SB40-ASA1-AA1,197,1411
49.45
(3) (cm) 1. Except as provided under subd. 2., the department shall issue
12payment for at least 95 percent of proper provider claims for reimbursement under
13the Medical Assistance program within 30 days of receipt of the claims and shall
14issue payment for 100 percent of such claims within 45 days of receipt of the claims.
SB40-ASA1-AA1,197,1615
2. The department may exceed the claims payment deadlines under subd.1.
16under any of the following circumstances:
SB40-ASA1-AA1,197,2017
a. If a claim is filed under Medicare, as defined in par. (L) 1. b., for payment for
18a service, the department has up to 6 months after the department or the provider
19receives notice of the disposition of the Medicare claim to issue payment for the
20service.
SB40-ASA1-AA1,197,2321
b. The department may issue payments at any time in accordance with a court
22order or to comply with a hearing decision or a corrective action taken by the
23department.
SB40-ASA1-AA1,198,3
1c. If the department is granted a waiver under
42 CFR 447.45 (e) that exempts
2the department from federal deadlines for payment of claims, the department may
3exceed the deadlines under subd.1. to the extent permitted in the waiver.".
SB40-ASA1-AA1,199,114
49.45
(24r) Family planning demonstration project. The department shall
5request a waiver from the secretary of the federal department of health and human
6services to permit the department to conduct a demonstration project to provide
7family planning services, as defined in s. 253.07 (1) (b), under medical assistance to
8any woman between the ages of
15 18 and 44 whose family income does not exceed
9185% of the poverty line for a family the size of the woman's family. If the waiver is
10granted and in effect, the department shall implement the waiver no later than July
111, 1998, or on the effective date of the waiver, whichever is later.".
SB40-ASA1-AA1,200,4
3"
Section 1589r. 49.46 (2) (b) 3. of the statutes is renumbered 49.46 (2) (b) 3.
4a. and amended to read:
SB40-ASA1-AA1,200,115
49.46
(2) (b) 3. a. Transportation by emergency medical vehicle to obtain
6emergency medical care
, transportation by specialized medical vehicle to obtain
7medical care including the unloaded travel of the specialized medical vehicle
8necessary to provide that transportation or, if authorized in advance by the county
9department under s. 46.215 or 46.22, transportation by common carrier or private
10motor vehicle and, if transportation by other means is contraindicated, to obtain
11nonemergency medical care.
SB40-ASA1-AA1,200,1613
49.46
(2) (b) 3. b. To obtain nonemergency medical services, except as provided
14in subd. 3. a., appropriate transportation that is provided through an entity with
15which the department has contracted to manage transportation services for the
16Medical Assistance program.".
SB40-ASA1-AA1,202,213
49.665
(3) Administration. Subject to sub. (2) (a) 2., the department shall
14administer a program to provide the health services and benefits described in s. 49.46
15(2) to persons that meet the eligibility requirements specified in sub. (4)
and issue
16payment for such services in accordance with s. 49.45 (3) (cm). The department shall
17promulgate rules setting forth the application procedures and appeal and grievance
18procedures. The department may promulgate rules limiting access to the program
19under this section to defined enrollment periods. The department may also
20promulgate rules establishing a method by which the department may purchase
21family coverage offered by the employer of a member of an eligible family or of a
22member of an eligible child's household, or family or individual coverage offered by
23the employer of an eligible unborn child's mother or her spouse, under circumstances
1in which the department determines that purchasing that coverage would not be
2more costly than providing the coverage under this section.".
SB40-ASA1-AA1,203,221
49.785
(1m) (b) If the total funeral and burial expenses for the recipient exceed
22$3,500 $4,500, the county or applicable tribal governing body or organization
1responsible for burial of the recipient is not required to make a payment for funeral
2and burial expenses under sub. (1) (b).".
