AB40,665,52 49.465 (2) (a) If the woman applies for benefits under s. 49.46 or 49.47 within
3the time required under sub. (4), the day on which the department or the county
4department under s. 46.215, 46.22 or 46.23
determines whether the woman is
5eligible for benefits under s. 49.46 or 49.47.
AB40, s. 1455 6Section 1455. 49.468 (1) (b) of the statutes is amended to read:
AB40,665,237 49.468 (1) (b) For an elderly or disabled individual who is entitled to coverage
8under part Part A of medicare Medicare, entitled to coverage under part Part B of
9medicare Medicare, and who does not meet the eligibility criteria for medical
10assistance
Medical Assistance under s. 49.46 (1), 49.465, 49.47 (4), or 49.471 but
11meets the limitations on income and resources under par. (d), medical assistance
12Medical Assistance shall pay the deductible and coinsurance portions of medicare
13Medicare services under 42 USC 1395 to 1395zz which that are not paid under 42
14USC 1395
to 1395zz, including those medicare Medicare services that are not
15included in the approved state plan for services under 42 USC 1396; the monthly
16premiums payable under 42 USC 1395v; the monthly premiums, if applicable, under
1742 USC 1395i-2 (d); and the late enrollment penalty, if applicable, for premiums
18under part Part A of medicare Medicare. Payment of coinsurance for a service under
19part Part B of medicare Medicare under 42 USC 1395j to 1395w, other than payment
20of coinsurance for outpatient hospital services, and payment of coinsurance for a
21service under Part A of Medicare
may not exceed the allowable charge for the service
22under medical assistance Medical Assistance minus the medicare Medicare
23payment.
AB40, s. 1456 24Section 1456. 49.468 (1) (c) of the statutes is amended to read:
AB40,666,13
149.468 (1) (c) For an elderly or disabled individual who is only entitled to
2coverage under part Part A of medicare Medicare and who does not meet the
3eligibility criteria for medical assistance Medical Assistance under s. 49.46 (1),
449.465, 49.47 (4), or 49.471 but meets the limitations on income and resources under
5par. (d), medical assistance Medical Assistance shall pay the deductible and
6coinsurance portions of medicare Medicare services under 42 USC 1395 to 1395i
7which that are not paid under 42 USC 1395 to 1395i, including those medicare
8Medicare services that are not included in the approved state plan for services under
942 USC 1396; the monthly premiums, if applicable, under 42 USC 1395i-2 (d); and
10the late enrollment penalty for premiums under part Part A of medicare Medicare,
11if applicable. Payment of coinsurance for a service under Part A of Medicare may not
12exceed the allowable charge for the service under Medical Assistance minus the
13Medicare payment.
AB40, s. 1457 14Section 1457. 49.47 (3) (b) of the statutes is amended to read:
AB40,666,1715 49.47 (3) (b) The agency department shall promptly review the application and
16shall issue a certificate to the individual showing eligibility when eligibility has been
17established.
AB40, s. 1458 18Section 1458. 49.47 (4) (c) 1. of the statutes is amended to read:
AB40,667,419 49.47 (4) (c) 1. Except as provided in par. (am) and as limited by subd. 3.,
20eligibility exists if income does not exceed 133 1/3% of the maximum aid to families
21with dependent children payment under s. 49.19 (11) for the applicant's family size
22or the combined benefit amount available under supplemental security income
23under 42 USC 1381 to 1383c and state supplemental aid under s. 49.77 49.39,
24whichever is higher. In this subdivision "income" includes earned or unearned
25income that would be included in determining eligibility for the individual or family

1under s. 49.19 or 49.77 49.39, or for the aged, blind or disabled under 42 USC 1381
2to 1385. "Income" does not include earned or unearned income which would be
3excluded in determining eligibility for the individual or family under s. 49.19 or 49.77
449.39, or for the aged, blind or disabled individual under 42 USC 1381 to 1385.
AB40, s. 1459 5Section 1459. 49.47 (4) (i) 1. of the statutes is amended to read:
AB40,667,196 49.47 (4) (i) 1. The department shall request a waiver from the secretary of the
7federal department of health and human services to permit the application of subd.
82. The waiver shall request approval to implement the waiver on a statewide basis,
9unless the department of health services determines that statewide implementation
10of the waiver would present an obstacle to the approval of the waiver by the secretary
11of the federal department of health and human services, in which case the waiver
12shall request approval to implement the waiver in 48 pilot counties to be selected by
13the department of health services. Within 30 days after August 12, 1993, the
14department of regulation and licensing safety and professional services shall notify
15funeral directors licensed under ch. 445, cemetery associations, as defined in s.
16157.061 (1r), and cemetery authorities, as defined in s. 157.061 (2), of the terms of
17the waiver required to be requested under this subdivision. If the waiver is approved
18by the secretary of the federal department of health and human services and if the
19waiver remains in effect, subd. 2. shall apply.
AB40, s. 1460 20Section 1460. 49.471 (5) (b) 3. a. of the statutes is amended to read:
AB40,667,2521 49.471 (5) (b) 3. a. If the woman or child applies for benefits under sub. (4)
22within the time required under par. (d), the benefits specified in subd. 1. or 2.,
23whichever is applicable, end on the day on which the department or the county
24department under s. 46.215, 46.22, or 46.23
determines whether the woman or child
25is eligible for benefits under sub. (4).
AB40, s. 1461
1Section 1461. 49.471 (7) (c) 4. of the statutes is amended to read:
AB40,668,32 49.471 (7) (c) 4. Not include in the calculation any income of an individual
3receiving benefits under s. 49.77 49.39 or federal Title XVI.
AB40, s. 1462 4Section 1462. 49.472 (4) (a) 2. a. of the statutes is amended to read:
AB40,668,85 49.472 (4) (a) 2. a. A maintenance allowance established by the department by
6rule. The maintenance allowance may not be less than the sum of $20, the federal
7supplemental security income payment level determined under 42 USC 1382 (b) and
8the state supplemental payment determined under s. 49.77 (2m) 49.39 (2m).
AB40, s. 1463 9Section 1463. 49.472 (6) (a) of the statutes is amended to read:
AB40,668,1510 49.472 (6) (a) Notwithstanding sub. (4) (a) 3., from the appropriation account
11accounts under s. 20.435 (4) (b), (gm), or (w), the department shall, on the part of an
12individual who is eligible for medical assistance under sub. (3), pay premiums for or
13purchase individual coverage offered by the individual's employer if the department
14determines that paying the premiums for or purchasing the coverage will not be more
15costly than providing medical assistance.
AB40, s. 1464 16Section 1464. 49.472 (6) (b) of the statutes is amended to read:
AB40,668,2017 49.472 (6) (b) If federal financial participation is available, from the
18appropriation account accounts under s. 20.435 (4) (b), (gm), or (w), the department
19may pay medicare Part A and Part B premiums for individuals who are eligible for
20medicare and for medical assistance under sub. (3).
AB40, s. 1465 21Section 1465. 49.473 (2) (intro.) of the statutes is amended to read:
AB40,668,2422 49.473 (2) (intro.) A woman is eligible for medical assistance as provided under
23sub. (5) if, after applying to the department or a county department, the department
24or a county department determines that she meets all of the following requirements:
AB40, s. 1466 25Section 1466. 49.473 (3) (intro.) of the statutes is amended to read:
AB40,669,5
149.473 (3) (intro.) Prior to applying to the department or a county department
2for medical assistance, a woman is eligible for medical assistance as provided under
3sub. (5) beginning on the date on which a qualified entity determines, on the basis
4of preliminary information, that the woman meets the requirements specified in sub.
5(2) and ending on one of the following dates:
AB40, s. 1467 6Section 1467. 49.473 (3) (a) of the statutes is amended to read:
AB40,669,107 49.473 (3) (a) If the woman applies to the department or a county department
8for medical assistance within the time limit required under sub. (4), the day on which
9the department or county department determines whether the woman meets the
10requirements under sub. (2).
AB40, s. 1468 11Section 1468. 49.473 (3) (b) of the statutes is amended to read:
AB40,669,1512 49.473 (3) (b) If the woman does not apply to the department or county
13department
for medical assistance within the time limit required under sub. (4), the
14last day of the month following the month in which the qualified entity determines
15that the woman is eligible for medical assistance.
AB40, s. 1469 16Section 1469. 49.473 (4) of the statutes is amended to read:
AB40,669,2017 49.473 (4) A woman who a qualified entity determines under sub. (3) is eligible
18for medical assistance shall apply to the department or county department no later
19than the last day of the month following the month in which the qualified entity
20determines that the woman is eligible for medical assistance.
AB40, s. 1470 21Section 1470. 49.473 (5) of the statutes is amended to read:
AB40,670,222 49.473 (5) The department shall audit and pay, from the appropriation
23accounts under s. 20.435 (4) (b), (gm), and (o), allowable charges to a provider who
24is certified under s. 49.45 (2) (a) 11. for medical assistance on behalf of a woman who

1meets the requirements under sub. (2) for all benefits and services specified under
2s. 49.46 (2).
AB40, s. 1471 3Section 1471. 49.473 (6) (b) of the statutes is amended to read:
AB40,670,74 49.473 (6) (b) Inform the woman at the time of the determination that she is
5required to apply to the department or a county department for medical assistance
6no later than the last day of the month following the month in which the qualified
7entity determines that the woman is eligible for medical assistance.
AB40, s. 1472 8Section 1472. 49.496 (4) (a) of the statutes is renumbered 49.496 (4) and
9amended to read:
AB40,670,2410 49.496 (4) The department may require a county department under s. 46.215,
1146.22, or 46.23 or the governing body of a federally recognized American Indian tribe
12administering medical assistance to gather and provide the department with
13information needed to recover medical assistance under this section. Except as
14provided in par. (b), the
The department shall pay to a county department or tribal
15governing body an amount equal to 5% of the recovery collected by the department
16relating to a beneficiary for whom the county department or tribal governing body
17made the last determination of medical assistance eligibility. A county department
18or tribal governing body may use funds received under this paragraph subsection
19only to pay costs incurred under this paragraph subsection and, if any amount
20remains, to pay for improvements to functions required under s. 49.78 (2). The
21department may withhold payments under this paragraph subsection for failure to
22comply with the department's requirements under this paragraph subsection. The
23department shall treat payments made under this paragraph subsection as costs of
24administration of the Medical Assistance program.
AB40, s. 1473 25Section 1473. 49.496 (4) (b) of the statutes is repealed.
AB40, s. 1474
1Section 1474. 49.496 (5) of the statutes is amended to read:
AB40,671,72 49.496 (5) Use of funds. From the appropriation under s. 20.435 (4) (im), the
3department shall pay the amount of the payments under sub. (4) (a) that is not paid
4from federal funds, shall pay to the federal government the amount of the funds
5recovered under this section equal to the amount of federal funds used to pay the
6benefits recovered under this section, and shall spend the remainder of the funds
7recovered under this section for medical assistance benefits under this subchapter.
AB40, s. 1475 8Section 1475. 49.497 (1) (b) of the statutes is amended to read:
AB40,671,159 49.497 (1) (b) The department's right of recovery is against any Medical
10Assistance or Badger Care recipient to whom or on whose behalf the incorrect
11payment was made. The extent of recovery is limited to the amount of the benefits
12incorrectly granted. The county department under s. 46.215 or 46.22 or the
13governing body of a federally recognized American Indian tribe administering
14Medical Assistance or Badger Care shall may begin recovery actions on behalf of the
15department according to rules promulgated by the department.
AB40, s. 1476 16Section 1476. 49.497 (2) (a) of the statutes is renumbered 49.497 (2) and
17amended to read:
AB40,671,2118 49.497 (2) Except as provided in par. (b), a A county or governing body of a
19federally recognized American Indian tribe may retain 15% of benefits provided
20under this subchapter or s. 49.665 that are recovered under this section due to the
21efforts of an employee or officer of the county or tribe.
AB40, s. 1477 22Section 1477. 49.497 (2) (b) of the statutes is repealed.
AB40, s. 1478 23Section 1478. 49.68 (3) (b) of the statutes is amended to read:
AB40,672,1524 49.68 (3) (b) From the appropriation accounts under ss. 20.435 (4) (e) and (je),
25the state shall pay the cost of, at a rate determined by the department under par. (e),

1for
medical treatment that is required as a direct result of chronic renal disease of
2certified patients from the date of certification, including the cost of administering
3recombinant human erythropoietin to appropriate patients, whether the treatment
4is rendered in an approved facility in the state or in a dialysis or transplantation
5center which that is approved as such by a contiguous state, subject to the conditions
6specified under par. (d). Approved facilities may include a hospital in-center dialysis
7unit or a nonhospital dialysis center which that is closely affiliated with a home
8dialysis program supervised by an approved facility. Aid shall also be provided for
9all reasonable expenses incurred by a potential living-related donor, including
10evaluation, hospitalization, surgical costs, and postoperative follow-up to the extent
11that these costs are not reimbursable under the federal medicare program or other
12insurance. In addition, all expenses incurred in the procurement, transportation,
13and preservation of cadaveric donor kidneys shall be covered to the extent that these
14costs are not otherwise reimbursable. All donor-related costs are chargeable to the
15recipient and reimbursable under this subsection.
AB40, s. 1479 16Section 1479. 49.68 (3) (e) of the statutes is amended to read:
AB40,673,417 49.68 (3) (e) State aids Payment for services provided under this section shall
18be equal to at a rate determined by the department that does not exceed the allowable
19charges under the federal Medicare program. In no case shall state rates for
20individual service elements exceed the federally defined allowable costs. The rate
21of charges for services not covered by public and private insurance shall not exceed
22the reasonable charges as established by medicare Medicare fee determination
23procedures. A person that provides to a patient a service for which aid is provided
24under this section shall accept the amount paid under this section for the service as
25payment in full and may not bill the patient for any amount by which the charge for

1the service exceeds the amount paid for the service under this section. The state may
2not pay for the cost of travel, lodging, or meals for persons who must travel to receive
3inpatient and outpatient dialysis treatment for kidney disease. This paragraph shall
4not apply to donor related costs as defined in par. (b).
AB40, s. 1480 5Section 1480. 49.688 (2) (a) 6. of the statutes is created to read:
AB40,673,96 49.688 (2) (a) 6. The person applies for and, if eligible, enrolls in Medicare
7under Part D of Title XVIII of the federal Social Security Act, 42 USC 1395w-101 to
81395w-153, if the secretary of the federal department of health and human services
9approves the condition on eligibility under this subdivision.
AB40, s. 1481 10Section 1481. 49.688 (2) (b) of the statutes is amended to read:
AB40,673,1711 49.688 (2) (b) A person to whom par. (a) 1. to 3. and, 5., and 6. applies, but whose
12annual household income, as determined by the department, exceeds 240% of the
13federal poverty line for a family the size of the persons' eligible family, is eligible to
14purchase a prescription drug at the amounts specified in sub. (5) (a) 4. only during
15the remaining amount of any 12-month period in which the person has first paid the
16annual deductible specified in sub. (3) (b) 2. a. in purchasing prescription drugs at
17the retail price and has then paid the annual deductible specified in sub. (3) (b) 2. b.
AB40, s. 1482 18Section 1482. 49.77 of the statutes is renumbered 49.39, and 49.39 (6), as
19renumbered, is amended to read:
AB40,673,2220 49.39 (6) Authority to administer; rules. The department shall administer
21this section and s. 49.775 49.395, and may promulgate rules to guide the
22administration of eligibility determinations and benefits payments.
AB40, s. 1483 23Section 1483. 49.775 of the statutes is renumbered 49.395, and 49.395 (2) (a),
24(b), (bm) and (e) 1., as renumbered, are amended to read:
AB40,674,3
149.395 (2) (a) The custodial parent is a recipient of supplemental security
2income under 42 USC 1381 to 1383c or of state supplemental payments under s.
349.77 49.39, or both.
AB40,674,64 (b) If the dependent child has 2 custodial parents, each custodial parent
5receives supplemental security income under 42 USC 1381 to 1383c or state
6supplemental payments under s. 49.77 49.39, or both.
AB40,674,157 (bm) The custodial parent assigns to the state any right of the custodial parent
8or of the dependent child to support from any other person accruing during the time
9that any payment under this subsection is made to the custodial parent. No amount
10of support that begins to accrue after the individual ceases to receive payments under
11this section may be considered assigned to the state. Seventy-five percent of all
12money that is received by the department of children and families under an
13assignment to the state under this paragraph shall be paid to the custodial parent.
14The department of children and families shall pay the federal share of support
15assigned under this paragraph as required under federal law or waiver.
AB40,674,1816 (e) 1. The custodial parent is ineligible for aid under s. 49.19 solely because he
17or she receives supplemental security income under 42 USC 1381 to 1383c or state
18supplemental payments under s. 49.77 49.39.
AB40, s. 1484 19Section 1484. 49.776 of the statutes is renumbered 49.396 and amended to
20read:
AB40,675,4 2149.396 Payment of support arrears. If a custodial parent who formerly
22received payments under s. 49.775, 2009 stats., or s. 49.395 but who is no longer
23receiving payments under s. 49.775, 2009 stats., or s. 49.395 assigned to the state
24under s. 49.775 (2) (bm), 2009 stats., or s. 49.395 (2) (bm) his or her right or the right
25of the dependent child to support from any other person, the department shall pay

1to the custodial parent all money in support arrears that is collected by the
2department after the custodial parent's receipt of payments under s. 49.775, 2009
3stats., or s. 49.395
ceased and that accrued while the custodial parent was receiving
4those payments.
AB40, s. 1485 5Section 1485. 49.78 (1) (b) of the statutes is amended to read:
AB40,675,96 49.78 (1) (b) "Income maintenance program" means the Medical Assistance
7program under subch. IV of ch. 49, the Badger Care health care program under s.
849.665, the food stamp program under 7 USC 2011 to 2036, or the cemetery, funeral,
9and burial expenses program under s. 49.785.
AB40, s. 1486 10Section 1486. 49.78 (1) (bm) of the statutes is created to read:
AB40,675,1311 49.78 (1) (bm) "Income maintenance worker" means a person employed by or
12under a contract with the department or a tribal governing body whose duties
13include determining eligibility for income maintenance programs.
AB40, s. 1487 14Section 1487. 49.78 (1) (f) of the statutes is created to read:
AB40,675,1515 49.78 (1) (f) "Unit" means the income maintenance administration unit.
AB40, s. 1488 16Section 1488 . 49.78 (1m) (intro.) of the statutes, as created by 2011 Wisconsin
17Act .... (this act), is amended to read:
AB40,675,2118 49.78 (1m) (intro.) The department shall establish an income maintenance
19administration unit under s. 15.02 (3) (c) 3. to administer income maintenance
20programs in this state, except as provided in s. 49.825 (2). Administration of income
21maintenance programs includes the following:
AB40, s. 1489 22Section 1489. 49.78 (1m) of the statutes is created to read:
AB40,676,223 49.78 (1m) Establishment of unit. The department shall establish an income
24maintenance administration unit under s. 15.02 (3) (c) 3. to administer income

1maintenance programs in this state, except as provided in s. 49.825 (2).
2Administration of income maintenance programs includes the following:
AB40,676,33 (a) Receiving applications.
AB40,676,44 (b) Determining eligibility.
AB40,676,55 (c) Conducting fraud investigation and fraud prevention activities.
AB40,676,66 (d) Implementing error reduction procedures.
AB40,676,77 (e) Recovering overpayments of benefits.
AB40, s. 1490 8Section 1490. 49.78 (1p) of the statutes is created to read:
AB40,676,139 49.78 (1p) Income maintenance administration unit contracts. The
10department may contract with a public or private entity to provide the income
11maintenance administrative services described in sub. (1m). A contract to provide
12income maintenance administrative services under this section is exempt from
13subch. IV of ch. 16.
AB40, s. 1491 14Section 1491. 49.78 (1r) of the statutes is created to read:
AB40,676,1915 49.78 (1r) Administration by a tribal governing body. A tribal governing body
16may administer income maintenance programs by electing to have the unit
17administer the tribe's income maintenance programs or by providing the required
18administrative services and entering into a contract with the department for
19reimbursement under sub. (2).
AB40, s. 1492 20Section 1492. 49.78 (2) of the statutes is amended to read:
AB40,677,221 49.78 (2) Contracts with a tribal governing body. Annually, for the income
22maintenance administrative program functions, if any, that the department
23delegates to a county or tribal governing body, the department and county
24department under s. 46.215, 46.22, or 46.23 shall enter into a contract, and
the
25department and tribal governing body may enter into a contract, for reimbursement

1of the county department or tribal governing body for the reasonable cost of
2administering income maintenance programs.
AB40, s. 1493 3Section 1493. 49.78 (4) of the statutes is renumbered 49.19 (19g) (a) and
4amended to read:
AB40,677,125 49.19 (19g) (a) Rules; merit system. The department of children and families
6shall promulgate rules for the efficient administration of aid to families with
7dependent children in agreement with the requirement for federal aid, including the
8establishment and maintenance of personnel standards on a merit basis. The
9provisions of this section subsection relating to personnel standards on a merit basis
10supersede any inconsistent provisions of any law relating to county personnel. This
11subsection paragraph shall not be construed to invalidate the provisions of s. 46.22
12(1) (d).
AB40, s. 1494 13Section 1494. 49.78 (5) of the statutes is renumbered 49.19 (19g) (b) and
14amended to read:
AB40,677,2215 49.19 (19g) (b) Personnel examinations. Statewide examinations to ascertain
16qualifications of applicants in any county department administering aid to families
17with dependent children shall be given by the administrator of the division of merit
18recruitment and selection in the office of state employment relations. The office of
19state employment relations shall be reimbursed for actual expenditures incurred in
20the performance of its functions under this section subsection from the
21appropriations available to the department of children and families for
22administrative expenditures.
AB40, s. 1495 23Section 1495. 49.78 (6) (title) of the statutes is repealed.
AB40, s. 1496 24Section 1496. 49.78 (6) of the statutes is renumbered 49.19 (19g) (c).
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