AB150: Bill Text

AB150, s. 3027 Section 3027 . 49.47 (4) (c) 1. of the statutes is amended to read:

AB150,1086,12 49.47 (4) (c) 1. Except as provided in par. (am) and as limited by subd. subds. 3. and 4., eligibility exists if income does not exceed 133 1/3% of the maximum aid to families with dependent children payment under s. 49.19 (11) for the applicant's family size or the combined benefit amount available under supplemental security income under 42 USC 1381 to 1383c and state supplemental aid under s. 49.177 whichever is higher. In this subdivision "income" includes earned or unearned income that would be included in determining eligibility for the individual or family under s. 49.177 or 49.19, or for the aged, blind or disabled under 42 USC 1381 to 1385. "Income" does not include earned or unearned income which would be excluded in determining eligibility for the individual or family under s. 49.177 or 49.19, or for the aged, blind or disabled individual under 42 USC 1381 to 1385.

AB150, s. 3028 Section 3028 . 49.47 (4) (c) 1. of the statutes, as affected by 1995 Wisconsin Act .... (this act), is amended to read:

AB150,1086,25 49.47 (4) (c) 1. Except as provided in par. (am) and subds. 3. and 4., eligibility exists if income does not exceed 133 1/3% of the maximum aid to families with dependent children payment under s. 49.19 (11) for the applicant's family size or the combined benefit amount available under supplemental security income under 42 USC 1381 to 1383c and state supplemental aid under s. 49.177 49.77 whichever is higher. In this subdivision "income" includes earned or unearned income that would be included in determining eligibility for the individual or family under s. 49.177 or 49.19 or 49.77, or for the aged, blind or disabled under 42 USC 1381 to 1385. "Income" does not include earned or unearned income which would be excluded in determining eligibility for the individual or family under s. 49.177 or 49.19 or 49.77, or for the aged, blind or disabled individual under 42 USC 1381 to 1385.

****Note: This is reconciled s. 49.47 (4) (c) 1. This Section has been affected by drafts with the following LRB numbers: -2153/1 and -2406/2.

AB150, s. 3029 Section 3029. 49.47 (4) (c) 3. of the statutes is repealed and recreated to read:

AB150,1087,4 49.47 (4) (c) 3. Notwithstanding the income limitations under sub. (4) (c) 1., an individual is eligible for medical assistance under this section if all of the following requirements are met:

AB150,1087,5 a. The individual is an individual described under par. (a) 3. or 4.

AB150,1087,8 b. The individual is eligible for medical assistance equal in amount, duration and scope to the medical assistance made available to individuals described in 42 USC 1396a (a) (10) (A).

AB150,1087,11 c. The income of the individual, as determined under 42 USC 1382a without regard to 42 USC 1382a (b), does not exceed 225% of the supplemental security income benefit rate established under 42 USC 1382 (b) (1).

AB150, s. 3030 Section 3030. 49.47 (4) (c) 4. of the statutes is created to read:

AB150,1087,22 49.47 (4) (c) 4. The department shall request a waiver from the secretary of the federal department of health and human services to allow the department to receive federal financial participation to provide, after January 1, 1996, medical assistance benefits under this section, notwithstanding subd. 1. or 3., to persons who received skilled nursing care services or intermediate care services as a resident of a facility, as defined under s. 49.45 (6m) (a) 3., on January 1, 1996, as a medical assistance benefit and who would qualify for medical assistance benefits under this section if the percentage in subd. 3. c. were 300% instead of 225%. If the waiver under this subdivision is granted and in effect, persons covered by the waiver are eligible for medical assistance under this section.

AB150, s. 3031 Section 3031. 49.47 (6) (a) 1. of the statutes is amended to read:

AB150,1088,3 49.47 (6) (a) 1. Except as provided in subds. 6. to 7., all beneficiaries, for all services under s. 49.46 (2) (a) and (b) other than services under s. 49.46 (2) (a) 4. c. and (b) 6. a.

AB150, s. 3032 Section 3032. 49.47 (6) (am) of the statutes is created to read:

AB150,1088,10 49.47 (6) (am) 1. The department shall request a waiver from the secretary of the federal department of health and human services to allow the department to receive federal financial participation to continue to provide, notwithstanding par. (a) 1., skilled nursing care services or intermediate care facility services as a medical assistance benefit under this section to an individual who meets all of the following conditions:

AB150,1088,11 a. The individual is eligible for medical assistance benefits under this section.

AB150,1088,14 b. The individual was receiving skilled nursing care services or intermediate care facility services as a resident of a facility, as defined under s. 49.45 (6m) (a) 3., on January 1, 1996.

AB150,1088,16 c. The skilled nursing care services or intermediate care facility services under subd. 1. b. were provided as a medical assistance benefit.

AB150,1088,21 d. The individual has continued to receive skilled nursing care services or intermediate care facility services as a resident of a facility, as defined under s. 49.45 (6m) (a) 3., or has received the services, provided as a medical assistance benefit, that are described in s. 46.27 (11m), 46.275 (5g), 46.277 (5g) (c) or 46.278 (6m) since January 1, 1996.

AB150,1088,25 2. If the waiver under subd. 1. is granted and remains in effect, the department shall provide skilled nursing care services or intermediate care facility services as a medical assistance benefit to individuals covered by the waiver notwithstanding par. (a) 1.

AB150, s. 3033 Section 3033. 49.47 (9m) (b) 5. a. of the statutes is repealed.

AB150, s. 3034 Section 3034. 49.47 (9m) (b) 5. c. of the statutes is repealed.

AB150, s. 3035 Section 3035. 49.48 (title) of the statutes is renumbered 49.68 (title).

AB150, s. 3036 Section 3036. 49.48 (1) of the statutes is renumbered 49.68 (1).

AB150, s. 3037 Section 3037. 49.48 (1m) of the statutes is renumbered 49.68 (1m).

AB150, s. 3038 Section 3038. 49.48 (2) of the statutes is renumbered 49.68 (2).

AB150, s. 3039 Section 3039. 49.48 (3) (title) of the statutes is renumbered 49.68 (3) (title).

AB150, s. 3040 Section 3040. 49.48 (3) (a) of the statutes is renumbered 49.68 (3) (a) and amended to read:

AB150,1089,13 49.68 (3) (a) Any permanent resident of this state who suffers from chronic renal disease may be accepted into the dialysis treatment phase of the renal disease control program if the resident meets standards set by rule under sub. (2) and s. 49.487 49.687.

AB150, s. 3041 Section 3041. 49.48 (3) (b) of the statutes is renumbered 49.68 (3) (b).

AB150, s. 3042 Section 3042. 49.48 (3) (c) of the statutes is renumbered 49.68 (3) (c).

AB150, s. 3043 Section 3043. 49.48 (3) (d) of the statutes is renumbered 49.68 (3) (d).

AB150, s. 3044 Section 3044. 49.48 (3) (e) of the statutes is renumbered 49.68 (3) (e).

AB150, s. 3045 Section 3045. 49.483 (title) of the statutes is renumbered 49.683 (title).

AB150, s. 3046 Section 3046. 49.483 (1) of the statutes is renumbered 49.683 (1) and amended to read:

AB150,1089,24 49.683 (1) The department may provide financial assistance for costs of medical care of persons over the age of 18 years with the diagnosis of cystic fibrosis who meet financial requirements established by the department by rule under s. 49.487 (1) 49.687 (1).

AB150, s. 3047 Section 3047. 49.483 (2) of the statutes is renumbered 49.683 (2).

AB150, s. 3048 Section 3048. 49.485 (title) of the statutes is renumbered 49.685 (title).

AB150, s. 3049 Section 3049. 49.485 (1) of the statutes is renumbered 49.685 (1).

AB150, s. 3050 Section 3050. 49.485 (2) of the statutes is renumbered 49.685 (2).

AB150, s. 3051 Section 3051. 49.485 (4) of the statutes is renumbered 49.685 (4) and amended to read:

AB150,1090,14 49.685 (4) Eligibility. Any permanent resident of this state who suffers from hemophilia or other related congenital bleeding disorder may participate in the program if that person meets the requirements of this section and s. 49.487 49.687 and the standards set by rule under this section and s. 49.487 49.687. The person shall enter into an agreement with the comprehensive hemophilia treatment center for a maintenance program to be followed by that person as a condition for continued eligibility. The physician director or a designee shall, at least once in each 6-month period, review the maintenance program and verify that the person is complying with the program.

AB150, s. 3052 Section 3052. 49.485 (5) of the statutes is renumbered 49.685 (5).

AB150, s. 3053 Section 3053. 49.485 (6) of the statutes is renumbered 49.685 (6).

AB150, s. 3054 Section 3054. 49.485 (7) (title) of the statutes is renumbered 49.685 (7) (title).

AB150, s. 3055 Section 3055. 49.485 (7) (a) 1. of the statutes is renumbered 49.685 (7) (a) 1. and amended to read:

AB150,1090,24 49.685 (7) (a) 1. The percentage of the patient's liability for the reasonable costs for blood products and supplies which are determined to be eligible for reimbursement under sub. (6) shall be based upon the income and the size of the person's family unit, according to standards to be established by the department under s. 49.487 49.687.

AB150, s. 3056 Section 3056. 49.485 (7) (a) 2. of the statutes is renumbered 49.685 (7) (a) 2.

AB150, s. 3057 Section 3057. 49.485 (7) (a) 4. of the statutes is renumbered 49.685 (7) (a) 4.

AB150, s. 3058 Section 3058. 49.485 (7) (a) 5. of the statutes is renumbered 49.685 (7) (a) 5.

AB150, s. 3059 Section 3059. 49.485 (7) (b) of the statutes is renumbered 49.685 (7) (b).

AB150, s. 3060 Section 3060. 49.485 (8) of the statutes is renumbered 49.685 (8).

AB150, s. 3061 Section 3061. 49.486 of the statutes, as affected by 1995 Wisconsin Act .... (this act), is renumbered 49.686.

****Note: This is reconciled s. 49.486. This Section has been affected by drafts with the following LRB numbers: -0733/1 and -2153/1.

AB150, s. 3062 Section 3062. 49.486 (2) of the statutes is amended to read:

AB150,1091,13 49.486 (2) Reimbursement. From the appropriation under s. 20.435 (1) (am), the department shall distribute not more than $375,600 in fiscal year 1993-94 and not more than $491,500 in fiscal year 1994-95 to may reimburse or supplement the reimbursement of the cost of AZT, the drug pentamidine and any drug approved for reimbursement under sub. (4) (c) for an applying individual who has HIV infection is eligible under sub. (3).

AB150, s. 3063 Section 3063. 49.487 (title) of the statutes is renumbered 49.687 (title).

AB150, s. 3064 Section 3064. 49.487 (1) of the statutes is renumbered 49.687 (1) and amended to read:

AB150,1091,22 49.687 (1) The department shall promulgate rules that require a person who is eligible for benefits under s. 49.48, 49.483 or 49.485 49.68, 49.683 or 49.685 and whose current income exceeds specified limits to obligate or expend specified portions of the income for medical care for treatment of kidney disease, cystic fibrosis or hemophilia before receiving benefits under s. 49.48, 49.483 or 49.485 49.68, 49.683 or 49.685.

AB150, s. 3065 Section 3065. 49.487 (2) of the statutes is renumbered 49.687 (2) and amended to read:

AB150,1092,10 49.687 (2) The department shall develop and implement a sliding scale of patient liability for kidney disease aid under s. 49.48 49.68, cystic fibrosis aid under s. 49.483 49.683 and hemophilia treatment under s. 49.485 49.685, based on the patient's ability to pay for treatment. To ensure that the needs for treatment of patients with lower incomes receive priority within the availability of funds under s. 20.435 (1) (e), the department shall revise the sliding scale for patient liability by January 1, 1994, and shall, every 3 years thereafter by January 1, review and, if necessary, revise the sliding scale.

AB150, s. 3066 Section 3066. 49.49 (6) of the statutes is created to read:

AB150,1092,18 49.49 (6) Recovery. In addition to other remedies available under this section, the court may award the department of justice the costs of investigation, an amount reasonably necessary to remedy the harmful effects of the violation and the expenses of prosecution, including attorney fees, from any person who violates this section. The department of justice shall deposit in the state treasury for deposit in the general fund all moneys that the court awards to the department or the state under this subsection.

AB150, s. 3067 Section 3067. 49.493 (1) of the statutes is renumbered 49.493 (1) (intro.) and amended to read:

AB150,1092,21 49.493 (1) (intro.) In this section, "uninsured:

AB150,1092,24 (c) "Uninsured health plan" means a partially or wholly uninsured plan, including a plan that is subject to 29 USC 1001 to 1461, providing health care benefits.

AB150, s. 3068 Section 3068. 49.493 (1) (a) of the statutes is created to read:

AB150,1093,4 49.493 (1) (a) "Department or contract provider" means the department, the county providing the medical benefits or assistance or a health maintenance organization that has contracted with the department to provide the medical benefits or assistance.

AB150, s. 3069 Section 3069. 49.493 (1) (b) of the statutes is created to read:

AB150,1093,7 49.493 (1) (b) "Medical benefits or assistance" means medical benefits under s. 49.02 or 49.046 or medical assistance.

AB150, s. 3070 Section 3070. 49.493 (2) of the statutes is amended to read:

AB150,1093,12 49.493 (2) The providing of medical benefits or assistance constitutes an assignment to the department or contract provider, to the extent of the medical benefits or assistance benefits provided, for benefits to which the recipient would be entitled under any uninsured health plan.

AB150, s. 3071 Section 3071. 49.493 (3) (d) of the statutes is amended to read:

AB150,1093,18 49.493 (3) (d) Impose on the department or contract provider, as assignee of a person or a person's dependent who is covered under the uninsured health plan and who is eligible for medical benefits or assistance, requirements that are different from those imposed on any other agent or assignee of a person who is covered under the uninsured health plan.

AB150, s. 3072 Section 3072. 49.493 (4) of the statutes is amended to read:

AB150,1093,21 49.493 (4) Benefits provided by an uninsured health plan shall be primary to those benefits provided under medical benefits or assistance.

AB150, s. 3073 Section 3073. 49.495 of the statutes is amended to read:

AB150,1094,8 49.495 Jurisdiction of the department of justice. The department of justice or the district attorney may institute, manage, control and direct, in the proper county, any prosecution for violation of criminal laws affecting the medical assistance program including but not limited to laws relating to medical assistance contained in this chapter subchapter and laws affecting the health, safety and welfare of recipients of medical assistance. For this purpose the department of justice shall have and exercise all powers conferred upon district attorneys in such cases. The department of justice or district attorney shall notify the medical examining board or the interested affiliated credentialing board of any such prosecution of a person holding a license granted by the board or affiliated credentialing board.

AB150, s. 3074 Section 3074. 49.496 (3) (a) 2. a. of the statutes, as created by 1993 Wisconsin Act 437, is amended to read:

AB150,1094,13 49.496 (3) (a) 2. a. Home-based or community-based services under 42 USC 1396d (7) and (8) and under any waiver granted under 42 USC 1396n (c) (4) (B) or 42 USC 1396u.

AB150, s. 3075 Section 3075. 49.496 (4) of the statutes is amended to read:

AB150,1095,3 49.496 (4) Administration. The department may require a county department under s. 46.215 or, 46.22 or 46.23 or the governing body of a federally recognized American Indian tribe administering medical assistance to gather and provide the department with information needed to recover medical assistance under this section. The department shall pay to a county department or tribal governing body an amount equal to 5% of the recovery collected by the department relating to a beneficiary for whom the county department or tribal governing body made the last determination of medical assistance eligibility. A county department or tribal governing body may use funds received under this subsection only to pay costs incurred under this subsection and, if any amount remains, to pay for improvements to functions required under s. 46.032 49.33 (2). The department may withhold payments under this subsection for failure to comply with the department's requirements under this subsection. The department shall treat payments made under this subsection as costs of administration of the medical assistance program.

AB150, s. 3076 Section 3076. 49.496 (5) of the statutes is amended to read:

AB150,1095,11 49.496 (5) Use of funds. From the appropriation under s. 20.435 (1) (im), the department shall pay the amount of the payments under sub. (4) that is not paid from federal funds, shall pay to the federal government the amount of the funds recovered under this section equal to the amount of federal funds used to pay the benefits recovered under this section and shall spend the remainder of the funds recovered under this section for medical assistance benefits administered under s. 49.45 under this subchapter.

AB150, s. 3077 Section 3077. 49.497 (2e) of the statutes is created to read:

AB150,1095,19 49.497 (2e) A county or elected governing body of a federally recognized American Indian tribe may assess a fee on a person who fails to comply with a plan for recovering benefits distributed under s. 49.46, 49.468 or 49.47, if the person is no longer eligible for benefits under those sections. The fee may not exceed 10% of the amount remaining to be recovered at the time of the noncompliance and may not be assessed more than once with respect to the same overpayment. The fee may be retained by the county or tribal governing body.

AB150, s. 3078 Section 3078. 49.497 (2m) of the statutes is created to read: