SB245: Bill Text

SB245,11,13 49.49 (3p) (title) Other prohibited provider charges.

SB245,28 Section 28. 49.49 (4) (title) of the statutes is repealed.

SB245,29 Section 29 . 49.49 (4) (a) and (b) of the statutes are consolidated, renumbered 946.91 (6) and amended to read:

SB245,12,3 946.91 (6) No person Whoever, in connection with the medical assistance program Medical Assistance when the cost of the services provided to the patient is paid for in whole or in part by the state, may knowingly and willfully charge, solicit, accept or receive intentionally charges, solicits, accepts, or receives, in addition to any amount otherwise required to be paid under a medical assistance program Medical Assistance, any gift, money, donation, or other consideration, other than a charitable, religious, or philanthropic contribution from an organization or from a person unrelated to the patient, as a precondition of admitting a patient to a hospital, skilled nursing facility, or intermediate care facility, or as a requirement for the patient's continued stay in such a facility. (b) A person who violates this subsection is guilty of a Class H felony, except that, notwithstanding the maximum fine specified in s. 939.50 (3) (h), the person may be fined not more than $25,000.

SB245,30 Section 30. 49.49 (5) of the statutes is amended to read:

SB245,12,10 49.49 (5) County collection. Any county may retain 15% 15 percent of state medical assistance Medical Assistance funds that are recovered due to the efforts of a county employee or officer or, if the county initiates action by the department of justice, due to the efforts of the department of justice under s. 49.495 49.846. This subsection applies only to recovery of medical assistance that was provided as a result of fraudulent activity by a recipient or by a provider.

SB245,31 Section 31. 49.49 (7) (d) of the statutes is amended to read:

SB245,12,19 49.49 (7) (d) A commission's imposition of an assessment described under par. (b), a member's payment of the assessment as described under par. (c), and acceptance of the payment by the commission do not constitute conduct prohibited under sub. (4) s. 946.91 (6) or prohibited under s. DHS 106.04 (3), Wis. Adm. Code, in effect on May 26, 2010. It is the intent of the legislature to create a mechanism whereby 2 or more political subdivisions may share in the operation, use, and funding of a nursing home or intermediate care facility without violating 42 USC 1320a-7b (d) or 42 USC 1396a (a) (25) (C).

SB245,32 Section 32. 49.495 (title) of the statutes is renumbered 49.846 (title).

SB245,33 Section 33. 49.495 of the statutes is renumbered 49.846 (2) and amended to read:

SB245,13,11 49.846 (2) The department of justice or the district attorney may institute, manage, control, and direct, in the proper county, any prosecution for violation of criminal laws affecting the medical a public assistance program, including but not limited to laws in this chapter, chs. 939 to 951 relating to medical assistance contained in this subchapter Medical Assistance, Wisconsin Works, the food stamp program, or any other public assistance program, and laws affecting the health, safety, and welfare of public assistance program recipients of medical assistance. For this purpose the department of justice shall have and exercise all powers conferred upon district attorneys in such cases. The If a prosecution under this section involves a person holding a license granted by the medical examining board or an interested affiliated credentialing board, the department of justice or district attorney shall notify the medical examining board or the interested affiliated credentialing board of any such the prosecution of a person holding a license granted by the board or affiliated credentialing board.

SB245,34 Section 34. 49.688 (9) (a) of the statutes is amended to read:

SB245,13,15 49.688 (9) (a) The department shall promulgate rules relating to prohibitions on fraud that are substantially similar to applicable provisions under s. 49.49 (1) (a) 946.91 (2).

SB245,35 Section 35. 49.795 (title) and (1) (intro.) of the statutes are renumbered 946.92 (title) and (1) (intro.).

SB245,36 Section 36 . 49.795 (1) (a), (b), (c), (d) and (e) of the statutes are renumbered 946.92 (1) (a), (b), (c), (d) and (e), and 946.92 (1) (b), (c) and (d), as renumbered, are amended to read:

SB245,13,22 946.92 (1) (b) "Food" means items which that may be purchased using food coupons stamp program benefits under 7 USC 2012 (g) and 2016 (b).

SB245,13,24 (c) "Food stamp program" means the federal food stamp program under 7 USC 2011 to 2029 2036a.

SB245,14,3 (d) "Supplier" means a retail grocery store or other person authorized by the federal department of agriculture to accept food coupons stamp program benefits in exchange for food under the food stamp program.

SB245,37 Section 37. 49.795 (1) (cm) of the statutes is repealed.

SB245,38 Section 38 . 49.795 (2) to (6) of the statutes are renumbered 946.92 (2) (a) to (f), and 946.92 (2) (c), (d), (e) and (f), as renumbered, are amended to read:

SB245,14,10 946.92 (2) (c) No person may knowingly issue food coupons stamp program benefits to a person who is not an eligible person or knowingly issue food coupons stamp program benefits to an eligible person in excess of the amount for which the person's household is eligible.

SB245,14,13 (d) No eligible person may knowingly transfer food coupons stamp program benefits except to purchase food from a supplier or knowingly obtain or use food coupons stamp program benefits for which the person's household is not eligible.

SB245,14,16 (e) No supplier may knowingly obtain food coupons stamp program benefits except as payment for food or knowingly obtain food coupons stamp program benefits from a person who is not an eligible person.

SB245,14,18 (f) No unauthorized person may knowingly obtain, possess, transfer , or use food coupons stamp program benefits.

SB245,39 Section 39. 49.795 (7) of the statutes is repealed.

SB245,40 Section 40. 49.795 (8) (a), (b) and (c) of the statutes are repealed.

SB245,41 Section 41. 49.795 (8) (d) 1. of the statutes is renumbered 946.92 (3) (b) and amended to read:

SB245,14,25 946.92 (3) (b) In addition to the penalties applicable under par. (a), (b) or (c), the court shall suspend a person who violates this section sub. (2) from participation in the food stamp program as follows:

SB245,15,3 1. For a first offense conviction under this section, for not less than one year. The court may extend the suspension by and not more than 18 months 2 years and 6 months.

SB245,15,6 2. For a 2nd offense conviction under this section, for not less than 2 years. The court may extend the suspension by and not more than 18 months 3 years and 6 months.

SB245,15,7 3. For a 3rd offense conviction under this section, permanently.

SB245,42 Section 42. 49.795 (8) (d) 1m. of the statutes is renumbered 946.92 (3) (c) and amended to read:

SB245,15,13 946.92 (3) (c) In addition to the penalties applicable under par. (a), (b) or (c), a court shall permanently suspend from the food stamp program a person who has been convicted of an offense under 7 USC 2024 (b) or (c) involving an item covered by 7 USC 2024 (b) or (c) having a value of $500 or more.

SB245,43 Section 43. 49.795 (8) (d) 2. of the statutes is renumbered 49.796 and amended to read:

SB245,15,21 49.796 Food stamp reinstatement. The A person may apply to the a multicounty consortium, as defined in s. 49.78 (1) (br), or the a federally recognized American Indian tribal governing body or, if the person is a supplier, as defined in s. 946.92 (1) (d), to the federal department of agriculture for reinstatement of benefits following the a period of suspension imposed under s. 946.92, if the suspension is not permanent.

SB245,44 Section 44. 49.795 (8) (e) and (f) of the statutes are renumbered 946.92 (3) (d) and (e) and amended to read:

SB245,16,2 946.92 (3) (d) 1. If a court finds that a person traded violated sub. (2) by trading a controlled substance, as defined in s. 961.01 (4), for food coupons stamp program benefits, the court shall suspend the person from participation in the food stamp program as follows:

SB245,16,3 a. Upon the first such finding a first conviction, for 2 years.

SB245,16,4 b. Upon the a 2nd such finding conviction, permanently.

SB245,16,7 2. If a court finds that a person violated sub. (2) by trading traded firearms, ammunition, or explosives for food coupons stamp program benefits, the court shall suspend the person permanently from participation in the food stamp program.

SB245,16,13 (e) Notwithstanding par. (d) pars. (b) and (c), in addition to the penalties applicable under par. (a), (b) or (c), the court shall suspend from the food stamp program for a period of 10 years a person who violates sub. (2) by fraudulently misstates misstating or misrepresents misrepresenting his or her identity or place of residence for the purpose of receiving multiple benefits simultaneously under the food stamp program.

SB245,45 Section 45. 49.797 (2) (a) of the statutes is amended to read:

SB245,16,22 49.797 (2) (a) 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. 49.795 946.92 (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.

SB245,46 Section 46. 49.835 of the statutes is created to read:

SB245,17,4 49.835 Affirmation of statements in applications. (1) A person who makes a statement in a written application for any aid or benefit provided under this chapter is considered to have made an admission as to the existence, correctness, or validity of any fact stated. Such a statement is prima facie evidence against the person who made it in any complaint, information, or indictment, or in any action brought for enforcement of any provision of this chapter.

SB245,17,9 (2) An employee of a county department, a Wisconsin Works agency, a multicounty consortium, the department of health services, or the department of children and families who accepts an application for any aid or benefit under this chapter has the authority to administer an oath to the applicant that the information given is true and correct to the best of the applicant's knowledge.

SB245,17,14 (3) The department of children and families and the department of health services shall promulgate rules that specify standards and procedures for the administration of an oath to an applicant for any aid or benefit under this chapter that the information provided by the applicant is true and correct to the best of the applicant's knowledge.

SB245,47 Section 47. 49.846 (1) of the statutes is created to read:

SB245,17,19 49.846 (1) In this section, "public assistance program" means any program administered by the department of health services or the department of children and families under this chapter under which the department administering the program provides services, benefits, or other assistance to individuals or families.

SB245,48 Section 48. 49.95 of the statutes is repealed.

SB245,49 Section 49. 59.54 (23) of the statutes is amended to read:

SB245,17,25 59.54 (23) Public assistance; false representation. The board may enact and enforce an ordinance to prohibit conduct that is the same as or similar to conduct that is prohibited by s. 49.95 (1) 946.93 (2) and provide a forfeiture for a violation of the ordinance.

SB245,50 Section 50. 940.11 (2) of the statutes is amended to read:

SB245,18,8 940.11 (2) Whoever hides or buries a corpse, with intent to conceal a crime or avoid apprehension, prosecution, or conviction for a crime or notwithstanding s. 49.141 (7), 49.49 (1), or 49.795 946.90 (2) or (3), 946.91 (2), 946.92, or 946.93 (2) or (3) with intent to collect benefits under one of those sections the assistance program for families with dependent children administered under ss. 49.141 to 49.161, the Medical Assistance program administered under subch. IV of ch. 49, or the food stamp program, as defined in s. 49.79 (1) (c), is guilty of a Class G felony.

SB245,51 Section 51 . 946.90 (title) of the statutes is created to read:

SB245,18,10 946.90 (title) Wisconsin Works fraud.

SB245,52 Section 52. 946.90 (1) of the statutes is created to read:

SB245,18,12 946.90 (1) In this section:

SB245,18,15 (a) "Provider" means a Wisconsin Works agency, a person that contracts with a Wisconsin Works agency to provide services to a participant in Wisconsin Works, or a person that provides child care for reimbursement under s. 49.155.

SB245,18,17 (b) "Wisconsin Works" means the assistance program for families with dependent children administered under ss. 49.141 to 49.161.

SB245,18,18 (c) "Wisconsin Works agency" has the meaning given in s. 49.001 (9).

SB245,53 Section 53 . 946.90 (2) of the statutes is created to read:

SB245,18,21 946.90 (2) Whoever does any of the following is guilty of a Class A misdemeanor:

SB245,18,24 (a) Intentionally makes or causes to be made any false statement or representation of a material fact in any application for or receipt of any Wisconsin Works benefit or payment.

SB245,19,5 (b) Having knowledge of the occurrence of any event affecting the initial or continued eligibility for a Wisconsin Works benefit or payment under Wisconsin Works, conceals or fails to disclose that event with an intent to fraudulently secure a Wisconsin Works benefit or payment either in a greater amount or quantity than is due or when no such benefit or payment is authorized.

SB245,54 Section 54 . 946.91 (title), (1) and (2) (intro.) of the statutes are created to read:

SB245,19,7 946.91 (title) Medical Assistance fraud. (1) In this section:

SB245,19,10 (a) "Facility" means a nursing home or a community-based residential facility that is licensed under s. 50.03 and that is certified by the department of health services as a provider of aid under Medical Assistance.

SB245,19,12 (b) "Medical Assistance" means the program providing aid under subch. IV of ch. 49, except ss. 49.468 and 49.471.

SB245,19,15 (c) "Provider" means a person, corporation, limited liability company, partnership, incorporated business, or professional association, and any agent or employee thereof, who provides services under Medical Assistance.

SB245,19,18 (2) (intro.) Whoever does any of the following is guilty of a Class H felony, except that, notwithstanding the maximum fine specified in s. 939.50 (3) (h), the person may be fined not more than $25,000:

SB245,55 Section 55. 946.92 (3) (a) of the statutes is created to read:

SB245,19,20 946.92 (3) (a) Whoever violates sub. (2) is subject to the following penalties:

SB245,19,22 1. If the value of the food stamp program benefits does not exceed $100, a Class B misdemeanor.

SB245,19,24 2. Except as provided in subd. 3., if the value of the food stamp program benefits exceeds $100, but is less than $5,000, a Class I felony.

SB245,20,2 3. If the value of the food stamp program benefits exceeds $100, but is less than $5,000, and the person has a prior conviction under this section, a Class H felony.

SB245,20,4 4. If the value of the food stamp program benefits is $5,000 or more, a Class G felony.

SB245,56 Section 56. 946.93 of the statutes is created to read:

SB245,20,7 946.93 Public assistance fraud. (1) In this section, "public assistance" means any aid, benefit, or services provided under ch. 49.

SB245,20,10 (2) Whoever intentionally makes or causes to be made any false statement or representation of material fact in any application for or receipt of public assistance is guilty of a Class A misdemeanor.

SB245,20,11 (3) No person may do any of the following:

SB245,20,15 (a) Having knowledge of an event affecting the initial or continued eligibility for public assistance, conceal or fail to disclose that event with an intent to fraudulently secure public assistance, including payment either in a greater amount or quantity than is due or when no such benefit or payment is authorized.

SB245,20,18 (b) Receive any income or assets and fail to notify the public assistance agency within 10 days after receiving the income or assets, unless a different time period is required under the applicable public assistance program.

SB245,20,22 (c) Fail to notify the public assistance agency within 10 days of any change in circumstances for which notification by the recipient must be provided under law, unless a different time period is required under the applicable public assistance program.

SB245,20,25 (d) Receive a voucher under a public assistance program for goods or services and use the funding granted under the voucher for purposes that are not authorized by the public assistance agency.

SB245,21,1 (e) Whoever violates par. (a), (b), (c), or (d) is subject to the following penalties:

SB245,21,3 1. If the value of the payment or benefit does not exceed $300, a Class B forfeiture.

SB245,21,5 2. If the value of the payment or benefit is more than $300 but does not exceed $1,000, a Class B misdemeanor.

SB245,21,7 3. If the value of the payment or benefit is more than $1,000 but does not exceed $2,000, a Class A misdemeanor.