Notice of Hearing
Health Services
Management and Technology and Strategic Finance,
Chs.
DHS 1—
NOTICE IS HEREBY GIVEN that pursuant to ss.
46.286 (7) and
227.11 (2) (a), Stats., the Wisconsin Department of Health Services will hold a public hearing on a proposed rule to revise Chapter
DHS 10, relating to fair hearings and continuation of benefits pending the outcome of a grievance, department review, or fair hearing under the family care program.
Hearing Information
Date and Time
April 30, 2009
9:00 – 10:00 am
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Location
Department of Health Services
1 W. Wilson Street
Room 518 B
Madison, Wisconsin
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The hearing site is fully accessible to people with disabilities. If you are hearing impaired, do not speak English or have circumstances that might make communication at a hearing difficult; you require an interpreter or a non-English large print or taped version of the proposed rules, contact the person at the address or telephone number given below at least 10 days before the hearing. With less than 10 days notice, an interpreter may not be available.
Submission of Written Comments
Written comments may be submitted at the public hearing or submitted to the contact person listed below. Comments may also be made using the Wisconsin Administrative Rule Website at
http://adminrules.wisconsin.gov.
The deadline for submitting comments to the Department is 4:30 p.m. on May 7, 2009.
Analysis Prepared by the Department of Health Services
Statute interpreted
Statutory authority
Explanation of agency authority
Section
46.286 (7), Stats., requires the Department to promulgate rules relating to the recovery of correctly or incorrectly paid Family Care Benefits. Section
227.11 (2) (a), Stats., permits the Department to promulgate rules of any statute interpreted or enforced by the Department, if the Department considers it necessary to effectuate the purpose of the statute.
Related statute or rule
Plain language analysis
Under this proposed order, the Department is providing an exception to the right to a fair hearing and continuation of services during a fair hearing, grievance, or Department review when Family Care benefits are reduced or terminated by an act or decision by the federal government or the state legislature and the individual whose benefits have been terminated or reduced does not dispute that he or she falls within the category of persons for whom the benefit was reduced or terminated.
The proposed exception was originally promulgated by the Department under an emergency order effective April 7, 2008, after eligibility of non-Medicaid individuals to receive Family Care benefits was rescinded under
2007 Act 20, and after the federal Centers for Medicare & Medicaid Services eliminated, for individuals who did not require non-nursing home level of care, home and community-based services.
Section
DHS 10.55, provides enrollees with a right to fair hearing when services are reduced or terminated, or eligibility is denied, and the option to continue services during an appeal. Persons who receive continuation of services are responsible to pay for the services if they lose on appeal.
Individuals whose benefits have been terminated or reduced under state or federal law or policy and who does not dispute that he or she falls within the category of persons for whom the benefit was reduced or terminated would lose the appeal and be responsible for paying the cost of any continued services they received. The cost could amount to thousands of dollars. The Department has determined that such situations may be detrimental to the welfare of the affected individuals and should be prevented.
Comparison with federal regulations
There are similar provisions in Medicaid rules at
42 CFR §431.220(b), which provides that the State Medicaid Agency “need not grant a hearing if the sole issue is a Federal or State law requiring an automatic change adversely affecting some or all recipients." And, at
42 CFR § 431.230(a)(1), which provides that individuals have a right to continuation of services pending the outcome of an appeal unless, “it is determined at the hearing that the sole issue is one of Federal or State law or policy."
Comparison with rules in adjacent states
Illinois:
Illinois does not have a program similar to Family Care.
Iowa:
Iowa does not have a program similar to Family Care.
Michigan:
Michigan does not have a program similar to Family Care.
Minnesota:
Minnesota does not have a program similar to Family Care.
Summary of factual data and analytical methodologies
The Department assessed the adverse impact on individuals affected by previous changes in benefits as a result of changes in state statute and federal policy.
Small Business Impact
The rules would not have an effect on businesses.
Small business regulatory coordinator
Rosie Greer
608-266-1279
Fiscal Estimate
The proposed rule will have no immediate fiscal impact, but may result in an indeterminate decrease in future costs to the state and to Family Care managed care organizations (MCOs). Some MCOs are units of county government. Some MCOs are private non-profit organizations, which are not small businesses. The potential future decrease in costs to the state and to MCOs will result from not being required to assign staff to conduct or participate in fair hearings in which the appellant cannot be successful. In addition, MCOs may have decreased costs because they will not be required to continue to provide services during an appeal in which the appellant cannot be successful.
Copies of Rules and Fiscal Estimate
A copy of the full text of the rules and the fiscal estimate can be obtained at no charge from the Wisconsin Admin. Rules Website at
http://adminrules.wisconsin.gov or by contacting the person listed below.
Agency Contact Person
Charles Jones
Division of Long Term Care
1 W. Wilson St., Room 518
P.O. Box 7851
Madison, WI 53707-7851
Phone: (608) 266-0991
TTY: (888) 241-9432
Notice of Hearing
Insurance
NOTICE IS HEREBY GIVEN That pursuant to the authority granted under s.
601.41 (3), Stats., and the procedures set forth under s.
227.18, Stats., the Office of the Commissioner of Insurance (OCI) will hold a public hearing to consider the adoption of rules revising section
Ins 2.81, Wis. Adm. Code, relating to use of the 1980 CSO Standard Ordinary Life Valuation Mortality Table in determining the minimum standard of valuation reserves and the minimum standard nonforfeiture values for preneed funeral life insurance products.
Hearing Information
Date: May 7, 2009
Time: 10:00 a.m., or as soon thereafter as
the matter may be reached
Place: OCI, Room 227, 2nd Floor
125 South Webster Street
Madison, WI
Submission of Written Comments
Written comments can be mailed to:
James W. Harris
Legal Unit - OCI Rule Comment for Rule Ins 281
Office of the Commissioner of Insurance
PO Box 7873
Madison WI 53707-7873
Written comments can be hand delivered to:
James W. Harris
Legal Unit - OCI Rule Comment for Rule Ins 281
Office of the Commissioner of Insurance
125 South Webster St – 2nd Floor
Madison WI 53703-3474
Comments can be emailed to:
James W. Harris
The deadline for submitting comments is 4:00 p.m. on the 14th day after the date for the hearing stated in this Notice of Hearing.
Analysis Prepared by the Office of the Commissioner of Insurance (OCI)
Statutes interpreted
Statutory authority
Explanation of agency authority
The proposed rule is promulgated under the commissioner's authority to prescribe valuation and reserve liabilities and accounting standards and reporting for insurers.
