (2) (b) 7. (intro.) of the statutes is amended to read:
SB40-CSA1,714,2210 49.45 (2) (b) 7. (intro.) Require, as a condition of certification under par. (a) 11.,
11all providers of a specific service that is among those enumerated under s. 49.46 (2)
12or, 49.47 (6) (a), or 49.471 (11), as specified in this subdivision, to file with the
13department a surety bond issued by a surety company licensed to do business in this
14state. Providers subject to this subdivision provide those services specified under s.
1549.46 (2) or, 49.47 (6) (a), or 49.471 (11) for which providers have demonstrated
16significant potential to violate s. 49.49 (1) (a), (2) (a) or (b), (3), (3m) (a), (3p), (4) (a),
17or (4m) (a), to require recovery under par. (a) 10., or to need additional sanctions
18under par. (a) 13. The surety bond shall be payable to the department in an amount
19that the department determines is reasonable in view of amounts of former
20recoveries against providers of the specific service and the department's costs to
21pursue those recoveries. The department shall promulgate rules to implement this
22subdivision that specify all of the following:
SB40-CSA1, s. 1518 23Section 1518. 49.45 (3) (ag) of the statutes is amended to read:
SB40-CSA1,715,3
149.45 (3) (ag) Reimbursement shall be made to each entity contracted with
2under s. 46.281 (1) (e) 46.283 (2) for functional screens screenings performed by the
3entity.
SB40-CSA1, s. 1519 4Section 1519. 49.45 (3) (b) 1. of the statutes is amended to read:
SB40-CSA1,715,115 49.45 (3) (b) 1. The contractor, if any, administering benefits or providing
6prepaid health care under s. 49.46, 49.465, 49.468 or , 49.47, or 49.471 shall be
7entitled to payment from the department for benefits so paid or prepaid health care
8so provided or made available when a certification of eligibility is properly on file
9with the contractor in addition to the payment of administrative expense incurred
10pursuant to the contract and as provided in sub. (2) (a) 4., but the contractor shall
11not be reimbursed for benefits erroneously paid where no certification is on file.
SB40-CSA1, s. 1520 12Section 1520. 49.45 (3) (b) 2. of the statutes is amended to read:
SB40-CSA1,715,1613 49.45 (3) (b) 2. The contractor, if any, insuring benefits under s. 49.46, 49.465,
1449.468 or, 49.47, or 49.471 shall be entitled to receive a premium, in an amount and
15on terms agreed, for such benefits for the persons eligible to receive them and for its
16services as insurer.
SB40-CSA1, s. 1521 17Section 1521. 49.45 (3) (dm) of the statutes is amended to read:
SB40-CSA1,715,2318 49.45 (3) (dm) After distribution of computer software has been made under
191993 Wisconsin Act 16, section 9126 (13h), no payment may be made for home health
20care services provided to persons who are enrolled in the federal medicare program
21and are recipients of medical assistance under s. 49.46 or , 49.47, or 49.471 unless the
22provider of the services has in use the computer software to maximize payments
23under the federal medicare program under 42 USC 1395.
SB40-CSA1, s. 1522 24Section 1522. 49.45 (3) (f) 2. of the statutes is amended to read:
SB40-CSA1,716,8
149.45 (3) (f) 2. The department may deny any provider claim for reimbursement
2which cannot be verified under subd. 1. or may recover the value of any payment
3made to a provider which cannot be so verified. The measure of recovery will be the
4full value of any claim if it is determined upon audit that actual provision of the
5service cannot be verified from the provider's records or that the service provided was
6not included in s. 49.46 (2) or 49.471 (11). In cases of mathematical inaccuracies in
7computations or statements of claims, the measure of recovery will be limited to the
8amount of the error.
SB40-CSA1, s. 1523 9Section 1523. 49.45 (3) (L) 2. of the statutes is amended to read:
SB40-CSA1,716,1510 49.45 (3) (L) 2. The department may not pay a provider for a designated health
11service that is authorized under this section or s. 49.46 or, 49.47, or 49.471, that is
12provided as the result of a referral made to the provider by a physician and that,
13under 42 USC 1396b (s), if made on behalf of a beneficiary of medicare under the
14requirements of 42 USC 1395nn, as amended to August 10, 1993, would result in the
15denial of payment for the service under 42 USC 1395nn.
SB40-CSA1, s. 1524 16Section 1524. 49.45 (3) (m) of the statutes is amended to read:
SB40-CSA1,717,817 49.45 (3) (m) To be certified under sub. (2) (a) 11. to provide transportation by
18specialized medical vehicle, a person must have at least one human service vehicle,
19as defined in s. 340.01 (23g), that satisfies the requirements imposed under s. 110.05
20for a vehicle that is used to transport a person in a wheelchair. If a certified provider
21uses 2 or more vehicles to provide transportation by specialized medical vehicle, at
22least 2 of the vehicles must be human service vehicles that satisfy the requirements
23imposed under s. 110.05 for a vehicle that is used to transport a person in a
24wheelchair, and any 3rd or additional vehicle must be a human service vehicle to
25which the equipment required under s. 110.05 for transporting a person in a

1wheelchair may be added. The department shall pay for transportation by
2specialized medical vehicle under s. 49.46 (2) (b) 3. or 49.471 (11) (m) that is provided
3in a human service vehicle that is not equipped to transport a person in a wheelchair
4if the person being transported does not use a wheelchair. The reimbursement rate
5for transportation by specialized medical vehicle provided in a vehicle that is not
6equipped to accommodate a wheelchair shall be the same as for transportation by
7specialized medical vehicle provided in a vehicle that is equipped to accommodate a
8wheelchair.
SB40-CSA1, s. 1526 9Section 1526. 49.45 (6c) (d) 1. of the statutes is amended to read:
SB40-CSA1,718,410 49.45 (6c) (d) 1. No payment may be made under sub. (6m) to a facility or to
11an institution for mental diseases for the care of an individual who is otherwise
12eligible for medical assistance under s. 49.46 or, 49.47, or 49.471, who has
13developmental disability or mental illness and for whom under par. (b) or (c) it is
14determined that he or she does not need facility care, unless it is determined that the
15individual requires active treatment for developmental disability or active
16treatment for mental illness and has continuously resided in a facility or institution
17for mental diseases for at least 30 months prior to the date of the determination. If
18that individual requires active treatment and has so continuously resided, he or she
19shall be offered the choice of receiving active treatment for developmental disability
20or active treatment for mental illness in the facility or institution for mental diseases
21or in an alternative setting. A facility resident who has developmental disability or
22mental illness, for whom under par. (c) it is determined that he or she does not need
23facility care and who has not continuously resided in a facility for at least 30 months
24prior to the date of the determination, may not continue to reside in the facility after
25December 31, 1993, and shall, if the department so determines, be relocated from the

1facility after March 31, 1990, and before December 31, 1993. The county department
2shall be responsible for securing alternative residence on behalf of an individual who
3is required to be relocated from a facility under this subdivision, and the facility shall
4cooperate with the county department in the relocation.
SB40-CSA1, s. 1527 5Section 1527. 49.45 (6c) (d) 2. of the statutes is amended to read:
SB40-CSA1,718,126 49.45 (6c) (d) 2. Payment may be made under sub. (6m) to a facility or
7institution for mental diseases for the care of an individual who is otherwise eligible
8for medical assistance under s. 49.46 or, 49.47, or 49.471 and who has developmental
9disability or mental illness and is determined under par. (b) or (c) to need facility care,
10regardless of whether it is determined under par. (b) or (c) that the individual does
11or does not require active treatment for developmental disability or active treatment
12for mental illness.
SB40-CSA1, s. 1530h 13Section 1530h. 49.45 (6m) (ar) 1. a. of the statutes is amended to read:
SB40-CSA1,719,214 49.45 (6m) (ar) 1. a. The department shall establish standards for payment of
15allowable direct care costs under par. (am) 1. bm., for facilities that do not primarily
16serve the developmentally disabled, that take into account direct care costs for a
17sample of all of those facilities in this state and separate standards for payment of
18allowable direct care costs, for facilities that primarily serve the developmentally
19disabled, that take into account direct care costs for a sample of all of those facilities
20in this state. The standards shall be adjusted by the department for regional labor
21cost variations. The department shall treat as a single labor region the counties of
22Dane, Iowa, Columbia, and Sauk, and Rock and shall adjust payment so that the
23direct care cost targets of facilities in Dane, Iowa, Columbia, and Sauk counties are
24not reduced as a result of including facilities in Rock County in this labor region
. For
25facilities in Douglas, Pierce, and St. Croix counties, the department shall perform the

1adjustment by use of the wage index that is used by the federal department of health
2and human services for hospital reimbursement under 42 USC 1395 to 1395ggg.
SB40-CSA1, s. 1532 3Section 1532 . 49.45 (6m) (br) 1. of the statutes is amended to read:
SB40-CSA1,719,134 49.45 (6m) (br) 1. Notwithstanding s. 20.410 (3) (cd), 20.435 (4) (bt) or (7) (b)
5or 20.445 (3) 20.437 (2) (dz), the department shall reduce allocations of funds to
6counties in the amount of the disallowance from the appropriation account under s.
720.435 (4) (bt) or (7) (b), or the department shall direct the department of workforce
8development
children and families to reduce allocations of funds to counties or
9Wisconsin works Works agencies in the amount of the disallowance from the
10appropriation account under s. 20.445 (3) 20.437 (2) (dz) or direct the department of
11corrections to reduce allocations of funds to counties in the amount of the
12disallowance from the appropriation account under s. 20.410 (3) (cd), in accordance
13with s. 16.544 to the extent applicable.
SB40-CSA1, s. 1533 14Section 1533. 49.45 (6m) (m) of the statutes is created to read:
SB40-CSA1,719,1815 49.45 (6m) (m) To hold a bed in a facility, the department may pay the full
16payment rate under this subsection for up to 30 days for services provided to a person
17during the pendency of an undue hardship determination, as provided in s. 49.453
18(8) (b) 3.
SB40-CSA1, s. 1538 19Section 1538 . 49.45 (6z) (a) (intro.) of the statutes is amended to read:
SB40-CSA1,720,820 49.45 (6z) (a) (intro.) Notwithstanding sub. (3) (e), from the appropriation
21accounts under s. 20.435 (4) (b), (gp), (o), and (w), the department shall may
22distribute funding in each fiscal year to supplement payment for services to hospitals
23that enter into a contract under s. 49.02 (2) to provide health care services funded
24by a relief block grant under this chapter
indigent care agreements, in accordance
25with the approved state plan for services under 42 USC 1396a, with relief agencies

1that administer the medical relief block grant under this chapter
, if the department
2determines that the hospitals serve a disproportionate number of low-income
3patients with special needs. If no medical relief block grant under this chapter is
4awarded or if the allocation of funds to such hospitals would exceed any limitation
5under 42 USC 1396b (i) (3), the department may distribute funds to hospitals that
6have not entered into a contract under s. 49.02 (2) indigent care agreements. The
7department may not distribute funds under this subsection to the extent that the
8distribution would do any of the following:
SB40-CSA1, s. 1539 9Section 1539. 49.45 (8) (a) 4. of the statutes is amended to read:
SB40-CSA1,720,1810 49.45 (8) (a) 4. "Patient care visit" means a personal contact with a patient in
11a patient's home that is made by a registered nurse, licensed practical nurse, home
12health aide, physical therapist, occupational therapist, or speech-language
13pathologist who is on the staff of or under contract or arrangement with a home
14health agency, or by a registered nurse or licensed practical nurse practicing
15independently, to provide a service that is covered under s. 49.46 or, 49.47, or 49.471.
16"Patient care visit" does not include time spent by a nurse, therapist, or home health
17aide on case management, care coordination, travel, record keeping , or supervision
18that is related to the patient care visit.
SB40-CSA1, s. 1541 19Section 1541. 49.45 (9) of the statutes is amended to read:
SB40-CSA1,721,1920 49.45 (9) Free choice. Any person eligible for medical assistance under ss. s.
2149.46, 49.468 and, 49.47, or 49.471 may use the physician, chiropractor, dentist,
22pharmacist, hospital, skilled nursing home, health maintenance organization,
23limited service health organization, preferred provider plan or other licensed,
24registered or certified provider of health care of his or her choice, except that free
25choice of a provider may be limited by the department if the department's alternate

1arrangements are economical and the recipient has reasonable access to health care
2of adequate quality. The department may also require a recipient to designate, in any
3or all categories of health care providers, a primary health care provider of his or her
4choice. After such a designation is made, the recipient may not receive services from
5other health care providers in the same category as the primary health care provider
6unless such service is rendered in an emergency or through written referral by the
7primary health care provider. Alternate designations by the recipient may be made
8in accordance with guidelines established by the department. Nothing in this
9subsection shall vitiate the legal responsibility of the physician, chiropractor,
10dentist, pharmacist, skilled nursing home, hospital, health maintenance
11organization, limited service health organization, preferred provider plan or other
12licensed, registered or certified provider of health care to patients. All contract and
13tort relationships with patients shall remain, notwithstanding a written referral
14under this section, as though dealings are direct between the physician, chiropractor,
15dentist, pharmacist, skilled nursing home, hospital, health maintenance
16organization, limited service health organization, preferred provider plan or other
17licensed, registered or certified provider of health care and the patient. No physician,
18chiropractor, pharmacist or dentist may be required to practice exclusively in the
19medical assistance program.
SB40-CSA1, s. 1542 20Section 1542. 49.45 (18) (ac) of the statutes is amended to read:
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