AB100: Bill Text

AB100,838,22 49.45 (6z) (a) (intro.) Notwithstanding sub. (3) (e), from the appropriations under s. 20.435 (1) (5) (b) and (o) the department shall distribute funding in each fiscal year to supplement payment for services to hospitals that enter into a contract under s. 49.02 (2) to provide health care services funded by a relief block grant under this chapter, if the department determines that the hospitals serve a disproportionate number of low-income patients with special needs. If no medical relief block grant under this chapter is awarded or if the allocation of funds to such hospitals would exceed any limitation under 42 USC 1396b (i) (3), the department may distribute funds to hospitals that have not entered into a contract under s. 49.02 (2). The department may not distribute funds under this subsection to the extent that the distribution would do any of the following:

AB100, s. 1939 Section 1939. 49.45 (8) (b) of the statutes is amended to read:

AB100,839,3 49.45 (8) (b) Reimbursement under s. 20.435 (1) (5) (b) and (o) for home health services provided by a certified home health agency or independent nurse shall be made at the home health agency's or nurse's usual and customary fee per patient care visit, subject to a maximum allowable fee per patient care visit that is established under par. (c).

AB100, s. 1940 Section 1940. 49.45 (8e) of the statutes is repealed.

AB100, s. 1941 Section 1941. 49.45 (8m) (intro.) of the statutes is amended to read:

AB100,839,10 49.45 (8m) Rates for respiratory care services. (intro.) Notwithstanding the limits under subs. (8) and (8e) limit under sub. (8), 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:

AB100, s. 1942 Section 1942. 49.45 (8r) of the statutes is amended to read:

AB100,839,19 49.45 (8r) Payment for certain obstetric and gynecological care. The rate of payment for obstetric and gynecological care provided in primary care health professional shortage areas, as defined in s. 560.184 (1) (c) 560.183 (1) (cm), or provided to recipients of medical assistance who reside in primary care health professional shortage areas, that is equal to 125% of the rates paid under this section to primary care physicians in primary care health professional shortage areas, shall be paid to all certified primary care providers who provide obstetric or gynecological care to those recipients.

AB100, s. 1943 Section 1943. 49.45 (24m) (intro.) of the statutes is amended to read:

AB100,839,25 49.45 (24m) Home health care and personal care pilot program. (intro.) From the appropriations under s. 20.435 (1) (5) (b) and (o), in order to test the feasibility of instituting a system of reimbursement for providers of home health care and personal care services for medical assistance recipients that is based on competitive bidding, the department shall:

AB100, s. 1944 Section 1944. 49.45 (25) (am) 14. of the statutes is created to read:

AB100,840,4 49.45 (25) (am) 14. Is a woman who is aged 45 to 64 and who is not a resident of a nursing home or otherwise receiving case management services under this paragraph.

AB100, s. 1945 Section 1945. 49.45 (25) (b) of the statutes is amended to read:

AB100,840,14 49.45 (25) (b) A county, city, village or , town or, in a county having a population of 500,000 or more, the department may elect to make case management services under this subsection available in the county, city, village or town to one or more of the categories of beneficiaries under par. (am) through the medical assistance program. A county, city, village or, town or, in a county having a population of 500,000 or more, the department that elects to make the services available shall reimburse a case management provider for the amount of the allowable charges for those services under the medical assistance program that is not provided by the federal government.

AB100, s. 1946 Section 1946. 49.45 (25) (be) of the statutes is amended to read:

AB100,840,21 49.45 (25) (be) A private nonprofit agency that is a certified case management provider may elect to provide case management services to medical assistance beneficiaries who have HIV infection, as defined in s. 252.01 (2). The amount of the allowable charges for those services under the medical assistance program that is not provided by the federal government shall be paid from the appropriation under s. 20.435 (1) (5) (am).

AB100, s. 1947 Section 1947. 49.45 (41) (a) 1. of the statutes is amended to read:

AB100,841,2 49.45 (41) (a) 1. "Mental health crisis intervention services" means services that are provided by a mental health crisis intervention program operated by, or under contract with, a county or, municipality or, in a county having a population of 500,000 or more, the department, if the county or, municipality or department is certified as a medical assistance provider.

AB100, s. 1948 Section 1948. 49.45 (41) (b) of the statutes is amended to read:

AB100,841,17 49.45 (41) (b) If a county or, municipality or, in a county having a population of 500,000 or more, the department elects to become certified as a provider of mental health crisis intervention services, the county or, municipality or department may provide mental health crisis intervention services under this subsection in the county or municipality to medical assistance recipients through the medical assistance program. A county or, municipality or, in a county having a population of 500,000 or more, the department that elects to provide the services shall pay the amount of the allowable charges for the services under the medical assistance program that is not provided by the federal government. The subunit of the department administering the medical assistance program shall reimburse the county or, municipality or subunit of the department administering child welfare services in a county having a population of 500,000 or more 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.

AB100, s. 1949 Section 1949. 49.46 (1) (a) 1. of the statutes is amended to read:

AB100,841,24 49.46 (1) (a) 1. Any person included in the grant of aid to families with dependent children and any person who does not receive such aid solely because of the application of s. 49.19 (11) (a) 7. This If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, this subdivision does not apply beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a).

AB100, s. 1950 Section 1950. 49.46 (1) (a) 1m. of the statutes is amended to read:

AB100,842,7 49.46 (1) (a) 1m. Any pregnant woman who meets the resource and income limits under s. 49.19 (4) (bm) and (es) and whose pregnancy is medically verified. Eligibility continues to the last day of the month in which the 60th day after the last day of the pregnancy falls. This If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, this subdivision does not apply beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a).

AB100, s. 1951 Section 1951. 49.46 (1) (a) 4m. of the statutes is created to read:

AB100,842,9 49.46 (1) (a) 4m. Any child for whom a payment is made under s. 49.775.

AB100, s. 1952 Section 1952. 49.46 (1) (a) 6. of the statutes is amended to read:

AB100,842,17 49.46 (1) (a) 6. Any person not described in pars. (c) to (e) who is considered, under federal law, to be receiving aid to families with dependent children for the purpose of determining eligibility for medical assistance. This If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, this subdivision does not apply beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a).

AB100, s. 1953 Section 1953. 49.46 (1) (a) 9. of the statutes is amended to read:

AB100,842,24 49.46 (1) (a) 9. Any pregnant woman not described under subd. 1. or 1m. whose family income does not exceed 133% of the poverty line for a family the size of the woman's family. This If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, this subdivision does not apply beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a).

AB100, s. 1954 Section 1954. 49.46 (1) (a) 10. of the statutes is amended to read:

AB100,843,6 49.46 (1) (a) 10. Any child not described under subd. 1. who is under 6 years of age and whose family income does not exceed 133% of the poverty line for a family the size of the child's family. This If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, this subdivision does not apply beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a).

AB100, s. 1955 Section 1955. 49.46 (1) (a) 11. of the statutes is amended to read:

AB100,843,14 49.46 (1) (a) 11. Any child not described under subd. 1. who was born after September 30, 1983, who has attained the age of 6 but has not attained the age of 19 and whose family income does not exceed 100% of the poverty line for a family the size of the child's family. This If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, this subdivision does not apply beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a).

AB100, s. 1956 Section 1956. 49.46 (1) (a) 12. of the statutes is amended to read:

AB100,843,21 49.46 (1) (a) 12. Any child not described under subd. 1. who is under 19 years of age and who meets the resource and income limits under s. 49.19 (4). This If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, this subdivision does not apply beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a).

AB100, s. 1957 Section 1957. 49.46 (1) (a) 13. of the statutes is amended to read:

AB100,844,3 49.46 (1) (a) 13. Any child who is under one year of age, whose mother was determined to be eligible under subd. 9. and who lives with his or her mother. This If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, this subdivision does not apply beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a).

AB100, s. 1958 Section 1958. 49.46 (1) (am) 3. of the statutes is amended to read:

AB100,844,7 49.46 (1) (am) 3. This If a waiver under s. 49.153 (1m) (a) is granted and in effect, this paragraph does not apply beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a).

AB100, s. 1959 Section 1959. 49.46 (1) (c) (intro.) of the statutes is amended to read:

AB100,844,13 49.46 (1) (c) (intro.) Except as provided under pars. par. (co) and (cs), a family that becomes ineligible for aid to families with dependent children under s. 49.19 because of increased income from employment or increased hours of employment or because of the expiration of the time during which the disregards under s. 49.19 (5) (a) 4. or 4m. or (am) apply shall receive medical assistance for:

AB100, s. 1960 Section 1960. 49.46 (1) (cb) of the statutes is amended to read:

AB100,844,18 49.46 (1) (cb) Paragraph If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, par. (c) does not apply beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a).

AB100, s. 1961 Section 1961. 49.46 (1) (cg) of the statutes is amended to read:

AB100,845,6 49.46 (1) (cg) Except as provided in par. (cs), medical Medical assistance shall be provided to a dependent child, a relative with whom the child is living or the spouse of the relative, if the spouse meets the requirements of s. 49.19 (1) (c) 2. a. or b., for 4 calendar months beginning with the month in which the child, relative or spouse is ineligible for aid to families with dependent children because of the collection or increased collection of maintenance or support, if the child, relative or spouse received aid to families with dependent children in 3 or more of the 6 months immediately preceding the month in which that ineligibility begins. This If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, this paragraph does not apply beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a).

AB100, s. 1962 Section 1962. 49.46 (1) (co) 1. of the statutes is amended to read:

AB100,845,15 49.46 (1) (co) 1. Except as provided under subd. 2. and par. (cs), medical assistance shall be provided to a family for 12 consecutive calendar months following the month in which the family becomes ineligible for aid to families with dependent children because of increased income from employment, because the family no longer receives the earned income disregard under s. 49.19 (5) (a) 4. or 4m. or (am) due to the expiration of the time limit during which the disregards are applied or because of the application of the monthly employment time eligibility limitation under 45 CFR 233.100 (a) (1) (i).

AB100, s. 1963 Section 1963. 49.46 (1) (co) 4. of the statutes is amended to read:

AB100,845,20 49.46 (1) (co) 4. This If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, this paragraph does not apply beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a).

AB100, s. 1964 Section 1964. 49.46 (1) (cr) of the statutes is repealed.

AB100, s. 1965 Section 1965. 49.46 (1) (cs) of the statutes is repealed.

AB100, s. 1966 Section 1966. 49.46 (1) (e) 2. of the statutes is amended to read:

AB100,846,4 49.46 (1) (e) 2. Beginning If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a), this paragraph does not apply with respect to a person who has income and resources within the limitations of s. 49.19 whether or not the person requests or receives a grant of aid under that section.

AB100, s. 1967 Section 1967. 49.46 (2) (a) 4. d. of the statutes is amended to read:

AB100,846,8 49.46 (2) (a) 4. d. Home health services, subject to the limitations limitation under s. 49.45 (8) and (8e), or, if a home health agency is unavailable, nursing services, subject to the limitations under s. 49.45 (8e).

AB100, s. 1968 Section 1968. 49.46 (2) (b) 6. j. of the statutes is amended to read:

AB100,846,11 49.46 (2) (b) 6. j. Personal care services, subject to the limitations limitation under s. 49.45 (8e) and (42).

AB100, s. 1969 Section 1969. 49.465 (7) of the statutes is amended to read:

AB100,846,16 49.465 (7) This If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, this section does not apply beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a).

AB100, s. 1970 Section 1970. 49.47 (1) of the statutes is amended to read:

AB100,846,25 49.47 (1) Purpose. Medical assistance as set forth herein shall be provided to persons over 65, if eligible under this section, all disabled children under 18, if eligible under this section, and persons who are blind or disabled , if eligible under this section. Unless a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, medical assistance as set forth herein shall also be provided to all children under 18 who are eligible under this section and, if a child is dependent pursuant to s. 49.19, the relatives enumerated in s. 49.19 with whom the child is living.

AB100, s. 1971 Section 1971. 49.47 (4) (ag) of the statutes is amended to read:

AB100,847,6 49.47 (4) (ag) No If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.153 (1m) (a), no individual is eligible for medical assistance in a month that the individual is eligible for health care coverage under s. 49.153.

AB100, s. 1972 Section 1972. 49.47 (4) (an) of the statutes is amended to read:

AB100,847,11 49.47 (4) (an) Paragraph If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, par. (am) does not apply beginning on the first day of the 6th month beginning after the date stated in the notice under s. 49.141 (2) (d) 49.153 (1m) (a).

AB100, s. 1973 Section 1973. 49.47 (4) (c) 2. of the statutes is amended to read:

AB100,847,22 49.47 (4) (c) 2. Whenever an applicant has excess income under subd. 1. or par. (am), no certification may be issued until the excess income above the applicable limits has been obligated or expended for medical care or for any other type of remedial care recognized under state law or for personal health insurance premiums or both. No If a waiver under s. 49.153 (1m) (a) is granted and in effect or federal legislation that permits the application of s. 49.153 is enacted, no individual is eligible for medical assistance under this subdivision in a month in which the individual is eligible for health care coverage under s. 49.153 beginning on first day of the 6th month beginning after the date stated in the notice under s. 49.153 (1m) (a).

AB100, s. 1974 Section 1974. 49.48 of the statutes is created to read:

AB100,848,3 49.48 Denial, nonrenewal and suspension of certification of service providers based on certain delinquency in payment. (1) The department shall require each applicant to provide the department with the applicant's social security number, if the applicant is an individual, as a condition of issuing or renewing a certification under s. 49.45 (2) (a) 11. as an eligible provider of services.

AB100,848,6 (2) The department may not disclose any information received under sub. (1) to any person except to the department of industry, labor and job development for the purpose of making certifications required under s. 49.857.

AB100,848,14 (3) The department shall deny an application for the issuance or renewal of a certification specified in sub. (1), shall suspend a certification specified in sub. (1) or may, under a memorandum of understanding under s. 49.857 (2), restrict a certification specified in sub. (1) if the department of industry, labor and job development certifies under s. 49.857 that the applicant for or holder of the certificate is delinquent in the payment of court-ordered payments of child or family support, maintenance, birth expenses, medical expenses or other expenses related to the support of a child or former spouse.

AB100, s. 1975 Section 1975. 49.496 (5) of the statutes is amended to read:

AB100,848,21 49.496 (5) Use of funds. From the appropriation under s. 20.435 (1) (5) (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 under this subchapter

AB100, s. 1976 Section 1976. 49.496 (7) of the statutes is created to read:

AB100,849,2 49.496 (7) Instalment payments. If a recovery under sub. (3) does not work an undue hardship on the heirs of the estate, and if the heirs wish to satisfy the recovery claim without selling a nonliquid asset that is subject to recovery, the department may establish a reasonable payment schedule subject to reasonable interest.

AB100, s. 1977 Section 1977. 49.497 (1) of the statutes is amended to read:

AB100,849,17 49.497 (1) The department may recover any payment made incorrectly for benefits specified under s. 49.46, 49.468 or 49.47 if the incorrect payment results from any misstatement or omission of fact by a person supplying information in an application for benefits under s. 49.46, 49.468 or 49.47. The department may also recover if a medical assistance recipient or any other person responsible for giving information on the recipient's behalf fails to report the receipt of income or assets in an amount that would have affected the recipient's eligibility for benefits. The department's right of recovery is against any medical assistance recipient to whom or on whose behalf the incorrect payment was made. The extent of recovery is limited to the amount of the benefits incorrectly granted. The county department under s. 46.215 or, 46.22 or 46.23, the governing body of a federally recognized American Indian tribe administering medical assistance, or a Wisconsin works agency administering medical assistance shall begin recovery actions on behalf of the department according to rules promulgated by the department.

AB100, s. 1978 Section 1978. 49.497 (2) of the statutes is amended to read:

AB100,849,22 49.497 (2) A county or, governing body of a federally recognized American Indian tribe or Wisconsin works agency may retain 15% of benefits distributed under s. 49.46, 49.468 or 49.47 that are recovered under sub. (1) due to the efforts of an employe or officer of the county or, tribe or Wisconsin works agency.

AB100, s. 1979 Section 1979. 49.498 (16) (g) of the statutes is amended to read:

AB100,850,6 49.498 (16) (g) All forfeitures, penalty assessments and interest, if any, shall be paid to the department within 10 days of receipt of notice of assessment or, if the forfeiture, penalty assessment and interest, if any, are contested under par. (f), within 10 days of receipt of the final decision after exhaustion of administrative review, unless the final decision is appealed and the order is stayed by court order under sub. (19) (b). The department shall remit all forfeitures paid to the state treasurer for deposit in the school fund. The department shall deposit all penalty assessments and interest in the appropriation under s. 20.435 (1) (6) (g).

AB100, s. 1980 Section 1980. 49.499 (intro.) of the statutes is amended to read:

AB100,850,12 49.499 Nursing facility resident protection. (intro.) From the appropriation under s. 20.435 (1) (6) (g), the department shall contribute to the payment of all of the following, as needed by a resident in a nursing facility, as defined in s. 49.498 (1) (i), that is in violation of s. 49.498 or of a rule promulgated under s. 49.498:

AB100, s. 1981 Section 1981. 49.683 (2) of the statutes is amended to read:

AB100,850,15 49.683 (2) Approved costs for medical care under sub. (1) shall be paid from the appropriation under s. 20.435 (1) (5) (e).

AB100, s. 1982 Section 1982. 49.686 (2) of the statutes is amended to read:

AB100,850,20 49.686 (2) Reimbursement. From the appropriation under s. 20.435 (1) (5) (am), the department 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 individual who is eligible under sub. (3).

AB100, s. 1983 Section 1983. 49.687 (2) of the statutes is amended to read: