SB45,746,2
1(e) Except as provided in par. (f), a statement is considered to be made when
2it is received by the fiscal agent.
SB45,746,53 (f) A statement that is not submitted to a fiscal agent but is retained by the
4provider to support a claim is considered to be made when it is entered in the
5provider's books, files or other records.
SB45,746,7 6(5) Any person who violates sub. (2) or (3) may be required to forfeit not more
7than $5,000 for each offense.
SB45,746,11 8(6) If the department assesses a forfeiture under sub. (5) for a violation of sub.
9(2), the department may impose on the violator, in addition to the forfeiture, a false
10claim surcharge in an amount that is not more than 200% of the amount of the claim
11in regard to which sub. (2) was found to have been violated.
SB45,746,17 12(7) The department may directly assess a forfeiture provided for in sub. (5).
13If the department determines that a forfeiture should be assessed for a particular
14violation, the department shall send a notice of assessment to the alleged violator.
15The notice shall specify the amount of the forfeiture assessed, the violation and the
16statute alleged to have been violated and shall inform the alleged violator of the right
17to a hearing under sub. (8).
SB45,747,3 18(8) An alleged violator may contest an assessment of a forfeiture by sending,
19within 30 days after receipt of the notice under sub. (7), a written request for hearing
20under s. 227.44 to the division of hearings and appeals created under s. 15.103 (1).
21The administrator of the division may designate a hearing examiner to preside over
22the case and recommend a decision to the administrator under s. 227.46. The
23decision of the administrator of the division shall be the final administrative
24decision. The division shall commence the hearing within 30 days after receipt of the
25request for hearing and shall issue a final decision within 15 days after the close of

1the hearing. Proceedings before the division are governed by ch. 227. In any petition
2for judicial review of a decision by the division, the party, other than the petitioner,
3who was in the proceeding before the division shall be the named respondent.
SB45,747,10 4(9) All forfeitures and false claim surcharges, if any, shall be paid to the
5department within 10 days after receipt of notice of assessment or, if the forfeiture
6is contested under sub. (8), within 10 days after receipt of the final decision after
7exhaustion of administrative review, unless the final decision is appealed. The
8department shall remit all forfeitures paid to the state treasurer for deposit in the
9school fund. The department shall credit all false claims surcharges to the
10appropriation account under s. 20.435 (1) (kx).
SB45,747,15 11(10) The attorney general may bring an action in the name of the state to collect
12any forfeiture or false claim surcharge imposed under this section if the forfeiture or
13false claim surcharge has not been paid following the exhaustion of all
14administrative and judicial reviews. The only issue to be contested in any such action
15is whether the forfeiture or false claim surcharge has been paid.
SB45, s. 1444 16Section 1444. 49.496 (2) (title) of the statutes is amended to read:
SB45,747,1817 49.496 (2) (title) Liens on the homes of nursing home residents and inpatients
18at hospitals
.
SB45, s. 1445 19Section 1445. 49.496 (2) (a) of the statutes is amended to read:
SB45,748,220 49.496 (2) (a) Except as provided in par. (b), the department may obtain a lien
21on a recipient's home if the recipient resides in a nursing home, or if the recipient
22resides in a hospital and is required to contribute to the cost of care,
and the recipient
23cannot reasonably be expected to be discharged from the nursing home or hospital
24and return home. The lien is for the amount of medical assistance paid on behalf of

1the recipient while the recipient resides in a nursing home that is recoverable under
2sub. (3) (a)
.
SB45, s. 1446 3Section 1446. 49.496 (2) (b) 3. of the statutes is amended to read:
SB45,748,64 49.496 (2) (b) 3. The recipient's sibling who has an ownership interest in the
5home and who has lived in the home continuously beginning at least 12 months
6before the recipient was admitted to the nursing home or hospital.
SB45, s. 1447 7Section 1447. 49.496 (2) (c) 1. of the statutes is amended to read:
SB45,748,118 49.496 (2) (c) 1. Notify the recipient in writing of its determination that the
9recipient cannot reasonably be expected to be discharged from the nursing home or
10hospital
, its intent to impose a lien on the recipient's home and the recipient's right
11to a hearing on whether the requirements for the imposition of a lien are satisfied.
SB45, s. 1448 12Section 1448. 49.496 (2) (f) 3. of the statutes is amended to read:
SB45,748,1613 49.496 (2) (f) 3. A child of any age who resides in the home, if that child resided
14in the home for at least 24 months before the recipient was admitted to the nursing
15home or hospital and provided care to the recipient that delayed the recipient's
16admission to the nursing home or hospital.
SB45, s. 1449 17Section 1449. 49.496 (2) (f) 4. of the statutes is amended to read:
SB45,748,2018 49.496 (2) (f) 4. A sibling who resides in the home, if the sibling resided in the
19home for at least 12 months before the recipient was admitted to the nursing home
20or hospital.
SB45, s. 1450 21Section 1450. 49.496 (2) (h) of the statutes is amended to read:
SB45,748,2422 49.496 (2) (h) The department shall file a release of a lien imposed under this
23subsection if the recipient is discharged from the nursing home or hospital and
24returns to live in the home.
SB45, s. 1451 25Section 1451. 49.496 (3) (a) (intro.) of the statutes is amended to read:
SB45,749,4
149.496 (3) (a) (intro.) Except as provided in par. (b), the department shall file
2a claim against the estate of a recipient or against the estate of the surviving spouse
3of a recipient
for all of the following unless already recovered by the department
4under this section:
SB45, s. 1452 5Section 1452. 49.496 (3) (a) 1. of the statutes is amended to read:
SB45,749,96 49.496 (3) (a) 1. The amount of medical assistance paid on behalf of the
7recipient while the recipient resided in a nursing home or while the recipient was an
8inpatient in a medical institution hospital and was required to contribute to the cost
9of care.
SB45, s. 1453 10Section 1453. 49.496 (3) (a) 2. a. of the statutes is amended to read:
SB45,749,1311 49.496 (3) (a) 2. a. Home-based or community-based services under 42 USC
121396d
(a) (7) and (8) and under any waiver granted under 42 USC 1396n (c) (4) (B)
13or 42 USC 1396u.
SB45, s. 1454 14Section 1454. 49.496 (3) (a) 2. d. of the statutes is created to read:
SB45,749,1515 49.496 (3) (a) 2. d. Personal care services under s. 49.46 (2) (b) 6. j.
SB45, s. 1455 16Section 1455. 49.496 (3) (am) (intro.) of the statutes is amended to read:
SB45,749,2017 49.496 (3) (am) (intro.) The court shall reduce the amount of a claim under par.
18(a) by up to $3,000 the amount specified in s. 861.33 (2) if necessary to allow the
19recipient's heirs or the beneficiaries of the recipient's will to retain the following
20personal property:
SB45, s. 1456 21Section 1456. 49.496 (3) (am) 3. of the statutes is amended to read:
SB45,749,2422 49.496 (3) (am) 3. Other tangible personal property not used in trade,
23agriculture or other business, not to exceed $1,000 in value the amount specified in
24s. 861.33 (1) (a) 4
.
SB45, s. 1457 25Section 1457. 49.496 (3) (b) of the statutes is amended to read:
SB45,750,2
149.496 (3) (b) A claim under par. (a) is not allowable if while the decedent has
2a surviving child who is under age 21 or disabled or a surviving spouse.
SB45, s. 1458 3Section 1458. 49.496 (3) (c) of the statutes is renumbered 49.496 (3) (c) 1. and
4amended to read:
SB45,750,115 49.496 (3) (c) 1. If the department's claim is not allowable because of par. (b)
6and the estate includes an interest in a home, the court exercising probate
7jurisdiction shall, in the final judgment or summary findings and order, assign the
8interest in the home subject to a lien in favor of the department for the amount
9described in par. (a). The personal representative or petitioner for summary
10settlement or summary assignment of the estate
shall record the final judgment as
11provided in s. 863.29, 867.01 (3) (h) or 867.02 (2) (h).
SB45, s. 1459 12Section 1459. 49.496 (3) (c) 2. of the statutes is created to read:
SB45,750,1913 49.496 (3) (c) 2. If the department's claim is not allowable because of par. (b),
14the estate includes an interest in a home and the personal representative closes the
15estate by sworn statement under s. 865.16, the personal representative shall
16stipulate in the statement that the home is assigned subject to a lien in favor of the
17department for the amount described in par. (a). The personal representative shall
18record the statement in the same manner as described in s. 863.29, as if the
19statement were a final judgment.
SB45, s. 1460 20Section 1460. 49.496 (3) (f) of the statutes is created to read:
SB45,750,2221 49.496 (3) (f) The department may contract with or employ an attorney to
22probate estates to recover under this subsection the costs of care.
SB45, s. 1461 23Section 1461. 49.496 (5) of the statutes is amended to read:
SB45,751,424 49.496 (5) Use of funds. From the appropriation under s. 20.435 (5) (4) (im),
25the department shall pay the amount of the payments under sub. (4) that is not paid

1from federal funds, shall pay to the federal government the amount of the funds
2recovered under this section equal to the amount of federal funds used to pay the
3benefits recovered under this section and shall spend the remainder of the funds
4recovered under this section for medical assistance benefits under this subchapter.
SB45, s. 1462 5Section 1462. 49.499 (intro.) of the statutes, as affected by 1997 Wisconsin Act
627
, is renumbered 49.499 (1) (intro.).
SB45, s. 1463 7Section 1463. 49.499 (1) to (3) of the statutes are renumbered 49.499 (1) (a)
8to (c).
SB45, s. 1464 9Section 1464. 49.499 (2m) of the statutes is created to read:
SB45,751,1210 49.499 (2m) From the appropriation under s. 20.435 (6) (g), the department
11may distribute funds for innovative projects designed to protect the health and
12property of a resident in a nursing facility, as defined in s. 49.498 (1) (i).
SB45, s. 1465 13Section 1465. 49.665 (1) (a) of the statutes is renumbered 49.665 (1) (e) and
14amended to read:
SB45,751,1615 49.665 (1) (e) "Custodial parent Parent" has the meaning given in s. 49.141 (1)
16(b) (j).
SB45, s. 1466 17Section 1466. 49.665 (1) (b) of the statutes is repealed and recreated to read:
SB45,751,1818 49.665 (1) (b) "Child" means a person who is under the age of 19.
SB45, s. 1467 19Section 1467. 49.665 (1) (d) of the statutes is amended to read:
SB45,751,2320 49.665 (1) (d) "Family" means a unit that consists of at least one dependent
21child and his or her custodial parent or parents, all of whom reside in the same
22household
. "Family" includes the spouse of an individual who is a custodial parent
23if the spouse resides in the same household as the individual.
SB45, s. 1468 24Section 1468. 49.665 (1) (f) of the statutes is created to read:
SB45,752,2
149.665 (1) (f) "State plan" means the state child health plan under 42 USC
21397aa
(b).
SB45, s. 1469 3Section 1469. 49.665 (3) of the statutes is amended to read:
SB45,752,144 49.665 (3) Administration. The department shall administer a program to
5provide the health services and benefits described in s. 49.46 (2) to families persons
6that meet the eligibility requirements specified in sub. (4). The department shall
7promulgate rules setting forth the application procedures and appeal and grievance
8procedures. The department may promulgate rules limiting access to the program
9under this section to defined enrollment periods. The department may also
10promulgate rules establishing a method by which the department may purchase
11family coverage offered by the employer of a member of an eligible family or by a
12member of a child's household
under circumstances in which the department
13determines that purchasing that coverage would not be more costly than providing
14the coverage under this section.
SB45, s. 1470 15Section 1470. 49.665 (4) (a) 1. of the statutes is amended to read:
SB45,752,2016 49.665 (4) (a) 1. The family's income does not exceed 185% of the poverty line,
17except as provided in par. (at) and except that a family that is already receiving
18health care coverage under this section may have an income that does not exceed
19200% of the poverty line. The department shall establish by rule the criteria to be
20used to determine income.
SB45, s. 1471 21Section 1471. 49.665 (4) (am) of the statutes is created to read:
SB45,752,2422 49.665 (4) (am) A child who does not reside with his or her parent is eligible
23for health care coverage under this section if the child meets all of the following
24requirements:
SB45,753,5
11. The child's income does not exceed 185% of the poverty line, except as
2provided in par. (at) and except that a child that is already receiving health care
3coverage under this section may have an income that does not exceed 200% of the
4poverty line. The department shall use the criteria established under par. (a) 1. to
5determine income under this subdivision.
SB45,753,66 2. The child does not have access to employer-subsidized health care coverage.
SB45,753,97 3. The child has not had access to employer-subsidized health care coverage
8within the time period established by the department under par. (a) 3. The
9department may establish exceptions to this subdivision.
SB45,753,1210 4. The child meets all other requirements established by the department by
11rule. In establishing other eligibility criteria, the department may not include any
12health condition requirements.
SB45, s. 1472 13Section 1472. 49.665 (4) (at) of the statutes is created to read:
SB45,753,1814 49.665 (4) (at) 1. The department shall establish by state plan amendment a
15lower maximum income level for the initial eligibility determination if funding under
16s. 20.435 (4) (bc), (jz) and (p) is insufficient to accommodate the projected enrollment
17levels for the health care program under this section. The adjustment may not be
18greater than necessary to ensure sufficient funding.
SB45,753,2319 2. If, after the department has established a lower maximum income level
20under subd. 1., projections indicate that funding under s. 20.435 (4) (bc), (jz) and (p)
21is sufficient to raise the level, the department shall, by state plan amendment, raise
22the maximum income level for initial eligibility, but not to exceed 185% of the poverty
23line.
SB45,753,2524 3. The department may not adjust the maximum income level of 200% of the
25poverty line for persons already receiving health care coverage under this section.
SB45, s. 1473
1Section 1473. 49.665 (4) (b) of the statutes is amended to read:
SB45,754,42 49.665 (4) (b) Notwithstanding fulfillment of the eligibility requirements
3under this subsection, a family no person is not entitled to health care coverage under
4this section.
SB45, s. 1474 5Section 1474. 49.665 (4) (c) of the statutes is amended to read:
SB45,754,86 49.665 (4) (c) No family person may be denied health care coverage under this
7section solely because of a health condition of that person or of any family member
8of that person.
SB45, s. 1475 9Section 1475. 49.665 (5) (a) of the statutes is amended to read:
SB45,755,410 49.665 (5) (a) Except as provided in par. (b), a family that, or child who does
11not reside with his or her parent, who
receives health care coverage under this
12section shall pay a percentage of the cost of that coverage in accordance with a
13schedule established by the department by rule. If the schedule established by the
14department requires a family, or child who does not reside with his or her parent, to
15contribute more than 3% of the family's or child's income towards the cost of the
16health care coverage provided under this section, the department shall submit the
17schedule to the joint committee on finance for review and approval of the schedule.
18If the cochairpersons of the joint committee on finance do not notify the department
19within 14 working days after the date of the department's submittal of the schedule
20that the committee has scheduled a meeting to review the schedule, the department
21may implement the schedule. If, within 14 days after the date of the department's
22submittal of the schedule, the cochairpersons of the committee notify the department
23that the committee has scheduled a meeting to review the schedule, the department
24may not require a family, or child who does not reside with his or her parent, to
25contribute more than 3% of the family's or child's income unless the joint committee

1on finance approves the schedule. The joint committee on finance may not approve
2and the department may not implement a schedule that requires a family or child
3to contribute more than 3.5% of the family's or child's income towards the cost of the
4health care coverage provided under this section.
SB45, s. 1476 5Section 1476. 49.665 (5) (b) of the statutes is amended to read:
SB45,755,86 49.665 (5) (b) The department may not require a family , or child who does not
7reside with his or her parent,
with an income below 143% 150% of the poverty line
8to contribute to the cost of health care coverage provided under this section.
SB45, s. 1477 9Section 1477. 49.682 (2) (c) (intro.) of the statutes is amended to read:
SB45,755,1310 49.682 (2) (c) (intro.) The court shall reduce the amount of a claim under par.
11(a) by up to $3,000 the amount specified in s. 861.33 (2) if necessary to allow the
12client's heirs or the beneficiaries of the client's will to retain the following personal
13property:
SB45, s. 1478 14Section 1478. 49.682 (2) (c) 3. of the statutes is amended to read:
SB45,755,1715 49.682 (2) (c) 3. Other tangible personal property not used in trade, agriculture
16or other business, not to exceed $1,000 in value the amount specified in s. 861.33 (1)
17(a) 4
.
SB45, s. 1479 18Section 1479. 49.682 (2) (e) of the statutes is renumbered 49.682 (2) (e) 1. and
19amended to read:
SB45,756,220 49.682 (2) (e) 1. If the department's claim is not allowable because of par. (d)
21and the estate includes an interest in a home, the court exercising probate
22jurisdiction shall, in the final judgment or summary findings and order, assign the
23interest in the home subject to a lien in favor of the department for the amount
24described in par. (a). The personal representative or petitioner for summary

1settlement or summary assignment of the estate
shall record the final judgment as
2provided in s. 863.29, 867.01 (3) (h) or 867.02 (2) (h).
SB45, s. 1480 3Section 1480. 49.682 (2) (e) 2. of the statutes is created to read:
SB45,756,104 49.682 (2) (e) 2. If the department's claim is not allowable because of par. (d),
5the estate includes an interest in a home and the personal representative closes the
6estate by sworn statement under s. 865.16, the personal representative shall
7stipulate in the statement that the home is assigned subject to a lien in favor of the
8department for the amount described in par. (a). The personal representative shall
9record the statement in the same manner as described in s. 863.29, as if the
10statement were a final judgment.
SB45, s. 1481 11Section 1481. 49.682 (6) of the statutes is created to read:
SB45,756,1312 49.682 (6) The department may contract with or employ an attorney to probate
13estates to recover under this section the costs of care.
SB45, s. 1482 14Section 1482. 49.683 (2) of the statutes is amended to read:
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