DHS 153.02(11r)(11r) “Medicare” means the health insurance program operated by the U.S. department of health and human services under 42 USC 1395 to 1395zz and 42 CFR Pts. 405 to 421. DHS 153.02(12)(12) “Participant” means a patient who has been found eligible by the department under s. 49.685, Stats., and this chapter for reimbursement for the costs of blood products and supplies used in the home care of hemophilia. DHS 153.02(13)(13) “Patient” means a person diagnosed as having hemophilia. DHS 153.02(14)(14) “Physician director” means the medical director of the comprehensive hemophilia treatment center which is directly responsible for a patient’s maintenance program. DHS 153.02(15)(15) “Program” means the hemophilia home care program under s. 49.685, Stats., and this chapter. DHS 153.02(16)(16) “Provider” means a comprehensive hemophilia treatment center, an approved source of blood products and supplies or a provider of case management services for program participants. DHS 153.02(17)(17) “Resident” means any person who is living in Wisconsin with the intention of remaining permanently in the state. DHS 153.02(18)(18) “SeniorCare” means the program of prescription drug assistance for eligible elderly persons under s. 49.688, Stats., and ch. DHS 109. DHS 153.02 HistoryHistory: Cr. Register, December, 1994, No. 468, eff. 1-1-95; CR 04-051: cr. (1m), (11g), (11r) and (18) Register November 2004 No. 587, eff. 12-1-04; corrections in (1m), (5), (11g) and (18) made under s. 13.92 (4) (b) 6. and 7., Stats., Register January 2009 No. 637; CR 23-046: am. (17) Register April 2024 No. 820, eff. 5-1-24. DHS 153.03DHS 153.03 Eligibility. To be eligible for the hemophilia home care program, a patient shall: DHS 153.03(2)(2) Be diagnosed by a comprehensive hemophilia treatment center as having hemophilia; DHS 153.03(3)(3) Enter into a written agreement with a comprehensive hemophilia treatment center for compliance with a maintenance program. The agreement shall specify: DHS 153.03(3)(b)(b) Responsibilities of the patient and the center relating to development of the plan of treatment and conformance of the patient to applicable center policies; DHS 153.03(3)(c)(c) The manner in which services are to be controlled, coordinated and evaluated by the center; and DHS 153.03(3)(d)(d) Procedures for semi-annual evaluation of the maintenance program and for verification that the patient is complying with the established treatment regimen; and DHS 153.03(4)(4) Provide to the department or its designated agent full, truthful and correct information necessary for the department to determine eligibility and liability on forms specified by the department. A patient shall be ineligible for financial assistance if he or she refuses to provide information, withholds information, refuses to assist the department in verifying the information or provides inaccurate information. The department may verify or audit an applicant’s total family income. DHS 153.03(5)(a)(a) First apply for benefits under all other health care coverage programs for which the person may reasonably be eligible, including medicare, BadgerCare, medical assistance and SeniorCare. DHS 153.03(5)(b)(b) Apply for and receive from the department a waiver from par. (a) for religious reasons. If the department does not approve the request for a waiver, the applicant shall meet the requirements of par. (a). DHS 153.03 NoteNote: Persons desiring a waiver from the requirements under par. (a) should submit their request to the Division of Public Health, Bureau of Community Health Promotion, Wisconsin Chronic Disease Program, P.O. Box 2659, Madison, WI 53701-2659, or call 1-800-947-9627. Requests must describe the basis of the religious belief that precludes application for benefits under one or more of the programs listed under par. (a).
DHS 153.035DHS 153.035 Termination of eligibility. Eligibility under the hemophilia home care program is terminated if any of the following events occur: DHS 153.035 HistoryHistory: CR 04-051: cr. Register November 2004 No. 587, eff. 12-1-04. DHS 153.037DHS 153.037 Retroactive eligibility. Retroactive eligibility is not available under the hemophilia home care program. Patients who are found to be eligible under s. DHS 153.03 become eligible for benefits on the date the application was received.