SB40,694,324 2. Subdivision 1. does not apply if, after considering the factors under par. (c)
251. to 11., the court finds by the greater weight of the credible evidence that limiting

1the amount of the child support payments to the amount of the adoption assistance
2maintenance payments under s. 48.975 (3) (a) is unfair to the child or to either of the
3parents.
SB40,694,104 (d) If the court finds under par. (c) that use of the percentage standard is unfair
5to the minor child or either of the parents, the court shall state in writing or on the
6record the amount of support that would be required by using the percentage
7standard, the amount by which the court's order deviates from that amount, its
8reasons for finding that use of the percentage standard is unfair to the child or the
9parent, its reasons for the amount of the modification, and the basis for the
10modification.
SB40,694,1811 (e) 1. An order issued under s. 48.355 (2) (b) 4., 48.357 (5m) (a), or 48.363 (2)
12for support determined under this subsection constitutes an assignment of all
13commissions, earnings, salaries, wages, pension benefits, benefits under ch. 102 or
14108, and other money due or to be due in the future to the county department under
15s. 46.22 or 46.23 in the county where the order was entered or to the department,
16depending upon the placement of the child as specified by rules promulgated under
17subd. 5. The assignment shall be for an amount sufficient to ensure payment under
18the order.
SB40,694,2219 2. Except as provided in subd. 3., for each payment made under the assignment,
20the person from whom the payer under the order receives money shall receive an
21amount equal to the person's necessary disbursements, not to exceed $3, which shall
22be deducted from the money to be paid to the payer.
SB40,695,223 3. Benefits under ch. 108 may be assigned and withheld only in the manner
24provided in s. 108.13 (4). Any order to withhold benefits under ch. 108 shall be for
25an amount certain. When money is to be withheld from these benefits, no fee may

1be deducted from the amount withheld and no fine may be levied for failure to
2withhold the money.
SB40,695,113 4. No employer may use an assignment under this paragraph as a basis for the
4denial of employment to a person, the discharge of an employee, or any disciplinary
5action against an employee. An employer who denies employment or discharges or
6disciplines an employee in violation of this subdivision may be fined not more than
7$500 and may be required to make full restitution to the aggrieved person, including
8reinstatement and back pay. Except as provided in this subdivision, restitution shall
9be in accordance with s. 973.20. An aggrieved person may apply to the district
10attorney or to the department of workforce development for enforcement of this
11subdivision.
SB40,695,1312 5. The department shall promulgate rules for the operation and
13implementation of assignments under this paragraph.
SB40,695,1914 (f) If the amount of the child support determined under this subsection is
15greater than the cost for the care and maintenance of the minor child in the
16residential, nonmedical facility, the assignee under par. (e) 1. shall expend or
17otherwise dispose of any funds that are collected in excess of the cost of such care and
18maintenance in a manner that the assignee determines will serve the best interests
19of the minor child.
SB40,696,3 20(16) The department shall delegate to county departments under ss. 46.22 and
2146.23 or the local providers of care and services meeting the standards established
22by the department under s. 49.34 the responsibilities vested in the department under
23this section for collection of fees for services other than those provided at state
24facilities, if the county departments or providers meet the conditions that the
25department determines are appropriate. The department may delegate to county

1departments under ss. 46.22 and 46.23 the responsibilities vested in the department
2under this section for collection of fees for services provided at the state facilities if
3the necessary conditions are met.
SB40, s. 1508 4Section 1508. 49.35 (1) (a) of the statutes is amended to read:
SB40,696,105 49.35 (1) (a) The department shall supervise the administration of programs
6under this subchapter and ch. 48. The department shall submit to the federal
7authorities state plans for the administration of programs under this subchapter and
8ch. 48
in such form and containing such information as the federal authorities
9require, and shall comply with all requirements prescribed to ensure their
10correctness.
SB40, s. 1509 11Section 1509. 49.35 (1) (b) of the statutes is amended to read:
SB40,696,1912 49.35 (1) (b) All records of the department and all county records relating to
13programs under this subchapter and ch. 48 and aid under s. 49.18, 1971 stats., s.
1449.20, 1971 stats., and s. 49.61, 1971 stats., as affected by chapter 90, laws of 1973,
15shall be open to inspection at all reasonable hours by authorized representatives of
16the federal government. Notwithstanding ss. 48.396 (2) and 938.396 (2), all county
17records relating to the administration of the services and public assistance specified
18in this paragraph shall be open to inspection at all reasonable hours by authorized
19representatives of the department.
SB40, s. 1510 20Section 1510. 49.35 (2) of the statutes is amended to read:
SB40,696,2321 49.35 (2) The county administration of all laws relating to programs under this
22subchapter and ch. 48 shall be vested in the officers and agencies designated in the
23statutes.
SB40, s. 1511 24Section 1511. 49.36 (2) of the statutes is amended to read:
SB40,697,9
149.36 (2) The department may contract with any county, tribal governing body,
2or Wisconsin Works agency to administer a work experience and job training
3program for parents who are not custodial parents and who fail to pay child support
4or to meet their children's needs for support as a result of unemployment or
5underemployment. The program may provide the kinds of work experience and job
6training services available from the program under s. 49.193, 1997 stats., or s. 49.147
7(3), (3m), or (4). The program may also include job search and job orientation
8activities. The department shall fund the program from the appropriations under
9s. 20.445 (3) (dz) and (k).
SB40, s. 1512 10Section 1512 . 49.36 (2) of the statutes, as affected by 2007 Wisconsin Act ....
11(this act), is amended to read:
SB40,697,2012 49.36 (2) The department may contract with any county, tribal governing body,
13or Wisconsin Works agency to administer a work experience and job training
14program for parents who are not custodial parents and who fail to pay child support
15or to meet their children's needs for support as a result of unemployment or
16underemployment. The program may provide the kinds of work experience and job
17training services available from the program under s. 49.193, 1997 stats., or s. 49.147
18(3), (3m), or (4). The program may also include job search and job orientation
19activities. The department shall fund the program from the appropriations under
20s. 20.445 (3) 20.437 (2) (dz) and (k).
SB40, s. 1513 21Section 1513. 49.45 (2) (a) 1. of the statutes is amended to read:
SB40,697,2422 49.45 (2) (a) 1. Exercise responsibility relating to fiscal matters, the eligibility
23for benefits under standards set forth in ss. 49.46 to 49.47 49.471, and general
24supervision of the medical assistance program.
SB40, s. 1514 25Section 1514. 49.45 (2) (a) 3. of the statutes is amended to read:
SB40,698,5
149.45 (2) (a) 3. Determine the eligibility of persons for medical assistance,
2rehabilitative, and social services under ss. 49.46, 49.468, and 49.47, and 49.471 and
3rules and policies adopted by the department and may, under a contract under s.
449.78 (2), delegate all, or any portion, of this function to the county department under
5s. 46.215, 46.22, or 46.23 or a tribal governing body.
SB40, s. 1515 6Section 1515. 49.45 (2) (a) 17. of the statutes is amended to read:
SB40,698,117 49.45 (2) (a) 17. Notify the governor, the joint committee on legislative
8organization, the joint committee on finance and appropriate standing committees,
9as determined by the presiding officer of each house, if the appropriation accounts
10under s. 20.435 (4) (b) and (gp) (xd) are insufficient to provide the state share of
11medical assistance.
SB40, s. 1516 12Section 1516. 49.45 (2) (b) 3. of the statutes is amended to read:
SB40,698,1413 49.45 (2) (b) 3. Audit all claims filed by any contractor making the payment of
14benefits paid under ss. 49.46 to 49.47 49.471 and make proper fiscal adjustments.
SB40, s. 1517 15Section 1517. 49.45 (2) (b) 7. (intro.) of the statutes is amended to read:
SB40,699,316 49.45 (2) (b) 7. (intro.) Require, as a condition of certification under par. (a) 11.,
17all providers of a specific service that is among those enumerated under s. 49.46 (2)
18or, 49.47 (6) (a), or 49.471 (11), as specified in this subdivision, to file with the
19department a surety bond issued by a surety company licensed to do business in this
20state. Providers subject to this subdivision provide those services specified under s.
2149.46 (2) or, 49.47 (6) (a), or 49.471 (11) for which providers have demonstrated
22significant potential to violate s. 49.49 (1) (a), (2) (a) or (b), (3), (3m) (a), (3p), (4) (a),
23or (4m) (a), to require recovery under par. (a) 10., or to need additional sanctions
24under par. (a) 13. The surety bond shall be payable to the department in an amount
25that the department determines is reasonable in view of amounts of former

1recoveries against providers of the specific service and the department's costs to
2pursue those recoveries. The department shall promulgate rules to implement this
3subdivision that specify all of the following:
SB40, s. 1518 4Section 1518. 49.45 (3) (ag) of the statutes is amended to read:
SB40,699,75 49.45 (3) (ag) Reimbursement shall be made to each entity contracted with
6under s. 46.281 (1) (e) 46.283 (2) for functional screens screenings performed by the
7entity.
SB40, s. 1519 8Section 1519. 49.45 (3) (b) 1. of the statutes is amended to read:
SB40,699,159 49.45 (3) (b) 1. The contractor, if any, administering benefits or providing
10prepaid health care under s. 49.46, 49.465, 49.468 or , 49.47, or 49.471 shall be
11entitled to payment from the department for benefits so paid or prepaid health care
12so provided or made available when a certification of eligibility is properly on file
13with the contractor in addition to the payment of administrative expense incurred
14pursuant to the contract and as provided in sub. (2) (a) 4., but the contractor shall
15not be reimbursed for benefits erroneously paid where no certification is on file.
SB40, s. 1520 16Section 1520. 49.45 (3) (b) 2. of the statutes is amended to read:
SB40,699,2017 49.45 (3) (b) 2. The contractor, if any, insuring benefits under s. 49.46, 49.465,
1849.468 or, 49.47, or 49.471 shall be entitled to receive a premium, in an amount and
19on terms agreed, for such benefits for the persons eligible to receive them and for its
20services as insurer.
SB40, s. 1521 21Section 1521. 49.45 (3) (dm) of the statutes is amended to read:
SB40,700,222 49.45 (3) (dm) After distribution of computer software has been made under
231993 Wisconsin Act 16, section 9126 (13h), no payment may be made for home health
24care services provided to persons who are enrolled in the federal medicare program
25and are recipients of medical assistance under s. 49.46 or , 49.47, or 49.471 unless the

1provider of the services has in use the computer software to maximize payments
2under the federal medicare program under 42 USC 1395.
SB40, s. 1522 3Section 1522. 49.45 (3) (f) 2. of the statutes is amended to read:
SB40,700,114 49.45 (3) (f) 2. The department may deny any provider claim for reimbursement
5which cannot be verified under subd. 1. or may recover the value of any payment
6made to a provider which cannot be so verified. The measure of recovery will be the
7full value of any claim if it is determined upon audit that actual provision of the
8service cannot be verified from the provider's records or that the service provided was
9not included in s. 49.46 (2) or 49.471 (11). In cases of mathematical inaccuracies in
10computations or statements of claims, the measure of recovery will be limited to the
11amount of the error.
SB40, s. 1523 12Section 1523. 49.45 (3) (L) 2. of the statutes is amended to read:
SB40,700,1813 49.45 (3) (L) 2. The department may not pay a provider for a designated health
14service that is authorized under this section or s. 49.46 or, 49.47, or 49.471, that is
15provided as the result of a referral made to the provider by a physician and that,
16under 42 USC 1396b (s), if made on behalf of a beneficiary of medicare under the
17requirements of 42 USC 1395nn, as amended to August 10, 1993, would result in the
18denial of payment for the service under 42 USC 1395nn.
SB40, s. 1524 19Section 1524. 49.45 (3) (m) of the statutes is amended to read:
SB40,701,1120 49.45 (3) (m) To be certified under sub. (2) (a) 11. to provide transportation by
21specialized medical vehicle, a person must have at least one human service vehicle,
22as defined in s. 340.01 (23g), that satisfies the requirements imposed under s. 110.05
23for a vehicle that is used to transport a person in a wheelchair. If a certified provider
24uses 2 or more vehicles to provide transportation by specialized medical vehicle, at
25least 2 of the vehicles must be human service vehicles that satisfy the requirements

1imposed under s. 110.05 for a vehicle that is used to transport a person in a
2wheelchair, and any 3rd or additional vehicle must be a human service vehicle to
3which the equipment required under s. 110.05 for transporting a person in a
4wheelchair may be added. The department shall pay for transportation by
5specialized medical vehicle under s. 49.46 (2) (b) 3. or 49.471 (11) (m) that is provided
6in a human service vehicle that is not equipped to transport a person in a wheelchair
7if the person being transported does not use a wheelchair. The reimbursement rate
8for transportation by specialized medical vehicle provided in a vehicle that is not
9equipped to accommodate a wheelchair shall be the same as for transportation by
10specialized medical vehicle provided in a vehicle that is equipped to accommodate a
11wheelchair.
SB40, s. 1525 12Section 1525. 49.45 (5m) (am) of the statutes is amended to read:
SB40,701,2013 49.45 (5m) (am) 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 $2,256,000 in each fiscal year, to provide supplemental funds to rural
16hospitals that, as determined by the department, have high utilization of inpatient
17services by patients whose care is provided from governmental sources, and to
18provide supplemental funds to critical access hospitals, except that the department
19may not distribute funds to a rural hospital or to a critical access hospital to the
20extent that the distribution would exceed any limitation under 42 USC 1396b (i) (3).
SB40, s. 1526 21Section 1526. 49.45 (6c) (d) 1. of the statutes is amended to read:
SB40,702,1622 49.45 (6c) (d) 1. No payment may be made under sub. (6m) to a facility or to
23an institution for mental diseases for the care of an individual who is otherwise
24eligible for medical assistance under s. 49.46 or, 49.47, or 49.471, who has
25developmental disability or mental illness and for whom under par. (b) or (c) it is

1determined that he or she does not need facility care, unless it is determined that the
2individual requires active treatment for developmental disability or active
3treatment for mental illness and has continuously resided in a facility or institution
4for mental diseases for at least 30 months prior to the date of the determination. If
5that individual requires active treatment and has so continuously resided, he or she
6shall be offered the choice of receiving active treatment for developmental disability
7or active treatment for mental illness in the facility or institution for mental diseases
8or in an alternative setting. A facility resident who has developmental disability or
9mental illness, for whom under par. (c) it is determined that he or she does not need
10facility care and who has not continuously resided in a facility for at least 30 months
11prior to the date of the determination, may not continue to reside in the facility after
12December 31, 1993, and shall, if the department so determines, be relocated from the
13facility after March 31, 1990, and before December 31, 1993. The county department
14shall be responsible for securing alternative residence on behalf of an individual who
15is required to be relocated from a facility under this subdivision, and the facility shall
16cooperate with the county department in the relocation.
SB40, s. 1527 17Section 1527. 49.45 (6c) (d) 2. of the statutes is amended to read:
SB40,702,2418 49.45 (6c) (d) 2. Payment may be made under sub. (6m) to a facility or
19institution for mental diseases for the care of an individual who is otherwise eligible
20for medical assistance under s. 49.46 or, 49.47, or 49.471 and who has developmental
21disability or mental illness and is determined under par. (b) or (c) to need facility care,
22regardless of whether it is determined under par. (b) or (c) that the individual does
23or does not require active treatment for developmental disability or active treatment
24for mental illness.
SB40, s. 1528 25Section 1528. 49.45 (6m) (ag) (intro.) of the statutes is amended to read:
SB40,703,7
149.45 (6m) (ag) (intro.) Payment for care provided in a facility under this
2subsection made under s. 20.435 (4) (b), (gp), (o), (pa), or (w), or (xd) shall, except as
3provided in pars. (bg), (bm), and (br), be determined according to a prospective
4payment system updated annually by the department. The payment system shall
5implement standards that are necessary and proper for providing patient care and
6that meet quality and safety standards established under subch. II of ch. 50 and ch.
7150. The payment system shall reflect all of the following:
SB40, s. 1529 8Section 1529. 49.45 (6m) (ap) of the statutes is repealed.
SB40, s. 1530 9Section 1530. 49.45 (6m) (ar) 1. a. of the statutes is amended to read:
SB40,703,2110 49.45 (6m) (ar) 1. a. The department shall establish standards for payment of
11allowable direct care costs under par. (am) 1. bm., for facilities that do not primarily
12serve the developmentally disabled, that take into account direct care costs for a
13sample of all of those facilities in this state and separate standards for payment of
14allowable direct care costs, for facilities that primarily serve the developmentally
15disabled, that take into account direct care costs for a sample of all of those facilities
16in this state. The standards shall be adjusted by the department for regional labor
17cost variations. The department shall treat as a single labor region the counties of
18Dane, Iowa, Columbia, and Sauk, and Rock. For facilities in Douglas, Pierce, and St.
19Croix counties, the department shall perform the adjustment by use of the wage
20index that is used by the federal department of health and human services for
21hospital reimbursement under 42 USC 1395 to 1395ggg.
SB40, s. 1531 22Section 1531. 49.45 (6m) (br) 1. of the statutes is amended to read:
SB40,704,623 49.45 (6m) (br) 1. Notwithstanding s. 20.410 (3) (cd), (ko), or (r), 20.435 (4) (bt)
24or (7) (b), or 20.445 (3) (dz), the department shall reduce allocations of funds to
25counties in the amount of the disallowance from the appropriation account under s.

120.435 (4) (bt) or (7) (b), or the department shall direct the department of workforce
2development to reduce allocations of funds to counties or Wisconsin works agencies
3in the amount of the disallowance from the appropriation account under s. 20.445 (3)
4(dz) or direct the department of corrections to reduce allocations of funds to counties
5in the amount of the disallowance from the appropriation account under s. 20.410 (3)
6(cd), (ko), or (r) in accordance with s. 16.544 to the extent applicable.
SB40, s. 1532 7Section 1532 . 49.45 (6m) (br) 1. of the statutes, as affected by 2007 Wisconsin
8Act .... (this act), is amended to read:
SB40,704,189 49.45 (6m) (br) 1. Notwithstanding s. 20.410 (3) (cd), (ko), or (r), 20.435 (4) (bt)
10or (7) (b) or 20.445 (3) 20.437 (2) (dz), the department shall reduce allocations of funds
11to counties in the amount of the disallowance from the appropriation account under
12s. 20.435 (4) (bt) or (7) (b), or the department shall direct the department of workforce
13development
children and families to reduce allocations of funds to counties or
14Wisconsin works Works agencies in the amount of the disallowance from the
15appropriation account under s. 20.445 (3) 20.437 (2) (dz) or direct the department of
16corrections to reduce allocations of funds to counties in the amount of the
17disallowance from the appropriation account under s. 20.410 (3) (cd), (ko), or (r) in
18accordance with s. 16.544 to the extent applicable.
SB40, s. 1533 19Section 1533. 49.45 (6m) (m) of the statutes is created to read:
SB40,704,2320 49.45 (6m) (m) To hold a bed in a facility, the department may pay the full
21payment rate under this subsection for up to 30 days for services provided to a person
22during the pendency of an undue hardship determination, as provided in s. 49.453
23(8) (b) 3.
SB40, s. 1534 24Section 1534. 49.45 (6v) (b) of the statutes is amended to read:
SB40,705,6
149.45 (6v) (b) The department shall, each year, submit to the joint committee
2on finance a report for the previous fiscal year, except for the 1997-98 fiscal year, that
3provides information on the utilization of beds by recipients of medical assistance in
4facilities and a discussion and detailed projection of the likely balances,
5expenditures, encumbrances and carry over of currently appropriated amounts in
6the appropriation accounts under s. 20.435 (4) (b), (gp), and (o), and (xd).
SB40, s. 1535 7Section 1535. 49.45 (6x) (a) of the statutes is amended to read:
SB40,705,138 49.45 (6x) (a) Notwithstanding sub. (3) (e), from the appropriation accounts
9under s. 20.435 (4) (b), (gp), (o), and (w), and (xd), the department shall distribute not
10more than $4,748,000 in each fiscal year, to provide funds to an essential access city
11hospital, except that the department may not allocate funds to an essential access
12city hospital to the extent that the allocation would exceed any limitation under 42
13USC 1396b
(i) (3).
SB40, s. 1536 14Section 1536. 49.45 (6y) (a) of the statutes is amended to read:
SB40,705,2415 49.45 (6y) (a) Notwithstanding sub. (3) (e), from the appropriation accounts
16under s. 20.435 (4) (b), (gp), (o), and (w), and (xd), the department shall may
17distribute funding in each fiscal year to provide supplemental payment to hospitals
18that enter into a contract under s. 49.02 (2) to provide health care services funded
19by a relief block grant, as determined by the department, for hospital services that
20are not in excess of the hospitals' customary charges for the services, as limited under
2142 USC 1396b (i) (3). If no relief block grant is awarded under this chapter or if the
22allocation of funds to such hospitals would exceed any limitation under 42 USC
231396b
(i) (3), the department may distribute funds to hospitals that have not entered
24into a contract under s. 49.02 (2).
SB40, s. 1537 25Section 1537. 49.45 (6y) (am) of the statutes is amended to read:
SB40,706,7
149.45 (6y) (am) Notwithstanding sub. (3) (e), from the appropriation accounts
2under s. 20.435 (4) (b), (h), (gp), (o), and (w), and (xd), the department shall distribute
3funding in each fiscal year to provide supplemental payments to hospitals that enter
4into contracts under s. 49.02 (2) with a county having a population of 500,000 or more
5to provide health care services funded by a relief block grant, as determined by the
6department, for hospital services that are not in excess of the hospitals' customary
7charges for the services, as limited under 42 USC 1396b (i) (3).
SB40, s. 1538 8Section 1538 . 49.45 (6z) (a) (intro.) of the statutes is amended to read:
SB40,706,229 49.45 (6z) (a) (intro.) Notwithstanding sub. (3) (e), from the appropriation
10accounts under s. 20.435 (4) (b), (gp), (o), and (w), and (xd), the department shall may
11distribute funding in each fiscal year to supplement payment for services to hospitals
12that enter into a contract under s. 49.02 (2) to provide health care services funded
13by a relief block grant under this chapter
indigent care agreements, in accordance
14with the approved state plan for services under 42 USC 1396a, with relief agencies
15that administer the medical relief block grant under this chapter
, if the department
16determines that the hospitals serve a disproportionate number of low-income
17patients with special needs. If no medical relief block grant under this chapter is
18awarded or if the allocation of funds to such hospitals would exceed any limitation
19under 42 USC 1396b (i) (3), the department may distribute funds to hospitals that
20have not entered into a contract under s. 49.02 (2) indigent care agreements. The
21department may not distribute funds under this subsection to the extent that the
22distribution would do any of the following:
SB40, s. 1539 23Section 1539. 49.45 (8) (a) 4. of the statutes is amended to read:
SB40,707,724 49.45 (8) (a) 4. "Patient care visit" means a personal contact with a patient in
25a patient's home that is made by a registered nurse, licensed practical nurse, home

1health aide, physical therapist, occupational therapist, or speech-language
2pathologist who is on the staff of or under contract or arrangement with a home
3health agency, or by a registered nurse or licensed practical nurse practicing
4independently, to provide a service that is covered under s. 49.46 or, 49.47, or 49.471.
5"Patient care visit" does not include time spent by a nurse, therapist, or home health
6aide on case management, care coordination, travel, record keeping , or supervision
7that is related to the patient care visit.
SB40, s. 1540 8Section 1540. 49.45 (8) (b) of the statutes is amended to read:
SB40,707,139 49.45 (8) (b) Reimbursement under s. 20.435 (4) (b), (gp), (o), and (w), and (xd)
10for home health services provided by a certified home health agency or independent
11nurse shall be made at the home health agency's or nurse's usual and customary fee
12per patient care visit, subject to a maximum allowable fee per patient care visit that
13is established under par. (c).
SB40, s. 1541 14Section 1541. 49.45 (9) of the statutes is amended to read:
SB40,708,1415 49.45 (9) Free choice. Any person eligible for medical assistance under ss. s.
1649.46, 49.468 and, 49.47, or 49.471 may use the physician, chiropractor, dentist,
17pharmacist, hospital, skilled nursing home, health maintenance organization,
18limited service health organization, preferred provider plan or other licensed,
19registered or certified provider of health care of his or her choice, except that free
20choice of a provider may be limited by the department if the department's alternate
21arrangements are economical and the recipient has reasonable access to health care
22of adequate quality. The department may also require a recipient to designate, in any
23or all categories of health care providers, a primary health care provider of his or her
24choice. After such a designation is made, the recipient may not receive services from
25other health care providers in the same category as the primary health care provider

1unless such service is rendered in an emergency or through written referral by the
2primary health care provider. Alternate designations by the recipient may be made
3in accordance with guidelines established by the department. Nothing in this
4subsection shall vitiate the legal responsibility of the physician, chiropractor,
5dentist, pharmacist, skilled nursing home, hospital, health maintenance
6organization, limited service health organization, preferred provider plan or other
7licensed, registered or certified provider of health care to patients. All contract and
8tort relationships with patients shall remain, notwithstanding a written referral
9under this section, as though dealings are direct between 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 and the patient. No physician,
13chiropractor, pharmacist or dentist may be required to practice exclusively in the
14medical assistance program.
SB40, s. 1542 15Section 1542. 49.45 (18) (ac) of the statutes is amended to read:
SB40,709,216 49.45 (18) (ac) Except as provided in pars. (am) to (d), and subject to par. (ag),
17any person eligible for medical assistance under s. 49.46, 49.468, or 49.47, or for the
18benefits under s. 49.46 (2) (a) and (b) under s. 49.471
shall pay up to the maximum
19amounts allowable under 42 CFR 447.53 to 447.58 for purchases of services provided
20under s. 49.46 (2). The service provider shall collect the specified or allowable
21copayment, coinsurance, or deductible, unless the service provider determines that
22the cost of collecting the copayment, coinsurance, or deductible exceeds the amount
23to be collected. The department shall reduce payments to each provider by the
24amount of the specified or allowable copayment, coinsurance, or deductible. No
25provider may deny care or services because the recipient is unable to share costs, but

1an inability to share costs specified in this subsection does not relieve the recipient
2of liability for these costs.
SB40, s. 1543 3Section 1543. 49.45 (18) (am) of the statutes is amended to read:
SB40,709,64 49.45 (18) (am) No person is liable under this subsection for services provided
5through prepayment contracts. This paragraph does not apply to a person who is
6eligible for the benefits under s. 49.46 (2) (a) and (b) under s. 49.471.
SB40, s. 1544 7Section 1544. 49.45 (18m) of the statutes is created to read:
SB40,709,128 49.45 (18m) Medicare Part B enrollment and premium payment. (a) The
9department may require an individual who is eligible for Medicare Part B under 42
10USC 1395j
to 1395L and who also is eligible for any of the following medical
11assistance services under any of the following to enroll in Medicare Part B as a
12condition of receiving those medical assistance services:
SB40,709,1313 1. Medical assistance services under s. 49.46, 49.47, or 49.472.
SB40,709,1514 2. Health care coverage under the Badger Care health care program under s.
1549.665.
SB40,709,1616 3. Services under s. 46.27 (11), 46.275, 46.277, 46.278, or 46.2785.
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