SB232: Bill Text

SB232,6,18 49.45 (23) (a) The department shall request a waiver from the secretary of the federal department of health and human services to permit the department to conduct a demonstration project to provide health care coverage for basic primary and preventive care to adults who are under the age of 65, who have family incomes not to exceed 200 percent of the poverty line, and who are not otherwise eligible for medical assistance under this subchapter, the Badger Care health care program under s. 49.665, or Medicare under 42 USC 1395 et seq. If the department creates a policy under sub. (2m) (c) 10., this paragraph does not apply to the extent that it conflicts with the policy.

SB232, s. 13 Section 13. 49.45 (23) (b) of the statutes, as affected by 2011 Wisconsin Act 10 and 2011 Wisconsin Act 32, section 1438h, is amended to read:

SB232,7,5 49.45 (23) (b) If the waiver is granted and in effect, the department may promulgate rules defining the health care benefit plan, including more specific eligibility requirements and cost-sharing requirements. Unless otherwise provided by the department by a policy created under sub. (2m) (c), cost Cost sharing may include an annual enrollment fee, which may not exceed $75 per year. Notwithstanding s. 227.24 (3), the plan details under this subsection may be promulgated as an emergency rule under s. 227.24 without a finding of emergency. If the waiver is granted and in effect, the demonstration project under this subsection shall begin on January 1, 2009, or on the effective date of the waiver, whichever is later.

SB232, s. 14 Section 14. 49.45 (24g) (c) of the statutes, as affected by 2011 Wisconsin Act 10 and 2011 Wisconsin Act 32, section 1438L, is amended to read:

SB232,7,17 49.45 (24g) (c) The department's proposal under par. (a) shall specify increases in reimbursement rates for providers that satisfy the conditions under par. (a) 1. or 2., and shall provide for payment of a monthly per-patient care coordination fee to those providers. The department shall set the increases in reimbursement rates and the monthly per-patient care coordination fee so that together they provide sufficient incentive for providers to satisfy a condition under par. (a) 1. or 2. The proposal shall specify effective dates for the increases in reimbursement rates and the monthly per-patient care coordination fee that are no sooner than July 1, 2011. If the department creates a policy under sub. (2m) (c) 4., this paragraph does not apply to the extent that it conflicts with the policy.

SB232, s. 15 Section 15. 49.45 (24s) (a) of the statutes, as created by 2011 Wisconsin Act 32, section 1441b, is amended to read:

SB232,7,24 49.45 (24s) (a) The department shall request a waiver from the secretary of the federal department of health and human services to permit the department to provide optional services for family planning, as defined in s. 253.07 (1) (a), under medical assistance, unless otherwise provided by the department by a policy created under sub. (2m) (c) 10. The department shall implement any waiver granted.

SB232, s. 16 Section 16. 49.45 (25g) (c) of the statutes, as affected by 2011 Wisconsin Act 10 and 2011 Wisconsin Act 32, section 1441c, is amended to read:

SB232,8,14 49.45 (25g) (c) The department's proposal under par. (b) shall specify increases in reimbursement rates for providers that satisfy the conditions under par. (b), and shall provide for payment of a monthly per-patient care coordination fee to those providers. The department shall set the increases in reimbursement rates and the monthly per-patient care coordination fee so that together they provide sufficient incentive for providers to satisfy a condition under par. (b) 1. or 2. The proposal shall specify effective dates for the increases in reimbursement rates and the monthly per-patient care coordination fee that are no sooner than January 1, 2011. The increases in reimbursement rates and monthly per-patient care coordination fees that are not provided by the federal government shall be paid from the appropriation under. s. 20.435 (1) (am). If the department creates a policy under sub. (2m) (c) 4., this paragraph does not apply to the extent it conflicts with the policy.

SB232, s. 17 Section 17. 49.45 (27) of the statutes, as affected by 2011 Wisconsin Act 10 and 2011 Wisconsin Act 32, section 1441f, is amended to read:

SB232,8,21 49.45 (27) Eligibility of aliens. A person who is not a U.S. citizen or an alien lawfully admitted for permanent residence or otherwise permanently residing in the United States under color of law may not receive medical assistance benefits except as provided under 8 USC 1255a (h) (3) or 42 USC 1396b (v), unless otherwise provided by the department by a policy created under sub. (2m) (c).

SB232, s. 18 Section 18. 49.45 (39) (b) 1. of the statutes, as affected by 2011 Wisconsin Act 10 and 2011 Wisconsin Act 32, section 1442g, is amended to read:

SB232,9,25 49.45 (39) (b) 1. `Payment for school medical services.' If a school district or a cooperative educational service agency elects to provide school medical services and meets all requirements under par. (c), the department shall reimburse the school district or the cooperative educational service agency for 60% of the federal share of allowable charges for the school medical services that it provides , unless otherwise provided by the department by a policy created under sub. (2m) (c), and, as specified in subd. 2., for allowable administrative costs. If the Wisconsin Center for the Blind and Visually Impaired or the Wisconsin Educational Services Program for the Deaf and Hard of Hearing elects to provide school medical services and meets all requirements under par. (c), the department shall reimburse the department of public instruction for 60% of the federal share of allowable charges for the school medical services that the Wisconsin Center for the Blind and Visually Impaired or the Wisconsin Educational Services Program for the Deaf and Hard of Hearing provides, unless otherwise provided by the department by a policy created under sub. (2m) (c), and, as specified in subd. 2., for allowable administrative costs. A school district, cooperative educational service agency, the Wisconsin Center for the Blind and Visually Impaired or the Wisconsin Educational Services Program for the Deaf and Hard of Hearing may submit, and the department shall allow, claims for common carrier transportation costs as a school medical service unless the department receives notice from the federal health care financing administration that, under a change in federal policy, the claims are not allowed. If the department receives the notice, a school district, cooperative educational service agency, the Wisconsin Center for the Blind and Visually Impaired, or the Wisconsin Educational Services Program for the Deaf and Hard of Hearing may submit, and the department shall allow, unreimbursed claims for common carrier transportation costs incurred before the date of the change in federal policy. The department shall promulgate rules establishing a methodology for making reimbursements under this paragraph. Alleother expenses for the school medical services provided by a school district or a cooperative educational service agency shall be paid for by the school district or the cooperative educational service agency with funds received from state or local taxes. The school district, the Wisconsin Center for the Blind and Visually Impaired, the Wisconsin Educational Services Program for the Deaf and Hard of Hearing, or the cooperative educational service agency shall comply with all requirements of the federal department of health and human services for receiving federal financial participation.

SB232, s. 19 Section 19. 49.46 (1) (n) of the statutes, as affected by 2011 Wisconsin Act 10 and 2011 Wisconsin Act 32, section 1453e, is repealed.

SB232, s. 20 Section 20. 49.46 (2) (a) (intro.) of the statutes, as affected by 2011 Wisconsin Act 10 and 2011 Wisconsin Act 32, section 1453h, is amended to read:

SB232,10,16 49.46 (2) (a) (intro.) Except as provided in par. (be) and unless otherwise provided by the department by a policy created under s. 49.45 (2m) (c), the department shall audit and pay allowable charges to certified providers for medical assistance on behalf of recipients for the following federally mandated benefits:

SB232, s. 21 Section 21. 49.46 (2) (b) (intro.) of the statutes, as affected by 2011 Wisconsin Act 10 and 2011 Wisconsin Act 32, section 1453k, is amended to read:

SB232,10,22 49.46 (2) (b) (intro.) Except as provided in pars. (be) and (dc) and unless otherwise provided by the department by a policy created under s. 49.45 (2m) (c), the department shall audit and pay allowable charges to certified providers for medical assistance on behalf of recipients for the following services:

SB232, s. 22 Section 22. 49.465 (2) (intro.) of the statutes, as affected by 2011 Wisconsin Act 10 and 2011 Wisconsin Act 32, section 1453r, is amended to read:

SB232,11,6 49.465 (2) (intro.) Unless otherwise provided by the department by a policy created under s. 49.45 (2m) (c), a A pregnant woman is eligible for medical assistance benefits, as provided under sub. (3), during the period beginning on the day on which a qualified provider determines, on the basis of preliminary information, that the woman's family income does not exceed the highest level for eligibility for benefits under s. 49.46 (1) or 49.47 (4) (am) or (c) 1. and ending as follows:

SB232, s. 23 Section 23. 49.47 (4) (a) (intro.) of the statutes, as affected by 2011 Wisconsin Act 10 and 2011 Wisconsin Act 32, section 1457p, is amended to read:

SB232,11,12 49.47 (4) (a) (intro.) Unless otherwise provided by the department by a policy created under s. 49.45 (2m) (c), any Any individual who meets the limitations on income and resources under pars. (b) to (c) and who complies with pars. (cm) and (cr) shall be eligible for medical assistance under this section if such individual is:

SB232, s. 24 Section 24. 49.47 (5) (c) of the statutes, as affected by 2011 Wisconsin Act 10 and 2011 Wisconsin Act 32, section 1459i, is repealed.

SB232, s. 25 Section 25. 49.47 (6) (a) (intro.) of the statutes, as affected by 2011 Wisconsin Act 10 and 2011 Wisconsin Act 32, section 1459n, is amended to read:

SB232,11,19 49.47 (6) (a) Unless otherwise provided by the department by a policy created under s. 49.45 (2m) (c), the The department shall audit and pay charges to certified providers for medical assistance on behalf of the following:

SB232, s. 26 Section 26. 49.471 (13) of the statutes, as affected by 2011 Wisconsin Act 10 and 2011 Wisconsin Act 32, section 1461g, is repealed.

SB232, s. 27 Section 27. 49.472 (3) (intro.) of the statutes, as affected by 2011 Wisconsin Act 10 and 2011 Wisconsin Act 32, section 1461p, is amended to read:

SB232,12,2 49.472 (3) Eligibility. (intro.) Except as provided in sub. (6) (a) and unless otherwise provided by the department by a policy created under s. 49.45 (2m) (c), an individual is eligible for and shall receive medical assistance under this section if all of the following conditions are met:

SB232, s. 28 Section 28. 49.472 (4) (b) (intro.) of the statutes, as affected by 2011 Wisconsin Act 10 and 2011 Wisconsin Act 32, section 1462g, is amended to read:

SB232,12,9 49.472 (4) (b) (intro.) The department may waive monthly premiums that are calculated to be below $10 per month. Unless otherwise provided by the department by a policy created under s. 49.45 (2m) (c), the The department may not assess a monthly premium for any individual whose income level, after adding the individual's earned income and unearned income, is below 150% of the poverty line.

SB232, s. 29 Section 29. 49.473 (2) (intro.) of the statutes, as affected by 2011 Wisconsin Act 10 and 2011 Wisconsin Act 32, section 1465n, is amended to read:

SB232,12,16 49.473 (2) (intro.) Unless otherwise provided by the department by a policy created under s. 49.45 (2m) (c), a A woman is eligible for medical assistance as provided under sub. (5) if, after applying to the department or a county department, the department or a county department determines that she meets all of the following requirements:

SB232, s. 30 Section 30. 49.473 (5) of the statutes, as affected by 2011 Wisconsin Act 10 and 2011 Wisconsin Act 32, section 1469y, is amended to read:

SB232,12,24 49.473 (5) The department shall audit and pay, from the appropriation accounts under s. 20.435 (4) (b), (gm), and (o), allowable charges to a provider who is certified under s. 49.45 (2) (a) 11. for medical assistance on behalf of a woman who meets the requirements under sub. (2) for all benefits and services specified under s. 49.46 (2), unless otherwise provided by the department by a policy created under s. 49.45 (2m) (c).

SB232,12,25 (End)