SB21: Bill Text

SB21,1799 Section 1799. 49.45 (30x) of the statutes is created to read:

SB21,728,18 49.45 (30x) Licensed midwife services. (a) Provider reimbursement. Beginning January 1, 2016, services under s. 49.46 (2) (b) 12t. provided to an individual are reimbursable under the Medical Assistance program if an amendment to the state medical assistance plan approved by the federal department of health and human services permits reimbursement under s. 49.46 (2) (b) 12t.

SB21,728,23 (b) Plan amendment. The department shall submit to the federal department of health and human services an amendment to the state medical assistance plan to permit the application of par. (a). The department may not pay reimbursement under par. (a) unless the amendment to the state plan allowing reimbursement under s. 49.46 (2) (b) 12t. is approved and in effect.

SB21,1800 Section 1800. 49.45 (39) (bm) of the statutes is created to read:

SB21,729,4 49.45 (39) (bm) Excess state share. Any portion of the state share under this subsection in excess of $42,200,000 in fiscal year 2015-16 and in excess of $41,700,000 in fiscal year 2016-17 and each fiscal year thereafter shall be deposited in the Medical Assistance trust fund.

SB21,1801 Section 1801. 49.45 (39m) of the statutes is created to read:

SB21,729,15 49.45 (39m) State plan amendment for pharmacist reimbursement. The department shall submit to the federal department of health and human services an amendment to the state Medical Assistance plan to permit Medical Assistance reimbursement to pharmacists who meet the training requirements specified by the department to administer vaccines, as determined by the department, to a person 6 to 18 years of age. The department shall provide Medical Assistance reimbursement under this subsection if the federal department of health and human services approves the amendment to the state Medical Assistance plan. A pharmacist or pharmacy shall enroll in the federal Vaccines for Children Program under 42 USC 1396s to be eligible for Medical Assistance reimbursement under this subsection.

SB21,1802 Section 1802. 49.45 (41) (b) of the statutes is amended to read:

SB21,730,2 49.45 (41) (b) If a county elects to become certified as a provider of mental health crisis intervention services, the county may provide mental health crisis intervention services under this subsection in the county to medical assistance recipients through the medical assistance program. A county that elects to provide the services shall pay the amount of the allowable charges for the services under the medical assistance program that is not provided by the federal government. From the appropriation account under s. 20.435 (5) (bL), the The department shall reimburse the county under this subsection only for the amount of the allowable charges for those services under the medical assistance program that is provided by the federal government.

SB21,1803 Section 1803. 49.452 of the statutes is created to read:

SB21,730,8 49.452 Counting promissory notes as assets for certain Medical Assistance programs. (1) In this section, "promissory note" means a written, unconditional agreement, given in return for goods, money loaned, or services rendered, under which one party promises to pay another party a specified sum of money at a specified time or on demand.

SB21,730,11 (2) If an individual's assets are counted when determining or redetermining the individual's financial eligibility for Medical Assistance, the department shall include a promissory note as a countable asset if all of the following apply:

SB21,730,14 (a) The individual applying for or receiving benefits under Medical Assistance or his or her spouse provided the goods, money loaned, or services rendered for the promissory note.

SB21,730,16 (b) The promissory note was entered into or purchased on or after the effective date of this paragraph .... [LRB inserts date].

SB21,730,18 (c) The promissory note is negotiable, assignable, and enforceable and does not contain any terms making it unmarketable.

SB21,730,24 (3) A promissory note is presumed to be negotiable and its asset value is the outstanding principal balance at the time the individual applies for Medical Assistance or at the time the individual's eligibility for Medical Assistance is redetermined, unless the individual shows by credible evidence from a knowledgeable source that the note is nonnegotiable or has a different current market value, which will then be considered the asset value.

SB21,1804 Section 1804. 49.453 (4c) (am) of the statutes is created to read:

SB21,731,4 49.453 (4c) (am) Notwithstanding par. (a), for purposes of sub. (2), the purchase of or entering into a promissory note by an individual or his or her spouse on or after the effective date of this paragraph .... [LRB inserts date], is a transfer of assets for less than fair market value unless all of the following apply:

SB21,731,5 1. The promissory note satisfies the requirements under par. (a) 1. to 3.

SB21,731,7 2. The promissory note is negotiable, assignable, and enforceable and does not contain any terms making it unmarketable.

SB21,1805 Section 1805. 49.453 (4c) (b) of the statutes is renumbered 49.453 (4c) (b) 1. and amended to read:

SB21,731,14 49.453 (4c) (b) 1. The value of a promissory note, purchased before the effective date of this subdivision .... [LRB inserts date], a loan, or a mortgage that does not satisfy the requirements under par. (a) 1. to 3. is the outstanding balance due on the date that the individual applies for medical assistance for nursing facility services or other long-term care services described in sub. (2).

SB21,1806 Section 1806. 49.453 (4c) (b) 2. of the statutes is created to read:

SB21,731,22 49.453 (4c) (b) 2. The value of a promissory note purchased or entered into on or after the effective date of this subdivision .... [LRB inserts date], that does not satisfy the requirements under par. (am) 1. and 2. is the outstanding balance due on the date that the individual applies for Medical Assistance for nursing facility services or other long-term care services described in sub. (2) or on the date that the individual's eligibility for Medical Assistance for nursing facility services or other long-term care services described in sub. (2) is redetermined.

SB21,1807 Section 1807. 49.46 (2) (b) 12t. of the statutes is created to read:

SB21,732,3 49.46 (2) (b) 12t. Subject to the limitations under s. 49.45 (30x), licensed midwife services provided by a certified professional midwife licensed under s. 440.982.

SB21,1808 Section 1808. 49.46 (2) (b) 14m. of the statutes is created to read:

SB21,732,7 49.46 (2) (b) 14m. Subject to par. (bt), substance abuse treatment services provided by a medically monitored treatment service or a transitional residential treatment service.

SB21,1809 Section 1809. 49.46 (2) (bt) of the statutes is created to read:

SB21,732,13 49.46 (2) (bt) 1. For the purposes of par. (b) 14m., a "medically monitored treatment service" is a 24-hour, community-based service providing observation, monitoring, and treatment by a multidisciplinary team under supervision of a physician, with a minimum of 12 hours of counseling provided per week for each patient.

SB21,732,17 2. For the purposes of par. (b) 14m., a "transitional residential treatment service" is a clinically supervised, peer-supported, therapeutic environment with clinical involvement providing substance abuse treatment in the form of counseling for 3 to 11 hours provided per week for each patient.

SB21,732,21 3. If approval by the federal department of health and human services of a state plan amendment or waiver request is necessary for federal reimbursement of the services under par. (b) 14m., the department is not required to pay for services described in par. (b) 14m. if the department does not receive the necessary approval.

SB21,1810 Section 1810. 49.471 (8) (d) 1. a. of the statutes is amended to read:

SB21,732,24 49.471 (8) (d) 1. a. A pregnant woman, except as provided in pars. par. (cr) 1. c. and (fm) 4.

SB21,1811 Section 1811. 49.471 (8) (f) of the statutes is repealed.

SB21,1812 Section 1812. 49.471 (8) (fm) of the statutes is repealed.

SB21,1813 Section 1813. 49.471 (8) (g) of the statutes is repealed.

SB21,1814 Section 1814. 49.472 (5) of the statutes is amended to read:

SB21,733,7 49.472 (5) Community options participants. From the appropriation under s. 20.435 (7) (4) (bd), the department may pay all or a portion of the monthly premium calculated under sub. (4) (a) for an individual who is a participant in the community options program under s. 46.27 (11).

SB21,1815 Section 1815. 49.475 (1) (e) 2. of the statutes is amended to read:

SB21,733,10 49.475 (1) (e) 2. An enrollee of the family care program, as defined in s. 46.2805 (4m).

SB21,1816 Section 1816. 49.496 (1) (bk) 2. of the statutes is repealed.

SB21,1817 Section 1817. 49.682 (title) of the statutes is amended to read:

SB21,733,13 49.682 (title) Recovery from estates; disease aids and funeral expenses.

SB21,1818 Section 1818. 49.682 (1) (a) of the statutes is amended to read:

SB21,733,17 49.682 (1) (a) "Client" means a person who receives or received aid under s. 49.68, 49.683, or 49.685 or a person on whose behalf funeral, burial, or cemetery expenses aid was provided under s. 49.785.

SB21,1819 Section 1819. 49.682 (1) (d) of the statutes is amended to read:

SB21,733,22 49.682 (1) (d) "Nonclient surviving spouse" means any person who was married to a client while the client was receiving or when the client received services or aid for which the cost may be recovered under sub. (2) (a) or (am) and who survived the client.

SB21,1820 Section 1820. 49.682 (2) (am) of the statutes is created to read:

SB21,734,3 49.682 (2) (am) The department shall file a claim against the estate of a client, and against the estate of a nonclient surviving spouse, for the amount of aid under s. 49.785 paid to or on behalf of the client.

SB21,1821 Section 1821. 49.682 (2) (bm) 1. of the statutes is amended to read:

SB21,734,7 49.682 (2) (bm) 1. Property that is subject to the department's claim under par. (a) or (am) in the estate of a client or in the estate of a nonclient surviving spouse is all property of a decedent that is included in the estate.

SB21,1822 Section 1822. 49.682 (2) (bm) 2. of the statutes is amended to read:

SB21,734,13 49.682 (2) (bm) 2. There is a presumption, consistent with s. 766.31, which may be rebutted, that all property in the estate of the nonclient surviving spouse was marital property held with the client and that 100 percent of the property in the estate of the nonclient surviving spouse is subject to the department's claim under par. (a) or (am).

SB21,1823 Section 1823. 49.682 (2) (c) (intro.) of the statutes is amended to read:

SB21,734,18 49.682 (2) (c) (intro.) The court shall reduce the amount of a claim under par. (a) or (am) by up to the amount specified in s. 861.33 (2) if necessary to allow the decedent's heirs or the beneficiaries of the decedent's will to retain the following personal property:

SB21,1824 Section 1824. 49.682 (3) of the statutes is amended to read:

SB21,734,25 49.682 (3) The department shall administer the program under this section and may contract with an entity to administer all or a portion of the program, including gathering and providing the department with information needed to recover payment of aid provided under s. 49.68, 49.683, or 49.685, or 49.785. All funds received under this subsection, net of any amount claimed under s. 49.849 (5), shall be remitted for deposit in the general fund.

SB21,1825 Section 1825. 49.682 (4) (a) of the statutes is amended to read:

SB21,735,5 49.682 (4) (a) The department may recover amounts under this section for the provision of aid provided under s. 49.68, 49.683, or 49.685 paid on and after September 1, 1995, and for the provision of aid provided under s. 49.785 paid on or after the effective date of this paragraph .... [LRB inserts date].

SB21,1826 Section 1826. 49.682 (4) (b) of the statutes is amended to read:

SB21,735,10 49.682 (4) (b) The department may file a claim under sub. (2) (a) only with respect to a client who dies after September 1, 1995. The department may file a claim under sub. (2) (am) only with respect to a client who dies after the effective date of this paragraph .... [LRB inserts date].

SB21,1827 Section 1827. 49.682 (5) of the statutes is amended to read:

SB21,735,17 49.682 (5) The department shall promulgate rules establishing standards for determining whether the application of this section with respect to a claim under sub. (1) (a) would work an undue hardship in individual cases. If the department determines that the application of this section with respect to a claim under sub. (1) (a) would work an undue hardship in a particular case, the department shall waive application of this section in that case.

SB21,1828 Section 1828. 49.688 (2) (a) 6. of the statutes is created to read:

SB21,735,22 49.688 (2) (a) 6. The person applies for and, if eligible, enrolls in Medicare under Part D of Title XVIII of the federal Social Security Act, 42 USC 1395w-101 to 1395w-153, if the secretary of the federal department of health and human services approves the condition on eligibility under this subdivision.

SB21,1829 Section 1829. 49.688 (2) (b) of the statutes is amended to read:

SB21,736,5 49.688 (2) (b) A person to whom par. (a) 1. to 3. and, 5., and 6. applies, but whose annual household income, as determined by the department, exceeds 240% of the federal poverty line for a family the size of the persons' eligible family, is eligible to purchase a prescription drug at the amounts specified in sub. (5) (a) 4. only during the remaining amount of any 12-month period in which the person has first paid the annual deductible specified in sub. (3) (b) 2. a. in purchasing prescription drugs at the retail price and has then paid the annual deductible specified in sub. (3) (b) 2. b.

SB21,1830 Section 1830. 49.78 (5) of the statutes is amended to read:

SB21,736,15 49.78 (5) Personnel examinations. Statewide examinations to ascertain qualifications of applicants in any county department administering aid to families with dependent children shall be given by the administrator of the division director of the bureau of merit recruitment and selection in the office of state employment relations department of administration. The office of state employment relations department of administration shall be reimbursed for actual expenditures incurred in the performance of its functions under this section from the appropriations available to the department of children and families for administrative expenditures.

SB21,1831 Section 1831. 49.785 (1m) (d) of the statutes is created to read:

SB21,736,21 49.785 (1m) (d) If the recipient, or the recipient's spouse or another person, owns a life insurance policy insuring the recipient's life and the face value of the policy is more than $3,000, any amount that the department would be obligated to pay under sub. (1) shall be reduced by one dollar for every dollar by which the face value of the policy exceeds $3,000.

SB21,1832 Section 1832. 49.785 (2) of the statutes is created to read:

SB21,736,25 49.785 (2) The department shall pursue recovery of any amounts paid under sub. (1) from the estate of the recipient and from the estate of any surviving spouse of the recipient as provided in s. 49.682.

SB21,1833 Section 1833. 49.79 (9) (d) of the statutes is created to read:

SB21,737,6 49.79 (9) (d) 1. The department shall request from the secretary of the federal department of agriculture a waiver to permit the department to screen and, if indicated, test, as specified by the department in the waiver request, participants in an employment and training program under this subsection for illegal use of a controlled substance without presenting evidence of a valid prescription.

SB21,737,11 2. If a waiver under subd. 1. is granted and in effect, the department shall screen and, if indicated, test, in a manner approved in the waiver granted by the secretary of the federal department of agriculture, participants in an employment and training program under this subsection for illegal use of a controlled substance without presenting evidence of a valid prescription.

SB21,1834 Section 1834. 49.849 (1) (c) of the statutes is amended to read:

SB21,737,15 49.849 (1) (c) "Nonrecipient surviving spouse" means any person who was married to a recipient while the recipient was receiving or when the recipient received public assistance and who survived the recipient.

SB21,1835 Section 1835. 49.849 (1) (e) of the statutes is amended to read:

SB21,737,20 49.849 (1) (e) "Public assistance" means any services provided as a benefit under a long-term care program, as defined in s. 49.496 (1) (bk), medical assistance under subch. IV, long-term community support services funded under s. 46.27 (7), or aid under s. 49.68, 49.683, or 49.685, or 49.785.

SB21,1836 Section 1836. 49.849 (2) (a) (intro.) of the statutes is amended to read:

SB21,738,3 49.849 (2) (a) (intro.) Subject to par. (b), the department may collect from the property of a decedent by affidavit under sub. (3) (b) or by lien under sub. (4) (a) an amount equal to the medical assistance that is recoverable under s. 49.496 (3) (a), the long-term community support services under s. 46.27 that is recoverable under s. 46.27 (7g) (c) 1., or the aid under s. 49.68, 49.683, or, 49.685, or 49.785 that is recoverable under s. 49.682 (2) (a) or (am), and that was paid on behalf of the decedent or the decedent's spouse, if all of the following conditions are satisfied:

SB21,1837 Section 1837. 49.849 (2) (a) 1. of the statutes is amended to read:

SB21,738,7 49.849 (2) (a) 1. The decedent died after September 30, 1991, or for the recovery of aid under s. 49.785 the decedent died after the effective date of this subdivision .... [LRB inserts date].

SB21,1838 Section 1838. 49.849 (2) (a) 2. of the statutes is amended to read:

SB21,738,11 49.849 (2) (a) 2. The decedent is not survived by a spouse, a child who is under age 21, or a child who is disabled, as defined in s. 49.468 (1) (a) 1. This subdivision does not apply for the recovery of aid under s. 49.785.

SB21,1839 Section 1839. 49.849 (3) (b) of the statutes is amended to read:

SB21,738,19 49.849 (3) (b) A person who possesses or receives property of a decedent shall transmit the property to the department, if the conditions in sub. (2) (a) 1. and, if applicable, sub. (2) (a) 2. are satisfied, upon receipt of an affidavit by a person designated by the secretary of health services to administer this section showing that the department paid on behalf of the decedent or the decedent's spouse recoverable benefits specified in sub. (2) (a). Upon transmittal, the person is released from any obligation to other creditors or heirs of the decedent.