AB75-SSA1,624,1523
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(2) Waiver and state plan amendments. The department shall request
24a waiver from, and submit amendments to the state Medical Assistance plan to, the
25secretary of the federal department of health and human services to implement
1BadgerCare Plus. If the state plan amendments are approved and a waiver that is
2substantially consistent with the provisions of this section, excluding sub. (2m), is
3granted and in effect, the department shall implement BadgerCare Plus beginning
4on January 1, 2008, the effective date of the state plan amendments, or the effective
5date of the waiver, whichever is latest.
If the state plan amendments are approved
6but the terms of approval do not allow for federal funding of the cost of benefits for
7all or any part of one or more of the eligibility categories under sub. (4) (b), the
8department may at its discretion pay for the cost of benefits for all or any part of any
9group for which federal funding was denied exclusively with moneys from the
10appropriation under s. 20.435 (4) (b). If the state plan amendments are not approved
11or if a waiver that is substantially consistent with the provisions of this section,
12excluding sub. (2m), is not granted, BadgerCare Plus may not be implemented. If
13the state plan amendments are approved but approval is not continued or if a waiver
14that is substantially consistent with the provisions of this section, excluding sub.
15(2m), is granted but not continued in effect, BadgerCare Plus shall be discontinued.
AB75-SSA1,624,2417
49.471
(3) (a) 1. Notwithstanding ss. 49.46 (1), 49.465, 49.47 (4), and 49.665 (4),
18if the amendments to the state plan under sub. (2) are approved and a waiver under
19sub. (2) that is
substantially consistent with
all of the provisions of this section,
20excluding sub. (2m), is granted and in effect, an individual described in sub. (4) (a)
21or (b) or (5) is not eligible under s. 49.46, 49.465, 49.47, or 49.665 for Medical
22Assistance or BadgerCare health program benefits. The eligibility of an individual
23described in sub. (4) (a) or (b) or (5) for Medical Assistance benefits shall be
24determined under this section.
AB75-SSA1, s. 1330
25Section
1330. 49.471 (3) (b) 1. (intro.) of the statutes is amended to read:
AB75-SSA1,625,7
149.471
(3) (b) 1. (intro.) If an individual over 18 years of age who is eligible for
2and receiving Medical Assistance benefits under s. 49.46, 49.47, or 49.665 in the
3month before BadgerCare Plus is implemented loses that eligibility solely due to the
4implementation of BadgerCare Plus and, because of his or her income, is not eligible
5for BadgerCare Plus, the individual shall continue receiving for
18 12 consecutive
6months the medical assistance he or she was receiving before the implementation of
7BadgerCare Plus if all of the following are satisfied:
AB75-SSA1, s. 1331
8Section
1331. 49.471 (3) (b) 1. c. of the statutes is amended to read:
AB75-SSA1,625,119
49.471
(3) (b) 1. c. The individual
continues to meet meets all nonfinancial
10eligibility requirements
for the coverage that he or she had in the month before the
11implementation of BadgerCare Plus under this section.
AB75-SSA1,625,1613
49.471
(3) (b) 2. Notwithstanding subd. 1., if at any time during an individual's
1418-month 12-month eligibility extension under subd. 1. any criterion under subd.
151. a. to d. is not satisfied, the individual's eligibility for the extended coverage is
16terminated and any time remaining in the eligibility period is lost.
AB75-SSA1, s. 1333
17Section
1333. 49.471 (4) (a) 4. a. of the statutes is amended to read:
AB75-SSA1,625,2318
49.471
(4) (a) 4. a. The individual is a parent or caretaker relative of a child who
19is living in the home with the parent or caretaker relative or who is temporarily
20absent from the home for not more than 6 months or, if the child has been removed
21from the home for more than 6 months, the parent or caretaker relative is working
22toward unifying the family by complying with a permanency plan under s. 48.38
or
23938.38.
AB75-SSA1,626,6
149.471
(4) (a) 5. An individual who, regardless of family income, was born on
2or after January 1, 1990, and who, on his or her 18th birthday, was in a foster care
3or treatment foster care placement under the responsibility of a state, as determined
4by the department. The coverage for an individual under this subdivision ends on
5the last day of the month in which the individual becomes 21 years of age, unless he
6or she otherwise loses eligibility sooner.
AB75-SSA1,626,108
49.471
(4) (a) 7. Individuals who qualify for a medical assistance eligibility
9extension under s. 49.46 (1) (c), (cg), or (co) when their income increases above the
10poverty line.
AB75-SSA1,626,1312
49.471
(4) (b) 1m. A pregnant woman
or unborn child who obtains eligibility
13under sub. (7) (b) 1.
AB75-SSA1, s. 1337
14Section
1337. 49.471 (4) (b) 4. a. of the statutes is amended to read:
AB75-SSA1,626,2015
49.471
(4) (b) 4. a. The individual is a parent or caretaker relative of a child who
16is living in the home with the parent or caretaker relative or who is temporarily
17absent from the home for not more than 6 months or, if the child has been removed
18from the home for more than 6 months, the parent or caretaker relative is working
19toward unifying the family by complying with a permanency plan under s. 48.38
or
20938.38.
AB75-SSA1,627,222
49.471
(5) (b) 1. Except as provided in sub. (6) (a)
1., a pregnant woman is
23eligible for the benefits specified in par. (c) during the period beginning on the day
24on which a qualified provider determines, on the basis of preliminary information,
1that the woman's family income does not exceed 300 percent of the poverty line and
2ending on the applicable day specified in subd. 3.
AB75-SSA1,627,84
49.471
(5) (b) 2. Except as provided in sub. (6) (a)
2., a child who is not an unborn
5child is eligible for the benefits described in s. 49.46 (2) (a) and (b) during the period
6beginning on the day on which a qualified entity determines, on the basis of
7preliminary information, that the child's family income does not exceed 150 percent
8of the poverty line and ending on the applicable day specified in subd. 3.
AB75-SSA1, s. 1340
9Section
1340. 49.471 (5) (c) of the statutes is renumbered 49.471 (5) (c) 2. and
10amended to read:
AB75-SSA1,627,1411
49.471
(5) (c) 2. On behalf of a woman under par. (b) 1.
whose family income
12exceeds 200 percent of the poverty line, the department shall audit and pay allowable
13charges to a provider certified under s. 49.45 (2) (a) 11. only for ambulatory prenatal
14care services under the benefits under sub. (11).
AB75-SSA1,627,1916
49.471
(5) (c) 1. On behalf of a woman under par. (b) 1. whose family income
17does not exceed 200 percent of the poverty line, the department shall audit and pay
18allowable charges to a provider certified under s. 49.45 (2) (a) 11. only for ambulatory
19prenatal care services under the benefits described in s. 49.46 (2) (a) and (b).
AB75-SSA1, s. 1342
20Section
1342. 49.471 (6) (a) of the statutes is renumbered 49.471 (6) (a) 2. and
21amended to read:
AB75-SSA1,628,322
49.471
(6) (a) 2. Any
pregnant woman, including a pregnant woman under sub
23(5) (b) 1., child who is not an unborn child, including a child under sub. (5) (b) 2.,
24parent, or caretaker relative whose family income is less than 150 percent of the
25poverty line is eligible for medical assistance under this section for any of the 3
1months prior to the month of application if the individual met the eligibility criteria
2under this section and had a family income of less than 150 percent of the poverty
3line in that month.