AB56: Bill Text

AB56,546,11 49.47 (4) (b) (intro.) Eligibility exists if the applicant's property, subject to the exclusion of any amounts under the Long-Term Care Partnership Program established under s. 49.45 (31), any amounts in an independence account, as defined in s. 49.472 (1) (c), or any retirement assets that accrued from employment while the applicant was eligible for the community options program under s. 46.27 (11), 2017 stats., or any other Medical Assistance program, including deferred compensation or the value of retirement accounts in the Wisconsin Retirement System or under the federal Social Security Act, does not exceed the following:

AB56,699 Section 699 . 49.471 (1) (cr) of the statutes is created to read:

AB56,546,14 49.471 (1) (cr) “Enhanced federal medical assistance percentage" means a federal medical assistance percentage described under 42 USC 1396d (y) or (z).

AB56,700 Section 700 . 49.471 (4) (a) 4. b. of the statutes is amended to read:

AB56,546,18 49.471 (4) (a) 4. b. The individual's family income does not exceed 100 133 percent of the poverty line before application of the 5 percent income disregard under 42 CFR 435.603 (d).

AB56,701 Section 701 . 49.471 (4) (a) 8. of the statutes is created to read:

AB56,546,20 49.471 (4) (a) 8. An individual who meets all of the following criteria:

AB56,546,21 a. The individual is an adult under the age of 65.

AB56,546,23 b. The adult has a family income that does not exceed 133 percent of the poverty line, except as provided in sub. (4g).

AB56,546,25 c. The adult is not otherwise eligible for the Medical Assistance program under this subchapter or the Medicare program under 42 USC 1395 et seq.

AB56,702 Section 702. 49.471 (4g) of the statutes is created to read:

AB56,547,9 49.471 (4g) Medicaid expansion; federal medical assistance percentage. For services provided to individuals described under sub. (4) (a) 8., the department shall comply with all federal requirements to qualify for the highest available enhanced federal medical assistance percentage. The department shall submit any amendment to the state medical assistance plan, request for a waiver of federal Medicaid law, or other approval request required by the federal government to provide services to the individuals described under sub. (4) (a) 8. and qualify for the highest available enhanced federal medical assistance percentage.

AB56,703 Section 703. 49.471 (6) (b) of the statutes is amended to read:

AB56,547,15 49.471 (6) (b) A pregnant woman who is determined to be eligible for benefits under sub. (4) remains eligible for benefits under sub. (4) for the balance of the pregnancy and to the last day of the month in which the 60th day or, if approved by the federal government, the 365th day after the last day of the pregnancy falls without regard to any change in the woman's family income.

AB56,704 Section 704. 49.471 (6) (L) of the statutes is created to read:

AB56,547,22 49.471 (6) (L) The department shall request from the federal department of health and human services approval of a state plan amendment, a waiver of federal Medicaid law, or approval of a demonstration project to maintain eligibility for post-partum women to the last day of the month in which the 365th day after the last day of the pregnancy falls under ss. 49.46 (1) (a) 1m. and 9. and (j), 49.47 (4) (ag) 2., and 49.471 (4) (a) 1g. and 1m., (6) (b), and (7) (b) 1.

AB56,705 Section 705. 49.471 (7) (b) 1. of the statutes is amended to read:

AB56,548,9 49.471 (7) (b) 1. A pregnant woman whose family income exceeds 300 percent of the poverty line may become eligible for coverage under this section if the difference between the pregnant woman's family income and the applicable income limit under sub. (4) (a) is obligated or expended for any member of the pregnant woman's family for medical care or any other type of remedial care recognized under state law or for personal health insurance premiums or for both. Eligibility obtained under this subdivision continues without regard to any change in family income for the balance of the pregnancy and to the last day of the month in which the 60th day or, if approved by the federal government, the 365th day after the last day of the woman's pregnancy falls. Eligibility obtained by a pregnant woman under this subdivision extends to all pregnant women in the pregnant woman's family.

AB56,706 Section 706. 49.472 (3) (b) of the statutes is amended to read:

AB56,548,18 49.472 (3) (b) The individual's assets do not exceed $15,000. In determining assets, the department may not include assets that are excluded from the resource calculation under 42 USC 1382b (a), assets accumulated in an independence account, and, to the extent approved by the federal government, assets from retirement benefits accumulated from income or employer contributions while employed and receiving medical assistance under this section or state-funded benefits under s. 46.27, 2017 stats. The department may exclude, in whole or in part, the value of a vehicle used by the individual for transportation to paid employment.

AB56,707 Section 707. 49.472 (3) (f) of the statutes is amended to read:

AB56,548,23 49.472 (3) (f) The individual maintains premium payments under sub. (4) (am) and, if applicable and to the extent approved by the federal government, premium payments calculated by the department in accordance with sub. (4) (bm), unless the individual is exempted from premium payments under sub. (4) (dm) or (5).

AB56,708 Section 708. 49.472 (4) (am) of the statutes is amended to read:

AB56,549,3 49.472 (4) (am) To the extent approved by the federal government and except as provided in pars. (dm) and (em) and sub. (5), an individual who receives medical assistance under this section shall pay a monthly premium of $25 to the department.

AB56,709 Section 709. 49.472 (5) of the statutes is repealed.

AB56,710 Section 710 . 49.485 of the statutes is renumbered 20.9315 (19) and amended to read:

AB56,549,12 20.9315 (19) Whoever knowingly presents or causes to be presented to any officer, employee, or agent of this state a false claim for medical assistance shall forfeit not less than $5,000 nor more than $10,000, plus 3 times the amount of the damages that were sustained by the state or would have been sustained by the state, whichever is greater, as a result of the false claim. The attorney general may bring an action on behalf of the state to recover any forfeiture incurred under this section.

AB56,711 Section 711 . 49.686 (3) (d) of the statutes is amended to read:

AB56,549,19 49.686 (3) (d) Has applied for coverage under and has been denied eligibility for medical assistance within 12 months prior to application for reimbursement under sub. (2). This paragraph does not apply to an individual who is eligible for benefits under the demonstration project for childless adults under s. 49.45 (23) BadgerCare Plus under s. 49.471 (4) (a) 8. or to an individual who is eligible for benefits under BadgerCare Plus under s. 49.471 (11).

AB56,712 Section 712. 49.79 (1) (bg) of the statutes is repealed.

AB56,713 Section 713. 49.79 (1) (em) of the statutes is repealed.

AB56,714 Section 714. 49.79 (6m) of the statutes is repealed.

AB56,715 Section 715. 49.79 (6q) of the statutes is repealed.

AB56,716 Section 716. 49.79 (6t) of the statutes is repealed.

AB56,717 Section 717. 49.79 (6u) of the statutes is repealed.

AB56,718 Section 718. 49.79 (9) (a) 1g. of the statutes is amended to read:

AB56,550,10 49.79 (9) (a) 1g. Except as provided in subds. 2. and 3., beginning October 1, 2019, the department shall require, to the extent allowed by the federal government, all able-bodied adults without dependents in this state to participate in the employment and training program under this subsection, except for able-bodied adults without dependents who are employed, as determined by the department. The department may require other able individuals who are 18 to 60 years of age, or a subset of those individuals to the extent allowed by the federal government, who are not participants in a Wisconsin Works employment position to participate in the employment and training program under this subsection.

AB56,719 Section 719. 49.79 (9) (d) of the statutes is repealed.

AB56,720 Section 720. 49.79 (9) (f) of the statutes is repealed.

AB56,721 Section 721. 49.791 of the statutes is repealed.

AB56,722 Section 722. 49.849 (1) (e) of the statutes is amended to read:

AB56,550,18 49.849 (1) (e) “Public assistance" means any services provided as a benefit under a long-term care program, as defined in s. 49.496 (1) (bk), medical assistance under subch. IV, long-term community support services funded under s. 46.27 (7), or aid under s. 49.68, 49.683, 49.685, or 49.785.

AB56,723 Section 723. 49.849 (2) (a) (intro.) of the statutes is amended to read:

AB56,551,2 49.849 (2) (a) (intro.) Subject to par. (b), the department may collect from the property of a decedent by affidavit under sub. (3) (b) or by lien under sub. (4) (a) an amount equal to the medical assistance that is recoverable under s. 49.496 (3) (a), the long-term community support services under s. 46.27, 2017 stats., that is recoverable under s. 46.27 (7g) (c) 1., 2017 stats., or the aid under s. 49.68, 49.683, 49.685, or 49.785 that is recoverable under s. 49.682 (2) (a) or (am), and that was paid on behalf of the decedent or the decedent's spouse, if all of the following conditions are satisfied:

AB56,724 Section 724. 49.849 (6) (a) of the statutes is renumbered 49.849 (6).

AB56,725 Section 725. 49.849 (6) (b) of the statutes is repealed.

AB56,726 Section 726 . 49.855 (3) of the statutes is amended to read:

AB56,552,4 49.855 (3) Receipt of a certification by the department of revenue shall constitute a lien, equal to the amount certified, on any state tax refunds or credits owed to the obligor. The lien shall be foreclosed by the department of revenue as a setoff under s. 71.93 (3), (6), and (7). When the department of revenue determines that the obligor is otherwise entitled to a state tax refund or credit, it shall notify the obligor that the state intends to reduce any state tax refund or credit due the obligor by the amount the obligor is delinquent under the support, maintenance, or receiving and disbursing fee order or obligation, by the outstanding amount for past support, or medical expenses, or birth expenses under the court order, or by the amount due under s. 46.10 (4), 49.345 (4), or 301.12 (4). The notice shall provide that within 20 days the obligor may request a hearing before the circuit court rendering the order under which the obligation arose. Within 10 days after receiving a request for hearing under this subsection, the court shall set the matter for hearing. Pending further order by the court or a circuit court commissioner, the department of children and families or its designee, whichever is appropriate, is prohibited from disbursing the obligor's state tax refund or credit. A circuit court commissioner may conduct the hearing. The sole issues at that hearing shall be whether the obligor owes the amount certified and, if not and it is a support or maintenance order, whether the money withheld from a tax refund or credit shall be paid to the obligor or held for future support or maintenance, except that the obligor's ability to pay shall also be an issue at the hearing if the obligation relates to an order under s. 767.805 (4) (d) 1. or 767.89 (3) (e) 1. regarding birth expenses and the order specifies that the court found that the obligor's income was at or below the poverty line established under 42 USC 9902 (2).

AB56,727 Section 727 . 49.855 (4m) (b) of the statutes is amended to read:

AB56,553,9 49.855 (4m) (b) The department of revenue may provide a certification that it receives under sub. (1), (2m), (2p), or (2r) to the department of administration. Upon receipt of the certification, the department of administration shall determine whether the obligor is a vendor or is receiving any other payments from this state, except for wages, retirement benefits, or assistance under s. 45.352, 1971 stats., s. 45.40 (1m), this chapter, or ch. 46, 108, or 301. If the department of administration determines that the obligor is a vendor or is receiving payments from this state, except for wages, retirement benefits, or assistance under s. 45.352, 1971 stats., s. 45.40 (1m), this chapter, or ch. 46, 108, or 301, it shall begin to withhold the amount certified from those payments and shall notify the obligor that the state intends to reduce any payments due the obligor by the amount the obligor is delinquent under the support, maintenance, or receiving and disbursing fee order or obligation, by the outstanding amount for past support, or medical expenses, or birth expenses under the court order, or by the amount due under s. 46.10 (4), 49.345 (4), or 301.12 (4). The notice shall provide that within 20 days after receipt of the notice the obligor may request a hearing before the circuit court rendering the order under which the obligation arose. An obligor may, within 20 days after receiving notice, request a hearing under this paragraph. Within 10 days after receiving a request for hearing under this paragraph, the court shall set the matter for hearing. A circuit court commissioner may conduct the hearing. Pending further order by the court or circuit court commissioner, the department of children and families or its designee, whichever is appropriate, may not disburse the payments withheld from the obligor. The sole issues at the hearing are whether the obligor owes the amount certified and, if not and it is a support or maintenance order, whether the money withheld shall be paid to the obligor or held for future support or maintenance, except that the obligor's ability to pay is also an issue at the hearing if the obligation relates to an order under s. 767.805 (4) (d) 1. or 767.89 (3) (e) 1. regarding birth expenses and the order specifies that the court found that the obligor's income was at or below the poverty line established under 42 USC 9902 (2).

AB56,728 Section 728 . 50.03 (3) (b) (intro.) of the statutes is amended to read:

AB56,553,15 50.03 (3) (b) (intro.) The application for a license and, except as otherwise provided in this subchapter, the report of a licensee shall be in writing upon forms provided by the department and shall contain such information as the department requires, including the name, address and type and extent of interest of each of the following persons:

AB56,729 Section 729. 50.03 (4) (c) 1. of the statutes is amended to read:

AB56,554,2 50.03 (4) (c) 1. A community-based residential facility license is valid until it is revoked or suspended under this section. Every 24 months, on a schedule determined by the department, a community-based residential facility licensee shall submit through an online system prescribed by the department a biennial report in the form and containing the information that the department requires, including payment of the fees required any fee due under s. 50.037 (2) (a). If a complete biennial report is not timely filed, the department shall issue a warning to the licensee. The department may revoke a community-based residential facility license for failure to timely and completely report within 60 days after the report date established under the schedule determined by the department.

AB56,730 Section 730. 50.033 (2m) of the statutes is amended to read:

AB56,554,11 50.033 (2m) Reporting. Every 24 months, on a schedule determined by the department, a licensed adult family home shall submit through an online system prescribed by the department a biennial report in the form and containing the information that the department requires, including payment of the any fee required due under sub. (2). If a complete biennial report is not timely filed, the department shall issue a warning to the licensee. The department may revoke the license for failure to timely and completely report within 60 days after the report date established under the schedule determined by the department.

AB56,731 Section 731. 50.034 (1) (a) of the statutes is amended to read:

AB56,554,21 50.034 (1) (a) No person may operate a residential care apartment complex that provides living space for residents who are clients under s. 46.27 (11) or 46.277 and publicly funded services as a home health agency or under contract with a county department under s. 46.215, 46.22, 46.23, 51.42 or 51.437 that is a home health agency unless the residential care apartment complex is certified by the department under this section. The department may charge a fee, in an amount determined by the department, for certification under this paragraph. The amount of any fee charged by the department for certification of a residential care apartment complex need not be promulgated as a rule under ch. 227.

AB56,732 Section 732 . 50.034 (2m) of the statutes is created to read:

AB56,555,6 50.034 (2m) Reporting. Every 24 months, on a schedule determined by the department, a residential care apartment complex shall submit through an online system prescribed by the department a report in the form and containing the information that the department requires, including payment of any fee required under sub. (1). If a complete report is not timely filed, the department shall issue a warning to the operator of the residential care apartment complex. The department may revoke a residential care apartment complex's certification or registration for failure to timely and completely report within 60 days after the report date established under the schedule determined by the department.

AB56,733 Section 733. 50.034 (3) (a) 1. of the statutes is repealed.

AB56,734 Section 734. 50.034 (5m) of the statutes is amended to read:

AB56,555,16 50.034 (5m) Provision of information required. Subject to sub. (5p), when When a residential care apartment complex first provides written material regarding the residential care apartment complex to a prospective resident, the residential care apartment complex shall also provide the prospective resident information specified by the department concerning the services of a resource center under s. 46.283, the family care benefit under s. 46.286, and the availability of a functional screening and a financial and cost-sharing screening to determine the prospective resident's eligibility for the family care benefit under s. 46.286 (1).

AB56,735 Section 735. 50.034 (5n) (intro.) of the statutes is amended to read:

AB56,555,24 50.034 (5n) Required referral. (intro.) Subject to sub. (5p), when When a residential care apartment complex first provides written material regarding the residential care apartment complex to a prospective resident who is at least 65 years of age or has developmental disability or a physical disability and whose disability or condition is expected to last at least 90 days, the residential care apartment complex shall refer the prospective resident to a resource center under s. 46.283, unless any of the following applies:

AB56,736 Section 736. 50.034 (5p) of the statutes is repealed.

AB56,737 Section 737. 50.034 (6) of the statutes is amended to read:

AB56,556,7 50.034 (6) Funding. Funding for supportive, personal or nursing services that a person who resides in a residential care apartment complex receives, other than private or 3rd-party funding, may be provided only under s. 46.27 (11) (c) 7. or 46.277 (5) (e), except if the provider of the services is a certified medical assistance provider under s. 49.45 or if the funding is provided as a family care benefit under ss. 46.2805 to 46.2895.

AB56,738 Section 738. 50.035 (4m) of the statutes is amended to read:

AB56,556,16 50.035 (4m) Provision of information required. Subject to sub. (4p), when When a community-based residential facility first provides written material regarding the community-based residential facility to a prospective resident, the community-based residential facility shall also provide the prospective resident information specified by the department concerning the services of a resource center under s. 46.283, the family care benefit under s. 46.286, and the availability of a functional screening and a financial and cost-sharing screening to determine the prospective resident's eligibility for the family care benefit under s. 46.286 (1).

AB56,739 Section 739. 50.035 (4n) (intro.) of the statutes is amended to read:

AB56,557,2 50.035 (4n) Required referral. (intro.) When a community-based residential facility first provides written information regarding the community-based residential facility to a prospective resident who is at least 65 years of age or has developmental disability or a physical disability and whose disability or condition is expected to last at least 90 days, the community-based residential facility shall refer the individual to a resource center under s. 46.283 or, if the secretary has not certified under s. 46.281 (3) that a resource center is available in the area of the community-based residential facility to serve individuals in an eligibility group to which the prospective resident belongs, to the county department that administers a program under ss. 46.27 or 46.277, unless any of the following applies:

AB56,740 Section 740. 50.035 (4p) of the statutes is repealed.

AB56,741 Section 741. 50.04 (2g) (a) of the statutes is amended to read:

AB56,557,10 50.04 (2g) (a) Subject to sub. (2i), a A nursing home shall, within the time period after inquiry by a prospective resident that is prescribed by the department by rule, inform the prospective resident of the services of a resource center under s. 46.283, the family care benefit under s. 46.286, and the availability of a functional screening and a financial and cost-sharing screening to determine the prospective resident's eligibility for the family care benefit under s. 46.286 (1).

AB56,742 Section 742. 50.04 (2h) (a) (intro.) of the statutes is amended to read:

AB56,557,16 50.04 (2h) (a) (intro.) Subject to sub. (2i), a A nursing home shall, within the time period prescribed by the department by rule, refer to a resource center under s. 46.283 a person who is seeking admission, who is at least 65 years of age or has developmental disability or physical disability and whose disability or condition is expected to last at least 90 days, unless any of the following applies:

AB56,743 Section 743. 50.04 (2i) of the statutes is repealed.

AB56,744 Section 744. 50.04 (2m) of the statutes is repealed.

AB56,745 Section 745. 50.06 (7) of the statutes is amended to read:

AB56,558,5 50.06 (7) An individual who consents to an admission under this section may request that an assessment be conducted for the incapacitated individual under the long-term support community options program under s. 46.27 (6) or, if the secretary has certified under s. 46.281 (3) that a resource center is available for the individual, a functional screening and a financial and cost-sharing screening to determine eligibility for the family care benefit under s. 46.286 (1). If admission is sought on behalf of the incapacitated individual or if the incapacitated individual is about to be admitted on a private pay basis, the individual who consents to the admission may waive the requirement for a financial and cost-sharing screening under s. 46.283 (4) (g), unless the incapacitated individual is expected to become eligible for medical assistance within 6 months.

AB56,746 Section 746 . 51.03 (7) of the statutes is created to read:

AB56,558,10 51.03 (7) From the appropriation under s. 20.435 (5) (dg), the department shall award grants to regional crisis stabilization facilities for adults. The department shall establish criteria for a regional crisis stabilization facility to receive a grant under this subsection.

AB56,747 Section 747. 51.06 (8) (b) 6. of the statutes is amended to read:

AB56,558,16 51.06 (8) (b) 6. The extent of Medical Assistance provided to relocated or diverted individuals that is in addition to Medical Assistance provided to the individuals under s. 46.27 (11), 46.275, 46.277, or 46.278, as a family care benefit under ss. 46.2805 to 46.2895, or under any other home-based or community-based program for which the department has received a waiver under 42 USC 1396n (c).

AB56,748 Section 748. 51.42 (3) (ar) 3. of the statutes is amended to read: