AB500,5,42 40.51 (8) Every Except as provided in sub. (17), every health care coverage plan
3offered by the state under sub. (6) shall comply with ss. 631.89, 631.90, 631.93 (2),
4632.72 (2), 632.87 (3) to (5), 632.895 (5m) and (8) to (10) and 632.896.
AB500, s. 4 5Section 4. 40.51 (9) of the statutes is amended to read:
AB500,5,86 40.51 (9) Every Except as provided in sub. (17), every health maintenance
7organization and preferred provider plan offered by the state under sub. (6) shall
8comply with s. 632.87 (2m).
AB500, s. 5 9Section 5. 40.51 (15m) of the statutes is amended to read:
AB500,5,1210 40.51 (15m) Every Except as provided in sub. (17), every health care plan,
11except a health maintenance organization or a preferred provider plan, offered by the
12state under sub. (6) shall comply with s. 632.86.
AB500, s. 6 13Section 6. 40.51 (17) of the statutes is created to read:
AB500,5,1714 40.51 (17) If one of the plans offered by the state under sub. (6) is the basic plan
15under ch. 637, that plan is required to comply with only those health insurance
16mandates, as defined in s. 601.423 (1), that the commissioner of insurance
17determines by rule under s. 637.05 (1) apply to the basic plan under ch. 637.
AB500, s. 7 18Section 7. 46.27 (11) (e) of the statutes is created to read:
AB500,5,2319 46.27 (11) (e) Beginning on the first day of the 12th month beginning after the
20date on which the department makes a certification under s. 49.44 (5), the
21department may not provide home and community-based services under this
22subsection to persons eligible for medical assistance under s. 49.46 (1) (a) 1., 1m., 6.
23or 12., (c), (cg), (co), (cr) or (cs) or 49.47 (4) (a) 1. or 2.
AB500, s. 8 24Section 8. 46.275 (6) of the statutes is amended to read:
AB500,6,10
146.275 (6) Effective period. This section takes effect on the date approved by
2the secretary of the U.S. federal department of health and human services as the
3beginning date of the period of waiver received under sub. (2). This section remains
4in effect for 3 years following that date and, if the secretary of the U.S. federal
5department of health and human services approves a waiver extension, shall
6continue an additional 3 years, except that, beginning on the first day of the 12th
7month beginning after the date on which the department makes a certification under
8s. 49.44 (5), the department may not provide services under this section to persons
9eligible for medical assistance under s. 49.46 (1) (a) 1., 1m., 6. or 12., (c), (cg), (co), (cr)
10or (cs) or 49.47 (4) (a) 1. or 2
.
AB500, s. 9 11Section 9. 46.278 (8) of the statutes is amended to read:
AB500,6,2112 46.278 (8) Effective period. Except as provided under sub. (2), this section
13takes effect on the date approved by the secretary of the federal department of health
14and human services as the beginning date of the period of waiver received under sub.
15(3). This section remains in effect for 3 years following that date and, if the secretary
16of the federal department of health and human services approves a waiver extension,
17shall continue an additional 3 years, except that, beginning on the first day of the
1812th month beginning after the date on which the department makes a certification
19under s. 49.44 (5), the department may not provide services under this section to
20persons eligible for medical assistance under s. 49.46 (1) (a) 1., 1m., 6. or 12., (c), (cg),
21(co), (cr) or (cs) or 49.47 (4) (a) 1. or 2
.
AB500, s. 10 22Section 10. 49.002 (2) of the statutes is renumbered 49.002 (2) (a) and
23amended to read:
AB500,7,724 49.002 (2) (a) It Before the first day of the 12th month beginning after the date
25on which the department makes a certification under s. 49.44 (5), it
is the declared

1legislative policy that general relief is the payer of last resort in all cases, except those
2cases involving crime victim awards under s. 949.06, where a dispute may arise over
3payment for costs associated with maintaining the health and welfare of recipients
4of general relief, including disputes concerning health care costs with private or
5public payees of health care costs, other governmental welfare programs,
6rehabilitation programs and programs requiring institutionalization or long-term
7medical and psychiatric treatment.
AB500, s. 11 8Section 11. 49.002 (2) (b) of the statutes is created to read:
AB500,7,149 49.002 (2) (b) Beginning on the first day of the 12th month beginning after the
10date on which the department makes a certification under s. 49.44 (5), it is the
11declared legislative policy that general relief is the payer of last resort in all cases,
12except those cases involving crime victim awards under s. 949.06, where a dispute
13may arise over payment for costs associated with maintaining the welfare of
14recipients of general relief.
AB500, s. 12 15Section 12. 49.01 (5m) of the statutes is renumbered 49.01 (5m) (a) and
16amended to read:
AB500,8,417 49.01 (5m) (a) "General Before the first day of the 12th month beginning after
18the date on which the department makes a certification under s. 49.44 (5), "general

19relief" means such services, commodities or money moneys as are reasonable and
20necessary under the circumstances to provide food, housing, clothing, fuel, light,
21water, medicine, medical, dental, and surgical treatment (including hospital care),
22optometrical services, nursing, transportation, and funeral expenses, and include
23includes wages for work relief. The food furnished shall be of a kind and quantity
24sufficient to provide a nourishing diet. The housing provided shall be adequate for
25health and decency. Where there are children of school age the general relief

1furnished shall include necessities for which no other provision is made by law. The
2general relief furnished, whether by money or otherwise, shall be at such times and
3in such amounts, as will in the discretion of the general relief official or agency meet
4the needs of the recipient and protect the public.
AB500, s. 13 5Section 13. 49.01 (5m) (b) of the statutes is created to read:
AB500,8,166 49.01 (5m) (b) Beginning on the first day of the 12th month beginning after the
7date on which the department makes a certification under s. 49.44 (5), "general
8relief" means such services, commodities or moneys as are reasonable and necessary
9under the circumstances to provide food, housing, clothing, fuel, light, water,
10transportation, and funeral expenses, and includes wages for work relief. The food
11furnished shall be of a kind and quantity sufficient to provide a nourishing diet. The
12housing provided shall be adequate for health and decency. Where there are children
13of school age the general relief furnished shall include necessities for which no other
14provision is made by law. The general relief furnished, whether by money or
15otherwise, shall be at such times and in such amounts, as will in the discretion of the
16general relief official or agency meet the needs of the recipient and protect the public.
AB500, s. 14 17Section 14. 49.015 (3) of the statutes is amended to read:
AB500,8,2518 49.015 (3) After December 31, 1986, a A general relief agency may waive the
19requirement under sub. (1) (b) or (2) (a) in a medical emergency or in case of unusual
20misfortune or hardship. Before the first day of the 12th month beginning after the
21date on which the department makes a certification under s. 49.44 (5), a general
22relief agency may also waive the requirement under sub. (1) (b) or (2) (a) in a medical
23emergency.
Each waiver shall be reported to the department. The department may
24deny reimbursement under s. 49.035 for any case in which a waiver is
25inappropriately granted.
AB500, s. 15
1Section 15. 49.02 (5m) of the statutes is created to read:
AB500,9,62 49.02 (5m) Beginning on the first day of the 12th month beginning after the
3date on which the department makes a certification under s. 49.44 (5), the general
4relief agency shall assist general relief recipients in applying for health care coverage
5under the basic plan under s. 637.05 and in applying for a premium subsidy under
6s. 637.27.
AB500, s. 16 7Section 16. 49.02 (20) of the statutes is created to read:
AB500,9,108 49.02 (20) Subsections (5), (6c), (6g), (6r), (8), (9) and (10) do not apply
9beginning on the first day of the 12th month beginning after the date on which the
10department makes a certification under s. 49.44 (5).
AB500, s. 17 11Section 17. 49.032 (4r) of the statutes is amended to read:
AB500,9,1612 49.032 (4r) If a general relief agency provides a monthly general relief benefit
13to an eligible dependent person which exceeds the monthly benefit amount required
14under sub. (1) (c), the department shall reimburse the general relief agency at the
15rate set forth under s. 49.035 (1) (d), from the appropriation under s. 20.435 (4) (eb),
16for the amount paid to the eligible dependent person.
AB500, s. 18 17Section 18. 49.035 (1) (intro.) and (d) of the statutes are consolidated,
18renumbered 49.035 (1) and amended to read:
AB500,9,2119 49.035 (1) As provided in sub. (4e), the department shall reimburse, except for
20medical costs: (d) A, a county for up to 37.5% of the eligible costs paid by the general
21relief agency for general relief provided under s. 49.02.
AB500, s. 19 22Section 19. 49.035 (2) (b) 7. and 8. of the statutes are amended to read:
AB500,9,2423 49.035 (2) (b) 7. Up to 40% of eligible medical costs that are incurred by the
24county before the first day of the 12th month beginning after the date on which the

1department makes a certification under s. 49.44 (5), that are incurred
on behalf of
2an individual client and that are not more than $10,000 per claim period.
AB500,10,63 8. Up to 70% of eligible medical costs that are incurred by the county before the
4first day of the 12th month beginning after the date on which the department makes
5a certification under s. 49.44 (5), that are incurred
on behalf of an individual client
6and that exceed $10,000 per claim period.
AB500, s. 20 7Section 20. 49.035 (2) (cm) (intro.) of the statutes is amended to read:
AB500,10,128 49.035 (2) (cm) (intro.) A county for up to 60% of the eligible medical costs that
9are incurred before the first day of the 12th month beginning after the date on which
10the department makes a certification under s. 49.44 (5)
for individual clients who are
11enrolled in a prepaid health care system with a uniform fee per person, if the
12following requirements are met:
AB500, s. 21 13Section 21. 49.035 (4e) (a) and (b) of the statutes are amended to read:
AB500,10,2114 49.035 (4e) (a) If claims for reimbursement of eligible general relief costs at the
15maximum rates under subs. (1) and (2) do not exceed the total of the funds available
16under s. 20.435 (4) (eb) and the payments to county hospitals and county mental
17health complexes under par. (c) for that fiscal year, the department shall determine
18the amount of a county's reimbursement from the appropriation under s. 20.435 (4)
19(eb) by applying the maximum rates under subs. (1) and (2) to the county's eligible
20costs and subtracting the amount paid to county hospitals and county mental health
21complexes in the county under par. (c).
AB500,11,522 (b) If claims for reimbursement of eligible general relief costs at the maximum
23rates under subs. (1) and (2) do exceed the total of the funds available under s. 20.435
24(4) (eb) and the payments to county hospitals and county mental health complexes
25under par. (c) for that fiscal year, the department shall prorate the funds available

1under s. 20.435 (4) (eb) among the counties. Under this paragraph, the department
2shall determine the amount of a county's reimbursement from the appropriation
3under s. 20.435 (4) (eb) by subtracting the amount paid to county hospitals and
4county mental health complexes in the county under par. (c) from its prorated share
5of the funds available under s. 20.435 (4) (eb).
AB500, s. 22 6Section 22. 49.035 (4e) (d) of the statutes is created to read:
AB500,11,107 49.035 (4e) (d) This subsection does not apply with respect to claims for
8reimbursement of eligible general relief costs that were incurred on or after the first
9day of the 12th month beginning after the date on which the department makes a
10certification under s. 49.44 (5).
AB500, s. 23 11Section 23. 49.035 (6) (am) and (b) of the statutes are amended to read:
AB500,11,1512 49.035 (6) (am) Requires Before the first day of the 12th month beginning after
13the date on which the department makes a certification under s. 49.44 (5), requires

14prior authorization or health care provider certification for a specified period of time
15by the general relief agency for all nonemergency medical care that is provided.
AB500,11,2316 (b) Develops Before the first day of the 12th month beginning after the date on
17which the department makes a certification under s. 49.44 (5), develops
and files
18with the department on or before October 1 of each year a medical cost containment
19plan for the subsequent calendar year. The plan shall include provisions limiting the
20inappropriate use of emergency room care and controlling payments to providers and
21may include provisions on supplying case management services. The department
22shall approve or disapprove the plan within a reasonable period of time after the plan
23is timely filed.
AB500, s. 24 24Section 24. 49.043 of the statutes is renumbered 49.043 (1) and amended to
25read:
AB500,12,4
149.043 (1) Any Except as provided in sub. (2), any municipality or county may
2purchase health or dental insurance for unemployed persons residing in the
3municipality or county who are not eligible for medical assistance under s. 49.46,
449.468 or 49.47.
AB500, s. 25 5Section 25. 49.043 (2) of the statutes is created to read:
AB500,12,86 49.043 (2) This section does not apply on or after the first day of the 12th month
7beginning after the date on which the department makes a certification under s.
849.44 (5).
AB500, s. 26 9Section 26. 49.046 (3) (b) 1. to 3. of the statutes are consolidated, renumbered
1049.046 (3) (b) 1 and amended to read:
AB500,12,1411 49.046 (3) (b) 1. Payments Except as provided in subd. 2., payments for medical
12care may be made for any benefit authorized under s. 49.46 (2). 2. Payments and
13shall be equal to the rates established under s. 49.45. 3. Recipients of aid for medical
14care are subject to the copayment provisions established under s. 49.45 (18).
AB500, s. 27 15Section 27. 49.046 (3) (b) 2. of the statutes is created to read:
AB500,12,1816 49.046 (3) (b) 2. This paragraph does not apply with respect to payments for
17medical care incurred on or after the first day of the 12th month beginning after the
18date on which the department makes a certification under s. 49.44 (5).
AB500, s. 28 19Section 28. 49.046 (4) (bm) of the statutes is created to read:
AB500,12,2420 49.046 (4) (bm) Beginning on the first day of the 12th month beginning after
21the date on which the department makes a certification under s. 49.44 (5), the
22administering agency shall assist recipients of aid under this section in applying for
23health care coverage under the basic plan under s. 637.05 and in applying for a
24premium subsidy under s. 637.27.
AB500, s. 29
1Section 29. 49.06 (3) of the statutes is renumbered 49.06 (3) (a) and amended
2to read:
AB500,13,73 49.06 (3) (a) A Except as provided in par. (b), a general relief agency may adopt
4written criteria to deny eligibility for general relief medical benefits to a person who,
5in contemplation of becoming eligible to receive general relief benefits, disposes of
6his or her assets for significantly less than full value during the 90 days immediately
7before the person applies for general relief medical benefits.
AB500, s. 30 8Section 30. 49.06 (3) (b) of the statutes is created to read:
AB500,13,119 49.06 (3) (b) This subsection does not apply after the first day of the 12th month
10beginning after the date on which the department makes a certification under s.
1149.44 (5).
AB500, s. 31 12Section 31. 49.43 (8) of the statutes is amended to read:
AB500,13,1913 49.43 (8) "Medical assistance" means any services or items under ss. 49.45 to
1449.47 and 49.49 to 49.497, or any payment or reimbursement made for such services
15or items, and, beginning on the first day of the 12th month beginning after the date
16on which the department makes a determination under s. 49.44 (5), coverage under
17the basic plan under s. 637.05 provided to persons eligible for medical assistance
18under s. 49.46 (1) (a) 1., 1m., 6. or 12., (c), (cg), (co), (cr) or (cs) or 49.47 (4) (a) 1. or
192
.
AB500, s. 32 20Section 32. 49.43 (10) of the statutes is amended to read:
AB500,14,321 49.43 (10) "Provider" means a person, corporation, limited liability company,
22partnership, unincorporated business or professional association and any agent or
23employe thereof who provides medical assistance under ss. 49.45 to 49.47, 49.49 and
2449.495
, including, beginning on the first day of the 12th month beginning after the
25date on which the department makes a certification under s. 49.44 (5), any insurer

1providing coverage under the basic plan under s. 637.05 to persons eligible for
2medical assistance under s. 49.46 (1) (a) 1., 1m., 6. or 12., (c), (cg), (co), (cr) or (cs) or
349.47 (4) (a) 1. or 2
.
AB500, s. 33 4Section 33. 49.44 of the statutes is created to read:
AB500,14,6 549.44 Basic health insurance plan waiver or legislation. (1) Definitions.
6 In this section:
AB500,14,77 (a) "Basic plan" means the basic health care plan under s. 637.05.
AB500,14,88 (b) "Eligible person" means a person eligible to receive medical assistance.
AB500,14,14 9(2) Federal waiver. Except as provided in sub. (3), the department shall
10request a waiver, developed in consultation with and approved by the commissioner
11of insurance, from the secretary of the federal department of health and human
12services to allow the state to receive federal funding to provide health care coverage
13under the basic plan to persons eligible for medical assistance under s. 49.46 (1) (a)
141., 1m., 6. or 12., (c), (cg), (co), (cr) or (cs) or 49.47 (4) (a) 1. or 2.
AB500,14,20 15(3) Federal legislation. If the waiver request is denied, the department shall
16seek the enactment of federal legislation, developed in consultation with and
17approved by the commissioner of insurance, providing federal funding to the state
18to provide health care coverage under the basic plan to persons eligible for medical
19assistance under s. 49.46 (1) (a) 1., 1m., 6. or 12., (c), (cg), (co), (cr) or (cs) or 49.47 (4)
20(a) 1. or 2.
AB500,14,24 21(5) Certification by department. If the department determines that a waiver
22under sub. (2) is approved or legislation under sub. (3) is enacted, the department
23shall certify its determination to the commissioner of insurance on the first day of
24the first month beginning after the waiver is approved or the waiver is enacted.
AB500,15,7
1(6) Effect of certification. Beginning on the first day of the 12th month
2beginning after the date on which the department makes a certification under sub.
3(5), from the appropriations under s. 20.435 (1) (b) and (o), medical assistance shall
4pay, for persons eligible for medical assistance under s. 49.46 (1) (a) 1., 1m., 6. or 12.,
5(c), (cg), (co), (cr) or (cs) or 49.47 (4) (a) 1. or 2., the premiums under s. 637.25 for
6coverage under the basic plan under s. 637.05 or, as provided in ss. 49.46 (2) (c) and
7(cm), 49.468 and 49.47 (6) (ag), medicare premiums, coinsurance and deductibles.
AB500, s. 34 8Section 34. 49.45 (8m) (intro.) of the statutes is amended to read:
AB500,15,149 49.45 (8m) Rates for respiratory care services. (intro.) Notwithstanding a
10determination by the department of a maximum rate under sub. (8), the rates under
11sub. (8) and rates charged by providers under s. 49.46 (2) (a) 4. d. that are not home
12health agencies, for reimbursement for respiratory care services for
13ventilator-dependent individuals under ss. 49.46 (2) (b) 6. m. and 49.47 (6) (a) 1.,
14shall be as follows:
AB500, s. 35 15Section 35. 49.45 (24m) (a) of the statutes is amended to read:
AB500,15,1916 49.45 (24m) (a) By September 1, 1990, select a county in this state and solicit
17bids from providers of home health care and personal care services in that county for
18the provision, on a contractual basis, of home health and personal care services
19authorized under ss. 49.46 (2) (a) 4. d. and (b) 6. j. and 49.47 (6) (a) 1.
AB500, s. 36 20Section 36. 49.45 (37) (intro.) of the statutes is amended to read:
AB500,16,621 49.45 (37) Plans of care. (intro.) The department may seek a waiver of the
22requirement under 42 USC 1396n (c) (1) that the department review and approve
23every written plan of care developed for each individual who receives, under 42 USC
241396n
(c) (1), home or community-based services under ss. 49.46 (2) (b) 8. and 49.47
25(6) (a) 1. The waiver of the requirement, if granted, shall apply to those county

1departments or private nonprofit agencies that administer the services and that the
2department finds and certifies have implemented effective quality assurance
3systems for service plan development and implementation. If the federal health care
4financing administration approves the department's request for waiver of the
5requirement, the department shall, in evaluating a quality assurance system for
6certification, consider all of the following:
AB500, s. 37 7Section 37. 49.45 (50) of the statutes is created to read:
AB500,16,138 49.45 (50) Applicability. Beginning on the first day of the 12th month
9beginning after the date on which the department makes a certification under s.
1049.44 (5), subs. (2) (a) 9. to 14. and (b), (3) (b) to (k), (6b) to (9s), (13) to (16), (18), (20)
11to (22), (24) to (26), (29) to (32) and (35) to (37) do not apply with respect to persons
12eligible for medical assistance under s. 49.46 (1) (a) 1., 1m., 6. or 12., (c), (cg), (co), (cr)
13or (cs) or 49.47 (4) (a) 1. or 2.
AB500, s. 38 14Section 38. 49.46 (2) (a) (intro.) of the statutes is amended to read:
AB500,16,1715 49.46 (2) (a) (intro.) Except as provided in par. pars. (be) and (bm), the
16department shall audit and pay allowable charges to certified providers for medical
17assistance on behalf of recipients for the following federally mandated benefits:
AB500, s. 39 18Section 39. 49.46 (2) (b) (intro.) of the statutes is amended to read:
AB500,16,2119 49.46 (2) (b) (intro.) Except as provided in par. pars. (be) and (bm), the
20department shall audit and pay allowable charges to certified providers for medical
21assistance on behalf of recipients for the following services:
AB500, s. 40 22Section 40. 49.46 (2) (bm) of the statutes is created to read:
AB500,17,323 49.46 (2) (bm) Beginning on the first day of the 12th month beginning after the
24date on which the department makes a certification under s. 49.44 (5), benefits for
25an individual who is eligible for medical assistance under sub. (1) (a) 1., 1m., 6. or 12.,

1(c), (cg), (co), (cr) or (cs) are limited to coverage under the basic plan under s. 637.05
2or to the payment of medicare premiums, coinsurance and deductibles to the extent
3provided in pars. (c) and (cm).
AB500, s. 41 4Section 41. 49.465 (10) of the statutes is created to read:
AB500,17,85 49.465 (10) This section does not apply on or after the first day of the 12th
6month beginning after the date on which the department makes a certification under
7s. 49.44 (5) with respect to persons eligible for medical assistance under s. 49.46 (1)
8(a) 1., 1m., 6. or 12., (c), (cg), (co), (cr) or (cs) or 49.47 (4) (a) 1. or 2.
AB500, s. 42 9Section 42. 49.47 (6) (a) (intro.) of the statutes is renumbered 49.47 (6) (a) and
10amended to read:
AB500,17,1411 49.47 (6) (a) The Except as provided in pars. (ag), (ar) and (as), the department
12shall audit and pay charges to certified providers for medical assistance services
13under s. 49.46 (2) (a) and (b)
on behalf of the following: all medical assistance
14recipients eligible under sub. (4).
AB500, s. 43 15Section 43. 49.47 (6) (a) 1. of the statutes is repealed.
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