DHS 109.63(2)(b)(b) The participant shall have 45 days from the effective date of the adverse action in which to file a request for hearing.

DHS 109.63(3)(3) If a recipient requests a hearing before the effective date of the action, SeniorCare benefits and services may not be suspended, reduced or discontinued until a decision is rendered after the hearing. However, SeniorCare benefit payments made pending the hearing decision may be recovered by the department if the contested decision or failure to act is upheld.

DHS 109.63 NoteNote: A hearing request should be mailed to the Division of Hearings and Appeals, P.O. Box 7875, Madison, WI, 53707-7875. Hearing requests may be delivered in person to that office at 5005 University Ave., Room 201, Madison, Wisconsin or transmitted by facsimile machine to 608-264-9885.

DHS 109.71DHS 109.71 Rebate agreement. The department shall provide to a drug manufacturer that sells drugs for prescribed use in this state documents designed for use by the manufacturer in entering into a rebate agreement with the department. The manufacturer shall make rebate payments for each prescription drug of the manufacturer that is prescribed for and purchased by persons under s. DHS 109.13 (2) (b) and (3) (b), to the state treasurer to be credited to the appropriation account under s. 20.435 (4) (j), Stats., each calendar quarter or according to a schedule established by the department.

DHS 109.72DHS 109.72 Payment for drugs. The department shall provide to SeniorCare providers payments for prescription drugs sold by the SeniorCare providers to eligible persons under s. DHS 109.13 (2) (b). The payment for each prescription drug under this subsection shall be no more than the program payment rate, minus any copayment paid by the person under s. DHS 109.13 (2) (b).

DHS 109.73DHS 109.73 Program suspension. During any period in which funding under s. 20.435 (4) (bv), Stats., is completely expended for the payments to SeniorCare providers, the requirements of ss. DHS 109.71 and 109.72 do not apply to prescription drugs purchased during that period. However, the department shall continue to accept applications and determine eligibility under subchapter II and shall indicate to applicants that the eligibility of program participants to purchase prescription drugs as specified in this chapter, under the requirements of s. DHS 109.72, is conditioned on the availability of funding under s. 20.435 (4) (bv), Stats.

DHS 109.74DHS 109.74 Safeguarded information.

DHS 109.74(1)(1) Except for purposes directly related to direct program administration, the department may not use or disclose any information concerning past or present applicants and participants in SeniorCare.

DHS 109.74(2)(2) For purposes of direct program administration, the department may permit disclosure to, or use of safeguarded information by, legally qualified persons or agency representatives outside the department. Governmental authorities, the courts, and law enforcement officers are persons outside the department who shall comply with sub. (3).

DHS 109.74(3)(3) Persons or agency representatives outside the department to whom the department may disclose or permit use of safeguarded information shall meet all of the following qualifications:

DHS 109.74(3)(a)(a) The persons’ or agency representatives’ purpose for use or disclosure shall involve direct program administration.

DHS 109.74(3)(b)(b) The person or agency shall be bound by law or other legally enforceable obligation to observe confidentiality standards comparable to those observed by the department.