SB1,714,109 49.453 (1) (e) "Institutionalized individual" has the meaning given in 42 USC
101396p
(e) (h) (3).
SB1, s. 1564 11Section 1564. 49.453 (1) (f) (intro.) of the statutes is amended to read:
SB1,714,1312 49.453 (1) (f) (intro.) "Look-back date" means for a covered individual, either
13of the following:
SB1,714,17 141m. For transfers made before February 8, 2006, the date that is 36 months
15before, or with respect to payments from a trust or portions of a trust that are treated
16as assets transferred by the covered individual under s. 49.454 (2) (c) or (3) (b) the
17date that is 60 months before:
SB1, s. 1565 18Section 1565. 49.453 (1) (f) 1. of the statutes is renumbered 49.453 (1) (f) 1m.
19a.
SB1, s. 1566 20Section 1566. 49.453 (1) (f) 2. of the statutes is renumbered 49.453 (1) (f) 1m.
21b.
SB1, s. 1567 22Section 1567. 49.453 (1) (f) 2m. of the statutes is created to read:
SB1,714,2423 49.453 (1) (f) 2m. For all transfers made on or after February 8, 2006, the date
24that is 60 months before the dates specified in subd. 1m. a. and b.
SB1, s. 1568 25Section 1568. 49.453 (1) (fm) of the statutes is amended to read:
SB1,715,2
149.453 (1) (fm) "Noninstitutionalized individual" has the meaning given in 42
2USC 1396p
(e) (h) (4).
SB1, s. 1569 3Section 1569. 49.453 (1) (i) of the statutes is amended to read:
SB1,715,44 49.453 (1) (i) "Resources" has the meaning given in 42 USC 1396p (e) (h) (5).
SB1, s. 1570 5Section 1570. 49.453 (3) (a) of the statutes is renumbered 49.453 (3) (a) (intro.)
6and amended to read:
SB1,715,87 49.453 (3) (a) (intro.) The period of ineligibility under this subsection begins
8on either of the following:
SB1,715,12 91. In the case of a transfer of assets made before February 8, 2006, the first day
10of the first month beginning on or after the look-back date during or after which
11assets have been transferred for less than fair market value and that does not occur
12in any other periods of ineligibility under this subsection.
SB1, s. 1571 13Section 1571. 49.453 (3) (a) 2. of the statutes is created to read:
SB1,715,2114 49.453 (3) (a) 2. In the case of a transfer of assets made on or after February
158, 2006, the first day of a month beginning on or after the look-back date during or
16after which assets have been transferred for less than fair market value, or the date
17on which the individual is eligible for medical assistance and would otherwise be
18receiving institutional level care described in sub. (2) (a) 1. to 3. based on an approved
19application for the care but for the application of the penalty period, whichever is
20later, and that does not occur during any other period of ineligibility under this
21subsection.
SB1, s. 1572 22Section 1572. 49.453 (3) (b) (intro.) of the statutes is amended to read:
SB1,715,2423 49.453 (3) (b) (intro.) The Subject to par. (bc), the department shall determine
24the number of months of ineligibility as follows:
SB1, s. 1573 25Section 1573. 49.453 (3) (bc) of the statutes is created to read:
SB1,716,4
149.453 (3) (bc) In determining the number of months of ineligibility under par.
2(b), with respect to asset transfers that occur after February 8, 2006, the department
3may not round down the quotient, or otherwise disregard any fraction of a month,
4obtained in the division under par. (b) 3.
SB1, s. 1574 5Section 1574. 49.453 (4) (a) of the statutes is renumbered 49.453 (4) (ag).
SB1, s. 1575 6Section 1575. 49.453 (4) (ac) of the statutes is created to read:
SB1,716,97 49.453 (4) (ac) In this subsection, "transaction" means any action taken by an
8individual that changes the course of payments to be made under an annuity or the
9treatment of the income or principal of an annuity, including all of the following:
SB1,716,1010 1. An addition of principal.
SB1,716,1111 2. An elective withdrawal.
SB1,716,1212 3. A request to change the distribution of the annuity.
SB1,716,1313 4. An election to annuitize the contract.
SB1,716,1414 5. A change in ownership.
SB1, s. 1576 15Section 1576. 49.453 (4) (am) of the statutes is amended to read:
SB1,716,1816 49.453 (4) (am) Paragraph (a) (ag) 1. does not apply to a variable annuity that
17is tied to a mutual fund that is registered with the federal securities and exchange
18commission.
SB1, s. 1577 19Section 1577. 49.453 (4) (b) of the statutes is amended to read:
SB1,716,2220 49.453 (4) (b) The amount of assets that is transferred for less than fair market
21value under par. (a) (ag) is the amount by which the transferred amount exceeds the
22expected value of the benefit.
SB1, s. 1578 23Section 1578. 49.453 (4) (c) of the statutes is amended to read:
SB1,717,824 49.453 (4) (c) The department shall promulgate rules specifying the method to
25be used in calculating the expected value of the benefit, based on 26 CFR 1.72-1 to

11.72-18, and specifying the criteria for adjusting the expected value of the benefit
2based on a medical condition diagnosed by a physician before the assets were
3transferred to the annuity, or transferred by promissory note or similar instrument.
4In calculating the amount of the divestment when a transfer to an annuity, or a
5transfer by promissory note or similar instrument, is made, payments made to the
6transferor in any year subsequent to the year in which the transfer was made shall
7be discounted to the year in which the transfer was made by the applicable federal
8rate specified under par. (a) (ag) on the date of the transfer.
SB1, s. 1579 9Section 1579. 49.453 (4) (cm) of the statutes is created to read:
SB1,717,1110 49.453 (4) (cm) Paragraphs (ag) to (c) apply to annuities purchased before
11February 8, 2006, for which no transaction has occurred on or after February 8, 2006.
SB1, s. 1580 12Section 1580. 49.453 (4) (d) of the statutes is created to read:
SB1,717,1613 49.453 (4) (d) For purposes of sub. (2), the purchase of an annuity by an
14institutionalized individual or his or her community spouse, or anyone acting on
15their behalf, shall be treated as a transfer of assets for less than fair market value
16unless any of the following applies:
SB1,717,1917 1. The state is designated as the remainder beneficiary in the first position for
18at least the total amount of medical assistance paid on behalf of the institutionalized
19individual.
SB1,717,2320 2. The state is named as a beneficiary in the 2nd position after the community
21spouse or a minor or disabled child and is named in the first position if the community
22spouse or a representative of the minor or disabled child disposes of any remainder
23for less than fair market value.
SB1,717,2424 3. The annuity satisfies the requirements under par. (e) 1. or 2.
SB1, s. 1581 25Section 1581. 49.453 (4) (e) of the statutes is created to read:
SB1,718,4
149.453 (4) (e) For purposes of sub. (2), the purchase of an annuity by or on behalf
2of an annuitant who has applied for medical assistance for nursing facility services
3or other long-term care services described in sub. (2) is a transfer of assets for less
4than fair market value unless either of the following applies:
SB1,718,651. The annuity is either an annuity described in section 408 (b) or (q) of the
6Internal Revenue Code of 1986 or purchased with proceeds from any of the following:
SB1,718,87a. An account or trust described in section 408 (a), (c), or (p) of the Internal
8Revenue Code of 1986.
SB1,718,109b. A simplified employee pension, within the meaning of section 408 (k) of the
10Internal Revenue Code of 1986.
SB1,718,1111c. A Roth IRA described in section 408A of the Internal Revenue Code of 1986.
SB1,718,1212 2. All of the following apply with respect to the annuity:
SB1,718,1313 a. The annuity is irrevocable and nonassignable.
SB1,718,1514 b. The annuity is actuarily sound, as determined in accordance with actuarial
15publications of the office of the chief actuary of the social security administration.
SB1,718,1716 c. The annuity provides for payments in equal amounts during the term of the
17annuity, with no deferral and no balloon payments made.
SB1, s. 1582 18Section 1582. 49.453 (4) (em) of the statutes is created to read:
SB1,718,1919 49.453 (4) (em) Paragraphs (d) and (e) apply to all of the following:
SB1,718,2020 1. Annuities purchased on or after February 8, 2006.
SB1,718,2221 2. Annuities purchased before February 8, 2006, for which a transaction has
22occurred on or after February 8, 2006.
SB1, s. 1583 23Section 1583. 49.453 (4c) of the statutes is created to read:
SB1,719,224 49.453 (4c) Purchase of note, loan, or mortgage. (a) For purposes of sub. (2),
25the purchase by an individual or his or her spouse of a promissory note, loan, or

1mortgage after February 8, 2006, is a transfer of assets for less than fair market
2value unless all of the following apply with respect to the note, loan, or mortgage:
SB1,719,33 1. The repayment term is actuarially sound.
SB1,719,54 2. The payments are to be made in equal amounts during the term of the loan,
5with no deferral and no balloon payment.
SB1,719,66 3. Cancellation of the balance upon the death of the lender is prohibited.
SB1,719,107 (b) The value of a promissory note, loan, or mortgage that does not satisfy the
8requirements under par. (a) 1. to 3. is the outstanding balance due on the date that
9the individual applies for medical assistance for nursing facility services or other
10long-term care services described in sub. (2).
SB1, s. 1584 11Section 1584. 49.453 (4m) of the statutes is created to read:
SB1,719,1512 49.453 (4m) Purchase of life estate. For purposes of sub. (2), the purchase
13by an individual or his or her spouse of a life estate in another individual's home after
14February 8, 2006, is a transfer of assets for less than fair market value unless the
15purchaser resides in the home for at least one year after the date of the purchase.
SB1, s. 1585 16Section 1585. 49.453 (8) of the statutes is renumbered 49.453 (8) (a) (intro.)
17and amended to read:
SB1,719,1918 49.453 (8) (a) (intro.) Subsections (2) and (3) do not apply to transfers of assets
19if the any of the following applies:
SB1,719,20 201. The assets are exempt under 42 USC 1396p (c) (2) or if the (A), (B), or (C).
SB1,719,23 212. The department determines under the process under par. (b) that application
22of this section would work an undue hardship. The department shall promulgate
23rules concerning the transfer of assets exempt under 42 USC 1396p (c) (2)
.
SB1, s. 1586 24Section 1586. 49.453 (8) (b) of the statutes is created to read:
SB1,720,2
149.453 (8) (b) The department shall establish a hardship waiver process that
2includes all of the following:
SB1,720,63 1. The department determines that undue hardship exists if the application of
4subs. (2) and (3) would deprive the individual of medical care to the extent that the
5individual's health or life would be endangered, or would deprive the individual of
6food, clothing, shelter, or other necessities of life.
SB1,720,107 2. A facility in which an institutionalized individual who has transferred assets
8resides is permitted to file an application for undue hardship on behalf of the
9individual with the consent of the individual or the individual's authorized
10representative.
SB1,720,1411 3. The department may, during the pendency of an undue hardship
12determination, pay the full payment rate under s. 49.45 (6m) for nursing facility
13services for up to 30 days for the individual who transferred assets, to hold a bed in
14the facility in which the individual resides.
SB1, s. 1587 15Section 1587. 49.46 (1) (a) 5. of the statutes is amended to read:
SB1,720,1816 49.46 (1) (a) 5. Any child in an adoption assistance, foster care, kinship care,
17long-term kinship care,
treatment foster care, or subsidized guardianship
18placement under ch. 48 or 938, as determined by the department.
SB1, s. 1588 19Section 1588. 49.46 (1) (a) 14m. of the statutes is amended to read:
SB1,720,2520 49.46 (1) (a) 14m. Any person who would meet the financial and other eligibility
21requirements for home or community-based services under the family care benefit
22but for the fact that the person engages in substantial gainful activity under 42 USC
231382c
(a) (3), if a waiver under s. 46.281 (1) (c) (1d) is in effect or federal law permits
24federal financial participation for medical assistance coverage of the person and if
25funding is available for the person under the family care benefit.
SB1, s. 1589
1Section 1589. 49.46 (2) (b) (intro.) of the statutes is amended to read:
SB1,721,42 49.46 (2) (b) (intro.) Except as provided in par. pars. (be) and (dc), the
3department shall audit and pay allowable charges to certified providers for medical
4assistance on behalf of recipients for the following services:
SB1, s. 1590 5Section 1590. 49.46 (2) (b) 8. of the statutes is amended to read:
SB1,721,106 49.46 (2) (b) 8. Home or community-based services, if provided under s. 46.27
7(11), 46.275, 46.277, 46.278, or 46.2785, under the family care benefit if a waiver is
8in effect under s. 46.281 (1) (c) (1d), or under a waiver requested under 2001
9Wisconsin Act 16
, section 9123 (16rs), or 2003 Wisconsin Act 33, section 9124 (8c)
the
10disabled children's long-term support program, as defined in s. 46.011 (1g)
.
SB1, s. 1591 11Section 1591. 49.46 (2) (dc) of the statutes is created to read:
SB1,721,1712 49.46 (2) (dc) For an individual who is eligible for medical assistance and who
13is eligible for coverage under Part D of Medicare under 42 USC 1395w-101 et seq.,
14benefits under par. (b) 6. h. do not include payment for any Part D drug, as defined
15in 42 CFR 423.100, regardless of whether the individual is enrolled in Part D of
16Medicare or whether, if the individual is enrolled, his or her Part D plan, as defined
17in 42 CFR 423.4, covers the Part D drug.
SB1, s. 1592 18Section 1592. 49.468 (1) (b) of the statutes is amended to read:
SB1,722,719 49.468 (1) (b) For an elderly or disabled individual who is entitled to coverage
20under part A of medicare, entitled to coverage under part B of medicare and who does
21not meet the eligibility criteria for medical assistance under s. 49.46 (1), 49.465 or,
2249.47 (4), or 49.471 but meets the limitations on income and resources under par. (d),
23medical assistance shall pay the deductible and coinsurance portions of medicare
24services under 42 USC 1395 to 1395zz which are not paid under 42 USC 1395 to
251395zz, including those medicare services that are not included in the approved state

1plan for services under 42 USC 1396; the monthly premiums payable under 42 USC
21395v
; the monthly premiums, if applicable, under 42 USC 1395i-2 (d); and the late
3enrollment penalty, if applicable, for premiums under part A of medicare. Payment
4of coinsurance for a service under part B of medicare under 42 USC 1395j to 1395w,
5other than payment of coinsurance for outpatient hospital services, may not exceed
6the allowable charge for the service under medical assistance minus the medicare
7payment.
SB1, s. 1593 8Section 1593. 49.468 (1) (c) of the statutes is amended to read:
SB1,722,179 49.468 (1) (c) For an elderly or disabled individual who is only entitled to
10coverage under part A of medicare and who does not meet the eligibility criteria for
11medical assistance under s. 49.46 (1), 49.465 or, 49.47 (4), or 49.471 but meets the
12limitations on income and resources under par. (d), medical assistance shall pay the
13deductible and coinsurance portions of medicare services under 42 USC 1395 to
141395i which are not paid under 42 USC 1395 to 1395i, including those medicare
15services that are not included in the approved state plan for services under 42 USC
161396
; the monthly premiums, if applicable, under 42 USC 1395i-2 (d); and the late
17enrollment penalty for premiums under part A of medicare, if applicable.
SB1, s. 1594 18Section 1594. 49.468 (1m) (a) of the statutes is amended to read:
SB1,722,2419 49.468 (1m) (a) Beginning on January 1, 1993, for an elderly or disabled
20individual who is entitled to coverage under part A of medicare and is entitled to
21coverage under part B of medicare, does not meet the eligibility criteria for medical
22assistance under s. 49.46 (1), 49.465 or, 49.47 (4), or 49.471 but meets the limitations
23on income and resources under par. (b), medical assistance shall pay the monthly
24premiums under 42 USC 1395r.
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