AB56-SA2,17,2 46.281 (1d) Waiver request. The department shall request from the secretary of the federal department of health and human services any waivers of federal medicaid laws necessary to permit the use of federal moneys to provide the family care benefit and the self-directed services option to recipients of medical assistance. The department shall implement any waiver that is approved and that is consistent with ss. 46.2805 to 46.2895. Regardless of whether a waiver is approved, the department may implement operation of resource centers, care management organizations, and the family care benefit.

AB56-SA2,462b Section 462b. 46.281 (1n) (d) of the statutes is repealed.

AB56-SA2,463b Section 463b. 46.281 (3) of the statutes is repealed.

AB56-SA2,464b Section 464b. 46.2825 of the statutes is repealed.

AB56-SA2,465b Section 465b. 46.283 (3) (f) of the statutes is amended to read:

AB56-SA2,17,12 46.283 (3) (f) Assistance to a person who is eligible for the family care benefit with respect to the person's choice of whether or not to enroll in the self-directed services option, as defined in s. 46.2899 (1), a care management organization for the family care benefit or the Family Care Partnership program, or the program of all-inclusive care for the elderly and, if so, which available long-term care program or care management organization would best meet his or her needs.

AB56-SA2,466b Section 466b. 46.283 (4) (e) of the statutes is repealed.

AB56-SA2,467b Section 467b. 46.283 (4) (f) of the statutes is amended to read:

AB56-SA2,17,18 46.283 (4) (f) Perform a functional screening and a financial and cost-sharing screening for any resident, as specified in par. (e), who requests a screening and assist any resident who is eligible and chooses to enroll in a care management organization or the self-directed services option to do so.

AB56-SA2,468b Section 468b. 46.283 (6) (b) 7. of the statutes is repealed.

AB56-SA2,469b Section 469b. 46.283 (6) (b) 9. of the statutes is amended to read:

AB56-SA2,17,24 46.283 (6) (b) 9. Review the number and types of grievances and appeals concerning the long-term care system in the area served by related to the resource center, to determine if a need exists for system changes, and recommend system or other changes if appropriate.

AB56-SA2,470b Section 470b. 46.283 (6) (b) 10. of the statutes is repealed.

AB56-SA2,471b Section 471b. 46.285 (intro.) of the statutes is renumbered 46.285 and amended to read:

AB56-SA2,18,8 46.285 Operation of resource center and care management organization. In order to meet federal requirements and assure federal financial participation in funding of the family care benefit, a county, a tribe or band, a long-term care district or an organization, including a private, nonprofit corporation, may not directly operate both a resource center and a care management organization, except as follows:.

AB56-SA2,472b Section 472b. 46.285 (1) of the statutes is repealed.

AB56-SA2,473b Section 473b. 46.285 (2) of the statutes is repealed.

AB56-SA2,474b Section 474b. 46.286 (3) (b) 2. a. of the statutes is repealed.

AB56-SA2,475b Section 475b. 46.287 (2) (a) 1. (intro.) of the statutes is amended to read:

AB56-SA2,18,18 46.287 (2) (a) 1. (intro.) Except as provided in subd. 2., a client may contest any of the following applicable matters by filing, within 45 days of the failure of a resource center or care management organization county to act on the contested matter within the time frames specified by rule by the department or within 45 days after receipt of notice of a decision in a contested matter, a written request for a hearing under s. 227.44 to the division of hearings and appeals created under s. 15.103 (1):

AB56-SA2,476b Section 476b. 46.287 (2) (a) 1. d. of the statutes is renumbered 46.287 (2) (a) 1m. b.

AB56-SA2,477b Section 477b. 46.287 (2) (a) 1. e. of the statutes is repealed.

AB56-SA2,478b Section 478b. 46.287 (2) (a) 1. f. of the statutes is repealed.

AB56-SA2,479b Section 479b. 46.287 (2) (a) 1m. of the statutes is created to read:

AB56-SA2,19,5 46.287 (2) (a) 1m. Except as provided in subd. 2., a client may contest any of the following adverse benefit determinations by filing, within 90 days of the failure of a care management organization to act on a contested adverse benefit determination within the time frames specified by rule by the department or within 90 days after receipt of notice of a decision upholding the adverse benefit determination, a written request for a hearing under s. 227.44 to the division of hearings and appeals created under s. 15.103 (1):

AB56-SA2,19,9 a. Denial of functional eligibility under s. 46.286 (1) as a result of the care management organization's administration of the long-term care functional screen, including a change from a nursing home level of care to a non-nursing home level of care.

AB56-SA2,19,12 c. Denial or limited authorization of a requested service, including determinations based on type or level of service, requirements or medical necessity, appropriateness, setting, or effectiveness of a covered benefit.

AB56-SA2,19,15 d. Reduction, suspension, or termination of a previously authorized service, unless the service was only authorized for a limited amount or duration and that amount or duration has been completed.

AB56-SA2,19,16 e. Denial, in whole or in part, of payment for a service.