AB150: Bill Text

AB150,1072,11 (a) For the reduction of operating deficits incurred by the county departments, estimate the availability of federal medicaid funds that may be matched to county funds that are expended for costs in excess of reimbursement for services provided under s. 49.46 (2) (a) 4. d. and (b) 6. f.

AB150,1072,15 (b) Based on the amount estimated to be available under par. (a), develop a method, which need not be promulgated as rules under ch. 227, to distribute this allocation to the individual county departments under s. 46.215, 46.22 or 46.23 that have incurred operating deficits that shall include all of the following:

AB150,1072,16 1. Development of criteria for determining operating deficits.

AB150,1072,18 2. Agreement, by the county in which is located a county department that has an operating deficit, to provide funds to match federal medicaid funds.

AB150,1072,19 3. Consideration of the size of a county department's operating deficit.

AB150,1072,21 (c) Except as provided in par. (d), distribute the allocation under the distribution method that is developed.

AB150,1073,2 (d) If the federal department of health and human services approves for state expenditure in a fiscal year amounts under s. 20.435 (1) (o) that result in a lesser allocation amount than that allocated under this subsection or disallows use of the allocation of federal medicaid funds under par. (c), reduce allocations under this subsection and distribute on a prorated basis, as determined by the department.

AB150, s. 2976 Section 2976. 49.45 (6u) (intro.) of the statutes is amended to read:

AB150,1073,10 49.45 (6u) Facility operating deficit reduction. (intro.) Except as provided in par. (g), from the appropriation under s. 20.435 (1) (o), for reduction of operating deficits, as defined under criteria developed by the department, incurred by a facility, as defined under sub. (6m) (a) 2., that is established under s. 49.14 (1) 49.70 (1) or that is owned and operated by a city, village or town, the department shall distribute to these facilities not more than $18,600,000 in each fiscal year, as determined by the department, and shall perform all of the following:

AB150, s. 2977 Section 2977. 49.45 (6u) (b) 2. of the statutes is amended to read:

AB150,1073,16 49.45 (6u) (b) 2. Agreement by the county in which is located the facility established under s. 49.14 (1) 49.70 (1) and agreement by the city, village or town that owns and operates the facility that the applicable county, city, village or town shall provide funds to match federal medical assistance matching funds under this subsection.

AB150, s. 2978 Section 2978. 49.45 (6u) (b) 2m. of the statutes is amended to read:

AB150,1073,21 49.45 (6u) (b) 2m. Identification by the county in which is located the facility established under s. 49.14 (1) 49.70 (1) of all county funds expended in each calendar year to operate the facility, and certification by the county to the department of this amount.

AB150, s. 2979 Section 2979. 49.45 (6v) of the statutes is repealed.

AB150, s. 2980 Section 2980. 49.45 (6w) (intro.) of the statutes is amended to read:

AB150,1074,5 49.45 (6w) Hospital operating deficit reduction. (intro.) From the appropriation under s. 20.435 (1) (o), for reduction of operating deficits, as defined under criteria developed by the department, incurred by a hospital, as defined under s. 50.33 (2) (a) and (b), that is operated by the state, established under s. 49.16 or owned and operated by a city or village, the department shall allocate distribute, beginning July 1, 1996, up to $3,300,000 $8,500,000 in each fiscal year to these hospitals, as determined by the department, and shall perform all of the following:

AB150, s. 2981 Section 2981 . 49.45 (6w) (intro.) of the statutes, as affected by 1995 Wisconsin Act .... (this act), is amended to read:

AB150,1074,14 49.45 (6w) Hospital operating deficit reduction. (intro.) From the appropriation under s. 20.435 (1) (o), for reduction of operating deficits, as defined under criteria developed by the department, incurred by a hospital, as defined under s. 50.33 (2) (a) and (b), that is operated by the state, established under s. 49.16 49.71 or owned and operated by a city or village, the department shall distribute, beginning July 1, 1996, up to $8,500,000 in each fiscal year to these hospitals, as determined by the department, and shall perform all of the following:

****Note: This is reconciled s. 49.45 (6w) (intro.). This Section has been affected by drafts with the following LRB numbers: -2153/1 and -2413/2.

AB150, s. 2982 Section 2982. 49.45 (6w) (a) 2. of the statutes is amended to read:

AB150,1074,16 49.45 (6w) (a) 2. County funds, for a hospital established under s. 49.16 49.71.

AB150, s. 2983 Section 2983. 49.45 (6w) (b) 2. b. of the statutes is amended to read:

AB150,1074,19 49.45 (6w) (b) 2. b. Agreement to provide matching funds by the county in which is located a hospital established under s. 49.16 49.71.

AB150, s. 2984 Section 2984. 49.45 (6x) (a) of the statutes is amended to read:

AB150,1075,3 49.45 (6x) (a) Notwithstanding sub. (3) (e), from the appropriations under s. 20.435 (1) (b) and (o) the department shall distribute not more than $4,748,000 in each of fiscal years 1993-94 and 1994-95 year, to provide funds to an essential access city hospital, except that the department may not allocate funds to an essential access city hospital to the extent that the allocation would exceed any limitation under 42 USC 1396b (i) (3).

AB150, s. 2985 Section 2985. 49.45 (6y) (a) of the statutes is amended to read:

AB150,1075,10 49.45 (6y) (a) Notwithstanding sub. (3) (e), from the appropriations under s. 20.435 (1) (b) and (o) the department shall distribute funding in each fiscal year to provide supplemental payment to county hospitals and to county mental health complexes, as determined by the department, for inpatient hospital services that are not in excess of the hospitals' customary charges for the services, as limited under 42 USC 1396b (i) (3).

AB150, s. 2986 Section 2986. 49.45 (7) (d) 4. of the statutes is amended to read:

AB150,1075,15 49.45 (7) (d) 4. The department's determination of serious misconduct under this subsection shall be cause for terminating the facility's participation in the state-funded portion of the medical assistance program under ss. 49.45 to 49.47 this subchapter.

AB150, s. 2987 Section 2987. 49.45 (8) (title) of the statutes is amended to read:

AB150,1075,18 49.45 (8) (title) Home Per-visit limits on home health services reimbursement.

AB150, s. 2988 Section 2988. 49.45 (8e) of the statutes is created to read:

AB150,1075,24 49.45 (8e) Monthly limits on home health, and private-duty nursing services reimbursement. (a) Except as provided in par. (b), reimbursement under s. 20.435 (1) (b) and (o) for home health and private-duty nursing services provided to a medical assistance recipient in a month may not exceed the average monthly cost of nursing home care, as determined by the department.

AB150,1075,25 (b) This subsection does not apply to any of the following:

AB150,1076,1 1. A medical assistance recipient under the age of 22.

AB150,1076,3 2. A ventilator-dependent individual under s. 49.46 (2) (b) 6. m. or 49.47 (6) (a) 1.

AB150,1076,7 3. An individual not covered under subds. 1. and 2., if the department determines that the cost of providing the individual with nursing home care would exceed the cost of providing the individual with home health and private-duty nursing services.

****Note: This is reconciled s. 49.45 (8e). It has been affected by drafts with the following LRB numbers: -1137/2 and-2408/1.

AB150, s. 2989 Section 2989. 49.45 (8m) (intro.) of the statutes is amended to read:

AB150,1076,14 49.45 (8m) Rates for respiratory care services. (intro.) Notwithstanding a determination by the department of a maximum rate the limits under sub. subs. (8) and (8e), the rates under sub. (8) and rates charged by providers under s. 49.46 (2) (a) 4. d. that are not home health agencies, for reimbursement for respiratory care services for ventilator-dependent individuals under ss. 49.46 (2) (b) 6. m. and 49.47 (6) (a) 1., shall be as follows:

AB150, s. 2990 Section 2990. 49.45 (11) of the statutes is amended to read:

AB150,1076,18 49.45 (11) Penalty. Any person who receives or assists another in receiving assistance under this section, to which the recipient is not entitled, shall be subject to the penalties under s. 49.12 49.95.

****Note: This is reconciled s. 49.45 (11). This Section has been affected by drafts with the following LRB numbers: -1701/3 and -2153/1.

AB150, s. 2991 Section 2991. 49.45 (12) (c) of the statutes is amended to read:

AB150,1077,4 49.45 (12) (c) The department shall request proposals for a system of machine-readable identification cards for medical assistance recipients and a computerized support system for the cards that will accept and respond to electronically conveyed requests from health care providers for information related to medical assistance recipients, such as eligibility, coverages and authorizations. The request for proposals shall specify that the systems are to be operating by January 1, 1996 1997.

AB150, s. 2992 Section 2992. 49.45 (24m) (a) of the statutes is amended to read:

AB150,1077,9 49.45 (24m) (a) By September 1, 1990, select a county in this state and solicit bids from providers of home health care and personal care services in that county for the provision, on a contractual basis, of home health and personal care services authorized under ss. 49.46 (2) (a) 4. d. and (b) 6. j. and 49.47 (6) (a) 1.

AB150, s. 2993 Section 2993. 49.45 (25) (am) of the statutes is renumbered 49.45 (25) (am) (intro.) and amended to read:

AB150,1077,17 49.45 (25) (am) (intro.) Except as provided under pars. (be) and (bg) and sub. (24), case management services under s. 49.46 (2) (b) 9. and (bm) are reimbursable under medical assistance only if provided to a medical assistance beneficiary who receives case management services from or through a certified case management provider in a county, city, village or town that elects, under par. (b), to make the services available and who has meets at least one of the following conditions:

AB150,1077,18 1. Has a developmental disability, as defined under s. 51.01 (5) (a),.

AB150,1077,19 2. Has a chronic mental illness, as defined under s. 51.01 (3g), or.

AB150,1077,20 3. Has Alzheimer's disease, as defined under s. 46.87 (1) (a), is.

AB150,1077,21 4. Is an alcoholic, as defined under s. 51.01 (1) , or.

AB150,1077,22 5. Is drug dependent, as defined under s. 51.01 (8), is.

AB150,1077,23 6. Is physically disabled, as defined by the department, is.

AB150,1077,24 7. Is a severely emotionally disturbed child, is.

AB150,1077,25 8. Is age 65 or over or, after December 31, 1991, has.

AB150,1078,1 10. Has HIV infection, as defined in s. 252.01 (2).

AB150, s. 2994 Section 2994. 49.45 (25) (am) 9. of the statutes is created to read:

AB150,1078,4 49.45 (25) (am) 9. Is a member of a family that has a child who is at risk of serious physical, mental or emotional dysfunction, as defined by the department.

AB150, s. 2995 Section 2995. 49.45 (25) (am) 11. of the statutes is created to read:

AB150,1078,7 49.45 (25) (am) 11. Is a child who is eligible for early intervention services under s. 51.44.

AB150, s. 2996 Section 2996. 49.45 (25) (am) 12. of the statutes is created to read:

AB150,1078,9 49.45 (25) (am) 12. Is infected with tuberculosis.

AB150, s. 2997 Section 2997. 49.45 (25) (bg) of the statutes is amended to read:

AB150,1078,18 49.45 (25) (bg) An independent living center, as defined in s. 46.96 (1) (a), that is a certified case management provider may elect to provide case management services to one or more of the categories of medical assistance beneficiaries specified under par. (am). The amount of allowable charges for the services under the medical assistance program that is not provided by the federal government shall be paid from nonfederal, public funds received by the independent living center from a county, city, village or town or from funds distributed under the appropriation under s. 20.435 (5) (bm) or as a grant under s. 46.96.

AB150, s. 2998 Section 2998. 49.45 (25) (bm) (intro.) of the statutes is amended to read:

AB150,1078,22 49.45 (25) (bm) (intro.) Case management services under this subsection may not be provided to a person under the category of severely emotionally disturbed child par. (am) 7. unless any of the following is true:

AB150, s. 2999 Section 2999. 49.45 (34) of the statutes is amended to read:

AB150,1079,3 49.45 (34) Medical assistance manual. The department shall prepare a medical assistance manual that is clear, comprehensive and consistent with ss. 49.43 to 49.47 this subchapter and 42 USC 1396a to 1396u and shall, no later than July 1, 1992, provide the manual to counties for use by county employes who administer the medical assistance program.

AB150, s. 3000 Section 3000. 49.45 (39) of the statutes is created to read:

AB150,1079,5 49.45 (39) School medical services. (a) Definitions. In this subsection:

AB150,1079,9 1. "School" means a public school described under s. 115.01 (1) or a charter school, as defined in s. 115.001 (1). It includes school-operated early childhood programs for developmentally delayed and disabled 4-year-old and 5-year-old children.

AB150,1079,12 2. "School medical services" means health care services that are provided in a school to children who are eligible for medical assistance and that are appropriate to a school setting, under rules promulgated by the department.

AB150,1079,22 (b) Payment for school medical services. If a school district elects to provide school medical services and meets all requirements under par. (c), the department shall reimburse the school district for the federal share of allowable charges for the school medical services that it provides and for allowable administrative costs. The department shall promulgate rules establishing a methodology for making reimbursements under this paragraph. All other expenses for the school medical services shall be paid for by the school district with funds received from state or local taxes. The school district shall comply with all requirements of the federal department of health and human services for receiving federal financial participation.

AB150,1079,25 (c) Certification and reporting requirements. The department shall promulgate rules establishing specific certification and reporting requirements with respect to school medical services under this subsection.

AB150, s. 3001 Section 3001. 49.45 (40) of the statutes is created to read:

AB150,1080,4 49.45 (40) Periodic record matches. The department shall cooperate with the department of industry, labor and human relations in matching records of medical assistance recipients under s. 49.32 (7).

AB150, s. 3002 Section 3002. 49.45 (41) of the statutes is created to read:

AB150,1080,16 49.45 (41) Mental health crisis intervention services. A county, city, village or town may elect to make mental health crisis intervention services under this subsection available in the county, city, village or town to medical assistance recipients through the medical assistance program. A county, city, village or town that elects to make the services available shall reimburse the provider of the mental health crisis intervention services for the amount of the allowable charges for those services under the medical assistance program that is not provided by the federal government. The department shall reimburse the provider of mental health crisis intervention services under this subsection only for the amount of the allowable charges for those services under the medical assistance program that is provided by the federal government.

AB150, s. 3003 Section 3003. 49.455 (4) (c) of the statutes is repealed and recreated to read:

AB150,1080,23 49.455 (4) (c) 1. For all years other than 1996 and 1997, the minimum monthly maintenance needs allowance equals $1,500 increased by the same percentage as the percentage increase in the consumer price index between September 1988 and September of the year before the year involved. For 1996 and 1997, the minimum monthly maintenance needs allowance equals the lesser of the amount determined under subd. 2., or the sum of the following:

AB150,1080,24 a. One-twelfth of 200% of the poverty line for a family of 2 persons.

AB150,1080,25 b. Any excess shelter allowance under par. (d).

AB150,1081,4 2. The minimum monthly maintenance needs allowance in a year may not exceed $1,500 increased by the same percentage as the percentage increase in the consumer price index between September 1988 and September of the year before the year involved.