49.471 (4) (a) 7. Individuals who qualify for a medical assistance eligibility extension under s. 49.46 (1) (c), (cg), or (co) when their income increases above the poverty line.
28,1336
Section
1336. 49.471 (4) (b) 1m. of the statutes is amended to read:
49.471 (4) (b) 1m. A pregnant woman or unborn child who obtains eligibility under sub. (7) (b) 1.
28,1337
Section
1337. 49.471 (4) (b) 4. a. of the statutes is amended to read:
49.471 (4) (b) 4. a. The individual is a parent or caretaker relative of a child who is living in the home with the parent or caretaker relative or who is temporarily absent from the home for not more than 6 months or, if the child has been removed from the home for more than 6 months, the parent or caretaker relative is working toward unifying the family by complying with a permanency plan under s. 48.38 or 938.38.
28,1337n
Section 1337n. 49.471 (4) (d) of the statutes is created to read:
49.471 (4) (d) An individual is eligible to purchase coverage of the benefits described in sub. (11) for himself or herself and for his or her spouse and dependent children, at the full per member per month cost of coverage, if all of the following apply:
1. The individual lost his or her employer-sponsored health care coverage as a result of his or her employer's or former employer's bankruptcy.
2. After losing his or her employer-sponsored health care coverage, the individual received health care coverage through a voluntary employment benefit association that was established before August 2006.
3. The individual is not otherwise eligible for coverage under this section.
4. The individual is under 65 years of age.
28,1338
Section
1338. 49.471 (5) (b) 1. of the statutes is amended to read:
49.471 (5) (b) 1. Except as provided in sub. (6) (a) 1., a pregnant woman is eligible for the benefits specified in par. (c) during the period beginning on the day on which a qualified provider determines, on the basis of preliminary information, that the woman's family income does not exceed 300 percent of the poverty line and ending on the applicable day specified in subd. 3.
28,1339
Section
1339. 49.471 (5) (b) 2. of the statutes is amended to read:
49.471 (5) (b) 2. Except as provided in sub. (6) (a)
2., a child who is not an unborn child is eligible for the benefits described in s. 49.46 (2) (a) and (b) during the period beginning on the day on which a qualified entity determines, on the basis of preliminary information, that the child's family income does not exceed 150 percent of the poverty line and ending on the applicable day specified in subd. 3.
28,1340
Section
1340. 49.471 (5) (c) of the statutes is renumbered 49.471 (5) (c) 2. and amended to read:
49.471 (5) (c) 2. On behalf of a woman under par. (b) 1. whose family income exceeds 200 percent of the poverty line, the department shall audit and pay allowable charges to a provider certified under s. 49.45 (2) (a) 11. only for ambulatory prenatal care services under the benefits under sub. (11).
28,1341
Section
1341. 49.471 (5) (c) 1. of the statutes is created to read:
49.471 (5) (c) 1. On behalf of a woman under par. (b) 1. whose family income does not exceed 200 percent of the poverty line, the department shall audit and pay allowable charges to a provider certified under s. 49.45 (2) (a) 11. only for ambulatory prenatal care services under the benefits described in s. 49.46 (2) (a) and (b).
28,1342
Section
1342. 49.471 (6) (a) of the statutes is renumbered 49.471 (6) (a) 2. and amended to read:
49.471 (6) (a) 2. Any pregnant woman, including a pregnant woman under sub (5) (b) 1., child who is not an unborn child, including a child under sub. (5) (b) 2., parent, or caretaker relative whose family income is less than 150 percent of the poverty line is eligible for medical assistance under this section for any of the 3 months prior to the month of application if the individual met the eligibility criteria under this section and had a family income of less than 150 percent of the poverty line in that month.
28,1343
Section
1343. 49.471 (6) (a) 1. of the statutes is created to read:
49.471 (6) (a) 1. Any pregnant woman, including a pregnant woman under sub. (5) (b) 1., is eligible for medical assistance under this section for any of the 3 months prior to the month of application if she met the eligibility criteria under this section in that month.
28,1344
Section
1344. 49.471 (6) (e) of the statutes is repealed.
28,1345
Section
1345. 49.471 (7) (b) 1. of the statutes is amended to read:
49.471 (7) (b) 1. A pregnant woman, or an unborn child, whose family income exceeds 300 percent of the poverty line may become eligible for coverage under this section if the difference between the pregnant woman's or unborn child's family income and the applicable income limit under sub. (4) (b) is obligated or expended for any member of the pregnant woman's or unborn child's family for medical care or any other type of remedial care recognized under state law or for personal health insurance premiums or for both. Eligibility obtained under this subdivision continues without regard to any change in family income for the balance of the pregnancy and, for a pregnant woman but not for an unborn child, to the last day of the month in which the 60th day after the last day of the woman's pregnancy falls. Eligibility obtained by a pregnant woman under this subdivision extends to all pregnant women in the pregnant woman's family.
28,1346
Section
1346. 49.471 (7) (b) 2. of the statutes is amended to read:
49.471 (7) (b) 2. A child who is not an unborn child and, whose family income exceeds 150 percent of the poverty line, and who is ineligible under this section solely because of sub. (8) (b) may obtain eligibility under this section if the difference between the child's family income and 150 percent of the poverty line is obligated or expended on behalf of the child or any member of the child's family for medical care or any other type of remedial care recognized under state law or for personal health insurance premiums or for both. Eligibility obtained under this subdivision during any 6-month period, as determined by the department, continues for the remainder of the 6-month period and extends to all children in the family.
28,1347
Section
1347. 49.471 (7) (b) 3. of the statutes is amended to read:
49.471 (7) (b) 3. For a pregnant woman or an unborn child to obtain eligibility under subd. 1., the amount that must be obligated or expended in any 6-month period is equal to the sum of the differences in each of those 6 months between the pregnant woman's or unborn child's monthly family income and the monthly family income that is 300 percent of the poverty line. For a child to obtain eligibility under subd. 2., the amount that must be obligated or expended in any 6-month period is equal to the sum of the differences in each of those 6 months between the child's monthly family income and the monthly family income that is 150 percent of the poverty line.
28,1348
Section
1348. 49.471 (7) (c) 1. of the statutes is amended to read:
49.471 (7) (c) 1. Deduct from family
the individual's income, up to the amount of the individual's income, any payments made by amount the individual is obligated to pay for court-ordered child or family support or maintenance.
28,1349
Section
1349. 49.471 (8) (d) 1. f. of the statutes is created to read:
49.471 (8) (d) 1. f. An individual described in sub. (4) (a) 7.
28,1350
Section
1350. 49.471 (8) (d) 2. c. of the statutes is amended to read:
49.471 (8) (d) 2. c. One or more members of the individual's family were eligible for other health insurance coverage or Medical Assistance under s. 49.46 or 49.47 at the time the employee failed to enroll in the health insurance coverage under par. (b) 1. and no member of the family was eligible for coverage under this section at that time or, if one or more members of the individual's family were eligible for coverage under this section at that time, family income did not exceed 150 percent of the poverty line or the individual qualified for a medical assistance eligibility extension as provided in sub. (4) (a) 7.
28,1351
Section
1351. 49.471 (10) (a) of the statutes is amended to read:
49.471 (10) (a) Copayments. Except as provided in s. 49.45 (18) (am) 2. and (b) 2., all cost-sharing provisions under s. 49.45 (18) apply to a recipient with coverage of the benefits described in s. 49.46 (2) (a) and (b) to the same extent as they apply to a person eligible for medical assistance under s. 49.46, 49.468, or 49.47.
28,1352
Section
1352. 49.471 (10) (b) 4. g. of the statutes is created to read:
49.471 (10) (b) 4. g. An individual described in sub. (4) (a) 7.
28,1353
Section
1353. 49.471 (10) (b) 5. of the statutes is amended to read:
49.471 (10) (b) 5. If a recipient who is required to pay a premium under this paragraph or under sub. (2m) or (4) (c) either does not pay a premium when due or requests that his or her coverage under this section be terminated, the recipient's coverage terminates and the recipient is not eligible for BadgerCare Plus for 6 consecutive calendar months following the date on which the recipient's coverage terminated, except for any month during that 6-month period when the recipient's family income does not exceed 150 percent of the poverty line.
28,1353n
Section 1353n. 49.471 (11c) of the statutes is created to read:
49.471 (11c) Podiatrists' services for childless adults. The department shall cover services under this section that are provided by podiatrists, as defined in s. 448.60 (3), within the scope of a podiatrist's professional license, to individuals who are eligible for the childless adults demonstration project under s. 49.45 (23) if the services are covered when provided by a physician to those individuals.
28,1354
Section
1354. 49.471 (12) (b) of the statutes is amended to read:
49.471 (12) (b) If the amendments to the state plan submitted under sub. (2) are approved and a waiver that is substantially consistent with all of the provisions of this section is granted and in effect, the department shall publish a notice in the Wisconsin Administrative Register that states the date on which BadgerCare Plus is implemented.
28,1356
Section
1356. 49.665 (6) of the statutes is repealed.
28,1357
Section
1357. 49.686 (2) of the statutes is amended to read:
49.686 (2) Reimbursement. From the
appropriations appropriation accounts under s. 20.435 (5) (1) (am), (i), and (ma), the department may reimburse or supplement the reimbursement of the cost of AZT, the drug pentamidine, and any drug approved for reimbursement under sub. (4) (c) for an individual who is eligible under sub. (3).
28,1358
Section
1358. 49.686 (3) (d) of the statutes is amended to read:
49.686 (3) (d) Has applied for coverage under and has been denied eligibility for medical assistance within 12 months prior to application for reimbursement under sub. (2). This paragraph does not apply to an individual who is eligible for benefits under the demonstration project for childless adults under s. 49.45 (23) or to an individual who is eligible for benefits under BadgerCare Plus under s. 49.471 (11).
28,1359
Section
1359. 49.686 (3) (f) of the statutes is amended to read:
49.686 (3) (f) Is an individual whose annual gross household income is at or below 200% of the poverty line and, if funding is available under s. 20.435 (1) (i) or (m) or (5) (i), is an individual whose annual gross household income is above 200% and at or below 300% of the poverty line.
28,1360
Section
1360. 49.686 (6) (title) of the statutes is amended to read:
49.686 (6) (title) Health Insurance Risk-Sharing Plan pilot program coverage
.
28,1361
Section
1361. 49.686 (6) (a) (intro.) of the statutes is amended to read:
49.686 (6) (a) (intro.) Subject to par. (b), the department shall conduct a 3-year pilot program, to begin on January 1, 2008, under which the department may pay premiums for coverage under the Health Insurance Risk-Sharing Plan under subch. II of ch. 149, and pay copayments under that plan for prescription drugs for which reimbursement may be provided under sub. (2), for individuals who satisfy all of the following:
28,1362
Section
1362. 49.686 (6) (b) of the statutes is amended to read:
49.686 (6) (b) The pilot program shall be open to a minimum of 100 participants at any given time, with more participants if the department determines that it is cost-effective.
28,1363
Section
1363. 49.686 (6) (c) of the statutes is amended to read:
49.686 (6) (c) The department may promulgate rules for the administration of the pilot program. Notwithstanding s. 227.24 (3), rules under this paragraph may be promulgated as emergency rules under s. 227.24 without a finding of emergency.
28,1364
Section
1364. 49.688 (1) (e) of the statutes is amended to read:
49.688 (1) (e) "Program payment rate" means the rate of payment made for the identical drug specified under s. 49.46 (2) (b) 6. h., plus 5%, plus a dispensing fee that is equal to the dispensing fee permitted to be charged for prescription drugs for which coverage is provided under s. 49.46 (2) (b) 6. h.
28,1365
Section
1365. 49.688 (3) (d) of the statutes is amended to read:
49.688 (3) (d) Notwithstanding s. 49.002, if If a person who is eligible under this section has other available coverage for payment of a prescription drug, this section applies only to costs for prescription drugs for the person that are not covered under the person's other available coverage.
28,1366
Section
1366. 49.688 (8) of the statutes is repealed.
28,1367
Section
1367. 49.688 (12) of the statutes is amended to read:
49.688 (12) Except as provided in subs. (8) (8m) to (11) and except for the department's rule-making requirements and authority, the department may enter into a contract with an entity to perform the duties and exercise the powers of the department under this section.
28,1369
Section
1369
. 49.775 (2) (bm) of the statutes is amended to read:
49.775 (2) (bm) The custodial parent assigns to the state any right of the custodial parent or of the dependent child to support from any other person accruing during the time that any payment under this subsection is made to the custodial parent. No amount of support that begins to accrue after the individual ceases to receive payments under this section may be considered assigned to the state. Any money that is received by the department of children and families under an assignment to the state under this paragraph and that is not the federal share of support shall be paid to the custodial parent. The department of children and families shall pay the federal share of support assigned under this paragraph as required under federal law or waiver.
28,1369c
Section 1369c. 49.775 (2) (bm) of the statutes, as affected by 2009 Wisconsin Act .... (this act), is amended to read:
49.775 (2) (bm) The custodial parent assigns to the state any right of the custodial parent or of the dependent child to support from any other person accruing during the time that any payment under this subsection is made to the custodial parent. No amount of support that begins to accrue after the individual ceases to receive payments under this section may be considered assigned to the state. Any Seventy-five percent of all money that is received by the department of children and families under an assignment to the state under this paragraph and that is not the federal share of support shall be paid to the custodial parent. The department of children and families shall pay the federal share of support assigned under this paragraph as required under federal law or waiver.
28,1370
Section
1370. 49.775 (2m) of the statutes is created to read:
49.775 (2m) Disregard of support. In determining a custodial parent's eligibility under this section, the department shall, for purposes of determining the custodial parent's income, disregard any court-ordered support that is received by or owed to the custodial parent.
28,1371
Section
1371. 49.776 of the statutes is created to read:
49.776 Payment of support arrears. If a custodial parent who formerly received payments under s. 49.775 but who is no longer receiving payments under s. 49.775 assigned to the state under s. 49.775 (2) (bm) his or her right or the right of the dependent child to support from any other person, the department shall pay to the custodial parent all money in support arrears that is collected by the department after the custodial parent's receipt of payments under s. 49.775 ceased and that accrued while the custodial parent was receiving those payments.
28,1371p
Section 1371p. 49.78 (8) (a) of the statutes is amended to read:
49.78 (8) (a) From the appropriation accounts under s. 20.435 (4) (bn) and (nn) and subject to par. (b), the department shall reimburse each county and tribal governing body that contracts with the department under sub. (2) for reasonable costs of administering the income maintenance programs, including conducting fraud prevention activities. The amount of each reimbursement paid under this paragraph shall be calculated using a formula based on workload within the limits of available state and federal funds under s. 20.435 (4) (bn) and (nn) by contract under sub. (2). The amount of reimbursement calculated under this paragraph and par. (b) is in addition to any reimbursement provided to a county or tribal governing body for fraud and error reduction under s. 49.197 or 49.845.
28,1371r
Section 1371r. 49.78 (8) (c) of the statutes is created to read:
49.78 (8) (c) From the appropriation under s. 20.435 (4) (np), the department shall provide supplemental funding to tribal governing bodies and counties for administration of the food stamp program.
During the 2009-11 fiscal biennium, the department shall allocate $4,550,000 of the total funding under this paragraph among tribal governing bodies and counties other than counties having populations of 500,000 or more for food stamp program administration and shall allocate the remainder of the federal funding for the department's administration of the food stamp program in Milwaukee County.
28,1371s
Section 1371s. 49.78 (8) (c) of the statutes, as created by 2009 Wisconsin Act .... (this act), is repealed.
28,1376
Section
1376. 49.797 (2) (a) of the statutes is amended to read:
49.797 (2) (a) Except Notwithstanding s. 46.028 and except as provided in par. (b) and sub. (8), the department shall administer a statewide program to deliver food stamp benefits to recipients of food stamp benefits by an electronic benefit transfer system. All suppliers, as defined in s. 49.795 (1) (d), may participate in the delivery of food stamp benefits under the electronic benefit transfer system. The department shall explore methods by which nontraditional retailers, such as farmers' markets, may participate in the delivery of food stamp benefits under the electronic benefit transfer system.
28,1376g
Section 1376g. 49.826 of the statutes is created to read:
49.826 Administration of child care provider services in certain counties. (1) Definitions. In this section:
(a) "County" means a county having a population of 500,000 or more.
(b) "Department" means the department of children and families.
(c) "Secretary" means the secretary of children and families.
(d) "Unit" means the child care provider services unit.
