SB45: Bill Text

SB45, s. 1447 Section 1447. 49.496 (2) (c) 1. of the statutes is amended to read:

SB45,748,11 49.496 (2) (c) 1. Notify the recipient in writing of its determination that the recipient cannot reasonably be expected to be discharged from the nursing home or hospital, its intent to impose a lien on the recipient's home and the recipient's right to a hearing on whether the requirements for the imposition of a lien are satisfied.

SB45, s. 1448 Section 1448. 49.496 (2) (f) 3. of the statutes is amended to read:

SB45,748,16 49.496 (2) (f) 3. A child of any age who resides in the home, if that child resided in the home for at least 24 months before the recipient was admitted to the nursing home or hospital and provided care to the recipient that delayed the recipient's admission to the nursing home or hospital.

SB45, s. 1449 Section 1449. 49.496 (2) (f) 4. of the statutes is amended to read:

SB45,748,20 49.496 (2) (f) 4. A sibling who resides in the home, if the sibling resided in the home for at least 12 months before the recipient was admitted to the nursing home or hospital.

SB45, s. 1450 Section 1450. 49.496 (2) (h) of the statutes is amended to read:

SB45,748,24 49.496 (2) (h) The department shall file a release of a lien imposed under this subsection if the recipient is discharged from the nursing home or hospital and returns to live in the home.

SB45, s. 1451 Section 1451. 49.496 (3) (a) (intro.) of the statutes is amended to read:

SB45,749,4 49.496 (3) (a) (intro.) Except as provided in par. (b), the department shall file a claim against the estate of a recipient or against the estate of the surviving spouse of a recipient for all of the following unless already recovered by the department under this section:

SB45, s. 1452 Section 1452. 49.496 (3) (a) 1. of the statutes is amended to read:

SB45,749,9 49.496 (3) (a) 1. The amount of medical assistance paid on behalf of the recipient while the recipient resided in a nursing home or while the recipient was an inpatient in a medical institution hospital and was required to contribute to the cost of care.

SB45, s. 1453 Section 1453. 49.496 (3) (a) 2. a. of the statutes is amended to read:

SB45,749,13 49.496 (3) (a) 2. a. Home-based or community-based services under 42 USC 1396d (a) (7) and (8) and under any waiver granted under 42 USC 1396n (c) (4) (B) or 42 USC 1396u.

SB45, s. 1454 Section 1454. 49.496 (3) (a) 2. d. of the statutes is created to read:

SB45,749,15 49.496 (3) (a) 2. d. Personal care services under s. 49.46 (2) (b) 6. j.

SB45, s. 1455 Section 1455. 49.496 (3) (am) (intro.) of the statutes is amended to read:

SB45,749,20 49.496 (3) (am) (intro.) The court shall reduce the amount of a claim under par. (a) by up to $3,000 the amount specified in s. 861.33 (2) if necessary to allow the recipient's heirs or the beneficiaries of the recipient's will to retain the following personal property:

SB45, s. 1456 Section 1456. 49.496 (3) (am) 3. of the statutes is amended to read:

SB45,749,24 49.496 (3) (am) 3. Other tangible personal property not used in trade, agriculture or other business, not to exceed $1,000 in value the amount specified in s. 861.33 (1) (a) 4.

SB45, s. 1457 Section 1457. 49.496 (3) (b) of the statutes is amended to read:

SB45,750,2 49.496 (3) (b) A claim under par. (a) is not allowable if while the decedent has a surviving child who is under age 21 or disabled or a surviving spouse.

SB45, s. 1458 Section 1458. 49.496 (3) (c) of the statutes is renumbered 49.496 (3) (c) 1. and amended to read:

SB45,750,11 49.496 (3) (c) 1. If the department's claim is not allowable because of par. (b) and the estate includes an interest in a home, the court exercising probate jurisdiction shall, in the final judgment or summary findings and order, assign the interest in the home subject to a lien in favor of the department for the amount described in par. (a). The personal representative or petitioner for summary settlement or summary assignment of the estate shall record the final judgment as provided in s. 863.29, 867.01 (3) (h) or 867.02 (2) (h).

SB45, s. 1459 Section 1459. 49.496 (3) (c) 2. of the statutes is created to read:

SB45,750,19 49.496 (3) (c) 2. If the department's claim is not allowable because of par. (b), the estate includes an interest in a home and the personal representative closes the estate by sworn statement under s. 865.16, the personal representative shall stipulate in the statement that the home is assigned subject to a lien in favor of the department for the amount described in par. (a). The personal representative shall record the statement in the same manner as described in s. 863.29, as if the statement were a final judgment.

SB45, s. 1460 Section 1460. 49.496 (3) (f) of the statutes is created to read:

SB45,750,22 49.496 (3) (f) The department may contract with or employ an attorney to probate estates to recover under this subsection the costs of care.

SB45, s. 1461 Section 1461. 49.496 (5) of the statutes is amended to read:

SB45,751,4 49.496 (5) Use of funds. From the appropriation under s. 20.435 (5) (4) (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.

SB45, s. 1462 Section 1462. 49.499 (intro.) of the statutes, as affected by 1997 Wisconsin Act 27, is renumbered 49.499 (1) (intro.).

SB45, s. 1463 Section 1463. 49.499 (1) to (3) of the statutes are renumbered 49.499 (1) (a) to (c).

SB45, s. 1464 Section 1464. 49.499 (2m) of the statutes is created to read:

SB45,751,12 49.499 (2m) From the appropriation under s. 20.435 (6) (g), the department may distribute funds for innovative projects designed to protect the health and property of a resident in a nursing facility, as defined in s. 49.498 (1) (i).

SB45, s. 1465 Section 1465. 49.665 (1) (a) of the statutes is renumbered 49.665 (1) (e) and amended to read:

SB45,751,16 49.665 (1) (e) "Custodial parent Parent" has the meaning given in s. 49.141 (1) (b) (j).

SB45, s. 1466 Section 1466. 49.665 (1) (b) of the statutes is repealed and recreated to read:

SB45,751,18 49.665 (1) (b) "Child" means a person who is under the age of 19.

SB45, s. 1467 Section 1467. 49.665 (1) (d) of the statutes is amended to read:

SB45,751,23 49.665 (1) (d) "Family" means a unit that consists of at least one dependent child and his or her custodial parent or parents, all of whom reside in the same household. "Family" includes the spouse of an individual who is a custodial parent if the spouse resides in the same household as the individual.

SB45, s. 1468 Section 1468. 49.665 (1) (f) of the statutes is created to read:

SB45,752,2 49.665 (1) (f) "State plan" means the state child health plan under 42 USC 1397aa (b).

SB45, s. 1469 Section 1469. 49.665 (3) of the statutes is amended to read:

SB45,752,14 49.665 (3) Administration. The department shall administer a program to provide the health services and benefits described in s. 49.46 (2) to families persons that meet the eligibility requirements specified in sub. (4). The department shall promulgate rules setting forth the application procedures and appeal and grievance procedures. The department may promulgate rules limiting access to the program under this section to defined enrollment periods. The department may also promulgate rules establishing a method by which the department may purchase family coverage offered by the employer of a member of an eligible family or by a member of a child's household under circumstances in which the department determines that purchasing that coverage would not be more costly than providing the coverage under this section.

SB45, s. 1470 Section 1470. 49.665 (4) (a) 1. of the statutes is amended to read:

SB45,752,20 49.665 (4) (a) 1. The family's income does not exceed 185% of the poverty line, except as provided in par. (at) and except that a family that is already receiving health care coverage under this section may have an income that does not exceed 200% of the poverty line. The department shall establish by rule the criteria to be used to determine income.

SB45, s. 1471 Section 1471. 49.665 (4) (am) of the statutes is created to read:

SB45,752,24 49.665 (4) (am) A child who does not reside with his or her parent is eligible for health care coverage under this section if the child meets all of the following requirements:

SB45,753,5 1. The child's income does not exceed 185% of the poverty line, except as provided in par. (at) and except that a child that is already receiving health care coverage under this section may have an income that does not exceed 200% of the poverty line. The department shall use the criteria established under par. (a) 1. to determine income under this subdivision.

SB45,753,6 2. The child does not have access to employer-subsidized health care coverage.

SB45,753,9 3. The child has not had access to employer-subsidized health care coverage within the time period established by the department under par. (a) 3. The department may establish exceptions to this subdivision.

SB45,753,12 4. The child meets all other requirements established by the department by rule. In establishing other eligibility criteria, the department may not include any health condition requirements.

SB45, s. 1472 Section 1472. 49.665 (4) (at) of the statutes is created to read:

SB45,753,18 49.665 (4) (at) 1. The department shall establish by state plan amendment a lower maximum income level for the initial eligibility determination if funding under s. 20.435 (4) (bc), (jz) and (p) is insufficient to accommodate the projected enrollment levels for the health care program under this section. The adjustment may not be greater than necessary to ensure sufficient funding.

SB45,753,23 2. If, after the department has established a lower maximum income level under subd. 1., projections indicate that funding under s. 20.435 (4) (bc), (jz) and (p) is sufficient to raise the level, the department shall, by state plan amendment, raise the maximum income level for initial eligibility, but not to exceed 185% of the poverty line.

SB45,753,25 3. The department may not adjust the maximum income level of 200% of the poverty line for persons already receiving health care coverage under this section.

SB45, s. 1473 Section 1473. 49.665 (4) (b) of the statutes is amended to read:

SB45,754,4 49.665 (4) (b) Notwithstanding fulfillment of the eligibility requirements under this subsection, a family no person is not entitled to health care coverage under this section.

SB45, s. 1474 Section 1474. 49.665 (4) (c) of the statutes is amended to read:

SB45,754,8 49.665 (4) (c) No family person may be denied health care coverage under this section solely because of a health condition of that person or of any family member of that person.

SB45, s. 1475 Section 1475. 49.665 (5) (a) of the statutes is amended to read:

SB45,755,4 49.665 (5) (a) Except as provided in par. (b), a family that, or child who does not reside with his or her parent, who receives health care coverage under this section shall pay a percentage of the cost of that coverage in accordance with a schedule established by the department by rule. If the schedule established by the department requires a family, or child who does not reside with his or her parent, to contribute more than 3% of the family's or child's income towards the cost of the health care coverage provided under this section, the department shall submit the schedule to the joint committee on finance for review and approval of the schedule. If the cochairpersons of the joint committee on finance do not notify the department within 14 working days after the date of the department's submittal of the schedule that the committee has scheduled a meeting to review the schedule, the department may implement the schedule. If, within 14 days after the date of the department's submittal of the schedule, the cochairpersons of the committee notify the department that the committee has scheduled a meeting to review the schedule, the department may not require a family, or child who does not reside with his or her parent, to contribute more than 3% of the family's or child's income unless the joint committee on finance approves the schedule. The joint committee on finance may not approve and the department may not implement a schedule that requires a family or child to contribute more than 3.5% of the family's or child's income towards the cost of the health care coverage provided under this section.

SB45, s. 1476 Section 1476. 49.665 (5) (b) of the statutes is amended to read:

SB45,755,8 49.665 (5) (b) The department may not require a family , or child who does not reside with his or her parent, with an income below 143% 150% of the poverty line to contribute to the cost of health care coverage provided under this section.

SB45, s. 1477 Section 1477. 49.682 (2) (c) (intro.) of the statutes is amended to read:

SB45,755,13 49.682 (2) (c) (intro.) The court shall reduce the amount of a claim under par. (a) by up to $3,000 the amount specified in s. 861.33 (2) if necessary to allow the client's heirs or the beneficiaries of the client's will to retain the following personal property:

SB45, s. 1478 Section 1478. 49.682 (2) (c) 3. of the statutes is amended to read:

SB45,755,17 49.682 (2) (c) 3. Other tangible personal property not used in trade, agriculture or other business, not to exceed $1,000 in value the amount specified in s. 861.33 (1) (a) 4.

SB45, s. 1479 Section 1479. 49.682 (2) (e) of the statutes is renumbered 49.682 (2) (e) 1. and amended to read:

SB45,756,2 49.682 (2) (e) 1. If the department's claim is not allowable because of par. (d) and the estate includes an interest in a home, the court exercising probate jurisdiction shall, in the final judgment or summary findings and order, assign the interest in the home subject to a lien in favor of the department for the amount described in par. (a). The personal representative or petitioner for summary settlement or summary assignment of the estate shall record the final judgment as provided in s. 863.29, 867.01 (3) (h) or 867.02 (2) (h).

SB45, s. 1480 Section 1480. 49.682 (2) (e) 2. of the statutes is created to read:

SB45,756,10 49.682 (2) (e) 2. If the department's claim is not allowable because of par. (d), the estate includes an interest in a home and the personal representative closes the estate by sworn statement under s. 865.16, the personal representative shall stipulate in the statement that the home is assigned subject to a lien in favor of the department for the amount described in par. (a). The personal representative shall record the statement in the same manner as described in s. 863.29, as if the statement were a final judgment.

SB45, s. 1481 Section 1481. 49.682 (6) of the statutes is created to read:

SB45,756,13 49.682 (6) The department may contract with or employ an attorney to probate estates to recover under this section the costs of care.

SB45, s. 1482 Section 1482. 49.683 (2) of the statutes is amended to read:

SB45,756,16 49.683 (2) Approved costs for medical care under sub. (1) shall be paid from the appropriation under s. 20.435 (5) (4) (e).

SB45, s. 1483 Section 1483. 49.687 (2) of the statutes is amended to read:

SB45,756,25 49.687 (2) The department shall develop and implement a sliding scale of patient liability for kidney disease aid under s. 49.68, cystic fibrosis aid under s. 49.683 and hemophilia treatment under s. 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 (5) (4) (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.

SB45, s. 1484 Section 1484. 49.775 (4) of the statutes is amended to read:

SB45,757,3 49.775 (4) Payment amount. The payment under sub. (2) is $100 $150 per month per dependent child.

SB45, s. 1485 Section 1485. 49.85 (2) (a) of the statutes is amended to read:

SB45,757,12 49.85 (2) (a) At least annually, the department of health and family services shall certify to the department of revenue the amounts that, based on the notifications received under sub. (1) and on other information received by the department of health and family services, the department of health and family services has determined that it may recover under s. 49.45 (2) (a) 10. or 49.497, except that the department of health and family services may not certify an amount under this subsection unless it has met the notice requirements under sub. (3) and unless its determination has either not been appealed or is no longer under appeal.

SB45, s. 1486 Section 1486. 49.85 (3) (a) 1. of the statutes is amended to read:

SB45,757,17 49.85 (3) (a) 1. Inform the person that the department of health and family services intends to certify to the department of revenue an amount that the department of health and family services has determined to be due under s. 49.45 (2) (a) 10. or 49.497, for setoff from any state tax refund that may be due the person.

SB45, s. 1487 Section 1487. 49.855 (7) of the statutes is repealed.

SB45, s. 1488 Section 1488. 49.857 (1) (d) 3. of the statutes is amended to read:

SB45,757,20 49.857 (1) (d) 3. A license issued under s. 48.66 (1) (a) or (b).

SB45, s. 1489 Section 1489. 49.89 (2) of the statutes is amended to read:

SB45,758,11 49.89 (2) Subrogation. The department of health and family services, the department of workforce development, a county or an elected tribal governing body that provides any public assistance under this chapter or under s. 253.05 as a result of the occurrence of an injury, sickness or death that creates a claim or cause of action, whether in tort or contract, on the part of a public assistance recipient or beneficiary or the estate of a recipient or beneficiary against a 3rd party, including an insurer, is subrogated to the rights of the recipient, beneficiary or estate and may make a claim or maintain an action or intervene in a claim or action by the recipient, beneficiary or estate against the 3rd party. Subrogation under this subsection because of the provision of medical assistance under subch. IV constitutes a lien, equal to the amount of the medical assistance provided as a result of the injury, sickness or death that gave rise to the claim. The lien is on any lump sum payment resulting from a judgment or settlement that may be due the obligor. A lien under this subsection continues until it is released and discharged by the department of health and family services.