SB21-SSA1,1797 20Section 1797. 49.45 (23) (g) of the statutes is created to read:
SB21-SSA1,557,2521 49.45 (23) (g) 1. Subject to subd. 3., the department shall submit to the
22secretary of the federal department of health and human services an amendment to
23the waiver requested under par. (a) that authorizes the department to do all of the
24following with respect to the childless adults demonstration project under this
25subsection:
SB21-SSA1,558,1
1a. Impose monthly premiums as determined by the department.
SB21-SSA1,558,32 b. Impose higher premiums for enrollees who engage in behaviors that increase
3their health risks, as determined by the department.
SB21-SSA1,558,44 c. Require a health risk assessment for all enrollees.
SB21-SSA1,558,75 d. Limit an enrollee's eligibility under the demonstration project to no more
6than 48 months. The department shall specify the eligibility formula in the waiver
7amendment.
SB21-SSA1,558,108 e. Require, as a condition of eligibility, that an applicant or enrollee submit to
9a drug screening assessment and, if indicated, a drug test, as specified by the
10department in the waiver amendment.
SB21-SSA1,558,1511 2. Subject to subd. 3., if the secretary of the federal department of health and
12human services approves the amendment to the waiver under par. (a), in whole or
13in part, the department shall implement the changes to the demonstration project
14under this subsection specified in subd. 1. a. to e. that are approved by the secretary,
15consistent with the approval.
SB21-SSA1,558,2416 3. Prior to submitting to the secretary of the federal department of health and
17human services the amendment described in subd. 1., the department shall submit
18to the joint committee on finance a report that summarizes the provisions, and
19provides an estimate of the fiscal effect, of the proposed amendment to the waiver.
20If the secretary of the federal department of health and human services approves the
21amendment described in subd. 1., in whole or in part, before implementing the
22changes approved by the secretary, the department shall submit a report to the joint
23committee on finance that summarizes the provisions, and provides an estimate of
24the fiscal effect, of the amendment approved by the secretary.
SB21-SSA1,1798 25Section 1798. 49.45 (24k) of the statutes is created to read:
SB21-SSA1,559,14
149.45 (24k) Dental reimbursement pilot project. (a) 1. Subject to approval
2of the federal department of health and human services under par. (b), the
3department, as a pilot project, shall distribute moneys in each fiscal year to increase
4the reimbursement rate under Medical Assistance for pediatric dental care and adult
5emergency dental services, as defined by the department, that are provided in
6Brown, Marathon, Polk, and Racine counties. The reimbursement rate for these
7services shall equal 80 percent of the median fee for each service as reported in the
8most recent fee survey for the east north central region conducted by the American
9Dental Association or shall equal the provider's usual and customary charge,
10whichever is less. If a median fee is not reported for a service, the department shall
11establish a fee for the service that approximates 80 percent of the median usual and
12customary charge for that service for dentists practicing in the state but the
13reimbursement received by a provider may not exceed the provider's usual and
14customary charge for that service.
SB21-SSA1,560,215 2. For dental services provided on a fee-for-service basis as of July 1, 2015, the
16reimbursement rate increase specified in subd. 1. shall be distributed on a
17fee-for-service basis. For dental services provided as of July 1, 2015, by a health
18maintenance organization that contracts with the department to provide Medical
19Assistance services at a capitated rate, the department shall distribute the
20reimbursement rate increase under subd. 1. to the health maintenance organization.
21The department shall include in a contract with a health maintenance organization
22that provides dental services described in subd. 1. in the counties specified in subd.
231. a requirement that the health maintenance organization reimburse providers of
24services in accordance with the reimbursement rate increase pilot project under

1subd. 1. The department may not distribute the reimbursement rate increase under
2subd. 1. to federally qualified health centers that receive a grant under 42 USC 254b.
SB21-SSA1,560,83 (b) The department shall request any waiver from and submit any
4amendments to the state Medical Assistance plan to the federal department of health
5and human services necessary for the reimbursement rate increase pilot project
6under par. (a). If any necessary waiver request or state plan amendment request is
7approved, the department shall implement par. (a) beginning on the effective date
8of the waiver or plan amendment.
SB21-SSA1,560,169 (c) If the reimbursement rate increase pilot project under par. (a) is
10implemented, before the first day of the 4th month beginning after the effective date
11of the waiver or plan amendment described in par. (b) and quarterly thereafter, the
12department shall collaborate with the Health Policy Institute of the American
13Dental Association to evaluate the pilot project under par. (a) and shall submit a
14report to the joint committee on finance that includes data on all of the following key
15outcomes of interest from the pilot counties specified in par. (a) and from counties
16that are not pilot counties:
SB21-SSA1,560,1817 1. Dental care utilization among children and adults in dental clinics and in
18emergency rooms.
SB21-SSA1,560,1919 2. Participation by dentists in the Medical Assistance program.
SB21-SSA1,560,2120 3. The fiscal impact of the pilot project under par. (a), including costs and
21savings.
SB21-SSA1,560,2322 4. If feasible, a comparison of the pilot project as administered under a
23fee-for-service system and under a health maintenance organization system.
SB21-SSA1,561,3
15. If feasible, the impact of the pilot project on oral health outcomes, such as
2Medical Assistance recipients' self-reported assessment of oral health and barriers
3to obtaining dental care.
SB21-SSA1,561,74 (d) The department may not distribute the reimbursement rate increases
5under par. (a) for pediatric dental care and adult emergency dental services provided
6after the first day of the 37th month beginning after the effective date of the waiver
7or plan amendment described in par. (b).
SB21-SSA1,1799 8Section 1799. 49.45 (30x) of the statutes is created to read:
SB21-SSA1,561,139 49.45 (30x) Licensed midwife services. (a) Provider reimbursement.
10Beginning January 1, 2016, services under s. 49.46 (2) (b) 12t. provided to an
11individual are reimbursable under the Medical Assistance program if an
12amendment to the state medical assistance plan approved by the federal department
13of health and human services permits reimbursement under s. 49.46 (2) (b) 12t.
SB21-SSA1,561,1814 (b) Plan amendment. The department shall submit to the federal department
15of health and human services an amendment to the state medical assistance plan to
16permit the application of par. (a). The department may not pay reimbursement
17under par. (a) unless the amendment to the state plan allowing reimbursement
18under s. 49.46 (2) (b) 12t. is approved and in effect.
SB21-SSA1,1800 19Section 1800. 49.45 (39) (bm) of the statutes is created to read:
SB21-SSA1,561,2320 49.45 (39) (bm) Excess state share. Any portion of the state share under this
21subsection in excess of $42,200,000 in fiscal year 2015-16 and in excess of
22$41,700,000 in fiscal year 2016-17 and each fiscal year thereafter shall be deposited
23in the Medical Assistance trust fund.
SB21-SSA1,1801 24Section 1801. 49.45 (39m) of the statutes is created to read:
SB21-SSA1,562,10
149.45 (39m) State plan amendment for pharmacist reimbursement. The
2department shall submit to the federal department of health and human services an
3amendment to the state Medical Assistance plan to permit Medical Assistance
4reimbursement to pharmacists who meet the training requirements specified by the
5department to administer vaccines, as determined by the department, to a person 6
6to 18 years of age. The department shall provide Medical Assistance reimbursement
7under this subsection if the federal department of health and human services
8approves the amendment to the state Medical Assistance plan. A pharmacist or
9pharmacy shall enroll in the federal Vaccines for Children Program under 42 USC
101396s
to be eligible for Medical Assistance reimbursement under this subsection.
SB21-SSA1,1802 11Section 1802. 49.45 (41) (b) of the statutes is amended to read:
SB21-SSA1,562,2112 49.45 (41) (b) If a county elects to become certified as a provider of mental
13health crisis intervention services, the county may provide mental health crisis
14intervention services under this subsection in the county to medical assistance
15recipients through the medical assistance program. A county that elects to provide
16the services shall pay the amount of the allowable charges for the services under the
17medical assistance program that is not provided by the federal government. From
18the appropriation account under s. 20.435 (5) (bL), the
The department shall
19reimburse the county under this subsection only for the amount of the allowable
20charges for those services under the medical assistance program that is provided by
21the federal government.
SB21-SSA1,1803 22Section 1803. 49.452 of the statutes is created to read:
SB21-SSA1,563,2 2349.452 Counting promissory notes as assets for certain Medical
24Assistance programs.
(1) In this section, "promissory note" means a written,
25unconditional agreement, given in return for goods, money loaned, or services

1rendered, under which one party promises to pay another party a specified sum of
2money at a specified time or on demand.
SB21-SSA1,563,5 3(2) If an individual's assets are counted when determining or redetermining
4the individual's financial eligibility for Medical Assistance, the department shall
5include a promissory note as a countable asset if all of the following apply:
SB21-SSA1,563,86 (a) The individual applying for or receiving benefits under Medical Assistance
7or his or her spouse provided the goods, money loaned, or services rendered for the
8promissory note.
SB21-SSA1,563,109 (b) The promissory note was entered into or purchased on or after the effective
10date of this paragraph .... [LRB inserts date].
SB21-SSA1,563,1211 (c) The promissory note is negotiable, assignable, and enforceable and does not
12contain any terms making it unmarketable.
SB21-SSA1,563,18 13(3) A promissory note is presumed to be negotiable and its asset value is the
14outstanding principal balance at the time the individual applies for Medical
15Assistance or at the time the individual's eligibility for Medical Assistance is
16redetermined, unless the individual shows by credible evidence from a
17knowledgeable source that the note is nonnegotiable or has a different current
18market value, which will then be considered the asset value.
SB21-SSA1,1804 19Section 1804. 49.453 (4c) (am) of the statutes is created to read:
SB21-SSA1,563,2320 49.453 (4c) (am) Notwithstanding par. (a), for purposes of sub. (2), the purchase
21of or entering into a promissory note by an individual or his or her spouse on or after
22the effective date of this paragraph .... [LRB inserts date], is a transfer of assets for
23less than fair market value unless all of the following apply:
SB21-SSA1,563,2424 1. The promissory note satisfies the requirements under par. (a) 1. to 3.
SB21-SSA1,564,2
12. The promissory note is negotiable, assignable, and enforceable and does not
2contain any terms making it unmarketable.
SB21-SSA1,1805 3Section 1805. 49.453 (4c) (b) of the statutes is renumbered 49.453 (4c) (b) 1.
4and amended to read:
SB21-SSA1,564,95 49.453 (4c) (b) 1. The value of a promissory note , purchased before the effective
6date of this subdivision .... [LRB inserts date], a
loan, or a mortgage that does not
7satisfy the requirements under par. (a) 1. to 3. is the outstanding balance due on the
8date that the individual applies for medical assistance for nursing facility services
9or other long-term care services described in sub. (2).
SB21-SSA1,1806 10Section 1806. 49.453 (4c) (b) 2. of the statutes is created to read:
SB21-SSA1,564,1711 49.453 (4c) (b) 2. The value of a promissory note purchased or entered into on
12or after the effective date of this subdivision .... [LRB inserts date], that does not
13satisfy the requirements under par. (am) 1. and 2. is the outstanding balance due on
14the date that the individual applies for Medical Assistance for nursing facility
15services or other long-term care services described in sub. (2) or on the date that the
16individual's eligibility for Medical Assistance for nursing facility services or other
17long-term care services described in sub. (2) is redetermined.
SB21-SSA1,1807 18Section 1807. 49.46 (2) (b) 12t. of the statutes is created to read:
SB21-SSA1,564,2119 49.46 (2) (b) 12t. Subject to the limitations under s. 49.45 (30x), licensed
20midwife services provided by a certified professional midwife licensed under s.
21440.982.
SB21-SSA1,1808 22Section 1808. 49.46 (2) (b) 14m. of the statutes is created to read:
SB21-SSA1,564,2523 49.46 (2) (b) 14m. Subject to par. (bt), substance abuse treatment services
24provided by a medically monitored treatment service or a transitional residential
25treatment service.
SB21-SSA1,1809
1Section 1809. 49.46 (2) (bt) of the statutes is created to read:
SB21-SSA1,565,62 49.46 (2) (bt) 1. For the purposes of par. (b) 14m., a "medically monitored
3treatment service" is a 24-hour, community-based service providing observation,
4monitoring, and treatment by a multidisciplinary team under supervision of a
5physician, with a minimum of 12 hours of counseling provided per week for each
6patient.
SB21-SSA1,565,107 2. For the purposes of par. (b) 14m., a "transitional residential treatment
8service" is a clinically supervised, peer-supported, therapeutic environment with
9clinical involvement providing substance abuse treatment in the form of counseling
10for 3 to 11 hours provided per week for each patient.
SB21-SSA1,565,1411 3. If approval by the federal department of health and human services of a state
12plan amendment or waiver request is necessary for federal reimbursement of the
13services under par. (b) 14m., the department is not required to pay for services
14described in par. (b) 14m. if the department does not receive the necessary approval.
SB21-SSA1,565,1715 4. The department may not provide reimbursement for services under par. (b)
1614m. that are provided before July 1, 2016, or before the date of approval of the state
17plan amendment or waiver request described under subd. 3., whichever is later.
SB21-SSA1,1810 18Section 1810. 49.471 (8) (d) 1. a. of the statutes is amended to read:
SB21-SSA1,565,2019 49.471 (8) (d) 1. a. A pregnant woman, except as provided in pars. par. (cr) 1.
20c. and (fm) 4.
SB21-SSA1,1811 21Section 1811. 49.471 (8) (f) of the statutes is repealed.
SB21-SSA1,1812 22Section 1812. 49.471 (8) (fm) of the statutes is repealed.
SB21-SSA1,1813 23Section 1813. 49.471 (8) (g) of the statutes is repealed.
SB21-SSA1,1814 24Section 1814. 49.472 (5) of the statutes is amended to read:
SB21-SSA1,566,4
149.472 (5) Community options participants. From the appropriation under s.
220.435 (7) (4) (bd), the department may pay all or a portion of the monthly premium
3calculated under sub. (4) (a) for an individual who is a participant in the community
4options program under s. 46.27 (11).
SB21-SSA1,1817 5Section 1817. 49.682 (title) of the statutes is amended to read:
SB21-SSA1,566,6 649.682 (title) Recovery from estates ; disease aids and funeral expenses.
SB21-SSA1,1818 7Section 1818. 49.682 (1) (a) of the statutes is amended to read:
SB21-SSA1,566,108 49.682 (1) (a) "Client" means a person who receives or received aid under s.
949.68, 49.683, or 49.685 or a person on whose behalf funeral, burial, or cemetery
10expenses aid was provided under s. 49.785
.
SB21-SSA1,1819b 11Section 1819b. 49.682 (1) (d) of the statutes is renumbered 49.682 (1) (d)
12(intro.) and amended to read:
SB21-SSA1,566,1313 49.682 (1) (d) (intro.) "Nonclient surviving spouse" means any of the following:
SB21-SSA1,566,16 141. A person who was married to a client while when the client was receiving or
15received
services or aid for which the cost may be recovered under sub. (2) (a) and who
16survived the client.
SB21-SSA1,1819c 17Section 1819c. 49.682 (1) (d) 2. of the statutes is created to read:
SB21-SSA1,566,2218 49.682 (1) (d) 2. A person who was married to a client on whose behalf funeral,
19burial, or cemetery expenses aid was provided under s. 49.785, who was married to
20the client at the client's death or when the client was receiving or received any of the
21benefits described in s. 49.785 (1c) that made the client an eligible recipient under
22s. 49.785, or at both times, and who survived the client.
SB21-SSA1,1820 23Section 1820. 49.682 (2) (am) of the statutes is created to read:
SB21-SSA1,567,3
149.682 (2) (am) The department shall file a claim against the estate of a client,
2and against the estate of a nonclient surviving spouse, for the amount of aid under
3s. 49.785 paid to or on behalf of the client.
SB21-SSA1,1821 4Section 1821. 49.682 (2) (bm) 1. of the statutes is amended to read:
SB21-SSA1,567,75 49.682 (2) (bm) 1. Property that is subject to the department's claim under par.
6(a) or (am) in the estate of a client or in the estate of a nonclient surviving spouse is
7all property of a decedent that is included in the estate.
SB21-SSA1,1822 8Section 1822. 49.682 (2) (bm) 2. of the statutes is amended to read:
SB21-SSA1,567,139 49.682 (2) (bm) 2. There is a presumption, consistent with s. 766.31, which may
10be rebutted, that all property in the estate of the nonclient surviving spouse was
11marital property held with the client and that 100 percent of the property in the
12estate of the nonclient surviving spouse is subject to the department's claim under
13par. (a) or (am).
SB21-SSA1,1823 14Section 1823. 49.682 (2) (c) (intro.) of the statutes is amended to read:
SB21-SSA1,567,1815 49.682 (2) (c) (intro.) The court shall reduce the amount of a claim under par.
16(a) or (am) by up to the amount specified in s. 861.33 (2) if necessary to allow the
17decedent's heirs or the beneficiaries of the decedent's will to retain the following
18personal property:
SB21-SSA1,1824 19Section 1824. 49.682 (3) of the statutes is amended to read:
SB21-SSA1,567,2520 49.682 (3) The department shall administer the program under this section
21and may contract with an entity to administer all or a portion of the program,
22including gathering and providing the department with information needed to
23recover payment of aid provided under s. 49.68, 49.683, or 49.685, or 49.785. All
24funds received under this subsection, net of any amount claimed under s. 49.849 (5),
25shall be remitted for deposit in the general fund.
SB21-SSA1,1825
1Section 1825. 49.682 (4) (a) of the statutes is amended to read:
SB21-SSA1,568,52 49.682 (4) (a) The department may recover amounts under this section for the
3provision of aid provided under s. 49.68, 49.683, or 49.685 paid on and after
4September 1, 1995, and for the provision of aid provided under s. 49.785 paid on or
5after the effective date of this paragraph .... [LRB inserts date]
.
SB21-SSA1,1826 6Section 1826. 49.682 (4) (b) of the statutes is amended to read:
SB21-SSA1,568,107 49.682 (4) (b) The department may file a claim under sub. (2) (a) only with
8respect to a client who dies after September 1, 1995. The department may file a claim
9under sub. (2) (am) only with respect to a client who dies after the effective date of
10this paragraph .... [LRB inserts date].
SB21-SSA1,1827 11Section 1827. 49.682 (5) of the statutes is amended to read:
SB21-SSA1,568,1712 49.682 (5) The department shall promulgate rules establishing standards for
13determining whether the application of this section with respect to a claim under
14sub. (2) (a)
would work an undue hardship in individual cases. If the department
15determines that the application of this section with respect to a claim under sub. (2)
16(a) would work an undue hardship in a particular case, the department shall waive
17application of this section in that case.
SB21-SSA1,1830 18Section 1830. 49.78 (5) of the statutes is amended to read:
SB21-SSA1,569,219 49.78 (5) Personnel examinations. Statewide examinations to ascertain
20qualifications of applicants in any county department administering aid to families
21with dependent children shall be given by the administrator of the division director
22of the bureau
of merit recruitment and selection in the office of state employment
23relations
department of administration. The office of state employment relations
24department of administration shall be reimbursed for actual expenditures incurred
25in the performance of its functions under this section from the appropriations

1available to the department of children and families for administrative
2expenditures.
SB21-SSA1,1831 3Section 1831. 49.785 (1m) (d) of the statutes is created to read:
SB21-SSA1,569,84 49.785 (1m) (d) If the recipient, or the recipient's spouse or another person,
5owns a life insurance policy insuring the recipient's life and the face value of the
6policy is more than $3,000, any amount that the department would be obligated to
7pay under sub. (1) shall be reduced by one dollar for every dollar by which the face
8value of the policy exceeds $3,000.
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