SB1,688,99 4. The financial resources of the parents.
SB1,688,1210 5. The earning capacity of each parent, based on each parent's education,
11training, and work experience and based on the availability of work in or near the
12parent's community.
SB1,688,1313 6. The need and capacity of the child for education, including higher education.
SB1,688,1414 7. The age of the child.
SB1,688,1515 8. The financial resources and the earning ability of the child.
SB1,688,1716 9. The needs of any person, including dependent children other than the child,
17whom either parent is legally obligated to support.
SB1,688,2318 10. The best interests of the child, including, but not limited to, the impact on
19the child of expenditures by the family for improvement of any conditions in the home
20that would facilitate the reunification of the child with the child's family, if
21appropriate, and the importance of a placement that is the least restrictive of the
22rights of the child and the parents and the most appropriate for meeting the needs
23of the child and the family.
SB1,688,2424 11. Any other factors that the court in each case determines are relevant.
SB1,689,8
1(cm) 1. Except as provided in subd. 2., if a parent who is required to pay child
2support under par. (b) or (c) is receiving adoption assistance under s. 48.975 for the
3child for whom support is ordered, the amount of the child support payments
4determined under par. (b) or (c) may not exceed the amount of the adoption assistance
5maintenance payments under s. 48.975 (3) (a). If an agreement under s. 48.975 (4)
6is in effect that provides for a payment of $0 under s. 48.975 (3) (a), the payment of
7$0 shall be considered to be an adoption assistance maintenance payment for
8purposes of this subdivision.
SB1,689,139 2. Subdivision 1. does not apply if, after considering the factors under par. (c)
101. to 11., the court finds by the greater weight of the credible evidence that limiting
11the amount of the child support payments to the amount of the adoption assistance
12maintenance payments under s. 48.975 (3) (a) is unfair to the child or to either of the
13parents.
SB1,689,2014 (d) If the court finds under par. (c) that use of the percentage standard is unfair
15to the minor child or either of the parents, the court shall state in writing or on the
16record the amount of support that would be required by using the percentage
17standard, the amount by which the court's order deviates from that amount, its
18reasons for finding that use of the percentage standard is unfair to the child or the
19parent, its reasons for the amount of the modification, and the basis for the
20modification.
SB1,690,321 (e) 1. An order issued under s. 48.355 (2) (b) 4., 48.357 (5m) (a), or 48.363 (2)
22for support determined under this subsection constitutes an assignment of all
23commissions, earnings, salaries, wages, pension benefits, benefits under ch. 102 or
24108, and other money due or to be due in the future to the county department under
25s. 46.22 or 46.23 in the county where the order was entered or to the department,

1depending upon the placement of the child as specified by rules promulgated under
2subd. 5. The assignment shall be for an amount sufficient to ensure payment under
3the order.
SB1,690,74 2. Except as provided in subd. 3., for each payment made under the assignment,
5the person from whom the payer under the order receives money shall receive an
6amount equal to the person's necessary disbursements, not to exceed $3, which shall
7be deducted from the money to be paid to the payer.
SB1,690,128 3. Benefits under ch. 108 may be assigned and withheld only in the manner
9provided in s. 108.13 (4). Any order to withhold benefits under ch. 108 shall be for
10an amount certain. When money is to be withheld from these benefits, no fee may
11be deducted from the amount withheld and no fine may be levied for failure to
12withhold the money.
SB1,690,2113 4. No employer may use an assignment under this paragraph as a basis for the
14denial of employment to a person, the discharge of an employee, or any disciplinary
15action against an employee. An employer who denies employment or discharges or
16disciplines an employee in violation of this subdivision may be fined not more than
17$500 and may be required to make full restitution to the aggrieved person, including
18reinstatement and back pay. Except as provided in this subdivision, restitution shall
19be in accordance with s. 973.20. An aggrieved person may apply to the district
20attorney or to the department of workforce development for enforcement of this
21subdivision.
SB1,690,2322 5. The department shall promulgate rules for the operation and
23implementation of assignments under this paragraph.
SB1,691,424 (f) If the amount of the child support determined under this subsection is
25greater than the cost for the care and maintenance of the minor child in the

1residential, nonmedical facility, the assignee under par. (e) 1. shall expend or
2otherwise dispose of any funds that are collected in excess of the cost of such care and
3maintenance in a manner that the assignee determines will serve the best interests
4of the minor child.
SB1,691,13 5(16) The department shall delegate to county departments under ss. 46.22 and
646.23 or the local providers of care and services meeting the standards established
7by the department under s. 49.34 the responsibilities vested in the department under
8this section for collection of fees for services other than those provided at state
9facilities, if the county departments or providers meet the conditions that the
10department determines are appropriate. The department may delegate to county
11departments under ss. 46.22 and 46.23 the responsibilities vested in the department
12under this section for collection of fees for services provided at the state facilities if
13the necessary conditions are met.
SB1, s. 1508 14Section 1508. 49.35 (1) (a) of the statutes is amended to read:
SB1,691,2015 49.35 (1) (a) The department shall supervise the administration of programs
16under this subchapter and ch. 48. The department shall submit to the federal
17authorities state plans for the administration of programs under this subchapter and
18ch. 48
in such form and containing such information as the federal authorities
19require, and shall comply with all requirements prescribed to ensure their
20correctness.
SB1, s. 1509 21Section 1509. 49.35 (1) (b) of the statutes is amended to read:
SB1,692,422 49.35 (1) (b) All records of the department and all county records relating to
23programs under this subchapter and ch. 48 and aid under s. 49.18, 1971 stats., s.
2449.20, 1971 stats., and s. 49.61, 1971 stats., as affected by chapter 90, laws of 1973,
25shall be open to inspection at all reasonable hours by authorized representatives of

1the federal government. Notwithstanding ss. 48.396 (2) and 938.396 (2), all county
2records relating to the administration of the services and public assistance specified
3in this paragraph shall be open to inspection at all reasonable hours by authorized
4representatives of the department.
SB1, s. 1510 5Section 1510. 49.35 (2) of the statutes is amended to read:
SB1,692,86 49.35 (2) The county administration of all laws relating to programs under this
7subchapter and ch. 48 shall be vested in the officers and agencies designated in the
8statutes.
SB1, s. 1511 9Section 1511. 49.36 (2) of the statutes is amended to read:
SB1,692,1810 49.36 (2) The department may contract with any county, tribal governing body,
11or Wisconsin Works agency to administer a work experience and job training
12program for parents who are not custodial parents and who fail to pay child support
13or to meet their children's needs for support as a result of unemployment or
14underemployment. The program may provide the kinds of work experience and job
15training services available from the program under s. 49.193, 1997 stats., or s. 49.147
16(3), (3m), or (4). The program may also include job search and job orientation
17activities. The department shall fund the program from the appropriations under
18s. 20.445 (3) (dz) and (k).
SB1, s. 1512 19Section 1512 . 49.36 (2) of the statutes, as affected by 2007 Wisconsin Act ....
20(this act), is amended to read:
SB1,693,421 49.36 (2) The department may contract with any county, tribal governing body,
22or Wisconsin Works agency to administer a work experience and job training
23program for parents who are not custodial parents and who fail to pay child support
24or to meet their children's needs for support as a result of unemployment or
25underemployment. The program may provide the kinds of work experience and job

1training services available from the program under s. 49.193, 1997 stats., or s. 49.147
2(3), (3m), or (4). The program may also include job search and job orientation
3activities. The department shall fund the program from the appropriations under
4s. 20.445 (3) 20.437 (2) (dz) and (k).
SB1, s. 1513 5Section 1513. 49.45 (2) (a) 1. of the statutes is amended to read:
SB1,693,86 49.45 (2) (a) 1. Exercise responsibility relating to fiscal matters, the eligibility
7for benefits under standards set forth in ss. 49.46 to 49.47 49.471, and general
8supervision of the medical assistance program.
SB1, s. 1514 9Section 1514. 49.45 (2) (a) 3. of the statutes is amended to read:
SB1,693,1410 49.45 (2) (a) 3. Determine the eligibility of persons for medical assistance,
11rehabilitative, and social services under ss. 49.46, 49.468, and 49.47, and 49.471 and
12rules and policies adopted by the department and may, under a contract under s.
1349.78 (2), delegate all, or any portion, of this function to the county department under
14s. 46.215, 46.22, or 46.23 or a tribal governing body.
SB1, s. 1515 15Section 1515. 49.45 (2) (a) 17. of the statutes is amended to read:
SB1,693,2016 49.45 (2) (a) 17. Notify the governor, the joint committee on legislative
17organization, the joint committee on finance and appropriate standing committees,
18as determined by the presiding officer of each house, if the appropriation accounts
19under s. 20.435 (4) (b) and (gp) (xd) are insufficient to provide the state share of
20medical assistance.
SB1, s. 1516 21Section 1516. 49.45 (2) (b) 3. of the statutes is amended to read:
SB1,693,2322 49.45 (2) (b) 3. Audit all claims filed by any contractor making the payment of
23benefits paid under ss. 49.46 to 49.47 49.471 and make proper fiscal adjustments.
SB1, s. 1517 24Section 1517. 49.45 (2) (b) 7. (intro.) of the statutes is amended to read:
SB1,694,13
149.45 (2) (b) 7. (intro.) Require, as a condition of certification under par. (a) 11.,
2all providers of a specific service that is among those enumerated under s. 49.46 (2)
3or, 49.47 (6) (a), or 49.471 (11), as specified in this subdivision, to file with the
4department a surety bond issued by a surety company licensed to do business in this
5state. Providers subject to this subdivision provide those services specified under s.
649.46 (2) or, 49.47 (6) (a), or 49.471 (11) for which providers have demonstrated
7significant potential to violate s. 49.49 (1) (a), (2) (a) or (b), (3), (3m) (a), (3p), (4) (a),
8or (4m) (a), to require recovery under par. (a) 10., or to need additional sanctions
9under par. (a) 13. The surety bond shall be payable to the department in an amount
10that the department determines is reasonable in view of amounts of former
11recoveries against providers of the specific service and the department's costs to
12pursue those recoveries. The department shall promulgate rules to implement this
13subdivision that specify all of the following:
SB1, s. 1518 14Section 1518. 49.45 (3) (ag) of the statutes is amended to read:
SB1,694,1715 49.45 (3) (ag) Reimbursement shall be made to each entity contracted with
16under s. 46.281 (1) (e) 46.283 (2) for functional screens screenings performed by the
17entity.
SB1, s. 1519 18Section 1519. 49.45 (3) (b) 1. of the statutes is amended to read:
SB1,694,2519 49.45 (3) (b) 1. The contractor, if any, administering benefits or providing
20prepaid health care under s. 49.46, 49.465, 49.468 or , 49.47, or 49.471 shall be
21entitled to payment from the department for benefits so paid or prepaid health care
22so provided or made available when a certification of eligibility is properly on file
23with the contractor in addition to the payment of administrative expense incurred
24pursuant to the contract and as provided in sub. (2) (a) 4., but the contractor shall
25not be reimbursed for benefits erroneously paid where no certification is on file.
SB1, s. 1520
1Section 1520. 49.45 (3) (b) 2. of the statutes is amended to read:
SB1,695,52 49.45 (3) (b) 2. The contractor, if any, insuring benefits under s. 49.46, 49.465,
349.468 or, 49.47, or 49.471 shall be entitled to receive a premium, in an amount and
4on terms agreed, for such benefits for the persons eligible to receive them and for its
5services as insurer.
SB1, s. 1521 6Section 1521. 49.45 (3) (dm) of the statutes is amended to read:
SB1,695,127 49.45 (3) (dm) After distribution of computer software has been made under
81993 Wisconsin Act 16, section 9126 (13h), no payment may be made for home health
9care services provided to persons who are enrolled in the federal medicare program
10and are recipients of medical assistance under s. 49.46 or , 49.47, or 49.471 unless the
11provider of the services has in use the computer software to maximize payments
12under the federal medicare program under 42 USC 1395.
SB1, s. 1522 13Section 1522. 49.45 (3) (f) 2. of the statutes is amended to read:
SB1,695,2114 49.45 (3) (f) 2. The department may deny any provider claim for reimbursement
15which cannot be verified under subd. 1. or may recover the value of any payment
16made to a provider which cannot be so verified. The measure of recovery will be the
17full value of any claim if it is determined upon audit that actual provision of the
18service cannot be verified from the provider's records or that the service provided was
19not included in s. 49.46 (2) or 49.471 (11). In cases of mathematical inaccuracies in
20computations or statements of claims, the measure of recovery will be limited to the
21amount of the error.
SB1, s. 1523 22Section 1523. 49.45 (3) (L) 2. of the statutes is amended to read:
SB1,696,323 49.45 (3) (L) 2. The department may not pay a provider for a designated health
24service that is authorized under this section or s. 49.46 or, 49.47, or 49.471, that is
25provided as the result of a referral made to the provider by a physician and that,

1under 42 USC 1396b (s), if made on behalf of a beneficiary of medicare under the
2requirements of 42 USC 1395nn, as amended to August 10, 1993, would result in the
3denial of payment for the service under 42 USC 1395nn.
SB1, s. 1524 4Section 1524. 49.45 (3) (m) of the statutes is amended to read:
SB1,696,215 49.45 (3) (m) To be certified under sub. (2) (a) 11. to provide transportation by
6specialized medical vehicle, a person must have at least one human service vehicle,
7as defined in s. 340.01 (23g), that satisfies the requirements imposed under s. 110.05
8for a vehicle that is used to transport a person in a wheelchair. If a certified provider
9uses 2 or more vehicles to provide transportation by specialized medical vehicle, at
10least 2 of the vehicles must be human service vehicles that satisfy the requirements
11imposed under s. 110.05 for a vehicle that is used to transport a person in a
12wheelchair, and any 3rd or additional vehicle must be a human service vehicle to
13which the equipment required under s. 110.05 for transporting a person in a
14wheelchair may be added. The department shall pay for transportation by
15specialized medical vehicle under s. 49.46 (2) (b) 3. or 49.471 (11) (m) that is provided
16in a human service vehicle that is not equipped to transport a person in a wheelchair
17if the person being transported does not use a wheelchair. The reimbursement rate
18for transportation by specialized medical vehicle provided in a vehicle that is not
19equipped to accommodate a wheelchair shall be the same as for transportation by
20specialized medical vehicle provided in a vehicle that is equipped to accommodate a
21wheelchair.
SB1, s. 1524y 22Section 1524y. 49.45 (5m) (title) of the statutes is amended to read:
SB1,696,2423 49.45 (5m) (title) Supplemental funding for rural and critical access
24hospitals.
SB1, s. 1525 25Section 1525. 49.45 (5m) (am) of the statutes is amended to read:
SB1,697,10
149.45 (5m) (am) Notwithstanding sub. (3) (e), from the appropriation accounts
2under s. 20.435 (4) (b), (gp), (o), and (w), and (xd), the department shall distribute not
3more than $2,256,000 in each fiscal year 2007-08 and not more than $5,256,000 in
4fiscal year 2008-09 and each fiscal year thereafter
, to provide supplemental funds
5to rural hospitals that, as determined by the department, have high utilization of
6inpatient services by patients whose care is provided from governmental sources,
7and to provide supplemental funds to critical access hospitals, except that the
8department may not distribute funds to a rural hospital or to a critical access hospital
9to the extent that the distribution would exceed any limitation under 42 USC 1396b
10(i) (3).
SB1, s. 1526 11Section 1526. 49.45 (6c) (d) 1. of the statutes is amended to read:
SB1,698,612 49.45 (6c) (d) 1. No payment may be made under sub. (6m) to a facility or to
13an institution for mental diseases for the care of an individual who is otherwise
14eligible for medical assistance under s. 49.46 or, 49.47, or 49.471, who has
15developmental disability or mental illness and for whom under par. (b) or (c) it is
16determined that he or she does not need facility care, unless it is determined that the
17individual requires active treatment for developmental disability or active
18treatment for mental illness and has continuously resided in a facility or institution
19for mental diseases for at least 30 months prior to the date of the determination. If
20that individual requires active treatment and has so continuously resided, he or she
21shall be offered the choice of receiving active treatment for developmental disability
22or active treatment for mental illness in the facility or institution for mental diseases
23or in an alternative setting. A facility resident who has developmental disability or
24mental illness, for whom under par. (c) it is determined that he or she does not need
25facility care and who has not continuously resided in a facility for at least 30 months

1prior to the date of the determination, may not continue to reside in the facility after
2December 31, 1993, and shall, if the department so determines, be relocated from the
3facility after March 31, 1990, and before December 31, 1993. The county department
4shall be responsible for securing alternative residence on behalf of an individual who
5is required to be relocated from a facility under this subdivision, and the facility shall
6cooperate with the county department in the relocation.
SB1, s. 1527 7Section 1527. 49.45 (6c) (d) 2. of the statutes is amended to read:
SB1,698,148 49.45 (6c) (d) 2. Payment may be made under sub. (6m) to a facility or
9institution for mental diseases for the care of an individual who is otherwise eligible
10for medical assistance under s. 49.46 or, 49.47, or 49.471 and who has developmental
11disability or mental illness and is determined under par. (b) or (c) to need facility care,
12regardless of whether it is determined under par. (b) or (c) that the individual does
13or does not require active treatment for developmental disability or active treatment
14for mental illness.
SB1, s. 1528 15Section 1528. 49.45 (6m) (ag) (intro.) of the statutes is amended to read:
SB1,698,2216 49.45 (6m) (ag) (intro.) Payment for care provided in a facility under this
17subsection made under s. 20.435 (4) (b), (gp), (o), (pa), or (w), or (xd) shall, except as
18provided in pars. (bg), (bm), and (br), be determined according to a prospective
19payment system updated annually by the department. The payment system shall
20implement standards that are necessary and proper for providing patient care and
21that meet quality and safety standards established under subch. II of ch. 50 and ch.
22150. The payment system shall reflect all of the following:
SB1, s. 1530h 23Section 1530h. 49.45 (6m) (ar) 1. a. of the statutes is amended to read:
SB1,699,1224 49.45 (6m) (ar) 1. a. The department shall establish standards for payment of
25allowable direct care costs under par. (am) 1. bm., for facilities that do not primarily

1serve the developmentally disabled, that take into account direct care costs for a
2sample of all of those facilities in this state and separate standards for payment of
3allowable direct care costs, for facilities that primarily serve the developmentally
4disabled, that take into account direct care costs for a sample of all of those facilities
5in this state. The standards shall be adjusted by the department for regional labor
6cost variations. The department shall treat as a single labor region the counties of
7Dane, Iowa, Columbia, and Sauk, and Rock and shall adjust payment so that the
8direct care cost targets of facilities in Dane, Iowa, Columbia, and Sauk counties are
9not reduced as a result of including facilities in Rock County in this labor region
. For
10facilities in Douglas, Pierce, and St. Croix counties, the department shall perform the
11adjustment by use of the wage index that is used by the federal department of health
12and human services for hospital reimbursement under 42 USC 1395 to 1395ggg.
SB1, s. 1532 13Section 1532 . 49.45 (6m) (br) 1. of the statutes is amended to read:
SB1,699,2314 49.45 (6m) (br) 1. Notwithstanding s. 20.410 (3) (cd), 20.435 (4) (bt) or (7) (b)
15or 20.445 (3) 20.437 (2) (dz), the department shall reduce allocations of funds to
16counties in the amount of the disallowance from the appropriation account under s.
1720.435 (4) (bt) or (7) (b), or the department shall direct the department of workforce
18development
children and families to reduce allocations of funds to counties or
19Wisconsin works Works agencies in the amount of the disallowance from the
20appropriation account under s. 20.445 (3) 20.437 (2) (dz) or direct the department of
21corrections to reduce allocations of funds to counties in the amount of the
22disallowance from the appropriation account under s. 20.410 (3) (cd), in accordance
23with s. 16.544 to the extent applicable.
SB1, s. 1533 24Section 1533. 49.45 (6m) (m) of the statutes is created to read:
SB1,700,4
149.45 (6m) (m) To hold a bed in a facility, the department may pay the full
2payment rate under this subsection for up to 30 days for services provided to a person
3during the pendency of an undue hardship determination, as provided in s. 49.453
4(8) (b) 3.
SB1, s. 1534 5Section 1534. 49.45 (6v) (b) of the statutes is amended to read:
SB1,700,116 49.45 (6v) (b) The department shall, each year, submit to the joint committee
7on finance a report for the previous fiscal year, except for the 1997-98 fiscal year, that
8provides information on the utilization of beds by recipients of medical assistance in
9facilities and a discussion and detailed projection of the likely balances,
10expenditures, encumbrances and carry over of currently appropriated amounts in
11the appropriation accounts under s. 20.435 (4) (b), (gp), and (o), and (xd).
SB1, s. 1535 12Section 1535. 49.45 (6x) (a) of the statutes is amended to read:
SB1,700,1813 49.45 (6x) (a) Notwithstanding sub. (3) (e), from the appropriation accounts
14under s. 20.435 (4) (b), (gp), (o), and (w), and (xd), the department shall distribute not
15more than $4,748,000 in each fiscal year, to provide funds to an essential access city
16hospital, except that the department may not allocate funds to an essential access
17city hospital to the extent that the allocation would exceed any limitation under 42
18USC 1396b
(i) (3).
SB1, s. 1536 19Section 1536. 49.45 (6y) (a) of the statutes is amended to read:
SB1,701,420 49.45 (6y) (a) Notwithstanding sub. (3) (e), from the appropriation accounts
21under s. 20.435 (4) (b), (gp), (o), and (w), and (xd), the department shall may
22distribute funding in each fiscal year to provide supplemental payment to hospitals
23that enter into a contract under s. 49.02 (2) to provide health care services funded
24by a relief block grant, as determined by the department, for hospital services that
25are not in excess of the hospitals' customary charges for the services, as limited under

142 USC 1396b (i) (3). If no relief block grant is awarded under this chapter or if the
2allocation of funds to such hospitals would exceed any limitation under 42 USC
31396b
(i) (3), the department may distribute funds to hospitals that have not entered
4into a contract under s. 49.02 (2).
SB1, s. 1537 5Section 1537. 49.45 (6y) (am) of the statutes is amended to read:
SB1,701,126 49.45 (6y) (am) Notwithstanding sub. (3) (e), from the appropriation accounts
7under s. 20.435 (4) (b), (h), (gp), (o), and (w), and (xd), the department shall distribute
8funding in each fiscal year to provide supplemental payments to hospitals that enter
9into contracts under s. 49.02 (2) with a county having a population of 500,000 or more
10to provide health care services funded by a relief block grant, as determined by the
11department, for hospital services that are not in excess of the hospitals' customary
12charges for the services, as limited under 42 USC 1396b (i) (3).
SB1, s. 1538 13Section 1538 . 49.45 (6z) (a) (intro.) of the statutes is amended to read:
SB1,702,214 49.45 (6z) (a) (intro.) Notwithstanding sub. (3) (e), from the appropriation
15accounts under s. 20.435 (4) (b), (gp), (o), and (w), and (xd), the department shall may
16distribute funding in each fiscal year to supplement payment for services to hospitals
17that enter into a contract under s. 49.02 (2) to provide health care services funded
18by a relief block grant under this chapter
indigent care agreements, in accordance
19with the approved state plan for services under 42 USC 1396a, with relief agencies
20that administer the medical relief block grant under this chapter
, if the department
21determines that the hospitals serve a disproportionate number of low-income
22patients with special needs. If no medical relief block grant under this chapter is
23awarded or if the allocation of funds to such hospitals would exceed any limitation
24under 42 USC 1396b (i) (3), the department may distribute funds to hospitals that
25have not entered into a contract under s. 49.02 (2) indigent care agreements. The

1department may not distribute funds under this subsection to the extent that the
2distribution would do any of the following:
SB1, s. 1539 3Section 1539. 49.45 (8) (a) 4. of the statutes is amended to read:
SB1,702,124 49.45 (8) (a) 4. "Patient care visit" means a personal contact with a patient in
5a patient's home that is made by a registered nurse, licensed practical nurse, home
6health aide, physical therapist, occupational therapist, or speech-language
7pathologist who is on the staff of or under contract or arrangement with a home
8health agency, or by a registered nurse or licensed practical nurse practicing
9independently, to provide a service that is covered under s. 49.46 or, 49.47, or 49.471.
10"Patient care visit" does not include time spent by a nurse, therapist, or home health
11aide on case management, care coordination, travel, record keeping , or supervision
12that is related to the patient care visit.
SB1, s. 1540 13Section 1540. 49.45 (8) (b) of the statutes is amended to read:
SB1,702,1814 49.45 (8) (b) Reimbursement under s. 20.435 (4) (b), (gp), (o), and (w), and (xd)
15for home health services provided by a certified home health agency or independent
16nurse shall be made at the home health agency's or nurse's usual and customary fee
17per patient care visit, subject to a maximum allowable fee per patient care visit that
18is established under par. (c).
SB1, s. 1541 19Section 1541. 49.45 (9) of the statutes is amended to read:
SB1,703,1920 49.45 (9) Free choice. Any person eligible for medical assistance under ss. s.
2149.46, 49.468 and, 49.47, or 49.471 may use the physician, chiropractor, dentist,
22pharmacist, hospital, skilled nursing home, health maintenance organization,
23limited service health organization, preferred provider plan or other licensed,
24registered or certified provider of health care of his or her choice, except that free
25choice of a provider may be limited by the department if the department's alternate

1arrangements are economical and the recipient has reasonable access to health care
2of adequate quality. The department may also require a recipient to designate, in any
3or all categories of health care providers, a primary health care provider of his or her
4choice. After such a designation is made, the recipient may not receive services from
5other health care providers in the same category as the primary health care provider
6unless such service is rendered in an emergency or through written referral by the
7primary health care provider. Alternate designations by the recipient may be made
8in accordance with guidelines established by the department. Nothing in this
9subsection shall vitiate the legal responsibility of the physician, chiropractor,
10dentist, pharmacist, skilled nursing home, hospital, health maintenance
11organization, limited service health organization, preferred provider plan or other
12licensed, registered or certified provider of health care to patients. All contract and
13tort relationships with patients shall remain, notwithstanding a written referral
14under this section, as though dealings are direct between the physician, chiropractor,
15dentist, pharmacist, skilled nursing home, hospital, health maintenance
16organization, limited service health organization, preferred provider plan or other
17licensed, registered or certified provider of health care and the patient. No physician,
18chiropractor, pharmacist or dentist may be required to practice exclusively in the
19medical assistance program.
SB1, s. 1542 20Section 1542. 49.45 (18) (ac) of the statutes is amended to read:
SB1,704,721 49.45 (18) (ac) Except as provided in pars. (am) to (d), and subject to par. (ag),
22any person eligible for medical assistance under s. 49.46, 49.468, or 49.47, or for the
23benefits under s. 49.46 (2) (a) and (b) under s. 49.471
shall pay up to the maximum
24amounts allowable under 42 CFR 447.53 to 447.58 for purchases of services provided
25under s. 49.46 (2). The service provider shall collect the specified or allowable

1copayment, coinsurance, or deductible, unless the service provider determines that
2the cost of collecting the copayment, coinsurance, or deductible exceeds the amount
3to be collected. The department shall reduce payments to each provider by the
4amount of the specified or allowable copayment, coinsurance, or deductible. No
5provider may deny care or services because the recipient is unable to share costs, but
6an inability to share costs specified in this subsection does not relieve the recipient
7of liability for these costs.
SB1, s. 1543 8Section 1543. 49.45 (18) (am) of the statutes is amended to read:
SB1,704,119 49.45 (18) (am) No person is liable under this subsection for services provided
10through prepayment contracts. This paragraph does not apply to a person who is
11eligible for the benefits under s. 49.46 (2) (a) and (b) under s. 49.471.
SB1, s. 1546 12Section 1546. 49.45 (23) of the statutes is created to read:
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