SB21,1799 13Section 1799. 49.45 (30x) of the statutes is created to read:
SB21,728,1814 49.45 (30x) Licensed midwife services. (a) Provider reimbursement.
15Beginning January 1, 2016, services under s. 49.46 (2) (b) 12t. provided to an
16individual are reimbursable under the Medical Assistance program if an
17amendment to the state medical assistance plan approved by the federal department
18of health and human services permits reimbursement under s. 49.46 (2) (b) 12t.
SB21,728,2319 (b) Plan amendment. The department shall submit to the federal department
20of health and human services an amendment to the state medical assistance plan to
21permit the application of par. (a). The department may not pay reimbursement
22under par. (a) unless the amendment to the state plan allowing reimbursement
23under s. 49.46 (2) (b) 12t. is approved and in effect.
SB21,1800 24Section 1800. 49.45 (39) (bm) of the statutes is created to read:
SB21,729,4
149.45 (39) (bm) Excess state share. Any portion of the state share under this
2subsection in excess of $42,200,000 in fiscal year 2015-16 and in excess of
3$41,700,000 in fiscal year 2016-17 and each fiscal year thereafter shall be deposited
4in the Medical Assistance trust fund.
SB21,1801 5Section 1801. 49.45 (39m) of the statutes is created to read:
SB21,729,156 49.45 (39m) State plan amendment for pharmacist reimbursement. The
7department shall submit to the federal department of health and human services an
8amendment to the state Medical Assistance plan to permit Medical Assistance
9reimbursement to pharmacists who meet the training requirements specified by the
10department to administer vaccines, as determined by the department, to a person 6
11to 18 years of age. The department shall provide Medical Assistance reimbursement
12under this subsection if the federal department of health and human services
13approves the amendment to the state Medical Assistance plan. A pharmacist or
14pharmacy shall enroll in the federal Vaccines for Children Program under 42 USC
151396s
to be eligible for Medical Assistance reimbursement under this subsection.
SB21,1802 16Section 1802. 49.45 (41) (b) of the statutes is amended to read:
SB21,730,217 49.45 (41) (b) If a county elects to become certified as a provider of mental
18health crisis intervention services, the county may provide mental health crisis
19intervention services under this subsection in the county to medical assistance
20recipients through the medical assistance program. A county that elects to provide
21the services shall pay the amount of the allowable charges for the services under the
22medical assistance program that is not provided by the federal government. From
23the appropriation account under s. 20.435 (5) (bL), the
The department shall
24reimburse the county under this subsection only for the amount of the allowable

1charges for those services under the medical assistance program that is provided by
2the federal government.
SB21,1803 3Section 1803. 49.452 of the statutes is created to read:
SB21,730,8 449.452 Counting promissory notes as assets for certain Medical
5Assistance programs.
(1) In this section, "promissory note" means a written,
6unconditional agreement, given in return for goods, money loaned, or services
7rendered, under which one party promises to pay another party a specified sum of
8money at a specified time or on demand.
SB21,730,11 9(2) If an individual's assets are counted when determining or redetermining
10the individual's financial eligibility for Medical Assistance, the department shall
11include a promissory note as a countable asset if all of the following apply:
SB21,730,1412 (a) The individual applying for or receiving benefits under Medical Assistance
13or his or her spouse provided the goods, money loaned, or services rendered for the
14promissory note.
SB21,730,1615 (b) The promissory note was entered into or purchased on or after the effective
16date of this paragraph .... [LRB inserts date].
SB21,730,1817 (c) The promissory note is negotiable, assignable, and enforceable and does not
18contain any terms making it unmarketable.
SB21,730,24 19(3) A promissory note is presumed to be negotiable and its asset value is the
20outstanding principal balance at the time the individual applies for Medical
21Assistance or at the time the individual's eligibility for Medical Assistance is
22redetermined, unless the individual shows by credible evidence from a
23knowledgeable source that the note is nonnegotiable or has a different current
24market value, which will then be considered the asset value.
SB21,1804 25Section 1804. 49.453 (4c) (am) of the statutes is created to read:
SB21,731,4
149.453 (4c) (am) Notwithstanding par. (a), for purposes of sub. (2), the purchase
2of or entering into a promissory note by an individual or his or her spouse on or after
3the effective date of this paragraph .... [LRB inserts date], is a transfer of assets for
4less than fair market value unless all of the following apply:
SB21,731,55 1. The promissory note satisfies the requirements under par. (a) 1. to 3.
SB21,731,76 2. The promissory note is negotiable, assignable, and enforceable and does not
7contain any terms making it unmarketable.
SB21,1805 8Section 1805. 49.453 (4c) (b) of the statutes is renumbered 49.453 (4c) (b) 1.
9and amended to read:
SB21,731,1410 49.453 (4c) (b) 1. The value of a promissory note, purchased before the effective
11date of this subdivision .... [LRB inserts date], a
loan, or a mortgage that does not
12satisfy the requirements under par. (a) 1. to 3. is the outstanding balance due on the
13date that the individual applies for medical assistance for nursing facility services
14or other long-term care services described in sub. (2).
SB21,1806 15Section 1806. 49.453 (4c) (b) 2. of the statutes is created to read:
SB21,731,2216 49.453 (4c) (b) 2. The value of a promissory note purchased or entered into on
17or after the effective date of this subdivision .... [LRB inserts date], that does not
18satisfy the requirements under par. (am) 1. and 2. is the outstanding balance due on
19the date that the individual applies for Medical Assistance for nursing facility
20services or other long-term care services described in sub. (2) or on the date that the
21individual's eligibility for Medical Assistance for nursing facility services or other
22long-term care services described in sub. (2) is redetermined.
SB21,1807 23Section 1807. 49.46 (2) (b) 12t. of the statutes is created to read:
SB21,732,3
149.46 (2) (b) 12t. Subject to the limitations under s. 49.45 (30x), licensed
2midwife services provided by a certified professional midwife licensed under s.
3440.982.
SB21,1808 4Section 1808. 49.46 (2) (b) 14m. of the statutes is created to read:
SB21,732,75 49.46 (2) (b) 14m. Subject to par. (bt), substance abuse treatment services
6provided by a medically monitored treatment service or a transitional residential
7treatment service.
SB21,1809 8Section 1809. 49.46 (2) (bt) of the statutes is created to read:
SB21,732,139 49.46 (2) (bt) 1. For the purposes of par. (b) 14m., a "medically monitored
10treatment service" is a 24-hour, community-based service providing observation,
11monitoring, and treatment by a multidisciplinary team under supervision of a
12physician, with a minimum of 12 hours of counseling provided per week for each
13patient.
SB21,732,1714 2. For the purposes of par. (b) 14m., a "transitional residential treatment
15service" is a clinically supervised, peer-supported, therapeutic environment with
16clinical involvement providing substance abuse treatment in the form of counseling
17for 3 to 11 hours provided per week for each patient.
SB21,732,2118 3. If approval by the federal department of health and human services of a state
19plan amendment or waiver request is necessary for federal reimbursement of the
20services under par. (b) 14m., the department is not required to pay for services
21described in par. (b) 14m. if the department does not receive the necessary approval.
SB21,1810 22Section 1810. 49.471 (8) (d) 1. a. of the statutes is amended to read:
SB21,732,2423 49.471 (8) (d) 1. a. A pregnant woman, except as provided in pars. par. (cr) 1.
24c. and (fm) 4.
SB21,1811 25Section 1811. 49.471 (8) (f) of the statutes is repealed.
SB21,1812
1Section 1812. 49.471 (8) (fm) of the statutes is repealed.
SB21,1813 2Section 1813. 49.471 (8) (g) of the statutes is repealed.
SB21,1814 3Section 1814. 49.472 (5) of the statutes is amended to read:
SB21,733,74 49.472 (5) Community options participants. From the appropriation under s.
520.435 (7) (4) (bd), the department may pay all or a portion of the monthly premium
6calculated under sub. (4) (a) for an individual who is a participant in the community
7options program under s. 46.27 (11).
SB21,1815 8Section 1815. 49.475 (1) (e) 2. of the statutes is amended to read:
SB21,733,109 49.475 (1) (e) 2. An enrollee of the family care program, as defined in s. 46.2805
10(4m)
.
SB21,1816 11Section 1816. 49.496 (1) (bk) 2. of the statutes is repealed.
SB21,1817 12Section 1817. 49.682 (title) of the statutes is amended to read:
SB21,733,13 1349.682 (title) Recovery from estates; disease aids and funeral expenses.
SB21,1818 14Section 1818. 49.682 (1) (a) of the statutes is amended to read:
SB21,733,1715 49.682 (1) (a) "Client" means a person who receives or received aid under s.
1649.68, 49.683, or 49.685 or a person on whose behalf funeral, burial, or cemetery
17expenses aid was provided under s. 49.785
.
SB21,1819 18Section 1819. 49.682 (1) (d) of the statutes is amended to read:
SB21,733,2219 49.682 (1) (d) "Nonclient surviving spouse" means any person who was married
20to a client while the client was receiving or when the client received services or aid
21for which the cost may be recovered under sub. (2) (a) or (am) and who survived the
22client.
SB21,1820 23Section 1820. 49.682 (2) (am) of the statutes is created to read:
SB21,734,3
149.682 (2) (am) The department shall file a claim against the estate of a client,
2and against the estate of a nonclient surviving spouse, for the amount of aid under
3s. 49.785 paid to or on behalf of the client.
SB21,1821 4Section 1821. 49.682 (2) (bm) 1. of the statutes is amended to read:
SB21,734,75 49.682 (2) (bm) 1. Property that is subject to the department's claim under par.
6(a) or (am) in the estate of a client or in the estate of a nonclient surviving spouse is
7all property of a decedent that is included in the estate.
SB21,1822 8Section 1822. 49.682 (2) (bm) 2. of the statutes is amended to read:
SB21,734,139 49.682 (2) (bm) 2. There is a presumption, consistent with s. 766.31, which may
10be rebutted, that all property in the estate of the nonclient surviving spouse was
11marital property held with the client and that 100 percent of the property in the
12estate of the nonclient surviving spouse is subject to the department's claim under
13par. (a) or (am).
SB21,1823 14Section 1823. 49.682 (2) (c) (intro.) of the statutes is amended to read:
SB21,734,1815 49.682 (2) (c) (intro.) The court shall reduce the amount of a claim under par.
16(a) or (am) by up to the amount specified in s. 861.33 (2) if necessary to allow the
17decedent's heirs or the beneficiaries of the decedent's will to retain the following
18personal property:
SB21,1824 19Section 1824. 49.682 (3) of the statutes is amended to read:
SB21,734,2520 49.682 (3) The department shall administer the program under this section
21and may contract with an entity to administer all or a portion of the program,
22including gathering and providing the department with information needed to
23recover payment of aid provided under s. 49.68, 49.683, or 49.685, or 49.785. All
24funds received under this subsection, net of any amount claimed under s. 49.849 (5),
25shall be remitted for deposit in the general fund.
SB21,1825
1Section 1825. 49.682 (4) (a) of the statutes is amended to read:
SB21,735,52 49.682 (4) (a) The department may recover amounts under this section for the
3provision of aid provided under s. 49.68, 49.683, or 49.685 paid on and after
4September 1, 1995, and for the provision of aid provided under s. 49.785 paid on or
5after the effective date of this paragraph .... [LRB inserts date]
.
SB21,1826 6Section 1826. 49.682 (4) (b) of the statutes is amended to read:
SB21,735,107 49.682 (4) (b) The department may file a claim under sub. (2) (a) only with
8respect to a client who dies after September 1, 1995. The department may file a claim
9under sub. (2) (am) only with respect to a client who dies after the effective date of
10this paragraph .... [LRB inserts date].
SB21,1827 11Section 1827. 49.682 (5) of the statutes is amended to read:
SB21,735,1712 49.682 (5) The department shall promulgate rules establishing standards for
13determining whether the application of this section with respect to a claim under
14sub. (1) (a)
would work an undue hardship in individual cases. If the department
15determines that the application of this section with respect to a claim under sub. (1)
16(a)
would work an undue hardship in a particular case, the department shall waive
17application of this section in that case.
SB21,1828 18Section 1828. 49.688 (2) (a) 6. of the statutes is created to read:
SB21,735,2219 49.688 (2) (a) 6. The person applies for and, if eligible, enrolls in Medicare
20under Part D of Title XVIII of the federal Social Security Act, 42 USC 1395w-101 to
211395w-153, if the secretary of the federal department of health and human services
22approves the condition on eligibility under this subdivision.
SB21,1829 23Section 1829. 49.688 (2) (b) of the statutes is amended to read:
SB21,736,524 49.688 (2) (b) A person to whom par. (a) 1. to 3. and, 5., and 6. applies, but whose
25annual household income, as determined by the department, exceeds 240% of the

1federal poverty line for a family the size of the persons' eligible family, is eligible to
2purchase a prescription drug at the amounts specified in sub. (5) (a) 4. only during
3the remaining amount of any 12-month period in which the person has first paid the
4annual deductible specified in sub. (3) (b) 2. a. in purchasing prescription drugs at
5the retail price and has then paid the annual deductible specified in sub. (3) (b) 2. b.
SB21,1830 6Section 1830. 49.78 (5) of the statutes is amended to read:
SB21,736,157 49.78 (5) Personnel examinations. Statewide examinations to ascertain
8qualifications of applicants in any county department administering aid to families
9with dependent children shall be given by the administrator of the division director
10of the bureau
of merit recruitment and selection in the office of state employment
11relations
department of administration. The office of state employment relations
12department of administration shall be reimbursed for actual expenditures incurred
13in the performance of its functions under this section from the appropriations
14available to the department of children and families for administrative
15expenditures.
SB21,1831 16Section 1831. 49.785 (1m) (d) of the statutes is created to read:
SB21,736,2117 49.785 (1m) (d) If the recipient, or the recipient's spouse or another person,
18owns a life insurance policy insuring the recipient's life and the face value of the
19policy is more than $3,000, any amount that the department would be obligated to
20pay under sub. (1) shall be reduced by one dollar for every dollar by which the face
21value of the policy exceeds $3,000.
SB21,1832 22Section 1832. 49.785 (2) of the statutes is created to read:
SB21,736,2523 49.785 (2) The department shall pursue recovery of any amounts paid under
24sub. (1) from the estate of the recipient and from the estate of any surviving spouse
25of the recipient as provided in s. 49.682.
SB21,1833
1Section 1833. 49.79 (9) (d) of the statutes is created to read:
SB21,737,62 49.79 (9) (d) 1. The department shall request from the secretary of the federal
3department of agriculture a waiver to permit the department to screen and, if
4indicated, test, as specified by the department in the waiver request, participants in
5an employment and training program under this subsection for illegal use of a
6controlled substance without presenting evidence of a valid prescription.
SB21,737,117 2. If a waiver under subd. 1. is granted and in effect, the department shall
8screen and, if indicated, test, in a manner approved in the waiver granted by the
9secretary of the federal department of agriculture, participants in an employment
10and training program under this subsection for illegal use of a controlled substance
11without presenting evidence of a valid prescription.
SB21,1834 12Section 1834. 49.849 (1) (c) of the statutes is amended to read:
SB21,737,1513 49.849 (1) (c) "Nonrecipient surviving spouse" means any person who was
14married to a recipient while the recipient was receiving or when the recipient
15received
public assistance and who survived the recipient.
SB21,1835 16Section 1835. 49.849 (1) (e) of the statutes is amended to read:
SB21,737,2017 49.849 (1) (e) "Public assistance" means any services provided as a benefit
18under a long-term care program, as defined in s. 49.496 (1) (bk), medical assistance
19under subch. IV, long-term community support services funded under s. 46.27 (7),
20or aid under s. 49.68, 49.683, or 49.685, or 49.785.
SB21,1836 21Section 1836. 49.849 (2) (a) (intro.) of the statutes is amended to read:
SB21,738,322 49.849 (2) (a) (intro.) Subject to par. (b), the department may collect from the
23property of a decedent by affidavit under sub. (3) (b) or by lien under sub. (4) (a) an
24amount equal to the medical assistance that is recoverable under s. 49.496 (3) (a), the
25long-term community support services under s. 46.27 that is recoverable under s.

146.27 (7g) (c) 1., or the aid under s. 49.68, 49.683, or, 49.685, or 49.785 that is
2recoverable under s. 49.682 (2) (a) or (am), and that was paid on behalf of the
3decedent or the decedent's spouse, if all of the following conditions are satisfied:
SB21,1837 4Section 1837. 49.849 (2) (a) 1. of the statutes is amended to read:
SB21,738,75 49.849 (2) (a) 1. The decedent died after September 30, 1991, or for the recovery
6of aid under s. 49.785 the decedent died after the effective date of this subdivision
7.... [LRB inserts date]
.
SB21,1838 8Section 1838. 49.849 (2) (a) 2. of the statutes is amended to read:
SB21,738,119 49.849 (2) (a) 2. The decedent is not survived by a spouse, a child who is under
10age 21, or a child who is disabled, as defined in s. 49.468 (1) (a) 1. This subdivision
11does not apply for the recovery of aid under s. 49.785.
SB21,1839 12Section 1839. 49.849 (3) (b) of the statutes is amended to read:
SB21,738,1913 49.849 (3) (b) A person who possesses or receives property of a decedent shall
14transmit the property to the department, if the conditions in sub. (2) (a) 1. and, if
15applicable, sub. (2) (a)
2. are satisfied, upon receipt of an affidavit by a person
16designated by the secretary of health services to administer this section showing that
17the department paid on behalf of the decedent or the decedent's spouse recoverable
18benefits specified in sub. (2) (a). Upon transmittal, the person is released from any
19obligation to other creditors or heirs of the decedent.
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