SB40-CSA1, s. 1618 13Section 1618. 49.475 (3) (intro.) of the statutes is amended to read:
SB40-CSA1,767,1614 49.475 (3) Written agreement. (intro.) Upon requesting an insurer a 3rd party
15to provide the information under sub. (2) (a), the department and the 3rd party shall
16enter into a written agreement with the insurer that satisfies all of the following:
SB40-CSA1, s. 1619 17Section 1619. 49.475 (3) (a) of the statutes is amended to read:
SB40-CSA1,767,1918 49.475 (3) (a) Identifies in detail the detailed format of the information to be
19disclosed provided to the department.
SB40-CSA1, s. 1620 20Section 1620. 49.475 (3) (c) of the statutes is amended to read:
SB40-CSA1,767,2221 49.475 (3) (c) Specifies how the insurer's 3rd party's reimbursable costs under
22sub. (5) will be determined and specifies the manner of payment.
SB40-CSA1, s. 1621 23Section 1621. 49.475 (4) (a) of the statutes is amended to read:
SB40-CSA1,768,224 49.475 (4) (a) An insurer A 3rd party shall provide the information requested
25under sub. (2) (a) within 180 days after receiving the department's request if it is the

1first time that the department has requested the insurer 3rd party to disclose
2information under this section.
SB40-CSA1, s. 1622 3Section 1622. 49.475 (4) (b) of the statutes is amended to read:
SB40-CSA1,768,74 49.475 (4) (b) An insurer A 3rd party shall provide the information requested
5under sub. (2) (a) within 30 days after receiving the department's request if the
6department has previously requested the insurer 3rd party to disclose information
7under this section.
SB40-CSA1, s. 1623 8Section 1623. 49.475 (4) (d) of the statutes is created to read:
SB40-CSA1,768,109 49.475 (4) (d) If a 3rd party other than an insurer fails to comply with par. (a)
10or (b), the department may so notify the attorney general.
SB40-CSA1, s. 1624 11Section 1624. 49.475 (5) of the statutes is amended to read:
SB40-CSA1,768,1712 49.475 (5) From the appropriations under s. 20.435 (4) (bm) and (pa), the
13department shall reimburse an insurer A 3rd party that provides information under
14this section sub. (2) (a) for the insurer's 3rd party's reasonable costs incurred in
15providing the requested information, including its reasonable costs, if any, to develop
16and operate automated systems specifically for the disclosure of the information
17under this section.
SB40-CSA1, s. 1625 18Section 1625. 49.475 (6) of the statutes is created to read:
SB40-CSA1,769,319 49.475 (6) Sharing information. The department of health and family services
20shall provide to the department of workforce development, for purposes of the
21medical support liability program under s. 49.22, any information that the
22department of health and family services receives under this section. The
23department of workforce development may allow a county child support agency
24under s. 59.53 (5) or a tribal child support agency access to the information, subject
25to the use and disclosure restrictions under s. 49.83, and shall consult with the

1department of health and family services regarding procedures and methods to
2adequately safeguard the confidentiality of the information provided under this
3subsection.
SB40-CSA1, s. 1626 4Section 1626. 49.475 (6) of the statutes, as created by 2007 Wisconsin Act ....
5(this act), is amended to read:
SB40-CSA1,769,156 49.475 (6) Sharing information. The department of health and family services
7shall provide to the department of workforce development children and families, for
8purposes of the medical support liability program under s. 49.22, any information
9that the department of health and family services receives under this section. The
10department of workforce development children and families may allow a county child
11support agency under s. 59.53 (5) or a tribal child support agency access to the
12information, subject to the use and disclosure restrictions under s. 49.83, and shall
13consult with the department of health and family services regarding procedures and
14methods to adequately safeguard the confidentiality of the information provided
15under this subsection.
SB40-CSA1, s. 1627 16Section 1627. 49.48 (1m) of the statutes is amended to read:
SB40-CSA1,769,2317 49.48 (1m) If an individual who applies for or to renew a certification under
18sub. (1) does not have a social security number, the individual, as a condition of
19obtaining the certification, shall submit a statement made or subscribed under oath
20or affirmation to the department that the applicant does not have a social security
21number. The form of the statement shall be prescribed by the department of
22workforce development children and families. A certification issued or renewed in
23reliance upon a false statement submitted under this subsection is invalid.
SB40-CSA1, s. 1628 24Section 1628. 49.48 (2) of the statutes is amended to read:
SB40-CSA1,770,4
149.48 (2) The department of health and family services may not disclose any
2information received under sub. (1) to any person except to the department of
3workforce development children and families for the purpose of making
4certifications required under s. 49.857.
SB40-CSA1, s. 1629 5Section 1629. 49.48 (3) of the statutes is amended to read:
SB40-CSA1,770,176 49.48 (3) The department of health and family services shall deny an
7application for the issuance or renewal of a certification specified in sub. (1), shall
8suspend a certification specified in sub. (1) or may, under a memorandum of
9understanding under s. 49.857 (2), restrict a certification specified in sub. (1) if the
10department of workforce development children and families certifies under s. 49.857
11that the applicant for or holder of the certificate is delinquent in the payment of
12court-ordered payments of child or family support, maintenance, birth expenses,
13medical expenses or other expenses related to the support of a child or former spouse
14or fails to comply, after appropriate notice, with a subpoena or warrant issued by the
15department of workforce development children and families or a county child
16support agency under s. 59.53 (5) and related to paternity or child support
17proceedings.
SB40-CSA1, s. 1629m 18Section 1629m. 49.485 of the statutes is created to read:
SB40-CSA1,770,25 1949.485 False claims. Whoever knowingly presents or causes to be presented
20to any officer, employee, or agent of this state a false claim for medical assistance
21shall forfeit not less than $5,000 nor more than $10,000, plus 3 times the amount of
22the damages that were sustained by the state or would have been sustained by the
23state, whichever is greater, as a result of the false claim. The attorney general may
24bring an action on behalf of the state to recover any forfeiture incurred under this
25section.
SB40-CSA1, s. 1630
1Section 1630. 49.49 (3m) (a) (intro.) of the statutes is amended to read:
SB40-CSA1,771,52 49.49 (3m) (a) (intro.) No provider may knowingly impose upon a recipient
3charges in addition to payments received for services under ss. 49.45 to 49.47 49.471
4or knowingly impose direct charges upon a recipient in lieu of obtaining payment
5under ss. 49.45 to 49.47 49.471 except under the following conditions:
SB40-CSA1, s. 1631 6Section 1631. 49.49 (3m) (a) 1. of the statutes is amended to read:
SB40-CSA1,771,87 49.49 (3m) (a) 1. Benefits or services are not provided under s. 49.46 (2) or
849.471 (11)
and the recipient is advised of this fact prior to receiving the service.
SB40-CSA1, s. 1632 9Section 1632. 49.49 (3m) (a) 2. of the statutes is amended to read:
SB40-CSA1,771,2010 49.49 (3m) (a) 2. If an applicant is determined to be eligible retroactively under
11s. 49.46 (1) (b) or 49.47 (4) (d) and a provider bills the applicant directly for services
12and benefits rendered during the retroactive period, the provider shall, upon
13notification of the applicant's retroactive eligibility, submit claims for
14reimbursement payment under s. 49.45 for covered services or benefits rendered to
15the recipient
during the retroactive period. Upon receipt of payment under s. 49.45,
16the provider shall reimburse the applicant recipient or other person who has made
17prior payment to the provider. No provider may be required to reimburse the
18applicant or other person in excess of the amount reimbursed under s. 49.45
for
19services provided to the recipient during the retroactive eligibility period, by the
20amount of the prior payment made
.
SB40-CSA1, s. 1633 21Section 1633 . 49.49 (3m) (a) 2. of the statutes, as affected by 2007 Wisconsin
22Act .... (this act), is amended to read:
SB40-CSA1,772,623 49.49 (3m) (a) 2. If an applicant is determined to be eligible retroactively under
24s. 49.46 (1) (b) or, 49.47 (4) (d), or 49.471 and a provider bills the applicant directly
25for services and benefits rendered during the retroactive period, the provider shall,

1upon notification of the applicant's retroactive eligibility, submit claims for payment
2under s. 49.45 for covered services or benefits rendered to the recipient during the
3retroactive period. Upon receipt of payment under s. 49.45, the provider shall
4reimburse the recipient or other person who has made prior payment to the provider
5for services provided to the recipient during the retroactive eligibility period, by the
6amount of the prior payment made.
SB40-CSA1, s. 1634 7Section 1634 . 49.49 (3m) (a) 3. of the statutes is amended to read:
SB40-CSA1,772,118 49.49 (3m) (a) 3. Benefits or services for which recipient copayment,
9coinsurance, or deductible is required under s. 49.45 (18), not to exceed maximum
10amounts allowable under 42 CFR 447.53 to 447.58, or for which recipient copayment
11or coinsurance is required under s. 49.471 (11)
.
SB40-CSA1, s. 1634r 12Section 1634r. 49.496 (3) (a) (intro.) of the statutes is amended to read:
SB40-CSA1,772,1613 49.496 (3) (a) (intro.) Except as provided in par. (b), the department shall file
14a claim against the estate of a recipient for all of the following , subject to the exclusion
15of any amounts under the Long-Term Care Partnership Program established under
16s. 49.45 (31),
unless already recovered by the department under this section:
SB40-CSA1, s. 1635 17Section 1635. 49.497 (title) of the statutes is amended to read:
SB40-CSA1,772,19 1849.497 (title) Recovery of incorrect Medical Assistance or Badger Care
19payments
and of unpaid employer penalties.
SB40-CSA1, s. 1636 20Section 1636. 49.497 (1r) of the statutes is created to read:
SB40-CSA1,773,621 49.497 (1r) (a) The department may recover any penalty assessment not paid
22under s. 49.471 (9) (c) from the employer against which the penalty was assessed.
23If, after notice that payment of a penalty is overdue, the employer who is liable fails
24to pay the penalty amount, or enter into or comply with an agreement for payment,
25the department may bring an action to enforce the liability or may issue an order to

1compel payment of the liability. Any person aggrieved by an order issued by the
2department under this paragraph may appeal the order as a contested case under
3ch. 227 by filing with the department a request for a hearing within 30 days after the
4date of the order. The only issue at the hearing shall be the determination by the
5department that the person has not paid the penalty or entered into, or complied
6with, an agreement for payment.
SB40-CSA1,773,167 (b) If any employer named in an order to compel payment issued under par. (a)
8fails to pay the department any amount due under the terms of the order and no
9contested case to review the order is pending and the time for filing for a contested
10case review has expired, the department may present a certified copy of the order to
11the circuit court for any county. The sworn statement of the secretary shall be
12evidence of the failure to pay the penalty. The circuit court shall, without notice,
13render judgment in accordance with the order. A judgment rendered under this
14paragraph shall have the same effect and shall be entered in the judgment and lien
15docket and may be enforced in the same manner as if the judgment had been
16rendered in an action tried and determined by the circuit court.
SB40-CSA1,773,1817 (c) The recovery procedure under this subsection is in addition to any other
18recovery procedure authorized by law.
SB40-CSA1, s. 1637 19Section 1637. 49.497 (4) of the statutes is amended to read:
SB40-CSA1,773,2420 49.497 (4) The department may appear for the state in any and all collection
21matters under this section, and may commence suit in the name of the department
22to recover an incorrect payment from the recipient to whom or on whose behalf it was
23made or to recover an unpaid penalty from the employer against which the penalty
24was assessed
.
SB40-CSA1, s. 1638 25Section 1638. 49.665 (4) (ap) 2. of the statutes is repealed.
SB40-CSA1, s. 1639
1Section 1639. 49.665 (4) (at) 1. a. of the statutes is amended to read:
SB40-CSA1,774,62 49.665 (4) (at) 1. a. Except as provided in subd. 1. b., the department shall
3establish a lower maximum income level for the initial eligibility determination if
4funding under s. 20.435 (4) (bc), (jz), (p), and (x) is insufficient to accommodate the
5projected enrollment levels for the health care program under this section. The
6adjustment may not be greater than necessary to ensure sufficient funding.
SB40-CSA1, s. 1640 7Section 1640. 49.665 (4) (at) 1. cm. of the statutes is amended to read:
SB40-CSA1,774,188 49.665 (4) (at) 1. cm. Notwithstanding s. 20.001 (3) (b), if, after reviewing the
9plan submitted under subd. 1. b., the joint committee on finance determines that the
10amounts appropriated under s. 20.435 (4) (bc), (jz), (p), and (x) are insufficient to
11accommodate the projected enrollment levels, the committee may transfer
12appropriated moneys from the general purpose revenue appropriation account of any
13state agency, as defined in s. 20.001 (1), other than a sum sufficient appropriation
14account, to the appropriation account under s. 20.435 (4) (bc) (b) to supplement the
15health care program under this section if the committee finds that the transfer will
16eliminate unnecessary duplication of functions, result in more efficient and effective
17methods for performing programs, or more effectively carry out legislative intent,
18and that legislative intent will not be changed by the transfer.
SB40-CSA1, s. 1641 19Section 1641. 49.665 (4) (at) 2. of the statutes is amended to read:
SB40-CSA1,774,2420 49.665 (4) (at) 2. If, after the department has established a lower maximum
21income level under subd. 1., projections indicate that funding under s. 20.435 (4) (bc),
22(jz), (p), and (x) is sufficient to raise the level, the department shall, by state plan
23amendment, raise the maximum income level for initial eligibility, but not to exceed
24185% of the poverty line.
SB40-CSA1, s. 1641d 25Section 1641d. 49.665 (4g) of the statutes is created to read:
SB40-CSA1,775,7
149.665 (4g) Disease management program. Based on the health conditions
2identified by the physical health risk assessments, if performed under sub. (4m), the
3department shall develop and implement, for individuals who are eligible under sub.
4(4), disease management programs that are similar to that developed and followed
5by the Marshfield Clinic in this state under the Physician Group Practice
6Demonstration Program authorized under 42 USC 1315 (e) and (f). These programs
7shall have at least the following characteristics:
SB40-CSA1,775,108 (a) The use of information science to improve health care delivery by
9summarizing a patient's health status and providing reminders for preventive
10measures.
SB40-CSA1,775,1211 (b) Educating health care providers on health care process improvement by
12developing best practice models.
SB40-CSA1,775,1513 (c) The improvement and expansion of care management programs to assist in
14standardization of best practices, patient education, support systems, and
15information gathering.
SB40-CSA1,775,1716 (d) Establishment of a system of provider compensation that is aligned with
17clinical quality, practice management, and cost of care.
SB40-CSA1,775,1918 (e) Focus on patient care interventions for certain chronic conditions, to reduce
19hospital admissions.
SB40-CSA1, s. 1641e 20Section 1641e. 49.665 (4m) of the statutes is created to read:
SB40-CSA1,775,2521 49.665 (4m) Physical health risk assessment. The department shall
22encourage each individual who is determined on or after the effective date of this
23subsection .... [revisor inserts date], to be eligible under sub. (4) to receive a physical
24health risk assessment as part of the first physical examination the individual
25receives under Badger Care.
SB40-CSA1, s. 1642
1Section 1642. 49.665 (5m) of the statutes is repealed and recreated to read:
SB40-CSA1,776,42 49.665 (5m) Information about Badger Care recipients. The department
3shall obtain and share information about Badger Care health care program
4recipients as provided in s. 49.475.
SB40-CSA1, s. 1644 5Section 1644. 49.665 (7) (a) 1. of the statutes is amended to read:
SB40-CSA1,776,96 49.665 (7) (a) 1. Notwithstanding sub. (4) (a) 3m. and (ap) 2., the department
7shall mail information verification forms to the employers of the individuals required
8to provide the verifications under sub. (4) (a) 3m. and (ap) 2. to obtain the information
9specified.
SB40-CSA1, s. 1646 10Section 1646. 49.686 (6) of the statutes is created to read:
SB40-CSA1,776,1611 49.686 (6) Health Insurance Risk-Sharing Plan pilot program. (a) Subject
12to par. (b), the department shall conduct a 3-year pilot program, to begin on January
131, 2008, under which the department may pay premiums for coverage under the
14Health Insurance Risk-Sharing Plan under subch. II of ch. 149, and pay copayments
15under that plan for prescription drugs for which reimbursement may be provided
16under sub. (2), for individuals who satisfy all of the following:
SB40-CSA1,776,1717 1. The individuals are eligible for reimbursement under this section.
SB40-CSA1,776,1818 2. The individuals are currently taking antiretroviral drugs.
SB40-CSA1,776,1919 3. The individuals do not have health insurance coverage.
SB40-CSA1,776,2320 4. The individuals are not eligible for premium subsidies under s. 252.16 or
21252.17 because they are not on unpaid medical leave, are not unable to continue
22employment, and have not had to reduce their employment hours because of an
23illness or medical condition arising from or related to HIV.
SB40-CSA1,776,2524 (b) The pilot program shall be open to a minimum of 100 participants, with
25more participants if the department determines that it is cost-effective.
SB40-CSA1,777,3
1(c) The department may promulgate rules for the administration of the pilot
2program. Notwithstanding s. 227.24 (3), rules under this paragraph may be
3promulgated as emergency rules under s. 227.24 without a finding of emergency.
SB40-CSA1, s. 1650 4Section 1650. 49.687 (6) of the statutes is created to read:
SB40-CSA1,777,75 49.687 (6) The department shall obtain and share information about
6individuals who receive benefits under s. 49.68, 49.683, or 49.685 as provided in s.
749.475.
SB40-CSA1, s. 1651 8Section 1651. 49.688 (5) (a) (intro.) of the statutes is amended to read:
SB40-CSA1,777,149 49.688 (5) (a) (intro.) Beginning on September 1, 2002, except as provided in
10sub. (7) (b), as a condition of participation by a pharmacy or pharmacist in the
11program under s. 49.45, 49.46, or 49.47, or 49.471, the pharmacy or pharmacist may
12not charge a person who presents a valid prescription order and a card indicating
13that he or she meets eligibility requirements under sub. (2) an amount for a
14prescription drug under the order that exceeds the following:
SB40-CSA1, s. 1655 15Section 1655. 49.688 (8m) of the statutes is repealed and recreated to read:
SB40-CSA1,777,1716 49.688 (8m) The department shall obtain and share information about
17participants in the program under this section as provided in s. 49.475.
SB40-CSA1, s. 1656 18Section 1656. 49.775 (2) (bm) of the statutes is amended to read:
SB40-CSA1,778,219 49.775 (2) (bm) The custodial parent assigns to the state any right of the
20custodial parent or of the dependent child to support from any other person. No
21amount of support that begins to accrue after the individual ceases to receive
22payments under this section may be considered assigned to the state. Any money
23that is received by the department of workforce development children and families
24under an assignment to the state under this paragraph and that is not the federal
25share of support shall be paid to the custodial parent. The department of workforce

1development
children and families shall pay the federal share of support assigned
2under this paragraph as required under federal law or waiver.
SB40-CSA1, s. 1657 3Section 1657. 49.78 (4) of the statutes is amended to read:
SB40-CSA1,778,104 49.78 (4) Rules; merit system. The department of workforce development
5children and families shall promulgate rules for the efficient administration of aid
6to families with dependent children in agreement with the requirement for federal
7aid, including the establishment and maintenance of personnel standards on a merit
8basis. The provisions of this section relating to personnel standards on a merit basis
9supersede any inconsistent provisions of any law relating to county personnel. This
10subsection shall not be construed to invalidate the provisions of s. 46.22 (1) (d).
SB40-CSA1, s. 1658 11Section 1658. 49.78 (5) of the statutes is amended to read:
SB40-CSA1,778,1912 49.78 (5) Personnel examinations. Statewide examinations to ascertain
13qualifications of applicants in any county department administering aid to families
14with dependent children shall be given by the administrator of the division of merit
15recruitment and selection in the office of state employment relations. The office of
16state employment relations shall be reimbursed for actual expenditures incurred in
17the performance of its functions under this section from the appropriations available
18to the department of health and family services children and families for
19administrative expenditures.
SB40-CSA1, s. 1659 20Section 1659. 49.78 (7) of the statutes is amended to read:
SB40-CSA1,779,221 49.78 (7) County personnel systems. Pursuant to rules promulgated under
22sub. (4), the department of workforce development children and families where
23requested by the county shall delegate to that county, without restriction because of
24enumeration, any or all of the authority of the department of workforce

1development's authority
children and families under sub. (4) to establish and
2maintain personnel standards including salary levels.
SB40-CSA1, s. 1660 3Section 1660. 49.785 (1) (intro.) of the statutes is amended to read:
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