SB400: Bill Text

SB400,103,5 2. Any An amount paid by an employer to an employee who has a bona fide employment relationship with such employer for employment in the provision of covered items or services.

SB400, s. 232 Section 232. 49.49 (3) (title) of the statutes is repealed.

SB400, s. 233 Section 233 . 49.49 (3) of the statutes is renumbered 946.91 (4) and amended to read:

SB400,103,17 946.91 (4) No person may Whoever knowingly and willfully make makes or cause causes to be made, or induce induces or seek seeks to induce the making of, any false statement or representation of a material fact with respect to the conditions or operation of any institution or facility in order that such institution or facility may qualify either upon initial certification or upon recertification as a hospital, skilled nursing facility, intermediate care facility, or home health agency . A person who violates this subsection is guilty of a Class H felony, except that, notwithstanding the maximum fine specified in s. 939.50 (3) (h), the person may be fined not more than $25,000.

SB400, s. 234 Section 234. 49.49 (3m) (title) of the statutes is repealed.

SB400, s. 235 Section 235 . 49.49 (3m) (a) of the statutes is renumbered 946.91 (5), and 946.91 (5) (intro.), (a) and (b), as renumbered, are amended to read:

SB400,104,2 946.91 (5) (intro.) No provider may Whoever knowingly impose imposes upon a Medical Assistance recipient charges in addition to payments received for services under ss. 49.45 to 49.471 or knowingly impose imposes direct charges upon a recipient in lieu of obtaining payment under ss. 49.45 to 49.471 except under the following conditions is guilty of a Class H felony, except that, notwithstanding the maximum fine specified in s. 939.50 (3) (h), the person may be fined not more than $25,000. This subsection does not apply to the following circumstances:

SB400,104,4 (a) Benefits or services are not provided under s. 49.46 (2) or 49.471 (11) and the Medical Assistance recipient is advised of this fact prior to receiving the service.

SB400,104,14 (b) If an An applicant is determined to be eligible retroactively under s. 49.46 (1) (1g) (b), 49.47 (4) (d), or 49.471 and, a provider bills the applicant directly for services and benefits rendered during the retroactive period, the provider shall the provider, upon notification of the applicant's retroactive eligibility, submit claims submits a claim for payment under s. 49.45 for covered services or benefits rendered to the recipient during the retroactive period. Upon receipt of payment under s. 49.45, the provider shall reimburse, and the provider reimburses the recipient or other person who has made prior payment to the provider for services provided to the recipient during the retroactive eligibility period, by the amount of the prior payment made upon receipt of payment under 49.45.

Note: Moves a provision requiring a recipient who is eligible retroactively for medical assistance benefits to be reimbursed for any eligible payments made to a provider.

SB400, s. 236 Section 236. 49.49 (3m) (b) of the statutes is repealed.

SB400, s. 237 Section 237. 49.49 (3p) (title) of the statutes is amended to read:

SB400,104,17 49.49 (3p) (title) Other prohibited provider charges.

SB400, s. 238 Section 238. 49.49 (4) (title) of the statutes is repealed.

SB400, s. 239 Section 239 . 49.49 (4) (a) and (b) of the statutes are consolidated, renumbered 946.91 (6) and amended to read:

SB400,105,9 946.91 (6) No person Whoever, in connection with the medical assistance Medical Assistance program when the cost of the services provided to the patient is paid for in whole or in part by the state, may knowingly and willfully charge, solicit, accept or receive intentionally charges, solicits, accepts, or receives, in addition to any amount otherwise required to be paid under a medical assistance Medical Assistance program, any gift, money, donation, or other consideration, other than a charitable, religious, or philanthropic contribution from an organization or from a person unrelated to the patient, as a precondition of admitting a patient to a hospital, skilled nursing facility, or intermediate care facility, or as a requirement for the patient's continued stay in such a facility. (b) A person who violates this subsection is guilty of a Class H felony, except that, notwithstanding the maximum fine specified in s. 939.50 (3) (h), the person may be fined not more than $25,000.

Note: Sections 227 , 229, 233 , 235, and 239 move criminal penalties relating to medical assistance to s. 946.91. Also, see Section 461.

SB400, s. 240 Section 240. 49.49 (7) (d) of the statutes is amended to read:

SB400,105,18 49.49 (7) (d) A commission's imposition of an assessment described under par. (b), a member's payment of the assessment as described under par. (c), and acceptance of the payment by the commission do not constitute conduct prohibited under sub. (4) 946.91 (6) or prohibited under s. DHS 106.04 (3), Wis. Adm. Code, in effect on May 26, 2010. It is the intent of the legislature to create a mechanism whereby 2 or more political subdivisions may share in the operation, use, and funding of a nursing home or intermediate care facility without violating 42 USC 1320a-7b (d) or 42 USC 1396a (a) (25) (C).

SB400, s. 241 Section 241. 49.493 (1) (b) of the statutes is amended to read:

SB400,105,21 49.493 (1) (b) "Medical benefits or assistance" means medical benefits under s. 49.02 49.803 or 253.05 or medical assistance.

SB400, s. 242 Section 242. 49.496 (4) (a) of the statutes is amended to read:

SB400,106,15 49.496 (4) (a) The department may require a county department under s. 46.215, 46.22, or 46.23 or the a tribal governing body of a federally recognized American Indian tribe administering medical assistance Medical Assistance to gather and provide the department with information needed to recover medical assistance under this section. Except as provided in par. (b), the department shall pay to a county department or tribal governing body an amount equal to 5% of the recovery collected by the department relating to a beneficiary for whom the county department or tribal governing body made the last determination of medical assistance Medical Assistance eligibility. A county department or tribal governing body may use funds received under this paragraph only to pay costs incurred under this paragraph and, if any amount remains, to pay for improvements to functions required under s. 49.78 49.003 (2). The department may withhold payments under this paragraph for failure to comply with the department's requirements under this paragraph. The department shall treat payments made under this paragraph as costs of administration of the Medical Assistance program.

SB400, s. 243 Section 243. Subchapter V (title) of chapter 49 [precedes 49.66] of the statutes is amended to read:

SB400,106,18 CHAPTER 49

SB400,106,19 SUBCHAPTER V

SB400,106,21 health; OTHER SUPPORT AND MEDICAL block grants

SB400, s. 244 Section 244. 49.685 (7) (a) 2. and 5. of the statutes are amended to read:

SB400,106,25 49.685 (7) (a) 2. In determining income, only the income of the patient and persons responsible for the patient's support under s. 49.90 49.039 may be considered.

SB400,107,2 5. In determining net worth, only the net worth of the patient and persons responsible for the patient's support under s. 49.90 49.039 will be considered.

SB400, s. 245 Section 245. 49.686 (1) (f) of the statutes is repealed.

Note: Repeals a definition for the term "residence", which is defined at the beginning of the chapter, in s. 49.001 (6).

SB400, s. 246 Section 246. 49.688 (1) (b) of the statutes is repealed.

Note: Repeals a definition for the term "poverty line", which is defined at the beginning of the chapter, in s. 49.001 (5).

SB400, s. 247 Section 247. 49.688 (9) (a) of the statutes is amended to read:

SB400,107,8 49.688 (9) (a) The department shall promulgate rules relating to prohibitions on fraud that are substantially similar to applicable provisions under s. 49.49 (1) (a) 946.91 (2).

Note: Modifies the cross-reference for medical assistance offenses in the senior care program statute.

SB400, s. 248 Section 248. 49.77 (1) of the statutes is renumbered 49.77 (1) (intro.) and amended to read:

SB400,107,11 49.77 (1) Definition Definitions. (intro.) In this section "secretary":

SB400,107,14 (m) Notwithstanding s. 49.66 (2), "secretary" means the secretary of the U.S. department of health and human services or the secretary of any other federal agency subsequently charged with the administration of federal Title XVI.

SB400, s. 249 Section 249. 49.77 (1) (b) of the statutes is created to read:

SB400,107,16 49.77 (1) (b) "Essential person" has the meaning given in s. 49.46 (1c).

SB400, s. 250 Section 250. 49.78 (title) of the statutes is renumbered 49.003 (title).

SB400, s. 251 Section 251. 49.78 (1) (intro.) and (b) of the statutes are renumbered 49.003 (1) (intro.) and (b).

SB400, s. 252 Section 252. 49.78 (1) (br), (1m), (1r), (2) (b), (2m) and (2r) of the statutes, as created by 2011 Wisconsin Act 32, are renumbered 49.003 (1) (br), (1m), (1r), (2) (b), (2m) and (2r).

SB400, s. 253 Section 253. 49.78 (1) (cr) of the statutes is repealed.

Note: Repeals a definition for the term "tribal governing body", which is created in Section 70 of the bill.

SB400, s. 254 Section 254. 49.78 (2) (title) and (a), (10) and (11) of the statutes, as affected by 2011 Wisconsin Act 32, are renumbered 49.003 (2) (title) and (a), (10) and (11).

SB400, s. 255 Section 255. 49.78 (4) to (7) of the statutes are renumbered 49.003 (4) to (7).

SB400, s. 256 Section 256. 49.78 (8) (title) and (b) of the statutes, as affected by 2011 Wisconsin Act 32, are renumbered 49.003 (8) (title) and (b).

SB400, s. 257 Section 257. 49.78 (8) (a) of the statutes, as affected by 2011 Wisconsin Act 32, is renumbered 49.003 (8) (a) and amended to read:

SB400,108,21 49.003 (8) (a) From the appropriations under s. 20.435 (4) (bn) and (nn) and subject to par. (b), the department shall provide funding to reimburse each multicounty consortium that contracts with the department under sub. (2) and each tribal governing body that contracts with the department under sub. (2m) for the costs of administering the income maintenance programs, including conducting fraud prevention activities, in accordance with the terms of the applicable contract. The amount of reimbursement calculated under this paragraph and par. (b) is in addition to any reimbursement provided to a county, multicounty consortium, or tribal governing body for fraud and error reduction under s. 49.019 or 49.197 or 49.845.

SB400, s. 258 Section 258. 49.785 (1) (intro.) of the statutes is amended to read:

SB400,109,8 49.785 (1) (intro.) Except as provided in sub. (1m) and subject to s. 49.825 49.009, if any recipient specified in sub. (1c) dies and the estate of the deceased recipient is insufficient to pay the funeral, burial, and cemetery expenses of the deceased recipient, the department or county or applicable tribal governing body or organization responsible for burial of the recipient shall pay, to the person designated by the department or county department under s. 46.215, 46.22, or 46.23 or applicable tribal governing body or organization responsible for the burial of the recipient, all of the following:

SB400, s. 259 Section 259. 49.79 (title) of the statutes is amended to read:

SB400,109,11 49.79 (title) Food stamp Supplemental nutrition assistance program administration.

SB400, s. 260 Section 260. 49.79 (1) (intro.) of the statutes is amended to read:

SB400,109,14 49.79 (1) Definitions. (intro.) In this section and ss. 49.793, 49.796, and 49.797:

SB400, s. 261 Section 261. 49.79 (1) (c) of the statutes is renumbered 49.79 (1) (fg) and amended to read:

SB400,109,19 49.79 (1) (fg) "Food stamp Supplemental nutrition assistance program" means the federal food stamp supplemental nutrition assistance program under 7 USC 2011 to 2036.

SB400, s. 262 Section 262. 49.79 (1) (e) of the statutes, as created by 2011 Wisconsin Act 32, is amended to read:

SB400,109,23 49.79 (1) (e) "Multicounty consortium" has the meaning given in s. 49.78 49.003 (1) (br).

SB400, s. 263 Section 263. 49.79 (2), (5) (a), (6), (7), (8m) (a) and (b) and (9) (a) 2., 3. and 4. of the statutes are amended to read:

SB400,110,4 49.79 (2) Denial of eligibility. An individual who fails to comply with the work requirements of the employment and training program under sub. (9) is ineligible to participate in the food stamp supplemental nutrition assistance program as specified under sub. (9) (b).

SB400,110,20 (5) (a) The department shall require an applicant for, or recipient under, the food stamp supplemental nutrition assistance program to state in writing whether the applicant or recipient or any member of the applicant's or recipient's household has been convicted, in any state or federal court of a felony that has as an element possession, use, or distribution of a controlled substance. The department shall require an applicant or recipient, or member of the applicant's or recipient's household to submit to a test for use of a controlled substance as a condition of continued eligibility if, after August 22, 1996, but not more than 5 years prior to the date the written statement is made, the applicant or recipient or the member of the applicant's or recipient's household was convicted in any state or federal court of a felony that had as an element possession, use, or distribution of a controlled substance. If the test results are positive with respect to any individual, the department may not consider the needs of that individual in determining the household's eligibility for the food stamp supplemental nutrition assistance program for at least 12 months from the date of the test. The department shall, however, consider the income and resources of that individual to be available to the household.

SB400,110,24 (6) Ineligibility for fugitive felons. No person is eligible for the food stamp supplemental nutrition assistance program in a month in which that person is a fugitive felon under 7 USC 2015 (k) (1) or is violating a condition of probation, extended supervision, or parole imposed by a state or federal court.

SB400,111,8 (7) Simplified food stamp supplemental nutrition assistance program. The department shall develop a simplified food stamp supplemental nutrition assistance program that meets all of the requirements under P.L. 104-193, section 854 42 USC 2035, and shall submit the plan to the secretary of the federal department of agriculture for approval. If the secretary of the federal department of agriculture approves the plan, the department shall submit the plan to the secretary of administration for approval. If the secretary of administration approves the plan, the department may implement the plan.

SB400,111,12 (8m) (a) The department shall allow a prisoner who is applying for the food stamp supplemental nutrition assistance program from a correctional institution in anticipation of being released from the institution to use the address of the correctional institution as his or her address on the application.

SB400,111,17 (b) The department shall allow an employee of a correctional institution who has been authorized by a prisoner of the institution to act on his or her behalf in matters related to the food stamp supplemental nutrition assistance program to receive and conduct telephone calls on behalf of the prisoner in matters related to the food stamp supplemental nutrition assistance program.

SB400,111,21 (9) (a) 2. The department may not require an individual who is a recipient under the food stamp supplemental nutrition assistance program and who is the caretaker of a child under the age of 12 weeks to participate in any employment and training program under this subsection.

SB400,112,2 3. The department may not require an individual who is a recipient under the food stamp supplemental nutrition assistance program to participate in any employment and training program under this subsection if that individual is enrolled at least half time in a school, as defined in s. 49.26 49.198 (1) (a) 2., a training program, or an institution of higher education.

SB400,112,6 4. The amount of food stamp supplemental nutrition assistance program benefits paid to a recipient who is a participant in a Wisconsin works Works employment position under s. 49.147 (4) or (5) shall be calculated based on the pre-sanction benefit amount received s. 49.148.

SB400, s. 264 Section 264. 49.79 (3) (title) of the statutes is amended to read:

SB400,112,8 49.79 (3) (title) Liability for lost food coupons misappropriated benefits .

SB400, s. 265 Section 265. 49.79 (3) (a) and (c), (4), (8) and (9) (a) 1. of the statutes, as affected by 2011 Wisconsin Act 32, are amended to read:

SB400,112,15 49.79 (3) (a) A county, multicounty consortium, or federally recognized American Indian tribe tribal governing body is liable for all food stamp coupons lost, supplemental nutrition assistance program benefits misappropriated, or destroyed while under the county's, consortium's, or tribe's direct control, except as provided in par. (b).

SB400,112,21 (c) A county, multicounty consortium, or federally recognized American Indian tribe tribal governing body is liable for food stamp coupons mailed supplemental nutrition assistance program benefits incorrectly transferred to residents of the county or counties that are in the multicounty consortium or members of the tribe and lost in the mail due to incorrect information submitted to the department by the county or tribe.

Note: Strikes language no longer applicable under the system of electronic benefit transfers.

SB400,113,5 (4) Deductions from county income maintenance payments. The department shall withhold the value of food stamp supplemental nutrition assistance program benefits losses for which a county, multicounty consortium, or federally recognized American Indian tribe tribal governing body is liable under sub. (3) from the payment to the county, multicounty consortium, or tribe under income maintenance contracts under s. 49.78 49.003 and reimburse the federal government from the funds withheld.

SB400,113,9 (8) Benefits for qualified aliens. The department shall not provide benefits under this section to a qualified alien, except to the extent that federal food stamp supplemental nutrition assistance program benefits for qualified aliens are required by the federal government.

SB400,113,20 (9) (a) 1. The department shall administer an employment and training program for recipients under the food stamp supplemental nutrition assistance program and may contract with county departments under ss. 46.215, 46.22, and 46.23, multicounty consortia, and with tribal governing bodies to carry out the administrative functions. The department may contract, or a county department, multicounty consortium, or tribal governing body may subcontract, with a Wisconsin Works agency or another provider to administer the employment and training program under this subsection. Except as provided in subds. 2. and 3., the department may require able individuals who are 18 to 60 years of age who are not participants in a Wisconsin Works employment position to participate in the employment and training program under this subsection.

SB400, s. 266 Section 266. 49.79 (3) (b) of the statutes, as affected by 2011 Wisconsin Act 32, is repealed.

Note: Eliminates language no longer applicable under the system of electronic benefit transfers.

SB400, s. 267 Section 267. 49.793 (title) of the statutes is amended to read:

SB400,114,2 49.793 (title) Recovery of food stamps supplemental nutrition assistance overpayments.

SB400, s. 268 Section 268. 49.793 (1) and (2) (a) of the statutes, as affected by 2011 Wisconsin Act 32, are amended to read:

SB400,114,11 49.793 (1) The department or a county, a multicounty consortium, as defined in s. 49.78 (1) (br), or an elected tribal governing body of a federally recognized American Indian tribe or band acting on behalf of the department, may recover overpayments that arise from an overissuance of food coupons benefits under the food stamp supplemental nutrition assistance program administered under s. 46.215 (1) (k) or 46.22 (1) (b) 2. d. Recovery shall the be made in accordance with 7 USC 2022.

SB400,114,20 (2) (a) Except as provided in par. (b), a county, a multicounty consortium, as defined in s. 49.78 (1) (br), or a tribal governing body of a federally recognized American Indian tribe may retain a portion of the amount of an overpayment the state is authorized to retain under 7 USC 2025 that is recovered under sub. (1) due to the efforts of an employee or officer of the county, multicounty consortium, or tribe. The department shall promulgate a rule establishing the portion of the amount of the overpayment that the county, multicounty consortium, or governing body may retain. This paragraph does not apply to recovery of an overpayment that was made as a result of state, county, multicounty consortium, or tribal governing body error.

SB400, s. 269 Section 269. 49.795 (title) and (1) (intro.) of the statutes are renumbered 946.92 (title) and (1) (intro.).