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:
SB40-CSA1,779,114 49.785 (1) (intro.) Except as provided in sub. (1m), if any recipient of benefits
5under s. 49.148, 49.46 or 49.77, or under 42 USC 1381 to 1385 in effect on
6May 8, 1980,
specified in sub. (1c) dies and the estate of the deceased recipient is
7insufficient to pay the funeral, burial, and cemetery expenses of the deceased
8recipient, the county or applicable tribal governing body or organization responsible
9for burial of the recipient shall pay, to the person designated by the county
10department under s. 46.215, 46.22, or 46.23 or applicable tribal governing body or
11organization responsible for the burial of the recipient, all of the following:
SB40-CSA1, s. 1661 12Section 1661. 49.785 (1c) of the statutes is created to read:
SB40-CSA1,779,1313 49.785 (1c) All of the following are eligible recipients under this section:
SB40-CSA1,779,1514(a) A recipient of benefits under s. 49.148, 49.46, or 49.77, or under 42 USC 1381
15to 1385 in effect on May 8, 1980.
SB40-CSA1,779,1616 (b) A recipient of benefits under s. 49.471 who is any of the following:
SB40-CSA1,779,1817 1. A pregnant woman or a child under 6 years of age with a family income not
18exceeding 185 percent of the poverty line at the time of death.
SB40-CSA1,779,2019 2. A child at least 6 years of age but less than 19 years of age with a family
20income not exceeding 100 percent of the poverty line at the time of death.
SB40-CSA1,779,2221 3. A parent or caretaker relative with a family income not exceeding 50 percent
22of the poverty line at the time of death.
SB40-CSA1, s. 1662 23Section 1662. 49.79 (1) (b) of the statutes is repealed.
SB40-CSA1, s. 1663 24Section 1663. 49.79 (1) (d) of the statutes is repealed.
SB40-CSA1, s. 1664 25Section 1664. 49.79 (1) (e) of the statutes is repealed.
SB40-CSA1, s. 1665
1Section 1665. 49.79 (1) (g) of the statutes is created to read:
SB40-CSA1,780,32 49.79 (1) (g) "Wisconsin Works employment position" has the meaning given
3in s. 49.141 (1) (r).
SB40-CSA1, s. 1666 4Section 1666. 49.79 (2) (a) of the statutes is repealed.
SB40-CSA1, s. 1667 5Section 1667. 49.79 (2) (b) of the statutes is renumbered 49.79 (2) and
6amended to read:
SB40-CSA1,780,97 49.79 (2) An individual who fails to comply with the work requirements of the
8employment and training program under s. 49.13 (2) (a) sub. (9) is ineligible to
9participate in the food stamp program as specified under s. 49.13 (3) sub. (9) (b).
SB40-CSA1, s. 1667f 10Section 1667f. 49.79 (8m) of the statutes is created to read:
SB40-CSA1,780,1411 49.79 (8m) Applicants from correctional institutions. (a) The department
12shall allow a prisoner who is applying for the food stamp program from a correctional
13institution in anticipation of being released from the institution to use the address
14of the correctional institution as his or her address on the application.
SB40-CSA1,780,1815 (b) The department shall allow an employee of a correctional institution who
16has been authorized by a prisoner of the institution to act on his or her behalf in
17matters related to the food stamp program to receive and conduct telephone calls on
18behalf of the prisoner in matters related to the food stamp program.
SB40-CSA1, s. 1669 19Section 1669. 49.79 (10) of the statutes is repealed.
SB40-CSA1, s. 1670 20Section 1670. 49.81 (intro.) of the statutes is amended to read:
SB40-CSA1,780,25 2149.81 Public assistance recipients' bill of rights. (intro.) The department
22of health and family services, the department of workforce development children and
23families,
and all public assistance and relief-granting agencies shall respect rights
24for recipients of public assistance. The rights shall include all rights guaranteed by
25the U.S. constitution and the constitution of this state, and in addition shall include:
SB40-CSA1, s. 1671
1Section 1671. 49.81 (4) of the statutes is amended to read:
SB40-CSA1,781,52 49.81 (4) The right to a speedy determination of the recipient's status or
3eligibility for public assistance, to notice of any proposed change in such status or
4eligibility, and, in the case of assistance granted under s. 49.19, 49.46, 49.468 or,
549.47, or 49.471, to a speedy appeals process for resolving contested determinations.
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