AB942,4,2019 (b) Any health or medical benefits, including Medical Assistance program
20benefits under subch. IV of ch. 49.
AB942,4,2421 (c) Any food or nutrition assistance, including the food stamp program under
227 USC 2011 to 2029; the special supplemental nutrition program for women, infants,
23and children under 42 USC 1786 and the state supplement under s. 253.06; and the
24federal national school lunch program under 42 USC 1751 et seq.
AB942,5,2
1(d) Any child care assistance, including the Wisconsin Shares child care
2subsidy under s. 49.155.
AB942,5,43 (e) Any energy or heating assistance, including low-income energy assistance
4under s. 16.27 and weatherization assistance under s. 16.26.
AB942,5,75 (f) Any water or sewer assistance, including benefits available from the low
6income household water assistance program under the federal American Rescue
7Plan Act of 2021, P.L. 117-2.
AB942,5,98 (g) Any refundable tax benefits, including the federal earned income credit
9under 26 USC 32 and the homestead credit under subch. VIII of ch. 71.
AB942,5,1110 (h) Any employment support or training services, including services available
11from Wisconsin works under ss. 49.141 to 49.161.
AB942,5,1312 (i) Any internet or broadband assistance, including the emergency broadband
13benefit under the federal Consolidated Appropriations Act, 2021, P.L. 116-260.
AB942,5,1514 (j) Any benefit or assistance program that provides direct payments to eligible
15individuals.
AB942,5,1616 (k) Any other public benefits or assistance that is available under law.
AB942,5,21 17(4) Assistance groups. The department of administration, in consultation with
18any state agency that is responsible for the administration of a public benefit, in
19preparing the report under sub. (1), shall report on the availability of public benefits
20for the following groups of individuals, all of whom earn 50 percent of the federal
21poverty line:
AB942,5,2222 (a) A single adult individual.
AB942,5,2323 (b) Two adults who are married.
AB942,5,2524 (c) An adult parent with 2 children, one under the age of 6 and the other
25between the ages of 6 and 17.
AB942,6,2
1(d) Two adults who are married with 2 children, one under the age of 6 and the
2other between the ages of 6 and 17.
AB942,2 3Section 2. 49.843 of the statutes is created to read:
AB942,6,5 449.843 Office of the inspector general; health services. (1) Definitions.
5In this section:
AB942,6,66 (a) “Department” means the department of health services.
AB942,6,77 (b) “Food stamp program” has the meaning given under s. 49.79 (1) (c).
AB942,6,98 (c) “Medical Assistance program” means the Medical Assistance program
9under subch. IV.
AB942,6,1110 (d) “Office of the inspector general” means the office of the inspector general
11in the department of health services.
AB942,6,15 12(2) General duties. The office of the inspector general shall identify and
13prevent fraud, waste, and abuse in the food stamp program, the Medical Assistance
14program, and other public assistance programs administered by the department of
15health services.
AB942,6,18 16(3) Monitoring and auditing of providers. The office of the inspector general
17shall monitor and audit providers to identify and prevent fraud, waste, and abuse,
18including by doing all of the following
AB942,6,2019 (a) Auditing providers of services under Medical Assistance to ensure
20compliance with Medical Assistance law and rules.
AB942,6,2121 (b) Investigating allegations of fraud, waste, and abuse.
AB942,6,2322 (c) Providing education and technical assistance to providers through audit
23activities.
AB942,6,2424 (d) Reviewing, tracking, and researching provider billing.
AB942,7,2
1(e) Conducting on-site visits to high-risk providers before Medical Assistance
2program certification.
AB942,7,43 (f) Educating providers and beneficiaries about Medical Assistance program
4law and rules.
AB942,7,65 (g) Ensuring contracts with providers contain language that helps prevent
6fraud, waste, and abuse.
AB942,7,87 (h) Ensuring the claims processing system has edit and audit procedures in
8place to prevent medically unlikely claims.
AB942,7,99 (i) Suspending provider payments when there are credible allegations of fraud.
AB942,7,1110 (j) Conducting audits and reviews of providers for compliance with Medical
11Assistance laws and rules.
AB942,7,1312 (k) Issuing explanations of benefits to recipients of Medical Assistance to assist
13in reporting of fraudulent claims.
AB942,7,1514 (L) Providing notices of remittance to providers for review of payments for
15possible errors.
AB942,7,18 16(4) Tracking retailer and recipient fraud. The office of the inspector general
17shall investigate and track retailer and public assistance recipient fraud including
18by doing all of the following:
AB942,7,2119 (a) Comparing public information, such as social security, state wage records,
20unemployment benefits, and prisoner data with data provided by the applicant or
21recipient for public assistance.
AB942,7,2422 (b) Conducting monitoring visits, audits, and undercover investigations of
23retailers who sell items to food stamp program recipients and other public assistance
24program recipients.
AB942,8,2
1(c) Monitoring the number of replacement electronic benefit transfer cards or
2other indicia of enrollment issued to each recipient.
AB942,8,43 (d) Monitoring social media Internet sites for advertisements of electronic
4benefit transfer cards or other means of selling food stamp program benefits.
AB942,8,55 (e) Using data analytics to identify patterns indicating fraud.
AB942,8,7 6(5) Reporting fraud. The office of the inspector general shall do all of the
7following:
AB942,8,138 (a) Forward cases of alleged fraud to the appropriate federal, state, and local
9officials for prosecution, including the Medicaid fraud control unit of the department
10of justice. The office of the inspector general shall cooperate with any investigation
11of the Medicaid fraud control unit or other unit of the department of justice into
12fraudulent activity in any public assistance program administered by the
13department.
AB942,8,2314 (b) Operate and maintain a telephone hotline and online portal to report
15suspected fraud, waste, and abuse related to public assistance programs and
16investigate suspected fraud, waste, and abuse that has been reported to the hotline
17or portal. The office of the inspector general shall coordinate with the legislative
18audit bureau to ensure that the office of the inspector general is notified of reports
19of fraud, waste, and abuse related to public assistance programs that are reported
20to the legislative audit bureau. The office of the inspector general shall forward to
21any appropriate agency or entity any reports to the hotline or portal of suspected
22fraud, waste, or abuse that are unrelated to the types of fraud, waste, and abuse
23investigated by the office of the inspector general.
AB942,9,324 (c) Annually submit to the legislature under s. 13.172 (2) a report summarizing
25the accomplishments in preventing and stopping fraud in public assistance

1programs within the department and across the state. The report under this
2paragraph shall include outcomes on recoupment of overpayments and the number
3of instances of fraud, waste, or abuse referred for prosecution.
AB942,9,44 (d) Publicly display on an Internet site monthly findings on all of the following:
AB942,9,55 1. Complaint activity to the fraud, waste, and abuse hotline and online portal.
AB942,9,86 2. Fraud prevention activities related to food stamp program and Medical
7Assistance program recipients, including projected cost avoidance and amounts of
8overpayments.
AB942,9,99 3. Statewide fraud prevention and investigation.
AB942,9,1010 4. Fraud prevent activities related to Medical Assistance program providers.
AB942,9,1111 5. Interstate matching activity.
AB942,9,1312 6. Fraud prevention activities related to the Women, Infants, and Children
13program vendors.
AB942,9,1614 (e) Publicly display any internal policies or guidance of the office of the
15inspector general on its process of reviewing and investigating fraud, waste, and
16abuse and include a display of any updates to the policies or guidance as applicable.
AB942,9,21 17(6) Requests for information. Upon request of the office of the inspector
18general for information relevant to an investigation of fraud, waste, or abuse in a
19public assistance program, any state agency that receives such a request shall
20cooperate with the office of the inspector general by providing any information in its
21possession responsive to that request.
AB942,9,2222 (End)
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