AB150-ASA,968,2313
(bm) All records of the department relating to aid provided under s. 49.19 are
14open to inspection at reasonable hours by members of the legislature who require the
15information contained in the records in pursuit of a specific state legislative purpose.
16All records of any county relating to aid provided under s. 49.19 are open to inspection
17at reasonable hours by members of the board of supervisors of the county or the
18governing body of a city, village or town located in the county who require the
19information contained in the records in pursuit of a specific county or municipal
20legislative purpose. The right to records access provided by this paragraph does not
21apply if access is prohibited by federal law or regulation or if this state is required
22to prohibit such access as a condition precedent to participation in a federal program
23in which this state participates.
AB150-ASA,969,724
(c) The department may at any time audit all county records relating to the
25administration of the services and public assistance specified in this section and may
1at any time conduct administrative reviews of county departments under ss. 46.215,
246.22 and 46.23. If the department conducts such an audit or administrative review
3in a county, the department shall furnish a copy of the audit or administrative review
4report to the chairperson of the county board of supervisors and the county clerk in
5a county with a single-county department or to the county boards of supervisors and
6the county clerks in counties with a multicounty department, and to the director of
7the county department under s. 46.215, 46.22 or 46.23.
AB150-ASA,969,9
8(2) The county administration of all laws relating to programs under this
9subchapter shall be vested in the officers and agencies designated in the statutes.
AB150-ASA,969,15
1149.41 Assistance grants exempt from levy. All grants of aid to families with
12dependent children, payments made for social services,
cash benefits paid by
13counties under s. 59.07 (154), and benefits under
ss. 49.032, 49.046 and s. 49.177 or
14federal Title XVI, are exempt from every tax, and from execution, garnishment,
15attachment and every other process and shall be inalienable.
AB150-ASA, s. 2940
16Section
2940. 49.41 of the statutes, as affected by 1995 Wisconsin Act .... (this
17act), is renumbered 49.96 and amended to read:
AB150-ASA,969,22
1849.96 Assistance grants exempt from levy. All grants of aid to families with
19dependent children, payments made for social services, cash benefits paid by
20counties under s. 59.07 (154), and benefits under s.
49.177 49.77 or federal Title XVI,
21are exempt from every tax, and from execution, garnishment, attachment and every
22other process and shall be inalienable.
AB150-ASA, s. 2941
23Section
2941. Subchapter IV (title) of chapter 49 [precedes 49.43] of the
24statutes is created to read:
AB150-ASA,970,2
1Subchapter IV
2
Medical assistance
AB150-ASA, s. 2942
3Section
2942. The unnumbered subchapter title preceding 49.43 of the
4statutes is repealed.
AB150-ASA,970,77
49.43
(3e) "Department" means the department of health and social services.
AB150-ASA,970,129
49.43
(10) "Provider" means a person, corporation, limited liability company,
10partnership, unincorporated business or professional association and any agent or
11employe thereof who provides medical assistance
under ss. 49.45 to 49.47, 49.49 and
1249.495.
AB150-ASA,970,1414
49.43
(10s) "Secretary" means the secretary of health and social services.
AB150-ASA,970,1816
49.45
(2) (a) 15. Routinely provide notification to persons eligible for medical
17assistance
under ss. 49.46 to 49.47, or such persons' guardians, of the department's
18access to provider records.
AB150-ASA,970,2320
49.45
(2) (a) 23. Promulgate rules that define "supportive services", "personal
21services" and "nursing services" provided in a certified assisted living facility, as
22defined under s. 50.01 (1d), for purposes of reimbursement under ss. 46.27 (11) (c) 7.
23and 46.277 (5) (e).
AB150-ASA,971,4
149.45
(2) (b) 4. Audit claims filed by any provider of medical assistance, and as
2part of that audit, request of any such provider, and review, medical records of
3individuals who have received benefits under the medical assistance program
, or
4under s. 49.046.
AB150-ASA,971,106
49.45
(3) (a) Reimbursement shall be made to each county department under
7ss. 46.215, 46.22 and 46.23 for the administrative services performed in the medical
8assistance program on the basis of s.
49.52 49.33 (8). For purposes of reimbursement
9under this paragraph, assessments completed under s. 46.27 (6) (a) are
10administrative services performed in the medical assistance program.
AB150-ASA,971,1712
49.45
(3) (e) 7m. Notwithstanding subd. 7., the daily reimbursement or
13payment rate for services at a hospital established under s. 45.375 (1) provided to
14medical assistance recipients whose continued hospitalization is no longer medically
15necessary or appropriate during a period where the recipient awaits placement in an
16alternate custodial living arrangement shall be the skilled nursing facility rate paid
17to the facility created under s. 45.365 (1).
AB150-ASA,971,2219
49.45
(5) Appeal. Any person whose application for medical assistance is
20denied or is not acted upon promptly or who believes that the payments made in the
21person's behalf have not been properly determined may file an appeal with the
22department pursuant to s.
49.50 (8) 49.21 (1).
AB150-ASA,972,524
49.45
(5m) (a) Notwithstanding sub. (3) (e), from the appropriations under s.
2520.435 (1) (b) and (o) the department shall distribute not more than $2,256,000 in
1each
of fiscal
years 1993-94 and 1994-95 year, to provide supplemental funds to
2rural hospitals that, as determined by the department, have high utilization of
3inpatient services by patients whose care is provided from governmental sources,
4except that the department may not distribute funds to a rural hospital to the extent
5that the distribution would exceed any limitation under
42 USC 1396b (i) (3).
AB150-ASA,972,97
49.45
(6b) (a) Beginning in fiscal year
1994-95 1995-96, for relocations from
8the central Wisconsin center for the developmentally disabled, by
$55.77 $220 per
9day.
AB150-ASA,972,1311
49.45
(6b) (b) Beginning in fiscal year
1994-95 1995-96, for relocations from
12the northern Wisconsin center for the developmentally disabled, by
$49.06 $214 per
13day.
AB150-ASA,972,1715
49.45
(6b) (c) Beginning in fiscal year
1994-95 1995-96, for relocations from
16the southern Wisconsin center for the developmentally disabled, by
$48.37 $164 per
17day.
AB150-ASA, s. 2960
18Section
2960. 49.45 (6m) (ag) 3m. of the statutes is amended to read:
AB150-ASA,972,2319
49.45
(6m) (ag) 3m. For state fiscal year
1993-94 1995-96, rates that shall be
20set by the department based on information from cost reports for the
1992 1994 fiscal
21year of the facility and for state fiscal year
1994-95
1996-97, rates that shall be set
22by the department based on information from cost reports for the
1993 1995 fiscal
23year of the facility.
AB150-ASA,973,11
149.45
(6m) (ag) 8. Calculation of total payments and supplementary payments
2to facilities that permits an increase in funds allocated under s. 20.435 (1) (b) and (o)
3for nursing home care provided medical assistance recipients over that paid for
4services provided in state fiscal year
1992-93 1994-95 of no more than
3.58% 4.25% 5during state fiscal year
1993-94 1995-96 and over that paid for services provided in
6state fiscal year
1993-94 1995-96 of no more than
3.57% 3.5% during state fiscal
7year
1994-95 1996-97, excluding increases in total payments attributable to
8increases in recipient utilization of facility care, payments for the provision of active
9treatment to facility residents with developmental disability or chronic mental
10illness and payments for preadmission screening of facility applicants and annual
11reviews of facility residents required under
42 USC 1396r (e).
AB150-ASA,973,1613
49.45
(6m) (am) 5. Allowable administrative and general costs, including costs
14related to the facility's overall management and administration and allowable
15expenses that are not recognized or reimbursed in other cost centers
and including
16the costs of commercial estimators approved by the department under par. (ar) 6.
AB150-ASA, s. 2963
17Section
2963. 49.45 (6m) (am) 5m. of the statutes is created to read:
AB150-ASA,973,2018
49.45
(6m) (am) 5m. Allowable interest expense of the facility, less interest
19income of the facility and less interest income of affiliated entities, to the extent
20required under the approved state plan for services under
42 USC 1396.
AB150-ASA, s. 2964
21Section
2964. 49.45 (6m) (ar) 1. c. of the statutes is amended to read:
AB150-ASA,974,222
49.45
(6m) (ar) 1. c. If a facility has an approved program for provision of
23service to
emotionally disturbed or mentally retarded residents, residents dependent
24upon ventilators, or residents requiring supplemental skilled care due to complex
25medical conditions, a supplement to the direct care component of the facility rate
1under subd. 1. b. may be made to that facility according to a method developed by the
2department.
AB150-ASA,974,94
49.45
(6m) (ar) 6. Capital payment shall be based on a replacement value for
5a facility
, as. The replacement value shall be determined by a commercial estimator
6with which contracted for by the department
has contracted for service, and
paid for
7by the facility. The replacement value shall be subject to limitations determined by
8the department, except that the department may not reduce final capital payment
9of a facility by more than $3.50 per patient day.
AB150-ASA,974,1511
49.45
(6m) (av) 2. The department shall compile an average payment rate for
12each facility based on that facility's rates for cost centers described under par. (am)
131. to 5. that were in effect on June 30
of the previous year, 1994. The department may
14develop a method for adjusting the facility's rate for the cost center under par. (am)
151. in compiling the average payment rate under this subdivision.
AB150-ASA,974,2117
49.45
(6m) (av) 4. If the facility's payment rate under subd. 1. is a decrease from
18its average payment rate
from the previous year under subd. 2., and if the figure
19calculated under subd. 3. exceeds the payment rate for the facility under subd. 1., the
20facility's average payment rate shall be the greater of its average payment rate under
21subd. 2. or its rate under subd. 1.
AB150-ASA,975,624
49.45
(6m) (br) 1. Notwithstanding s.
20.410 (3) (cd), 20.435
(3) (cd), (4) (de) or
25(eb) (1) (bt) or (bu) or (7) (b)
or 20.445 (3) (de), the department shall reduce allocations
1of funds to counties in the amount of the disallowance from the appropriations under
2s.
20.410 (3) (cd) or 20.435
(3) (cd), (4) (de) or (eb) (1) (bt) or (bu) or (7) (b)
, or the
3department shall direct the department of industry, labor and human relations to
4reduce allocations of funds to counties in the amount of the disallowance from the
5appropriation under s. 20.445 (3) (de), in accordance with s. 16.544 to the extent
6applicable.
AB150-ASA,975,98
49.45
(6m) (c) 6. Provide, upon request, such information as the department
9considers necessary to determine allowable interest expenses under par. (am) 5m.
AB150-ASA,975,1611
49.45
(6m) (h) The department may require by rule that all claims for payment
12of services provided facility residents under this
chapter subchapter be submitted or
13countersigned by the respective facility administrator. The department may specify
14those categories of services for which payment will be made only if the services are
15rendered or authorized in writing by a primary health care provider designated by
16the recipient for the particular category of services.
AB150-ASA,975,2318
49.45
(6m) (L) For purposes of ss. 46.27 (11) (c) 7. and 46.277 (5) (e), the
19department shall, by July 1 annually, determine the statewide medical assistance
20daily cost of nursing home care and submit the determination to the department of
21administration for review. The department of administration shall approve the
22determination before payment may be made under s. 46.27 (11) (c) 7. or 46.277 (5)
23(e).
AB150-ASA,976,7
149.45
(6t) County department operating deficit reduction. From the
2appropriation under s. 20.435 (1) (o), for reduction of operating deficits, as defined
3under criteria developed by the department, incurred by a county department under
4s. 46.215, 46.22, 46.23 or 51.42 for services provided under s. 49.46 (2) (a) 4. d. and
5(b) 6. f., the department shall allocate up to $4,500,000 in each fiscal year to these
6county departments, as determined by the department, and shall perform all of the
7following:
AB150-ASA,976,118
(a) For the reduction of operating deficits incurred by the county departments,
9estimate the availability of federal medicaid funds that may be matched to county
10funds that are expended for costs in excess of reimbursement for services provided
11under s. 49.46 (2) (a) 4. d. and (b) 6. f.
AB150-ASA,976,1512
(b) Based on the amount estimated to be available under par. (a), develop a
13method, which need not be promulgated as rules under ch. 227, to distribute this
14allocation to the individual county departments under s. 46.215, 46.22, 46.23 or
1551.42 that have incurred operating deficits that shall include all of the following:
AB150-ASA,976,1616
1. Development of criteria for determining operating deficits.
AB150-ASA,976,1817
2. Agreement, by the county in which is located a county department that has
18an operating deficit, to provide funds to match federal medicaid funds.
AB150-ASA,976,1919
3. Consideration of the size of a county department's operating deficit.
AB150-ASA,976,2120
(c) Except as provided in par. (d), distribute the allocation under the
21distribution method that is developed.
AB150-ASA,977,222
(d) If the federal department of health and human services approves for state
23expenditure in a fiscal year amounts under s. 20.435 (1) (o) that result in a lesser
24allocation amount than that allocated under this subsection or disallows use of the
1allocation of federal medicaid funds under par. (c), reduce allocations under this
2subsection and distribute on a prorated basis, as determined by the department.
AB150-ASA,977,104
49.45
(6u) Facility operating deficit reduction. (intro.) Except as provided
5in par. (g), from the appropriation under s. 20.435 (1) (o), for reduction of operating
6deficits, as defined under criteria developed by the department, incurred by a facility,
7as defined under sub. (6m) (a) 2., that is established under s.
49.14 (1) 49.70 (1) or
8that is owned and operated by a city, village or town, the department shall distribute
9to these facilities not more than $18,600,000 in each fiscal year, as determined by the
10department, and shall perform all of the following:
AB150-ASA,977,1612
49.45
(6u) (b) 2. Agreement by the county in which is located the facility
13established under s.
49.14 (1) 49.70 (1) and agreement by the city, village or town that
14owns and operates the facility that the applicable county, city, village or town shall
15provide funds to match federal medical assistance matching funds under this
16subsection.
AB150-ASA,977,2118
49.45
(6u) (b) 2m. Identification by the county in which is located the facility
19established under s.
49.14 (1) 49.70 (1) of all county funds expended in each calendar
20year to operate the facility, and certification by the county to the department of this
21amount.
AB150-ASA,978,524
49.45
(6w) Hospital operating deficit reduction. (intro.) From the
25appropriation under s. 20.435 (1) (o), for reduction of operating deficits, as defined
1under criteria developed by the department, incurred by a hospital, as defined under
2s. 50.33 (2) (a) and (b), that is operated by the state, established under s.
49.16 49.71 3or owned and operated by a city or village, the department shall allocate up to
4$3,300,000 in each fiscal year to these hospitals, as determined by the department,
5and shall perform all of the following:
AB150-ASA,978,77
49.45
(6w) (a) 2. County funds, for a hospital established under s.
49.16 49.71.
AB150-ASA, s. 2983
8Section
2983. 49.45 (6w) (b) 2. b. of the statutes is amended to read:
AB150-ASA,978,109
49.45
(6w) (b) 2. b. Agreement to provide matching funds by the county in
10which is located a hospital established under s.
49.16
49.71.
