49.682(1)(a)
(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.
49.682(1)(am)
(am) “Decedent" means a deceased client or a deceased nonclient surviving spouse, whichever is applicable.
49.682(1)(c)
(c) “Home" means property in which a person has an ownership interest consisting of the person's dwelling and the land used and operated in connection with the dwelling.
49.682(1)(d)
(d) “Nonclient surviving spouse" means any of the following:
49.682(1)(d)1.
1. A person who was married to a client when the client was receiving or received services or aid for which the cost may be recovered under
sub. (2) (a) and who survived the client.
49.682(1)(d)2.
2. A person who was married to a client on whose behalf funeral, burial, or cemetery expenses aid was provided under
s. 49.785, who was married to the client at the client's death or when the client was receiving or received any of the benefits described in
s. 49.785 (1c) that made the client an eligible recipient under
s. 49.785, or at both times, and who survived the client.
49.682(1)(e)
(e) “Property of a decedent" means all real and personal property to which the client held any legal title or in which the client had any legal interest immediately before death, to the extent of that title or interest, including assets transferred to a survivor, heir, or assignee through joint tenancy, tenancy in common, survivorship, life estate, revocable trust, or any other arrangement, excluding an irrevocable trust.
49.682(2)(a)(a) Except as provided in
par. (d), 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. 49.68,
49.683, or
49.685 paid to or on behalf of the client.
49.682(2)(am)
(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.
49.682(2)(b)
(b) The affidavit of a person designated by the secretary to administer this subsection is evidence of the amount of the claim.
49.682(2)(bm)1.1. 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.
49.682(2)(bm)2.
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).
49.682(2)(c)
(c) 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:
49.682(2)(c)1.
1. The decedent's wearing apparel and jewelry held for personal use.
49.682(2)(c)3.
3. Other tangible personal property not used in trade, agriculture or other business, not to exceed in value the amount specified in
s. 861.33 (1) (a) 4.
49.682(2)(d)
(d) A claim under
par. (a) is not allowable if the decedent has a surviving child who is under age 21 or disabled or a surviving spouse.
49.682(2)(e)1.1. If the department's claim is not allowable because of
par. (d) and the estate includes an interest in real property, including a home, the court exercising probate jurisdiction shall, in the final judgment or summary findings and order, assign the interest in the real property subject to a lien in favor of the department for the amount described in
par. (a). The personal representative or petitioner for summary settlement or summary assignment of the estate shall record the final judgment as provided in
s. 863.29,
867.01 (3) (h), or
867.02 (2) (h).
49.682(2)(e)2.
2. If the department's claim is not allowable because of
par. (d), the estate includes an interest in real property, including a home, and the personal representative closes the estate by sworn statement under
s. 865.16, the personal representative shall stipulate in the statement that the real property is assigned subject to a lien in favor of the department for the amount described in
par. (a). The personal representative shall record the statement in the same manner as described in
s. 863.29, as if the statement were a final judgment.
49.682(2)(f)
(f) The department may not enforce a lien under
par. (e) as long as any of the following survive the decedent:
49.682(2)(fm)
(fm) All of the following apply to a lien under
par. (e) that the department may not enforce because of
par. (f):
49.682(2)(fm)1.
1. If the decedent's surviving spouse or child who is under age 21 or disabled refinances a mortgage on the real property, the lien is subordinate to the new encumbrance.
49.682(2)(g)
(g) The department may enforce a lien under
par. (e) by foreclosure in the same manner as a mortgage on real property.
49.682(3)
(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,
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.
49.682(4)(a)(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 July 14, 2015.
49.682(4)(b)
(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 July 14, 2015.
49.682(5)
(5) The department shall promulgate rules establishing standards for determining whether the application of this section with respect to a claim under
sub. (2) (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. (2) (a) would work an undue hardship in a particular case, the department shall waive application of this section in that case.
49.682(6)
(6) The department may contract with or employ an attorney to probate estates to recover under this section the costs of care.
49.682 History
History: 1995 a. 27 ss.
3044b to
3044j; Stats. 1995 s. 49.682;
1995 a. 225 ss.
127,
128;
1999 a. 9;
2013 a. 20,
92;
2015 a. 55.
49.683
49.683
Cystic fibrosis aids. 49.683(1)
(1) Subject to
s. 49.687 (1m), the department may provide financial assistance for costs of medical care of persons over the age of 18 years with the diagnosis of cystic fibrosis who meet financial requirements established by the department by rule under
s. 49.687 (1).
49.683(3)
(3) No payment shall be made under this section for any portion of medical care costs that are payable under any state, federal, or other health care coverage program, including a health care coverage program specified by rule under
s. 49.687 (1m), or under any grant, contract, or other contractual arrangement.
49.683 History
History: 1973 c. 300; Stats. 1973 s. 146.35;
1973 c. 336 s.
55; Stats. 1973 s. 146.36;
1975 c. 39;
1979 c. 34 s.
2102 (43) (a);
1983 a. 27 s.
1562; Stats. 1983 s. 49.483;
1993 a. 16,
449;
1995 a. 27 ss.
3045,
3046,
3047; Stats. 1995 s. 49.683;
1997 a. 27;
1999 a. 9;
2001 a. 16;
2003 a. 33.
49.683 Cross-reference
Cross-reference: See also ch.
DHS 154, Wis. adm. code.
49.685
49.685
Hemophilia treatment services. 49.685(1)(a)
(a) “Comprehensive hemophilia treatment center" means a center, and its satellite facilities, approved by the department, which provide services, including development of the maintenance program, to persons with hemophilia and other related congenital bleeding disorders.
49.685(1)(c)
(c) “Hemophilia" means a bleeding disorder resulting from a genetically determined clotting factor abnormality or deficiency.
49.685(1)(d)
(d) “Home care" means the self-infusion of a clotting factor on an outpatient basis by the patient or the infusion of a clotting factor to a patient on an outpatient basis by a person trained in such procedures.
49.685(1)(e)
(e) “Maintenance program" means the individual's therapeutic and treatment regimen, including medical, dental, social and vocational rehabilitation including home health care.
49.685(1)(f)
(f) “Net worth" means the sum of the value of liquid assets, real property, after excluding the first $10,000 of the full value of the home derived by dividing the assessed value by the assessment ratio of the taxation district.
49.685(1)(g)
(g) “Physician director" means the medical director of the comprehensive hemophilia treatment center which is directly responsible for an individual's maintenance program.
49.685(2)
(2) Assistance program. From the appropriation accounts under
s. 20.435 (4) (e) and
(je), the department shall establish a program of financial assistance to persons suffering from hemophilia and other related congenital bleeding disorders. The program shall assist such persons to purchase the blood derivatives and supplies necessary for home care. The program shall be administered through the comprehensive hemophilia treatment centers.
49.685(4)
(4) Eligibility. Any permanent resident of this state who suffers from hemophilia or other related congenital bleeding disorder may participate in the program if that person meets the requirements of this section and
s. 49.687 and the standards set by rule under this section and
s. 49.687. The person shall enter into an agreement with the comprehensive hemophilia treatment center for a maintenance program to be followed by that person as a condition for continued eligibility. The physician director or a designee shall, at least once in each 6-month period, review the maintenance program and verify that the person is complying with the program.
49.685(5)
(5) Recovery from other sources. The department is responsible for payments for blood products and supplies used in home care by persons participating in the program. The department may enter into agreements with comprehensive hemophilia treatment centers under which the treatment center assumes the responsibility for recovery of the payments from a 3rd party, including any insurer.
49.685(6)(a)(a) The department shall, by rule, establish a reasonable cost for blood products and supplies used in home care as a basis of reimbursement under this section.
49.685(6)(b)
(b) Reimbursement shall not be made under this section for any blood products or supplies that are not purchased from or provided by a comprehensive hemophilia treatment center, or a source approved by the treatment center. Reimbursement shall not be made under this section for any portion of the costs of blood products or supplies that are payable under any other state, federal, or other health care coverage program under which the person is covered, including a health care coverage program specified by rule under
s. 49.687 (1m), or under any grant, contract, or other contractual arrangement.
49.685(6)(c)
(c) The reasonable cost, determined under
par. (a), of blood products and supplies used in home care for which reimbursement is not prohibited under
par. (b), shall be reimbursed under this section after deduction of the patient's liability, determined under
sub. (7).
49.685(7)(a)1.1. The percentage of the patient's liability for the reasonable costs for blood products and supplies which are determined to be eligible for reimbursement under
sub. (6) shall be based upon the income and the size of the person's family unit, according to standards to be established by the department under
s. 49.687.
49.685(7)(a)2.
2. In determining income, only the income of the patient and persons responsible for the patient's support under
s. 49.90 may be considered.
49.685(7)(a)4.
4. In determining family size, only persons who are related to the patient as parent, spouse, legal dependent or, if under the age of 18, as brother or sister may be considered.
49.685(7)(a)5.
5. In determining net worth, only the net worth of the patient and persons responsible for the patient's support under
s. 49.90 will be considered.
49.685(7)(b)
(b) Individual liability shall be determined at the time of initial treatment and shall be redetermined annually or upon the patient's notification to the department of a change in family size or financial condition.
49.685(8)
(8) Department's duties. The department shall:
49.685(8)(a)
(a) Extend financial assistance under this section to eligible persons suffering from hemophilia or other related congenital bleeding disorders.
49.685(8)(b)
(b) Employ administrative personnel to implement this section.
49.685(8)(c)
(c) Promulgate all rules necessary to implement this section.
49.685 Cross-reference
Cross-reference: See also ch.
DHS 153, Wis. adm. code.
49.686
49.686
AZT and pentamidine reimbursement program. 49.686(1)(a)
(a) “AIDS" means acquired immunodeficiency syndrome.
49.686(1)(b)
(b) “Gross income" means all income, from whatever source derived and in whatever form realized, whether in money, property or services.
49.686(1)(c)
(c) “HIV" means any strain of human immunodeficiency virus, which causes acquired immunodeficiency syndrome.
49.686(1)(d)
(d) “HIV infection" means the pathological state produced by a human body in response to the presence of HIV.
49.686(1)(f)
(f) “Residence" means the concurrence of physical presence with intent to remain in a place of fixed habitation. Physical presence is prima facie evidence of intent to remain.
49.686(2)
(2) Reimbursement. From the appropriation accounts under
s. 20.435 (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).
49.686(3)
(3) Eligibility. An individual is eligible to receive the reimbursement specified under
sub. (2) if he or she meets all of the following criteria:
49.686(3)(b)
(b) Has an infection that is certified by a physician to be an HIV infection.
49.686(3)(c)
(c) Has a prescription issued by a physician for AZT, for pentamidine or for a drug approved for reimbursement under
sub. (4) (c).
49.686(3)(d)
(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).
49.686(3)(e)
(e) Has no insurance coverage for AZT, the drug pentamidine or any drug approved for reimbursement under
sub. (4) (c) or, if he or she has insurance coverage, the coverage is inadequate to pay the full cost of the individual's prescribed dosage of AZT, the drug pentamidine or any drug approved for reimbursement under
sub. (4) (c).
49.686(3)(f)
(f) Is an individual whose annual gross household income is at or below 200 percent of the poverty line and, if funding is available under
s. 20.435 (1) (i) or
(m), is an individual whose annual gross household income is above 200 percent and at or below 300 percent of the poverty line.
49.686(4)
(4) Departmental duties. The department shall do all of the following:
